Global role of kidney transplantation.

Summary: World Kidney Day on March 8, 2012, provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations, which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical, and nursing workforces with the required expertise. These problems have solutions that involve the full range of societal, professional, governmental, and political environments. World Kidney Day is a call to deliver transplantation therapy to the 1 million people a year who have a right to benefit. 在2012年3月8日舉行的世界腎臟日，讓我們再度檢視腎臟移植療法在治療末期腎病上所取得的成果，無論在患者死亡率、生活品質、或成本效益方面，腎臟移植療法均超越了透析療法。然而，基於多方面的原因，腎臟移植療法至今仍然未能全面取代透析療法的地位，例如某些國家基於經濟上的限制，使得腎臟移植的優先順序位列於潔淨水源、環境衛生、及疫苗接種等公衛基本環節之後。即使在較富裕的國家中，手術的技術需求及免疫抑制的後遺症，亦限制了適合接受移植的個案數目；但是腎臟移植普及化的主要限制性因素，仍然是捐贈器官來源的短缺及具經驗醫護人手的不足。為解決這些問題，必須依靠社會、專業團體、政府、及政治力量的共同努力。世界腎臟日提醒了我們，要致力為每年一百萬的合資格患者，提供他們所需的腎臟移植療法。 [Copyright &y& Elsevier]