Garcia Garcia Guillermo, Harden Paul, Chapman Jeremy
Nephrology Service, Hospital Civil de Guadalajara, University of Guadalajara Health Sciences Center Hospital, Guadalajara, Mexico.
Iran J Kidney Dis. 2012 Mar;6(2):81-7.
World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end-stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation, and vaccination. Even in high-income countries, the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical, and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental, and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.
2012年3月8日的世界肾脏日为我们提供了一个契机，来反思肾脏移植作为终末期肾病治疗方法所取得的成功。与透析治疗相比，肾脏移植在提高患者生活质量和延长寿命方面，以及在成本效益方面都更具优势。任何一种既便宜又有效的治疗方法，若未能成为主流疗法，必然存在其他阻碍因素，导致无法完全取代透析治疗。将肾脏移植作为终末期肾病的普遍治疗方法存在诸多障碍，其中包括经济限制，在一些国家，相较于清洁水源、卫生设施和疫苗接种等公共卫生基本需求，肾脏移植被合理地置于较低优先级。即便在高收入国家，手术技术挑战以及免疫抑制的后果也限制了合适受者的数量，但对肾脏移植率的主要限制因素是捐赠器官的短缺以及具备所需专业知识的医疗、外科和护理人员的不足。这些问题是有解决办法的，这需要全社会、专业人士、政府和政治环境的共同努力。世界肾脏日呼吁每年为一百万有权受益的人提供肾脏移植治疗。
