Section of Nephrology, Washington Hospital Center, Washington, DC, USA.
Am J Kidney Dis. 2010 Apr;55(4):717-25. doi: 10.1053/j.ajkd.2009.11.022. Epub 2010 Feb 26.
The increasing number of patients with end-stage renal disease and the expanding waiting lists for various solid-organ transplants, particularly kidney transplants, has compelled prospective transplant recipients and their care teams to explore novel ways to accelerate this process, initiating the practice of multiple listing. Multiple listing is defined as being listed for an organ transplant at more than 1 transplant center. Current policy allows patients to be listed at more than 1 transplant center in 1 or more organ procurement organization. Multiple listing can be beneficial for different groups of transplant candidates. Current data support a beneficial effect for the patient on multiple waiting lists, most notably portending a survival advantage for transplant recipients. The kidney transplant list has the most patients who are multiply listed (4.7%), followed by the liver transplant list at 3.8%. The main potential downside of multiple listing is its effect on patients not on multiple lists, as well as the cost accrued to achieve multiple listings. With the newly clarified policy of the United Network for Organ Sharing, a pivotal role for nephrologists in educating patients about the option of multiple listing becomes more apparent. In this article, current practices and policies regarding multiple listing are reviewed and opinions and ethics relating to the practice are discussed.
终末期肾病患者数量的增加和各种实体器官移植（特别是肾移植）候补名单的扩大，迫使潜在的移植受者及其护理团队探索加速这一过程的新方法，从而开始了多机构登记制度。多机构登记是指在一个以上的移植中心登记器官移植。现行政策允许患者在一个或多个器官获取组织中，在一个以上的移植中心登记。多机构登记对不同群体的移植候选人都有好处。目前的数据支持在多个候补名单上的患者获益，尤其是对移植受者预示着生存优势。肾移植候补名单上有最多的多机构登记患者（4.7%），其次是肝移植候补名单（3.8%）。多机构登记的主要潜在缺点是对不在多个名单上的患者的影响，以及为实现多机构登记而产生的费用。随着美国器官共享网络新政策的明确，肾脏病专家在教育患者选择多机构登记方面的作用更加明显。本文回顾了多机构登记的现行做法和政策，并讨论了与该做法相关的意见和伦理问题。
