Al-Thnaibat Mohammad H, Balaw Mohammad K, Al-Aquily Mohammed K, Ghannam Reem A, Mohd Omar B, Alabidi Firas, Alabidi Suzan, Hussein Fadi, Rawashdeh Badi
Department of Internal Medicine, Faculty of Medicine, Hashemite University, Zarqa 13133, Jordan.
College of Medicine, Hashemite University, Zarqa 13133, Jordan.
J Transplant. 2024 Mar 28;2024:4538034. doi: 10.1155/2024/4538034. eCollection 2024.
Jordan performed the Middle East's first living-donor kidney transplant in 1972. In 1977, the country became one of the first Arab countries to regulate organ donation and transplantation. Despite these early advances in living donor transplantation, Jordan's organ donation after brain death program remains inactive, making it challenging to meet organ demand and placing many patients on long transplant waiting lists. As of 2020, only 14.2% of the patients with end-stage kidney disease have access to a living donor. The scarcity of compatible living donors exacerbates Jordan's organ shortage, leaving patients with extended waits and uncertain transplant prospects. Due to the lack of living donors and the inactive brain death donation program, additional options are needed to meet organ demand. Kidney paired exchange (KPE), emerges as a potential solution to the problem of donor shortage and donor-recipient incompatibility. By allowing living donors to direct their donated organs to different compatible recipients, KPE offers the promise of expanding transplant opportunities for patients without suitable living donors. However, the current Jordanian law restricting living kidney donation to fifth-degree relatives further limits the pool of potential donors, aggravating the organ shortage situation. This article explores the feasibility of implementing KPE in Jordan and proposes an approach to implementing KPE in Jordan, considering ethical and legal aspects to substantially increase kidney transplants.
1972年，约旦实施了中东首例活体肾移植手术。1977年，该国成为最早对器官捐赠和移植进行规范的阿拉伯国家之一。尽管在活体供体移植方面取得了这些早期进展，但约旦脑死亡后的器官捐赠项目仍然处于停滞状态，这使得满足器官需求具有挑战性，并使许多患者长期处于移植等待名单上。截至2020年，只有14.2%的终末期肾病患者能够获得活体供体。合适的活体供体稀缺加剧了约旦的器官短缺问题，使患者等待时间延长，移植前景不明朗。由于缺乏活体供体以及脑死亡捐赠项目处于停滞状态，需要其他选择来满足器官需求。肾脏配对交换（KPE）作为解决供体短缺和供体-受体不匹配问题的潜在解决方案应运而生。通过允许活体供体将其捐赠的器官导向不同的合适受体，KPE有望为没有合适活体供体的患者扩大移植机会。然而，约旦现行法律将活体肾捐赠限制在五代以内亲属，这进一步限制了潜在供体库，加剧了器官短缺状况。本文探讨了在约旦实施KPE的可行性，并提出了一种在约旦实施KPE的方法，同时考虑到伦理和法律方面，以大幅增加肾脏移植数量。
