Lebendspende-Nierentransplantation

Abstract

Due to the existing organ shortage the option of a kidney transplantation (KTx) in patients with end-stage renal disease is not always possible despite the offer of this therapy. So far the required number of KTx could not be adequately achieved by organ donations from deceased persons. To solve this problem living donation KTx programs have already become established in many transplantation centers. In published reports it has been shown that with the living donation program better results could be achieved in terms of graft function and patient survival compared to cadaver donation KTx. Therefore, living donation KTx allows an optimal alternative to expand the organ pool. The aim of our study is to present the long-term results of our living donation KTx program regarding graft function and patient survival. Finally, the risks of living donation KTx will be discussed based on the reported experiences of other centers.

Differences in emotional responses in living and deceased donor kidney transplant patients

“…However, due to the existing organ shortage, the option of a renal transplant from a deceased donor (DD) is limited and average waiting times on the Eurotransplant waiting list range from 7 to 8 years. Therefore, living donors (LDs) have become more prominent in transplantation centres, with better results in terms of graft function and patient survival compared with deceased donation [ 4 ], and it reduces the waiting time for transplantation.…”

Towards Metabolic Biomarkers for the Diagnosis and Prognosis of CKD

“…Both indications specifically rely on accurate estimates in the near-normal range. The catastrophic failure of all current equations to meet this expectation was recently highlighted in a compelling analysis [37]: in a study comprising almost 300 potential living kidney donors, eGFR values below 80 ml/min/1.73 m 2 (the typical cut-off for acceptance of living donors) had positive predictive values (PPV) for an mGFR below this threshold of only 0-40% with the vast majority of situations (formula, age, sex, and BMI) yielding less than 20% (Figure 2). In other words, many-actually most (!…”

“…As noted in the introduction, decision-makers in diagnostics companies, in insurances, and in clinical practice will scrutinize new biomarkers or assays regarding their actual diagnostic performance but also regarding the clinical utility of the additional information they provide, that is, their therapeutic consequences. Of course, such deliberations can always be countered by the thought-terminating cliché that better diagnostic tools will eventually facilitate better standards of care for patients or, in this concise case, earlier diagnosis of impaired renal function and more accurate staging/monitoring of CKD will allow for more informed clinical Positive predictive values (PPVs) for a measured GFR below 80 ml/min/1.73 m 2 in individuals with an eGFR below 80 ml/min/1.73 m 2 , modified after [37,82]. Subsets are analyzed according to sex (male vs. female), age (<50 vs. >50) and BMI (<25 vs. >25).…”