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[活体肾供体的评估与随访]

[Evaluation and follow-up of living kidney donors].

作者信息

Giessing M, Schönberger B, Fritsche L, Budde K

机构信息

Universitätsklinik für Urologie, Charité, Berlin, Germany.

出版信息

Dtsch Med Wochenschr. 2004 Jan 23;129(4):147-50. doi: 10.1055/s-2004-817602.

DOI:10.1055/s-2004-817602
PMID:14724776
Abstract

An increase in waiting time for a cadaveric organs and a better graft-function, graft- and patient-survival with kidneys from a living donors have lead to an increase in living-donor renal transplantation in the therapy of end-stage renal disease. In Germany, with the implementation of a transplantation law in 1997 and due to improved surgical techniques (laparoscopy) the proportion of living renal donors has almost tripled during the last five years. The transplantation law also names the potential donors, including not only genetically related but also emotionally related donors. Inclusion criteria for living donation are age > 18 years, mental ability to give consent and an altruistic motivation (exclusion of financial benefits for the donor). If ABO blood group compatibility between donor and recipient is given and a cross match does not reveal immunologic obstacles a thorough medical and psychological examination must be performed with the potential donor. All risk factors for the donor beyond the actual operation must be excluded. Therefore all organ-systems have to be evaluated and risks for the donor as well as transferable pathologies and infections must be ruled out. International guidelines help to perform an efficient evaluation. Following organ donation the donor should be medically controlled as requested by law. Also, psychological counselling should be offered. The aim is to minimize risks for the single kidney and to recognize early potentially kidney damaging affections.

摘要

尸体器官等待时间的增加以及活体供肾移植后更好的移植物功能、移植物和患者存活率,使得活体供肾移植在终末期肾病治疗中的应用有所增加。在德国,随着1997年移植法的实施以及手术技术(腹腔镜检查)的改进,过去五年中活体肾供者的比例几乎增加了两倍。移植法还明确了潜在供者,不仅包括有血缘关系的,还包括情感上有联系的供者。活体捐赠的纳入标准为年龄>18岁、有同意捐赠的心智能力以及利他动机(排除供者获得经济利益)。如果供者与受者的ABO血型相容且交叉配型未发现免疫障碍,则必须对潜在供者进行全面的医学和心理检查。必须排除供者实际手术之外的所有风险因素。因此,必须对所有器官系统进行评估,并排除供者的风险以及可传播的疾病和感染。国际指南有助于进行有效的评估。器官捐赠后,应依法对供者进行医学监测。此外,还应提供心理咨询。目的是将单肾的风险降至最低,并尽早识别可能损害肾脏的疾病。

相似文献

1
[Evaluation and follow-up of living kidney donors].[活体肾供体的评估与随访]
Dtsch Med Wochenschr. 2004 Jan 23;129(4):147-50. doi: 10.1055/s-2004-817602.
2
[The Swiss Organ Living Donor Health Registry (SOL-DHR)].[瑞士活体器官捐献者健康登记处(SOL-DHR)]
Ther Umsch. 2005 Jul;62(7):449-57. doi: 10.1024/0040-5930.62.7.449.
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Clin Transpl. 1997:135-47.
4
[Living-donor kidney transplantation].
Ugeskr Laeger. 2000 Nov 27;162(48):6527-32.
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Assessment of kidneys procured from expanded criteria donors before transplantation.移植前对来自扩大标准供体的肾脏进行评估。
Transplant Proc. 2009 Oct;41(8):2966-9. doi: 10.1016/j.transproceed.2009.08.004.
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Transplant Proc. 2008 Sep;40(7):2100-3. doi: 10.1016/j.transproceed.2008.06.033.
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[Quality of life of living kidney donor: a national report].[活体肾供体的生活质量:一份全国性报告]
Nephrol Ther. 2011 Jul;7 Suppl 1:S1-39. doi: 10.1016/S1769-7255(11)70007-4.
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Can a living kidney donor become a kidney recipient?活体肾供体可以成为肾受体吗?
Transplant Proc. 2004 Jul-Aug;36(6):1630-1. doi: 10.1016/j.transproceed.2004.07.036.
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The OPTN/UNOS Renal Transplant Registry.器官获取与移植网络/美国器官共享联合网络肾脏移植登记处
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Dual kidney transplants from adult marginal donors successfully expand the limited deceased donor organ pool.来自成年边缘供体的双肾移植成功扩大了有限的 deceased 供体器官库。 (注:这里“deceased donor”直译为“已故供体”,在医学领域常表述为“脑死亡供体”等更符合语境的说法,但按要求未作修改。)
Clin Transplant. 2016 Apr;30(4):380-92. doi: 10.1111/ctr.12697. Epub 2016 Feb 15.