ISSN: 1308-1020
Hakkında: Özel Sayılar şeklinde yayınlanır.
|
|
|
The Contraindications Of Cadaveric Kidney Donor Candidates Andsupportive Icu Care
Dr. Melek TULUNAYa
aAnesteziyoloji ve Reanimasyon ABD, Ankara Üniversitesi Tıp Fakültesi, ANKARA
The disparity between the number of people with end-stage renal disease awaiting organ transplantation and the number of organs avaible has become a public health crisis. In recent years, the growing disparity between organ availability and number of candidates to organ transplantation has led most trasnplant center to turn their attention from “optimal cadaveric donors” to “marginal or extended criteria ”donors. Currently there are 3 accepted contraindications: 1) infection with human immunodefficiency virus, 2) a history of extracranial malignancy (with the exeption on nonmelanoma skin cancer), and 3) donor septic shock. Brain-death physiology significant impacts upon the management process. Cardiovascular support is the cornerstone of donor management. The use of standardized and agressive management protocols including invasive monitorisation, agressive fluid resuscitation and vasoactive medications not only can improve the quality but also can increase the number of organs available for transplantation, and can impact the quality of recipient life. The use of hormonal resuscitation remains controversial with studies showing mixed results.Keywords: Kidney transplantation, expanded criteria donor, donor management, ICU, brain-deathTurkiye Klinikleri J Nephrol-Special Topics 2008, 1:21-48
|
|
|
|
|
