商业性肾移植的结果：加拿大的经验
Outcomes of commercial renal transplantation: a Canadian experience.
作者信息
Prasad G V Ramesh, Shukla Ashutosh, Huang Michael, D'A Honey R John, Zaltzman Jeffrey S
机构信息
Division of Nephrology, Department of Medicine, University of Toronto, Renal Transplant Program, St. Michael's Hospital, Toronto, Ontario, Canada.
出版信息
Transplantation. 2006 Nov 15;82(9):1130-5. doi: 10.1097/01.tp.0000241072.03400.11.
BACKGROUND
Financial compensation in exchange for live kidney donation is prohibited in Canada. However, patients in Canada with end-stage renal disease and without a suitable biologically or emotionally related live donor face substantial waiting times on lists for deceased donor kidneys, and so may therefore choose to acquire organs from a live donor in a procedure performed outside Canada as part of a commercial transaction.
METHODS
We describe the clinical outcomes in such patients transplanted between 1998 and 2005, managed after their surgery at a single Canadian transplant center.
RESULTS
Patient and graft survival at three years were significantly worse in this group compared to recipients of live biologically related (P<0.0001) and emotionally related transplants (P<0.01) performed in Canada during this period. A number of different surgical and infectious complications were seen, requiring frequent and often lengthy hospitalization.
CONCLUSION
Patients considering this method of acquiring live-donated kidneys should be counseled of the inherent risks and possible adverse outcomes including diminished dialysis-free survival.
背景
在加拿大，禁止为活体肾捐赠提供经济补偿。然而，加拿大患有终末期肾病且没有合适的生物学或情感上相关的活体捐赠者的患者，在等待 deceased donor 肾脏的名单上要面临很长的等待时间，因此他们可能会选择在加拿大境外进行的一项商业交易程序中从活体捐赠者那里获取器官。
方法
我们描述了 1998 年至 2005 年间移植的此类患者的临床结果，这些患者在加拿大的一个单一移植中心接受手术后进行管理。
结果
与同期在加拿大进行的生物学相关活体移植（P<0.0001）和情感相关移植（P<0.01）的受者相比，该组患者三年时的患者和移植物存活率显著更差。出现了一些不同的手术和感染并发症，需要频繁且往往是长时间的住院治疗。
结论
对于考虑通过这种方式获取活体捐赠肾脏的患者，应告知他们存在的固有风险和可能的不良后果，包括无透析生存期缩短。
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