Kidney Paired Donation

ZusammenfassungHintergrundLebendnierentransplantation stellt die beste therapeutische Option bei terminalem Nierenversagen dar. Aufgrund von immunologischen Barrieren bei HLA- und/oder AB0-Inkompatibilität zwischen Spender und Empfänger kann jedoch ein Drittel der Lebendspenden nicht durchgeführt werden. Um diesen Patienten eine Lebendspende zu ermöglichen, wurden spezielle Nierenaustauschprogramme in Kombination mit extrakorporalen Desensibilisierungsprogrammen geschaffen.Ziel der ArbeitDieser Artikel fasst die derzeitigen Standards bezüglich Indikationen und Methoden, Risiken und Ergebnissen dieser Programme zusammen.Material und MethodenDazu wurden relevante wissenschaftliche Originalarbeiten in der Medline analysiert sowie eigene Zentrumserfahrungen einbezogen.ErgebnisseMithilfe von Nierenaustauschprogrammen in Kombination mit extrakorporalen Antikörpereliminationsverfahren kann für viele Paare eine Möglichkeit zur Transplantation gefunden werden.DiskussionUnklar bleiben dabei die beste Kombination mit bestehenden Strategien und die Antworten auf neu aufgeworfene ethische Fragen.AbstractBackgroundLive kidney donation represents the gold standard for renal replacement therapy. Due to ABO and HLA incompatibility between donor and recipient pairs, one third of possible transplantations cannot be performed. Kidney exchange programs in combination with extracorporeal desensitization have been introduced to enable successful kidney transplantation in such circumstances.ObjectiveThis review discusses the current indications, methods, ethical problems and results within such programs.Materialsand methodsRelevant Medline articles were analyzed and personal experiences of the authors are included in this article.ResultsKidney exchange programs in combination with extracorporeal desensitization enable successful transplantation for most patients.DiscussionThe best combinations of existing strategies have to be defined and newly arisen ethical questions have to be answered.

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