Organ Transplantation in Colombia

Niño-Murcia, Alejandro; Ramirez, Jessica; Torres, Laura Niño

doi:10.1097/tp.0000000000002409

Cited by 13 publications

(19 citation statements)

References 2 publications

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“…Recent analysis shows a minimal increase in transplant activity -however this trend was observed before the opt-out system was implemented in 2017. 47 Argentina, the largest country by geographical area in Latin America, transitioned to an "opt-out" system in 2005 (Opt-out used in inverted commas here, as this system does not follow traditional opt-out principles). 48 Like most other countries, the change was prompted by low donor rates under the opt-in system.…”

Section: Latin Americamentioning

confidence: 99%

“…Firstly, there does not seem to be a single country where an increase in deceased donor numbers can be simply attributed to a change in donation system. [13][14][15]22,47 In fact, a change in system from opt-in to opt-out, without accompanying changes addressing public education, awareness and health system structures has resulted in lower donation rates, for instance in Brazil. Moreover, those countries that are heralded as barometers of a successful opt-out system may not be so -like Spain.…”

Section: Latin Americamentioning

confidence: 99%

“…Recent analysis shows a minimal increase in transplant activity – however this trend was observed before the opt-out system was implemented in 2017. 47 …”

Section: Opt-in Opt-out and Developing Countriesmentioning

confidence: 99%

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Assessing Global Organ Donation Policies: Opt-In vs Opt-Out

Etheredge

2021

RMHP

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This paper argues that there is little difference between opt-in and opt-out organ donation systems for increasing donor numbers when used in isolation. Independently diverting to an opt-out system confers no obvious advantage and can harm efforts to bolster donations. Rather, it is essential to address barriers to organ donation on several levels along with a switch in system. Moreover, for many countries, it may be more beneficial to adequately capacitate the donation system already in place, rather than entertain a significant change with its attendant resource requirements. For decades, the international transplant community has been involved in vigorous debate as to the merits of moving from default opt-in systems to opt-out policies to grow organ donor numbers and better meet the everincreasing demand for lifesaving transplants. Opt-out is certainly en vogue, with Wales, England and Nova Scotia recently switching over, Scotland due to become opt-out in March 2021 and Northern Ireland and Canada seriously considering a similar move. Thanks to several countries making the switch from opt-in to opt-out over the last 20-30 years, there are sets of robust longitudinal data that aid in analysing the efficacy of donation systems. However, these data are often contradictory and largely inconclusive, suggesting other factors may be in play. This paper reviews some emerging trends in opt-in versus opt-out organ donation policies and considers recent data that elucidates some of the main contentions across each. Ethical frameworks underpinning donation systems, such as informed consent, trust and transparency, are discussed in detail. Substantial time is also devoted to opt-in vs opt-out systems in developing countries, which tend to be excluded from many analyses, and where the challenges faced are magnified by socio-economic constraints. This constitutes a major gap in recently published literature, as developing countries often lag far behind their developed counterparts in donor and transplant numbers.

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Section: Latin Americamentioning

confidence: 99%

Section: Latin Americamentioning

confidence: 99%

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Assessing Global Organ Donation Policies: Opt-In vs Opt-Out

Etheredge

2021

RMHP

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“…Debido a la brecha entre los pacientes que necesitan un trasplante renal y los órganos disponibles, los centros de trasplante aceptan más frecuentemente órganos de calidad subóptima 13,14 . Esta alternativa incluye riesgos específicos para el injerto y para el receptor, que deben considerarse individualmente 15,16 , por lo que se han propuesto enfoques alternativos a la selección tradicional de donantes, como aceptar riñones de DCE.…”

Section: Discussionunclassified

Desenlaces a largo plazo en pacientes trasplantados renales con donantes de criterios expandidos: experiencia de 10 años

