ABSTRACT
ABSTRACT Introduction: In some countries, organ donation is not widespread enough due to medical, cultural, ethical and socioeconomic factors. Living-donor kidney transplant constitutes the main source of kidney donation. Aim: To evaluate the causes of cancellation of living-donor kidney transplant and improve the effectiveness of transplant programs. Methods: Medical records of possible donors and recipients who were evaluated for living-donor kidney transplant at a tertiary medical center between November 2010 and September 2019 were reviewed retrospectively. Results: Evaluations were performed on 364 potential donors and 338 living-donor kidney transplant recipients; 207 of the latter (61.24%) underwent living-donor kidney transplant. Immune disorders represented the majority of cancellations (38.84%). Fifty-six donors (15.38%) were rejected mainly due to renal disorders (39%). Conclusion: Timely referral of patients to transplant centers must be guaranteed in order to overcome immune problems. Transplant centers should invest in programs adequate both for their resources and for their patients: paired kidney exchange, desensitization protocols, future research, etc.
RESUMEN Introducción: En algunos países la donación de órganos no es suficiente debido a factores médicos, culturales, éticos y socioeconómicos. El donante vivo de riñón constituye la principal fuente de donación de riñones. Objetivo: Evaluar las causas de cancelación de los donantes vivos de riñón y mejorar la eficacia de los programas de trasplante. Material y métodos: Se evaluaron retrospectivamente los registros médicos de posibles donantes y receptores para trasplante de riñón con donante vivo en un centro terciario, entre noviembre de 2010 y septiembre de 2019. Resultados: Se evaluaron 364 donantes potenciales y 338 receptores de trasplante de riñón con donante vivo; 207 receptores (61,24%) se sometieron a trasplante de riñón con donante vivo. Los problemas inmunológicos ocasionaron la mayoría de las cancelaciones (38,84%). A cincuenta y seis donantes (15,38%) se les negó la donación, principalmente debido a problemas renales (39%). Conclusión: La derivación oportuna de los pacientes a los centros de trasplante debe garantizarse para superar las barreras inmunológicas. Los centros de trasplante deberían invertir en programas adecuados, tanto por sus recursos como por los pacientes: protocolos de desensibilización, trasplante renal cruzado, investigación futura, etc.
ABSTRACT
Hepatitis B virus (HBV) infection is a significant health problem around the world and may cause serious morbidity and mortality. The most common transmission routes are parenteral, sexual, perinatal and horizontal way. Identification of the risk factors for viral hepatitis transmission is the main rule to reduce the spread of this infection. The aim of this study was to review the possible occupational risk factors for nanparenteral transmission of Hepatitis B virus for health care workers, especially for otorhinolaryngologists. The Medline / PubMed, Google Scholar, and Cochrane databases were searched by using different combinations of MeSH terms for HBV, transmission routes, and risk factors. The results were collected from articles published between January 2000 and July 2015. There were no language restriction during searching the data, whether the abstracts of the studies contain sufficient data were analysed. All searchable relevant data was evaluated and reviewed. The presence of viral particles, including HBsAg and / or HBV DNA in body secretions such as saliva, tears and cerumen may suggest the possibility of horizontal transmission of HBV infection. Therefore, the healthcare workers, particularly otorhinolaryngologists, ophthalmologists or other surgeons, audiologists, dentists, pulmonologists, intensive care specialists and nurses should pay special attention while applying the standard infection control precautions in order to prevent HBV infection in themselves and their patients.