Gonzalez Fernando M, Gonzalez Cohens Francisca Del Rocío
Department of Nephrology, Faculty of Medicine, Universidad de Chile, Santiago 7500922, Chile.
Web Intelligence Centre, Faculty of Physics and Mathematical Sciences, Universidad de Chile, Santiago 8370397, Chile.
World J Transplant. 2024 Sep 18;14(3):91214. doi: 10.5500/wjt.v14.i3.91214.
Famure describe that close to 50% of their patients needed early or very early hospital readmissions after their kidney transplantation. As they taught us the variables related to those outcomes, we describe eight teaching capsules that may go beyond what they describe in their article. First two capsules talk about the ideal donors and recipients we should choose for avoiding the risk of an early readmission. The third and fourth capsules tell us about the reality of cadaveric donors and recipients with comorbidities, and the way transplant physicians should choose them to maximize survival. Fifth capsule shows that any mistake can result in an early readmission, and thus, in poorer outcomes. Sixth capsule talks about economic losses of early readmissions, cost-effectiveness of transplantation, and how to improve outcomes and reduce costs by managing a risky patient-portfolio. Seventh capsule argues about knowing your risk behavior to better manage your portfolio; and Eighth capsule about the importance of the center experience in transplanting complex patients. We finish with some lessons of the importance of the transplantation process and the collaboration with other disciplines in order to prevent the conditions that lead to early readmissions.
法穆尔指出，他们近50%的肾移植患者在术后需要早期或极早期再次入院。在他们向我们介绍了与这些结果相关的变量后，我们阐述了八个教学要点，其内容可能超出了他们文章所描述的范围。前两个要点讨论了为避免早期再次入院风险我们应选择的理想供体和受体。第三和第四个要点讲述了尸体供体和患有合并症受体的实际情况，以及移植医生应如何选择他们以最大化生存率。第五个要点表明任何失误都可能导致早期再次入院，进而导致更差的结果。第六个要点讨论了早期再次入院的经济损失、移植的成本效益，以及如何通过管理高风险患者组合来改善结果并降低成本。第七个要点主张了解自身风险行为以更好地管理患者组合；第八个要点阐述了中心经验在移植复杂患者中的重要性。我们最后总结了移植过程的重要性以及与其他学科合作以预防导致早期再次入院情况的一些经验教训。
