The evaluation of patients for the kidney transplantation waiting list
Authors:
O. Viklický
Authors‘ workplace:
Přednosta: prof. MUDr. Ondřej Viklický, CSc.
; Klinika nefrologie
; Transplantcentrum
; Přednosta: MUDr. Pavel Trunečka, CSc.
; Institut klinické a experimentální medicíny, Praha
Published in:
Prakt. Lék. 2011; 91(1): 37-41
Category:
40th Anniversary IKEM
Overview
Kidney transplantation represents a treatment of choice for end stage renal disease (ESRD) patients. ESRD is associated with several comorbidities and the long-term survival of patients treated with dialysis has been limited. The aim of pretransplant work-up in kidney transplant candidates is to eliminate surgical morbidity and mortality and to identify patients at risk for immunosuppression related diseases. In ideal situation, kidney transplantation should be performed just before the start of dialysis therapy.
The evaluation of cardiovascular system and ischemic heart disease screening have been routinely performed before the placement on the waiting list, however, the benefit of this procedures have not been verified in prospective randomized trials.
Urological work-up is important in anuric patients in whom disorders of lower urinary tracts are obvious with normal dieresis. Similarly, chronic infections should be treated before patient placement on the waiting list. Successfully treated malignancies have not represents the contraindication for transplantation if the patients wait for a defined period of time without the disease recurrence.
After HLA antigen and panel reactive antibodies determination, patients are placed on the waiting list. The waiting time depends on blood group and HLA match. In the Czech Republic, patients wait for transplantation for about 1,5 years. When placed on the waiting list, patients should be routinely screened for concomitant diseases that may influence the outcome of kidney transplantation.
Key words:
kidney transplantation, waiting list, cardiovascular complications.
Sources
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2011 Issue 1
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