Priority setting in kidney transplantation: A qualitative study evaluating Swedish practices

Omar, Faisal; Tinghög, Gustav; Carlsson, Per; Omnell-Persson, Marie; Welin, Stellan

doi:10.1177/1403494812470399

Cited by 11 publications

(10 citation statements)

References 17 publications

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“…Kidney transplant is the treatment of choice for endstage renal patients; in other words, it improves both survival and quality of life of patients and is more costeffective compared to dialysis [19,20]. The purpose of this study was to evaluate the status of kidney transplant in patients at Razi Hospital in Rasht between 2009 and 2010.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of the current status of kidney transplant in terms of the type of receipt among Iranian patients

et al. 2020

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Introduction With the increasing prevalence and incidence of chronic renal failure leading to advanced kidney disease (ESRD), the use of renal transplant therapy is increasing globally. The aim of this study was to determine the status of kidney transplant in patients during a period of 4–5 years. Materials and methods In this retrospective, analytical study, patients undergoing renal transplant at one of the hospitals in northern Iran were studied. The data was collected using a checklist assessing the required information, including the age, sex, place of residence, source of the kidney for transplant (living related, living non-related, deceased), kidney receiving method (donated, purchased), and wait time for a kidney transplant. Results A total of 228 patients were included in the study, of which 73.7% were male and 26.3% were female. The average wait time for kidney transplant was 386.22 days. The mean age of patients was 32.7 ± 10.7 years. In addition, living non-related (66.2%) and deceased (14%) were the most and least frequent sources of kidney transplant, respectively. Moreover, 51.8% of all transplanted kidneys were purchased. Conclusion Over the past 5 years, there has been a decrease in wait time for kidney transplant in Rasht, Iran. Factors, such as being female, lower age, and living in urban areas, are related to a shorter wait time for kidney transplant. The most common types of kidney transplant are from non-related donors and purchased.

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Section: Discussionmentioning

confidence: 99%

An evaluation of the current status of kidney transplant in terms of the type of receipt among Iranian patients

et al. 2020

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“…In another study, treatment adherence, life gains quality, and social productivity were substantially preferred for transparent and efficient allocating policy [ 23 ]. Further, patient advocacy, professional integrity, center reputation, social benefits [ 27 , 58 ], enforcement, relevance, appeal [ 43 ], medical background, sociodemographic status [ 59 ], and religious conviction [ 60 ] are the cluster of factors substantial for making an improved allocation system that attracts significant organ donors.…”

Section: Limitations and Future-prospectsmentioning

confidence: 99%

“…Usually, comparing and ranking criteria for allocation eligibility regarding the importance of patients is rarely executed. However, the interviews are often exploratory [ 42 , 43 ]. In this regard, Thamer et al determined the U.S. nephrologists’ recommendations regarding eight unique hypothetical patient scenarios.…”

Section: Introductionmentioning

confidence: 99%

Israeli Medical Experts’ Knowledge, Attitudes, and Preferences in Allocating Donor Organs for Transplantation

Elalouf

2022

IJERPH

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Medical advancement has increased the confidence in successful organ transplants in end-stage patients. As the waitlist of organ demand is multiplying, the organ allocation process is becoming more crucial. In this situation, a transparent and efficient organ allocation policy is required. This study evaluates the preferences of medical experts to substantial factors for allocating organs in different hypothetical scenarios. Twenty-five medical professionals with a significant role in organ allocation were interviewed individually. The interview questionnaire comprised demographic information, organ donation status, important organ allocation factors, public preference knowledge, and experts’ preferences in different hypothetical scenarios. Most medical experts rated the waiting time and prognosis as the most important, while the next of kin donor status and care and contribution to the well-being of others were the least important factors for organ allocation. In expert opinion, medical experts significantly considered public preferences for organ allocation in making their decisions. Altogether, experts prioritized waiting time over successful transplant, age, and donor status in the hypothetical scenarios. In parallel, less chance of finding another organ, donor status, and successful transplant were prioritized over age. Medical experts are the key stakeholders; therefore, their opinions are substantial in formulating an organ allocation policy.

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“…Renal transplantation is the most effective therapy for ESKD. (3) This is achieved by a multidisciplinary team of nephrologists, transplant surgeons, pathologists, nurse coordinators as well as consultation services from urology, vascular surgery, cardiology, infectious diseases and psychiatry. Immunosuppressive therapy is essential, even in patients with ideal tissue matches, in order to prevent allograft rejection.…”

Section: Introductionmentioning

confidence: 99%

“…The donor can be a living related, unrelated living or a cadaveric donor. (3,5) In the late 1950s, 6-mercaptopurine and azathioprine (AZA) were developed. (6) AZA is one of the oldest agents still in use to date.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Cadaveric Renal Transplantation Using Mycophenolate Mofetil or Azathioprine in South Africa

Gathara¹,

Naicker²

2019

Wits Journal of Clinical Medicine

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Introduction: Mycophenolate mofetil (MMF) has, to a great extent, replaced azathioprine (AZA) in immunosuppressive regimens worldwide in the prevention of acute allograft rejection. However, there are no studies in South Africa to show that MMF is superior to AZA. Objectives: To describe the outcomes of cadaveric renal transplantation in patients treated with either MMF or AZA and followed up over a 5-year period. Design: This was a retrospective comparative study. Methods: A convenience sample of all eligible patients, 208 in total, was recruited from the Renal Transplant Unit at the Charlotte Maxeke Johannesburg Academic Hospital from 1985 to 2013, who were treated with either MMF or AZA. Results: Of the 208 patients, 101 patients were treated with AZA and 107 patients treated with MMF, in addition to corticosteroids and cyclosporine. A total of 16 patients developed acute allograft rejection 12-52 weeks after cadaveric transplantation. Of these, 6% were in the AZA group and 10% in the MMF group. There was a 1% mortality in the MMF group and 16.8% in the AZA group (p < 0.001). The serum creatinine at a 3-month follow-up was found to be a strong predictor of allograft function in patients on MMF (p < 0.001). Conclusion: Patient survival was superior in the long term in cadaveric renal transplant patients receiving MMF therapy.

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Priority setting in kidney transplantation: A qualitative study evaluating Swedish practices

Cited by 11 publications

References 17 publications

An evaluation of the current status of kidney transplant in terms of the type of receipt among Iranian patients

An evaluation of the current status of kidney transplant in terms of the type of receipt among Iranian patients

Israeli Medical Experts’ Knowledge, Attitudes, and Preferences in Allocating Donor Organs for Transplantation

Outcomes of Cadaveric Renal Transplantation Using Mycophenolate Mofetil or Azathioprine in South Africa

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