Espitia

García-López²,

Patiño-Jaramillo³

et al. 2022

Rev Colomb Cir

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Introducción. El trasplante renal es el tratamiento de elección para la enfermedad renal crónica. Debido a la brecha con la disponibilidad de donantes, el uso de criterios expandidos es una opción que busca mejorar la tasa de donación mundial. El objetivo de este estudio fue comparar la sobrevida del injerto y del paciente trasplantado con donante de criterios expandidos versus el donante estándar. Métodos. Cohorte retrospectiva de 1002 pacientes con trasplante renal donde se determinó la sobrevida del injerto renal y del receptor a 10 años después del trasplante. La sobrevida del injerto renal y el receptor fueron estimadas por el método de Kaplan-Meier. Una regresión de Cox fue realizada ajustando el modelo multivariado. Resultados. El análisis incluyó 1002 receptores, con un 18,8 % (n=189) que correspondían al uso de donante de criterios expandidos. El grupo de trasplante renal con donante de criterios expandidos tuvo menor sobrevida del paciente (48,1 % versus 63,8 %) y del injerto (63,3 % versus 74,7 %) en comparación con el grupo de trasplante renal con donantes con criterios estándar a los 10 años después del trasplante. La asociación de trasplante renal con donante de criterios expandidos y muerte o pérdida del injerto renal no fueron significativas cuando se ajustaron las variables en el modelo multivariado. Conclusión. El trasplante renal con donante de criterios expandidos tiene menor sobrevida del receptor y del injerto frente al grupo de trasplante renal con donante estándar. No hubo diferencias estadísticamente significativas en cuanto al trasplante renal con donante de criterios expandidos frente a la pérdida del injerto renal o muerte.

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“…For deceased brain donors (DBD), the National Health Institute in Colombia allocates organs according to geographical location within the nation, blood type, accumulated time on the waiting list, HLA mismatch, sensitization and loss of vascular access. 16 Diverse preservation solutions are used by different transplant centers during procurement. Kidneys are preserved in cold static storage.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Urologic Complications After Kidney Transplantation and Impact in Graft Survival

Torres¹,

García-López²,

Patiño-Jaramillo³

et al. 2022

RRU

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Background and Purpose: Kidney transplantation (KT) is the best therapy for chronic kidney disease (CKD). Major urologic complications (MUCs) are the second etiology associated to morbidity and graft loss following KT, after rejection episodes. The objective of this study was to estimate the incidence, risk factors and impact on graft survival associated to urological complications in KT patients. Patients and Methods: A retrospective cohort based on electronic patient files of kidney transplant recipients from Colombiana de Trasplantes was created for the period August 2008 to September 2019. Initiation of follow-up was defined as the date of transplantation up to 3 years post-transplantation. Incidence of ureteral stenosis, ureteral obstruction, and ureteral leak was measured. A logistic regression multivariate model was adjusted to determine the associated factors to MUCs (yes/no). Patient and graft survival time were analyzed using a Kaplan-Meier method. Results: A total of 1584 KT patients were included in the cohort. MUCs were present in 195 (12.6%) KT patients. We found that dialysis duration (OR: 1.004; p = 0.02) remained significant for the incidence of MUCs in KT patients of deceased donors. Probability of graft and patient survival at 3 years of follow-up was 90.5% and 85.5%, respectively. No significant difference was found on graft and patient survival in KT patients with or without MUCs. Conclusion: MUCs are frequent complications for KT. We did not observe significant differences in graft or patient survival according to the presence of MUCs. The identification of MUCs and risk factors may guide transplant teams for future surgical and clinical decisions.

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Organ Transplantation in Colombia

Cited by 13 publications

References 2 publications

Assessing Global Organ Donation Policies: Opt-In vs Opt-Out

Assessing Global Organ Donation Policies: Opt-In vs Opt-Out

Desenlaces a largo plazo en pacientes trasplantados renales con donantes de criterios expandidos: experiencia de 10 años

Risk Factors for Urologic Complications After Kidney Transplantation and Impact in Graft Survival

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