Что необходимо знать о трансплантации почки?
Kidney transplant is the placement of a healthy kidney to a patient suffering from chronic renal failure. This is one of the three treatments for end-stage renal disease (the other being hemodialysis and peritoneal dialysis).
How many kidneys does a person receive?
He usually receives only one kidney since one is more than enough to live a healthy life.
Where is the kidney placed?
Where is the kidney coming from?
The new kidney received by the patient (recipient) comes either from a living donor (the one giving the kidney) or from deceased donors. The living donor is usually a member of the family while the donor who has died is someone who has declared his desire to become an organ donor or his family has decided to donate his organs and is a suitable donor.
What does the preparation of a potential recipient entail?
The patient suffering from end-stage chronic renal failure and undergoes hemodialysis or peritoneal dialysis, must be enrolled in the National Candidate Registry (the so-called national transplant waiting list) for transplantation by a cadaveric donor. It is mandatory that he undergoes a very thorough check (the so-called pre-transfusion test) to verify the acceptability of the recipient to receive a renal transplant safely and to ensure a successful transplant as much as possible.
What does the process entail?
There is a form, which clearly describes all the tests that need to be done. This check is coordinated by the nephrologist and he is the one who will prepare and validate the final pre-transfusion check. Then the patient visits the transplant center he has chosen, and enters the national transplant waiting list after the nephrologist’s or the coordinator’s consultation. A copy of the pre-transfusion check is filed at the National Transplant Organization, which is authorized to maintain and manage the National Candidate Registry.
How are the donated kidneys distributed, by what criteria?
Implantations from cadaver donors are allocated according to the applicable law of the Ministerial decision 4d/8874 of 1996. The distribution criteria are the blood type, the patient's clinical status, the age, the time the patient undergoes dialysis and the histocompatibility with the potential organ donor. Another important criterion is the patient's cytotoxic antibody levels (since high levels increase the likelihood of graft rejection). All the above criteria are recorded in a special database at the Hellenic Transplant Organization - EOM. In the same database, the data of the respective organ donor are also entered. The order of the candidate recipients is based on an automatic score made by the electronic system and automatically communicated by the EOM to the transplantation units and histocompatibility laboratories for the initiation of the transplantation process.
Why more than one patient is contacted to visit the transplant center when there is a renal transplant?
The Transplant Unit invites for each renal transplant at least the 2 or 3 first candidates on the list to perform the final cross-match, which is performed with the blood of the candidate recipient and the donor tissue. This test is necessary and will show if the recipient's body will accept or discard the transplant. If the testing of the first candidate in the list appears to be prohibitive for transplantation, or the clinical condition of the recipient at that time is not considered safe, the kidney is grafted to the next one in the row, showing signs of graft acceptance. Candidate recipients, when called to be examined, have the right to be informed about each stage of the transplant process, their turn on the list and the quality of the graft they are going to take.
How much does the transplant cost?
The whole process is free of charge.
Mesogeios Dialysis Centers Group Scientific Team
2.National Kidney Foundation : Kidney transplantation, Date Reviewed: January 26, 2017
3.UpToDate 2017: Patient education: Kidney transplant
4.American Society of Transplantation : Kidney Transplantation, 2017
5.Pimentel A, Ureña-Torres P, Zillikens MC, Bover J, Cohen-Solal M. Fractures in patients with CKD-diagnosis, treatment, and prevention: a review by members of the European Calcified Tissue Society and the European Renal Association of Nephrology Dialysis and Transplantation. Kidney Int. 2017 Sep 27. pii:S0085-2538(17)30567-7. doi: 10.1016/j.kint.2017.07.021. [Epub ahead of print] Review. PubMed PMID: 28964571.
6.Aiyegbusi OL, Kyte D, Cockwell P, Marshall T, Gheorghe A, Keeley T, Slade A, Calvert M. Measurement properties of patient-reported outcome measures (PROMs) used in adult patients with chronic kidney disease: A systematic review. PLoS One. 2017 Jun 21;12(6):e0179733. doi: 10.1371/journal.pone.0179733. eCollection 2017. Review. PubMed PMID: 28636678; PubMed Central PMCID: PMC5479575.
7.KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009 Nov;9 Suppl 3:S1-155.