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Expanded criteria donors in deceased donor kidney transplantation – An Asian perspective
There is an increasing gulf between demand and supply for kidneys in end-stage renal failure patients worldwide, especially Asia. Renal transplantation is often the treatment of choice for long-suffering patients who have to undergo dialysis on a regular basis. The utilization of expanded criteria d...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279103/ https://www.ncbi.nlm.nih.gov/pubmed/32549658 http://dx.doi.org/10.4103/iju.IJU_269_19 |
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author | Wang, Ziting Durai, Pradeep Tiong, Ho Yee |
author_facet | Wang, Ziting Durai, Pradeep Tiong, Ho Yee |
author_sort | Wang, Ziting |
collection | PubMed |
description | There is an increasing gulf between demand and supply for kidneys in end-stage renal failure patients worldwide, especially Asia. Renal transplantation is often the treatment of choice for long-suffering patients who have to undergo dialysis on a regular basis. The utilization of expanded criteria donors (ECDs) to address the donor pool shortage has been proven to be a legitimate solution. Metzger first described the classification of standard criteria donor and ECD in 2002. Since then, the criterion has undergone various modifications, with the key aims of optimizing organ procurement rate while minimizing discard and rejection rates. We review the methods to improve selection, characterization of risks, and surgical techniques. Although the ECD kidneys have a higher risk of impaired donor and recipient outcome than the “standard criteria” transplants, it may be justified by the improved overall survival of these patients compared to those who remained on dialysis. It is, therefore, crucial that we perform meticulous selection, along with state of the art surgical techniques to maximize the use of this scarce resource. In this article, we review the pre-procurement and post-procurement processes implemented to preserve outcomes. |
format | Online Article Text |
id | pubmed-7279103 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-72791032020-06-16 Expanded criteria donors in deceased donor kidney transplantation – An Asian perspective Wang, Ziting Durai, Pradeep Tiong, Ho Yee Indian J Urol Review Article There is an increasing gulf between demand and supply for kidneys in end-stage renal failure patients worldwide, especially Asia. Renal transplantation is often the treatment of choice for long-suffering patients who have to undergo dialysis on a regular basis. The utilization of expanded criteria donors (ECDs) to address the donor pool shortage has been proven to be a legitimate solution. Metzger first described the classification of standard criteria donor and ECD in 2002. Since then, the criterion has undergone various modifications, with the key aims of optimizing organ procurement rate while minimizing discard and rejection rates. We review the methods to improve selection, characterization of risks, and surgical techniques. Although the ECD kidneys have a higher risk of impaired donor and recipient outcome than the “standard criteria” transplants, it may be justified by the improved overall survival of these patients compared to those who remained on dialysis. It is, therefore, crucial that we perform meticulous selection, along with state of the art surgical techniques to maximize the use of this scarce resource. In this article, we review the pre-procurement and post-procurement processes implemented to preserve outcomes. Wolters Kluwer - Medknow 2020 2020-04-07 /pmc/articles/PMC7279103/ /pubmed/32549658 http://dx.doi.org/10.4103/iju.IJU_269_19 Text en Copyright: © 2020 Indian Journal of Urology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Review Article Wang, Ziting Durai, Pradeep Tiong, Ho Yee Expanded criteria donors in deceased donor kidney transplantation – An Asian perspective |
title | Expanded criteria donors in deceased donor kidney transplantation – An Asian perspective |
title_full | Expanded criteria donors in deceased donor kidney transplantation – An Asian perspective |
title_fullStr | Expanded criteria donors in deceased donor kidney transplantation – An Asian perspective |
title_full_unstemmed | Expanded criteria donors in deceased donor kidney transplantation – An Asian perspective |
title_short | Expanded criteria donors in deceased donor kidney transplantation – An Asian perspective |
title_sort | expanded criteria donors in deceased donor kidney transplantation – an asian perspective |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279103/ https://www.ncbi.nlm.nih.gov/pubmed/32549658 http://dx.doi.org/10.4103/iju.IJU_269_19 |
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