Cohen Bernard, Smits Jacqueline M, Haase Bernadette, Persijn Guido, Vanrenterghem Yves, Frei Ulrich
Eurotransplant International Foundation, Leiden, The Netherlands.
Nephrol Dial Transplant. 2005 Jan;20(1):34-41. doi: 10.1093/ndt/gfh506. Epub 2004 Nov 2.
The goal of the Eurotransplant renal allocation scheme is to provide every patient on the waiting list with a reasonably balanced opportunity for a donor offer. New initiatives were taken in order to maximize donor usage while maintaining a successful transplant outcome.
Two Eurotransplant projects were launched in order to accommodate changes in donor and recipient profiles. A re-addressing of the non-heart-beating donor pool was undertaken and an allocation scheme in which organs from donors aged >65 are allocated to recipients aged >65 [the Eurotransplant Senior Programme (ESP)] was introduced.
Especially in The Netherlands, an enormous increase in the number of non-heart-beating donor kidneys has been observed, however with a pace-keeping reduction in heart-beating donors. The organization-wide implementation of the ESP has been successful. The 3 year graft survival rates for these age-matched transplants were as good as the human leukocyte antigen (HLA)-matched transplants (64 vs 67%) (P = 0.4).
Within the framework of sound research, the utmost flexibility and creativity is needed to keep or even increase the number of renal transplants when faced with a quantitatively stagnating but qualitatively deteriorating donor pool. Both the non-heart-beating donor protocol and the ESP have proven to be quite successful in achieving this goal without compromising the outcome for the individual end-stage renal disease patient.
欧洲移植肾脏分配计划的目标是为等候名单上的每位患者提供获得供体肾脏的合理均等机会。为了在保持移植成功结果的同时最大限度地利用供体，采取了新举措。
启动了两个欧洲移植项目以适应供体和受体情况的变化。对非心脏跳动供体库进行了重新调整，并引入了一种分配方案，即将65岁以上供体的器官分配给65岁以上的受体[欧洲移植老年项目（ESP）]。
特别是在荷兰，已观察到非心脏跳动供体肾脏数量大幅增加，然而心脏跳动供体数量相应减少。ESP在整个组织范围内的实施取得了成功。这些年龄匹配移植的3年移植物存活率与人类白细胞抗原（HLA）匹配移植的存活率相当（64%对67%）（P = 0.4）。
在合理研究的框架内，面对数量停滞但质量下降的供体库时，需要最大程度的灵活性和创造力来维持甚至增加肾脏移植数量。非心脏跳动供体方案和ESP在实现这一目标方面均已证明相当成功，且不影响个体终末期肾病患者的移植结果。
