Foundations and principles of the Canadian living donor paired exchange program.
Foundations and principles of the Canadian living donor paired exchange program.
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DOI：
10.1186/2054-3581-1-6
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发表时间：
2014
影响因子：
1.7
通讯作者：
Cole E
中科院分区：
文献类型：
--
作者：
Malik S;Cole E
肾配对捐献（KPD）仍然是一种重要的策略，以促进移植的患者谁有一个健康和愿意的捐助者，但无法进行直接捐赠，由于ABO不相容或积极的交叉匹配对他们的预期供体。个人知识，加拿大血液服务数据库活体捐献者交流，发表报告和个人通信。2009年，加拿大设立了全国活体捐赠者配对交流方案。完成了235例移植，其中190例是登记的受体，45例来自已故供体（DD）等待名单。1年时，患者存活率为100%，移植物存活率为98%，活检证实急性排斥反应率为8%。1年结束时的平均血清肌酐（Cr）为109 mmol/l。捐献者的存活率是100%。成功的关键是抗体检测和交叉配型的国家标准，以及评估捐赠者和接受者的国家标准，以及运行该计划的基础设施（软件和人员）。加拿大方案的结构进行了比较，在英国，澳大利亚，荷兰和美国的其他方案。本综述不包括有关旅行距离和困难或患者满意度的信息。国家合作和接受共同标准是可能的，并带来实质性的好处，特别是对那些最难匹配的患者。以前知道的：肾脏配对捐赠被认为是道德上可接受的。一些国家制定了国家和区域方案。这篇论文补充说：加拿大国家方案成功的关键是接受标准化程序以及国家和省的支持和监督。
Kidney paired donation (KPD) remains an important strategy to facilitate transplantation in patients who have a healthy and willing donor, but are unable to proceed with directed donation due to either ABO incompatibility or a positive cross-match against their intended donor. Personal knowledge, The Canadian Blood Services Database for Living Donor Exchange, published reports and personal communications. The national Living Donor Paired Exchange Programme (LDPE) in Canada was established in 2009. 235 transplants were completed of which 190 were registered recipients and 45 were from the deceased donor (DD) wait list. At 1 year, patient survival was 100%, graft survival 98%, with a biopsy proven acute rejection rate of 8%. The mean serum creatinine (Cr) at the end of one year was 109 mmol/l. Donor survival is 100%. Key to success are national standards for antibody testing and cross-matching, and for evaluating donors and recipients, as well infrastructure (software and personnel) to run the program. The structure of the Canadian program is compared with that of other programs in the United Kingdom, Australia, the Netherlands, and the United States. This review does not include information on travel distances and difficulties, or patient satisfaction. National collaboration and acceptance of common standards is possible and leads to substantial benefits, especially for those patients who are hardest to match. What was known before: Kidney paired donation is considered ethically acceptable. National and regional programs have been created in a number of countries. What this paper adds: Key to the success of the Canadian national program are acceptance of standardized procedures and national and provincial support and oversight.