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Pre-emptive live donor kidney transplantation-moving barriers to opportunities:An ethical,legal and psychological aspects of organ transplantation view

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World Journal of Transplantation 2021年第4期11卷 88-98页

作者： David van Dellen lisa burnapp Franco Citterio Nizam Mamode Greg Moorlock Kristof van Assche Willij CZuidema Annette Lennerling Frank JMF Dor Department of Renal and Pancreas Transplantation Manchester University NHS Foundation TrustManchester M139WLUnited Kingdom Department of Faculty of Biology Medicine and HealthUniversity of ManchesterManchester M139PLUnited Kingdom Department of Transplantation Guy's and St.Thomas'NHS Foundation TrustLondon SE19RTUnited Kingdom Department of Surgery Renal TransplantationCatholic UniversityRome 00153Italy Warwick Medical School University of WarwickCoventry CV47ALUnited Kingdom Res Grp Personal Rights&Property Rights University of AntwerpAntwerp 2000Belgium Departments of Internal Medicine Erasmus Medical CentreRotterdam CE 1015Netherlands The Transplant Centre Sahlgrenska University HospitalGothenburg S-41345Sweden Institute of Health and Care Sciences The Sahlgrenska AcademyUniversity of GothenburgGothenburg S-40530Sweden Imperial College Renal and Transplant Centre Hammersmith HospitalLondon W21NYUnited Kingdom

Live donor kidney transplantation(LDKT)is the optimal treatment modality for end stage renal disease(ESRD),enhancing patient and graft ***-emptive LDKT,prior to requirement for renal replacement therapy(RRT),provides further advantages,due to uraemia and dialysis *** are a number of potential barriers and opportunities to promoting pre-emptive *** infrastructure is needed to deliver robust programmes,which varies based on socio-economic *** frameworks can impact on national prioritisation of pre-emptive LDKT and supporting education *** on other programme’s components,including deceased kidney transplantation and RRT,can also hamper *** programmes are designed to provide maximal benefit to the recipient,which is specifically true for pre-emptive *** care providers need to be educated to maximize early LDKT *** access for varying population groups,without socioeconomic bias,also requires *** barriers,including religious influence,also need consideration in developing successful *** addition,the benefit of pre-emptive LDKT needs to be emphasised,and opportunities provided to potential donors,to ensure timely and safe work-up *** education and preparation for pre-emptive LDKT needs to ensure increased *** of the benefits of pre-emptive transplantation require prioritisation for this population *** recommend an approach where patients approaching ESRD are referred early to pre-transplant clinics facilitating early discussion regarding pre-emptive LDKT and potential donors for LDKT are prioritized for work-up to ensure *** regarding preemptive LDKT should be the norm for patients approaching ESRD,appropriate for the patient’s cultural needs and physical ***-emptive transplantation maximize benefit to potential recipients,with the potential to occur within successful service *** f

关键词： Pre-emptive Kidney transplantation Living donor Ethics End-stage renal disease

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