Chaudhuri Abanti, Gallo Amy, Grimm Paul
Department of Pediatric Nephrology, Stanford University, Stanford, CA, USA.
Department of Surgery, Stanford University, Stanford, CA, USA.
Pediatr Transplant. 2015 Nov;19(7):776-84. doi: 10.1111/petr.12569. Epub 2015 Oct 1.
Renal transplantation is the treatment of choice for children with end-stage renal disease. More than 50% of children receive a deceased donor renal transplant. Marked disparity between the number of children on the renal transplant wait list and the supply has prompted numerous advances to increase supply as well as maximize the utility of donor organs. Allocation of deceased donor kidneys is based on several criteria. The organ allocation system policy is continually evaluated and changed incrementally to optimize allocation. We, in the United States, are in the process of transitioning into a new kidney allocation system to enhance post-transplant survival benefit, increase utilization of donated kidneys, and increase transplant access for biologically disadvantaged candidates. This review will provide a brief overview of the organ sharing system in the United States, compare the "old" and the "new" allocation system, and discuss the considerations for the pediatric nephrologist while accepting a deceased donor kidney for a particular pediatric patient.
肾移植是终末期肾病患儿的首选治疗方法。超过50%的儿童接受 deceased donor 肾移植。肾移植等待名单上的儿童数量与供体数量之间存在显著差距，这促使人们在增加供体数量以及最大化供体器官效用方面取得了诸多进展。deceased donor 肾脏的分配基于多项标准。器官分配系统政策会持续评估并逐步改变，以优化分配。在美国，我们正在向一种新的肾脏分配系统过渡，以提高移植后的生存获益、增加捐赠肾脏的利用率，并增加生物条件不利的候选者的移植机会。本综述将简要概述美国的器官共享系统，比较“旧”的和“新”的分配系统，并讨论儿科肾病学家在为特定儿科患者接受 deceased donor 肾脏时的考量因素。 （注：“deceased donor”直译为“已故捐赠者”，在医学语境中通常指脑死亡等判定死亡后进行器官捐赠的情况 ）
