A tale of two kidneys, and the case for machine perfusion in South Africa
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...
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| Format: | Article |
| Language: | English |
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South African Medical Association
2024-04-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1328 |
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| author | N B Leech Z Keyser D E Du Plessis V Soyizwapi L Bertels T du Toit |
| author_facet | N B Leech Z Keyser D E Du Plessis V Soyizwapi L Bertels T du Toit |
| author_sort | N B Leech |
| collection | DOAJ |
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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.
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| format | Article |
| id | doaj-art-b116c53b618b4399be7fff7d7caf5cae |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-b116c53b618b4399be7fff7d7caf5cae2025-02-10T12:26:13ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-04-011143b10.7196/SAMJ.2024.v114i3b.1328A tale of two kidneys, and the case for machine perfusion in South AfricaN B Leech0Z Keyser1D E Du Plessis2V Soyizwapi3L Bertels4T du Toit5Division of General Surgery, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South AfricaTrauma Unit, Division of General Surgery, Tygerberg Academic Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South AfricaDepartment of Urology, Tygerberg Academic Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Division of General Surgery, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa Division of General Surgery, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa Division of General Surgery, Department of Surgery, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa 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. https://samajournals.co.za/index.php/samj/article/view/1328Renal TransplantationMachine perfusion |
| spellingShingle | N B Leech Z Keyser D E Du Plessis V Soyizwapi L Bertels T du Toit A tale of two kidneys, and the case for machine perfusion in South Africa South African Medical Journal Renal Transplantation Machine perfusion |
| title | A tale of two kidneys, and the case for machine perfusion in South Africa |
| title_full | A tale of two kidneys, and the case for machine perfusion in South Africa |
| title_fullStr | A tale of two kidneys, and the case for machine perfusion in South Africa |
| title_full_unstemmed | A tale of two kidneys, and the case for machine perfusion in South Africa |
| title_short | A tale of two kidneys, and the case for machine perfusion in South Africa |
| title_sort | tale of two kidneys and the case for machine perfusion in south africa |
| topic | Renal Transplantation Machine perfusion |
| url | https://samajournals.co.za/index.php/samj/article/view/1328 |
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