Fonouni H, Golriz M, Mehrabi A, Oweira H, Schmied B M, Müller S A, Jarahian P, Tahmasbi Rad M, Esmaeilzadeh M, Tönshoff B, Weitz J, Büchler M W, Zeier M, Schmidt J
Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.
Transplant Proc. 2010 Jan-Feb;42(1):137-40. doi: 10.1016/j.transproceed.2009.12.038.
During the last decades, the disparity between the organ supply and the demand for kidney transplantation in Europe has led to consider living donors as a more acceptable option. In the last 7 years, we have established an interdisciplinary supporting transplant team to increase the rate of living donation. After 2001, the new interdisciplinary transplant team consisted of a transplant surgeon, a nephrologist, a pediatrician, a radiologist, a psychologist, a transplant coordinator, and a transplant nurse. We performed a prospective analysis to examine the effect of implementing this team on our living donation program. Demographic data, the annual number of procedures, the duration of waiting, and the cold ischemia time were evaluated among brain-dead and living donors. From January 2002 until December 2008, the number of patients who were annually on the waiting list increased 42% (from 377 to 536 patients). Consequently, the number of the total kidney transplants increased from 81 to 120 with an annual median of 98 cases. By implementing the interdisciplinary transplant team, a significant increase of living kidney donors was observed: from 18 to 42 cases; median = 27). In the last 7 years, a total number of 796 kidney transplants have been performed: 567 from brain-dead and 229 from living donors. In 2001, the waiting list times for recipients who received grafts from brain-dead versus living donors were 1356 versus 615 days respectively. Compared with 2008, the duration on the waiting list decreased significantly for patients receiving a living donor graft, whereas there was a slight increase for the patients in the brain-dead group: brain death versus living donors: 1407 versus 305 days. The interdisciplinary approach has also reduced the cold ischemia time for the living donor recipients: 3 hours and 42 minutes in 2001 versus 2 hours and 50 minutes in 2008. During the last years, by implementing an interdisciplinary transplant team, supporting living donor procedures has produce a gradual increase in the number of kidney transplants from living donors with a remarkable decrease in waiting and cold ischemia times, the latter presumably influencing graft quality.
在过去几十年间，欧洲肾脏移植的器官供应与需求之间的差距促使人们将活体供体视为更可接受的选择。在过去7年里，我们组建了一个跨学科的移植支持团队，以提高活体捐赠率。2001年后，新的跨学科移植团队由一名移植外科医生、一名肾病学家、一名儿科医生、一名放射科医生、一名心理学家、一名移植协调员和一名移植护士组成。我们进行了一项前瞻性分析，以研究该团队的实施对我们的活体捐赠项目的影响。对脑死亡供体和活体供体的人口统计学数据、每年的手术数量、等待时间和冷缺血时间进行了评估。从2002年1月至2008年12月，每年等待名单上的患者数量增加了42%（从377例增至536例）。因此，肾脏移植总数从81例增至120例，年中位数为98例。通过组建跨学科移植团队，观察到活体肾脏供体数量显著增加：从18例增至42例；中位数=27例）。在过去7年里，共进行了796例肾脏移植：567例来自脑死亡供体，229例来自活体供体。2001年，接受脑死亡供体与活体供体移植的受者等待名单时间分别为1356天和615天。与2008年相比，接受活体供体移植的患者等待名单时间显著缩短，而脑死亡组患者的等待时间略有增加：脑死亡供体与活体供体：1407天与305天。跨学科方法还缩短了活体供体受者的冷缺血时间：2001年为3小时42分钟，2008年为2小时50分钟。在过去几年里，通过组建跨学科移植团队，支持活体供体手术使来自活体供体的肾脏移植数量逐渐增加，等待时间和冷缺血时间显著缩短，后者可能影响移植质量。
