de Klerk M, Ijzermans J N, Kranenburg L W, Hilhorst M T, van Busschbach J J, Weimar W
Afd. Inwendige Geneeskunde, sectie Transplantatie, Erasmus Medisch Centrum, Postbus 2040, 3000 CA Rotterdam.
Ned Tijdschr Geneeskd. 2004 Feb 28;148(9):420-3.
In the Netherlands, cross-over kidney transplantation has been introduced as an extra option in the living kidney donation programme. In cross-over transplantation, patients who cannot be given their own partner's kidney for immunological reasons are given a kidney from the partner of another patient in exchange for a kidney from their own partner. There is no difference in the medical indications and contraindications between direct and indirect living donation. There are no ethical obstacles since the net gain for the two couples is no different from that of direct living kidney donation and because the exchange takes place on the basis of equality. One should be aware that the extra possibilities may result in more psychological pressure on potential donors. It is important that the donation procedures start at the same moment and that the wishes of patients and donors for anonymity be preserved. A successful cross-over kidney transplantation programme requires a large pool of donors and patients. Therefore, this has been organised in a national programme. The Dutch Transplantation Foundation is responsible for the allocation of cross-over kidneys. Organ trade will thus be impossible. The seven Dutch centres for kidney transplantation have developed a protocol.
在荷兰，交叉换肾移植已被引入活体肾捐赠项目，作为一种额外选择。在交叉换肾移植中，因免疫原因无法接受自己配偶肾脏的患者，会接受另一名患者配偶的肾脏，以换取自己配偶的一个肾脏。直接和间接活体捐赠的医学适应症和禁忌症并无差异。不存在伦理障碍，因为两对夫妻的净收益与直接活体肾捐赠并无不同，而且交换是在平等基础上进行的。应该意识到，这些额外的可能性可能会给潜在捐赠者带来更大的心理压力。重要的是，捐赠程序要同时启动，并且要尊重患者和捐赠者对匿名的意愿。一个成功的交叉换肾移植项目需要大量的捐赠者和患者。因此，这已在一个全国性项目中进行组织。荷兰移植基金会负责交叉换肾的分配。这样一来，器官交易将成为不可能。荷兰的七个肾移植中心已经制定了一项方案。
