N B Leech, Z Keyser, D E Du Plessis, V Soyizwapi, L Bertels, T Du Toit
{"title":"A tale of two kidneys, and the case for machine perfusion in South Africa.","authors":"N B Leech, Z Keyser, D E Du Plessis, V Soyizwapi, L Bertels, T Du Toit","doi":"10.7196/SAMJ.2024.v114i3b.1328","DOIUrl":null,"url":null,"abstract":"<p><p>Extended-criteria donors (ECDs) are seen as a means of addressing the shortfall in solid-organ availability for transplant. However, the use of ECD kidneys is associated with a greater risk of primary non-function compared with standard-criteria donor kidneys, and a higher discard rate has been described internationally. There seems to be a lack of consensus in the consideration of ECD kidneys for transplant, with reliance often placed on the subjective assessment of individual clinicians. The following case examines the difference in the institutional decision-making process applied to two kidneys from a single donor, and provides an argument for the use of hypothermic machine perfusion in low- to middle-income countries as an efficacious and objective means of assessing ECD kidney suitability.</p>","PeriodicalId":49576,"journal":{"name":"Samj South African Medical Journal","volume":"114 3b","pages":"e1328"},"PeriodicalIF":1.5000,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Samj South African Medical Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7196/SAMJ.2024.v114i3b.1328","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Extended-criteria donors (ECDs) are seen as a means of addressing the shortfall in solid-organ availability for transplant. However, the use of ECD kidneys is associated with a greater risk of primary non-function compared with standard-criteria donor kidneys, and a higher discard rate has been described internationally. There seems to be a lack of consensus in the consideration of ECD kidneys for transplant, with reliance often placed on the subjective assessment of individual clinicians. The following case examines the difference in the institutional decision-making process applied to two kidneys from a single donor, and provides an argument for the use of hypothermic machine perfusion in low- to middle-income countries as an efficacious and objective means of assessing ECD kidney suitability.
期刊介绍：
The SAMJ is a monthly peer reviewed, internationally indexed, general medical journal. It carries The SAMJ is a monthly, peer-reviewed, internationally indexed, general medical journal publishing leading research impacting clinical care in Africa. The Journal is not limited to articles that have ‘general medical content’, but is intending to capture the spectrum of medical and health sciences, grouped by relevance to the country’s burden of disease. This will include research in the social sciences and economics that is relevant to the medical issues around our burden of disease
The journal carries research articles and letters, editorials, clinical practice and other medical articles and personal opinion, South African health-related news, obituaries, general correspondence, and classified advertisements (refer to the section policies for further information).
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