Transformation of organ donation in China

Zhang, Lei; Zeng, Li; Gao, Xiangyang; Wang, Haibo; Zhu, Youhua

doi:10.1111/tri.12467

Cited by 34 publications

(23 citation statements)

References 11 publications

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“…[15] Time spent waiting on national transplant lists has long been an important influence on allocation of deceased donor kidneys in Western countries. Waiting time is now plays a role in China, [16,17] where in addition to other factors, obtaining authorization of the health authorities extends the dialysis time of those waiting to receive a donor kidney. Additionally, there are no data on the willingness of ESRD patients in China to accept KT.…”

Section: Introductionmentioning

confidence: 99%

Factors affecting willingness to receive a kidney transplant among hemodialysis patients in West China

Tan

Song²,

Jiang³

et al. 2017

Medicine

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Many factors are associated with the willingness of ESRD patients to receive a kidney transplant. No data are available for patients in China. The study aim was to describe the attitudes toward transplantation in a cohort of patients at a single dialysis center in China.A study questionnaire derived from previously published literature was completed by 239 hemodialysis outpatients. Factors associated with willingness to receive a transplant were identified by univariate and multivariate logistic regression analyses.The respondents were primarily men 50.7 ± 15.1 years of age; 46.4% were willing to receive a transplant. Younger age (OR = 0.928, 95% CI: 0.898–0.959), good self-reported health (OR = 0.203, 95% CI: 0.081–0.51), and awareness of the benefits of transplantation (OR = 0.195, 95% CI: 0.083–0.456) were less likely to deny the transplant. Patients ≤60 years of age were about 13 times more likely to favor transplantation than those >60 years of age (OR = 12.99, 95% CI: 3.75–45.45). For every 10 years under 60, participants were 2.16 times more willing to receive a kidney transplant (OR = 2.16, 95% CI: 1.53–3.02). Older patients were also less likely to be referred for evaluation (OR = 0.955, 95% CI: 0.923–0.989, P = .009).The percentage of ESRD patients in China, particularly older patients, who are willing to accept a transplant, is relatively low. A better understanding of the benefits of transplantation is needed to increase their acceptance.

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Section: Introductionmentioning

confidence: 99%

Factors affecting willingness to receive a kidney transplant among hemodialysis patients in West China

Tan

Song²,

Jiang³

et al. 2017

Medicine

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“…Since 2010, China has developed a new organ donation system to address the need for organ transplantation in the country [1]. Kidneys from donation after circulatory death (DCD) are a major source of the organ in China [2,3]; however, a few concerns are persistent.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Intensified Dosage Regimen of Mycophenolic Acid is Associated with Less Acute Rejection in Kidney Transplantation from Donation after Circulatory Death

et al. 2018

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Introduction: Whether an early, short-term, adequate exposure to mycophenolic acid (MPA) under tacrolimus-based immunosuppression regimen in kidney transplantation from donation after circulatory death (DCD) was effective and safe is yet unknown. Material and Methods: The study was a single-center, retrospective, cohort study of DCD transplantation in China. Intensified and standard dosage regimens of enteric-coated mycophenolate sodium (EC-MPS) were week 1, 2,160 vs. 1,440 mg/day. The incidences of biopsy-proven acute rejection (BPAR), delayed graft function, infection, and patient and graft survival were compared between the 2 groups. Results: A total of 209 patients (n = 82 in intensified group and n = 127 in standard group) were enrolled from August 2013 to December 2014. The incidence of BPAR at 12 months was significantly lower in the intensified group as compared to that of the standard group. (2.4 vs. 10.2%, p = 0.035). The mean MPA area under curve (AUC) levels at day 7 was significantly higher in the intensified group than that in the standard group (66.18 ± 35.48 vs. 45.30 ± 23.5 mg·h/L, p < 0.001). MPA AUC levels were significantly decreased in patients with BPAR as compared to those with NO-BPAR. Conclusion: An early, short-term regimen of intensified EC-MPS with tacrolimus increased early MPA exposure and achieved a low rate of BPAR in kidney transplantation from DCD.

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“…Since March 2010 when the Chinese organ donation system been developed, the ratio of DCD liver transplantation have stepwise become dominate. 24 The main challenge of current DCD practice is prolonged warm ischemia time which could lead to a series of post-OLT disorders, such as AKI and hepatobiliary complications. 25 Two out of 3 of our patients suffered with AKI and needed CRRT treatment.…”

Section: Discussionmentioning

confidence: 99%

Child-to-Adult Liver Transplantation With Donation After Cardiac Death Donors

Liu

Zhang

et al. 2016

Medicine

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Development of organ transplantation is restricted by the discrepancy between the lack of donors and increasing number of patients. The outcome of pediatric donors transplanted into adult recipients especially with donation after circulatory death (DCD) pattern has not been well studied. The aim of this paper is to describe our experience of 3 successful DCD donor child-to-adult liver transplantations lately.Three DCD donors were separately 7, 5, and 8 years old. The ratio between donor graft weight and recipient body weight was 1.42%, 1.00%, and 1.33%, respectively. Ratio between the volume of donor liver and the expected liver volume was 0.65, 0.46, and 0.60. Splenectomy was undertaken for the second recipient according to the portal vein pressure (PVP) which was observed during the operation.Two out of 3 of the recipients suffered with acute kidney injury and got recovered after renal replacement therapy. The first recipient also went through early allograft dysfunction and upper gastrointestinal bleeding. The hospital course of the third recipient was uneventful. After 1 year of follow-up visit, the first and second recipients maintain good quality of life and liver function. The third patient was followed up for 5 months until now and recovered well.DCD child-to-adult liver transplantation should only be used for comparatively matched donor and recipient. PVP should be monitored during the operation. The short-term efficacy is good, but long-term follow-up and clinical study with large sample evaluation are still needed.

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Transformation of organ donation in China

Cited by 34 publications

References 11 publications

Factors affecting willingness to receive a kidney transplant among hemodialysis patients in West China

Factors affecting willingness to receive a kidney transplant among hemodialysis patients in West China

Short-Term Intensified Dosage Regimen of Mycophenolic Acid is Associated with Less Acute Rejection in Kidney Transplantation from Donation after Circulatory Death

Child-to-Adult Liver Transplantation With Donation After Cardiac Death Donors

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