肾移植作为慢性肾脏疾病综合护理的一个组成部分的作用

IF 19.3 2区 医学 Q1 UROLOGY & NEPHROLOGY Kidney International Supplements Pub Date : 2020-03-01 DOI:10.1016/j.kisu.2019.11.006
Philip J. O'Connell , Mark Brown , Tak Mao Chan , Rolando Claure-Del Granado , Simon J. Davies , Somchai Eiam-Ong , Mohamed H. Hassan , Kamyar Kalantar-Zadeh , Adeera Levin , Dominique E. Martin , Elmi Muller , Shahrzad Ossareh , Irma Tchokhonelidze , Michele Trask , Ahmed Twahir , Anthony J.O. Were , Chih-Wei Yang , Alexander Zemchenkov , Paul N. Harden
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引用次数: 13

摘要

作为终末期肾脏疾病的治疗,肾移植提供了比透析更好的结果。因此,将肾移植作为慢性肾脏疾病(CKD)综合治疗和管理计划的一部分是至关重要的。制定一个有效的国家移植计划是具有挑战性的,因为对肾脏供体的需求和需要一个多学科团队为供体和受体提供专家护理。本文概述了建立国家肾移植计划的必要步骤,首先是需要有效的立法,为移植提供法律框架,同时保护器官捐赠者、他们的家人、接受者和工作人员,这是打击器官贩运的基本要求。接下来的步骤包括能力建设,发展一支多技能的劳动力队伍,对移植中心进行认证,并通过国家或地区登记处报告结果。虽然大多数移植项目将从生前亲属的肾脏捐赠开始,但渴望和发展一个已故捐赠者项目是必不可少的。这需要多方利益相关者的参与,特别是患者、普通社区、重症监护医生和卫生部门。移植中心的发展应与透析项目的发展相协调。两者都是慢性肾病综合护理的重要组成部分,都应被视为世界卫生组织全民健康覆盖倡议的一部分。需要考虑到每个国家整体卫生框架的发展状况,制定支付病人治疗费用的规定。
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The role of kidney transplantation as a component of integrated care for chronic kidney disease

Kidney transplant provides superior outcomes to dialysis as a treatment for end-stage kidney disease. Therefore, it is essential that kidney transplantation be part of an integrated treatment and management plan for chronic kidney disease (CKD). Developing an effective national program of transplantation is challenging because of the requirement for kidney donors and the need for a multidisciplinary team to provide expert care for both donors and recipients. This article outlines the steps necessary to establish a national kidney transplant program, starting with the requirement for effective legislation that provides the legal framework for transplantation whilst protecting organ donors, their families, recipients, and staff and is an essential requirement to combat organ trafficking. The next steps involve capacity building with the development of a multiskilled workforce, the credentialing of transplant centers, and the reporting of outcomes through national or regional registries. Although it is accepted that most transplant programs will begin with living related kidney donation, it is essential to aspire to and develop a deceased donor program. This requires engagement with multiple stakeholders, especially the patients, the general community, intensivists, and health departments. Development of transplant centers should be undertaken in concert with the development of a dialysis program. Both are essential components of integrated care for CKD and both should be viewed as part of the World Health Organization’s initiative for universal health coverage. Provisions to cover the costs of treatment for patients need to be developed taking into account the state of development of the overall health framework in each country.

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来源期刊
Kidney International Supplements
Kidney International Supplements UROLOGY & NEPHROLOGY-
CiteScore
11.80
自引率
0.00%
发文量
13
期刊介绍: Kidney International Supplements is published on behalf of the International Society of Nephrology (ISN) and comes complimentary as part of a subscription to Kidney International. Kidney International Supplements is a peer-reviewed journal whose focus is sponsored, topical content of interest to the nephrology community.
期刊最新文献
Editorial Board Table of Contents Variations in kidney care management and access: regional assessments of the 2023 International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) Update on variability in organization and structures of kidney care across world regions Capacity for the management of kidney failure in the International Society of Nephrology Newly Independent States and Russia region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA)
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