Milanés C L, Bellorín-Font E, Weisinger J, Pernalete N, Urbina D, Paz-Martínez V
Centro Nacional de Diálisis y Transplante, Ministerio de Sanidad, Caracas, Venezuela.
Invest Clin. 1993;34(1):15-27.
The number of cadaveric kidneys available for transplantation has become insufficient around the world. Despite concerted efforts, we have been unsuccessful in greatly improve the supply of organ donors, and consequently the number of end stage renal failure patients awaiting for kidney transplantation continues to increase. The primary objective of this paper is to quantify the need and supply of kidneys for transplant in Venezuela. An overview of the current level of kidney transplant activity in Venezuela is presented, observing that the activity with cadaveric donors had been predominant since 1983, although not to an optimal level. The annual activity in kidney transplant between 1989-1991 remained stable in 6 transplants/million people, but went sharply down to 4.6 in 1992. An estimate of the current need is around 10 donors/million people. This is in contrast with an effective donation rate of only 2.01 and 1.92 donors/million achieved in 1990 and 1991 respectively. The most frequent cause for no donation was the lack of familiar consent. Based on an analysis of the factors involved in the shortage of donor supply in Venezuela, we present some recommendations to increase the availability of cadaveric organ donors in the country. These measures include an improvement of education and legal regulation in the field of organ donation and transplantation, and following the Spanish model, the creation of a program of hospital transplant coordinators that can detect and evaluate potential organ donors as well as coordinate the logistical aspects of transplantation.
全球范围内可用于移植的尸体肾脏数量已变得不足。尽管各方共同努力，但我们仍未能大幅增加器官捐献者的供应，因此等待肾脏移植的终末期肾衰竭患者数量持续增加。本文的主要目的是量化委内瑞拉肾脏移植的需求和供应情况。文中概述了委内瑞拉目前肾脏移植活动的水平，观察到自1983年以来，尸体捐献者的移植活动一直占主导地位，尽管尚未达到最佳水平。1989 - 1991年期间肾脏移植的年活动量保持稳定，为每百万人口6例移植，但在1992年急剧降至4.6例。目前的需求估计约为每百万人口10名捐献者。这与1990年和1991年分别仅达到每百万人口2.01名和1.92名的有效捐献率形成对比。未进行捐献的最常见原因是缺乏家属同意。基于对委内瑞拉捐献者供应短缺所涉及因素的分析，我们提出了一些建议，以增加该国尸体器官捐献者的可获得性。这些措施包括改善器官捐献和移植领域的教育与法律法规，并效仿西班牙模式，设立一个医院移植协调员项目，该项目能够检测和评估潜在器官捐献者，并协调移植的后勤工作。
