Living-donor kidney transplant in Colombia
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Keywords

Living Donor Kidney
Preemptive
Health Promoter
Health Provider Institution
PRA
Single Antigen
MDRD
CKD-EPI.

How to Cite

1.
García García Álvaro, Rodelo J. Living-donor kidney transplant in Colombia. Rev. Colomb. Nefrol. [Internet]. 2015 Jan. 1 [cited 2022 Jan. 21];2(1):41-6. Available from: https://revistanefrologia.org/index.php/rcn/article/view/194

Abstract

The best alternative for the treatment of patients with CKD-5 is renal transplantation; unfortunately, it has declined significantly, not only in Colombia but worldwide. Among the proposed medical and surgical approaches to extend this treatment, marginal donors were used at the beginning, but soon they were not enough due to the huge increase in the number of people in the waiting lists, many of them dying waiting for an organ. Given the excellent results of living donors, with graft survival approaching 90% at 10 years of follow up, explained by an increase in HLA compatibility, ease of planning the optimal moment for the transplantation, lower delayed graft function andcosts, in addition to a minimum peri-operative risk for the donor as evidenced by Hartman et al, with a mortality rate of 3.1 x 10,000, when laparoscopic and pain control techniques are used, renal transplantation with living donors becomes an acceptable alternative worldwide. Clear policies for patient and donor follow-up after nephrectomy, in which the donor loses 35% of his kidney function, are mandatory these protocols. Initial follow-up studies of living donors showed a similar relative risk of hypertension, proteinuria and CKDcimpared to the general population, which facilitated this medical practice; nevertheless, in the last five years the convenience of this practice is in doubt by some authors due to a significant increase in the relative risk of diabetes mellitus, hypertension and cardiovascular disease, compared with healthy donors.This has been shown by Muzale et al., in a cohort of 96 217 living donors compared to 20 024 persons of NHANES III: an increase of CKD in living donors compared with healthy patients at 10 and 15 years; the relative risk at 15 years was 30.8 and 3.9 x 10,000, respectively. Regarding female donors in reproductive age, Amit. X. puts into question this type of donor as he found a significant increase in hypertension and preeclampsia during pregnancy in these women (11%) when compared to healthy women (5%). That is why we ask the health providers and transplant groups a comprehensive assessment, with fully defined protocols to evaluate, prevent and reduce the risks of this excellent treatment modality for patients with stage 5 CKD.

https://doi.org/10.22265/acnef.2.1.194
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