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In Chapter One we described the development of live kidney donation. Currently, live donor
kidney transplantation is the best solution to attack the persistent organ shortage in the
Western World. Because of this shortage live kidney donation is still interesting over fifty years
after Joseph Murray and Rene Kuss performed the first live kidney...
Contexts in source publication
Context 1
... majority of the transplants had a single artery and a single vein (Figure 1). Three trans- plants had a single artery and three veins, five transplants had three arteries and a single vein, Table 2A. The number of renal arteries found at surgery versus the number of arteries as assessed by the MRA. Data presented as number (%). Twenty-three MRIs (10%) were discordant with regard to arterial anatomy assessed intraop- eratively as compared to 3 (3%) DSAs. (Table 2A and B). The sensitivity of MRI and DSA was 0.61 and 0.81 respectively (Table 2A and B). The specificity of MRI and DSA was 0.98 and ...
Context 2
... replies were received (72%). Two centers did not practice live donor nephrec- tomy anymore. Therefore these results are based on 92 replies from all twelve aforemen- tioned countries. The specialists who responded and their affiliations are mentioned in the acknowledgements. Figure 1 shows the case volume of the responding centers. In 2004 approximately 6800 trans- plantations were carried out in total. Seventy-nine percent of the transplants (about 5350 kidneys) was derived from a deceased donor and 21% (about 1450 kidneys) was derived from a live donor. The responding centers were responsible for approximately 80.6% of the live kidney donor transplantations in the twelve aforementioned countries and for approximately 62% of all European live kidney donor transplantations (12)(13)(14)(15)(16)(17). In figure 2 the estimated num- bers of live kidney donor transplantations of the responding centers, the remaining centers in the investigated countries and the rest of Europe respectively are shown. The number of ...
Context 3
... were older in the MIDN group and more frequently unrelated to the donor. Figure 1 demonstrates the abdomen of a patient several weeks after MIDN. The scar is relatively small and is located subcostally in the natural shadow of the costal ...
Context 4
... data and complications are depicted in Table 3. Major complications (i.e. re- quiring re-operation or re-admission) did not occur. Seven minor complications occurred in Figure 1. The scar of a male donor following mini-incision donor nephrectomy. In upright position, the scar is located just below the costal ...
Context 5
... the late 1980s and 1990s an increasing number of patients suffering from renal insuf- ficiency and a stagnating number of transplants resulted in a discrepancy between organ demand and supply. This prompted new interest in live donor kidney transplantation ( Figure 1) amongst other alternatives. In the Netherlands, the number of patients awaiting kidney transplantation increased until 2004 despite a rising number of live donors. At that time the waiting list consisted of approximately 1200 patients. It is important to realize that only patients who started dialysis were considered for this list. The average waiting time for trans- plantation increased to five years. Meanwhile, approximately twenty percent of the patients waiting had to be removed of the list annually, because of mortality, worsening condition Currently, the number of patients awaiting kidney transplantation has stabilized as a conse- quence of a significant rise in live kidney donation nation wide (3). In particular, the number of unrelated donors including spouses attributed to this increase. The results of transplanta- tion of kidneys derived from unrelated donors are excellent ...
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Citations
... Due to a shortage of organ donors, kidney transplantation using living donors is increasingly performed in the Netherlands. Quality of life of most living donors is better than or equal to the general population [1,2] and returns to pre-donation levels after donation [3,4]. Receiving a living donor kidney has clear advantages in terms of improved graft survival [5], but disadvantages may be psychological, for example that it influences the donor-recipient relationship. ...
Background
Limited data exist on the impact of living kidney donation on the donor-recipient relationship. Purpose of this study was to explore motivations to donate or accept a (living donor) kidney, whether expected relationship changes influence decision making and whether relationship changes are actually experienced.
Methods
We conducted 6 focus groups in 47 of 114 invited individuals (41%), asking retrospectively about motivations and decision making around transplantation. We used qualitative and quantitative methods to analyze the focus group transcripts.
Results
Most deceased donor kidney recipients had a potential living donor available which they refused or did not want. They mostly waited for a deceased donor because of concern for the donor’s health (75%). They more often expected negative relationship changes than living donor kidney recipients (75% vs. 27%, p = 0.01) who also expected positive changes. Living donor kidney recipients mostly accepted the kidney to improve their own quality of life (47%). Donors mostly donated a kidney because transplantation would make the recipient less dependent (25%). After transplantation both positive and negative relationship changes are experienced.
Conclusion
Expected relationship changes and concerns about the donor’s health lead some kidney patients to wait for a deceased donor, despite having a potential living donor available. Further research is needed to assess whether this concerns a selected group.
... However, it was reported recently that DSA had a sensitivity of 97% compared with intra-operative findings. 283 In the same study, the accuracy of MR angiography was reported to be 90%, 283 a higher estimate than the mean estimate from the studies we found. However, these values for DSA and MR angiography accuracy were within the ranges of the sensitivity analyses we performed and our results have shown to be robust to these sensitivity analyses. ...
The incidence of end-stage renal disease is increasing and therefore, the number of
patients requiring renal replacement therapy (RRT), renal dialysis or renal transplantation
(RTx), has been rising. The various forms of RRT are associated with differences
in survival and quality of life. Knowledge of long-term outcomes of these patients is
imperative to the optimal implementation of treatment modalities and care for this
patient population.
