Spasovski G, Vanholder R
Department of Nephrology, University Clinical Center, Skopje, Macedonia.
Minerva Urol Nefrol. 2012 Sep;64(3):183-9.
Although it seems that end stage renal disease (ESRD) therapies gradually become more accessible in the developing world, yet, the vast majority of people living in those areas do not have access to dialysis and especially transplantation because of the economic and technological inequality as compared with the developed world. Despite the great advantage in survival and considerable socioeconomic advantages of transplantation vs. dialysis, there is a widespread recognition that the growing gap between organ supply and demand will continue into the foreseeable future. Several reasons might be considered in this regard as: insufficient data on the topic in the public domain, inadequate governmental financial resources, lack of public awareness, education and motivation for organ donation as well as the low number of organized teams of transplant surgeons and nephrologists, and lack of organizational infrastructure, i.e. coordinators. The defined priorities for the future in terms of improving living donor transplantation, composition of the official waiting lists and registries of transplant recipients and living donors and the role of transplant professionals have been discussed. In conclusion, whatever the governmental support is, as professionals, we should just reinforce our efforts to help our patients as best as we can in the current situation.
尽管终末期肾病（ESRD）治疗方法在发展中世界似乎逐渐变得更容易获得，然而，由于与发达世界相比存在经济和技术不平等，这些地区的绝大多数人无法获得透析治疗，尤其是移植治疗。尽管移植相对于透析在生存方面具有巨大优势以及显著的社会经济优势，但人们普遍认识到，在可预见的未来，器官供需之间不断扩大的差距仍将持续。在这方面可考虑几个原因：公共领域关于该主题的数据不足、政府财政资源不足、公众意识缺乏、器官捐赠的教育和积极性不足，以及移植外科医生和肾病学家的有组织团队数量少，且缺乏组织基础设施，即协调员。已经讨论了未来在改善活体供体移植、官方等待名单的构成以及移植受者和活体供体登记方面的既定优先事项，以及移植专业人员的作用。总之，无论政府提供何种支持，作为专业人员，我们都应在当前形势下尽最大努力加强帮助患者的力度。
