Gender disparities in kidney replacement therapies and transplantation in Colombia.

BACKGROUND: In chronic kidney disease (CKD), there are historical inequities in multiple stages of the pathway for organ transplantation. Women have been recognized as disadvantaged within this process even after several efforts. Therefore, we aimed to analyze the prevalence and incidence of CKD by gender and their access to Kidney replacement therapy (KRT) in Colombia. METHODS: A cross-sectional study based on secondary analysis of national information on CKD, hypertension, diabetes, waiting list, deceased, and living donor transplantation between 2015 and 2020. RESULTS: In Colombia, 4.934.914 patients were diagnosed with hypertension, diabetes, or CKD. 60,64% were female, with a mean age of 63.84 years (SD 14,36). Crude incidence for hypertension (10.85 vs. 7.21 /1000 inhabitants), diabetes mellitus (3.77 vs. 2.98 /1000 inhabitants), and CKD (4 vs. 2 /1000 inhabitants) was higher for females. Crude incidence for KRT was 86.45 cases /100.0000 inhabitants. In 2020, 2978 patients were on the waiting list, 44% female. There were 251 deaths on the waiting list, 38% female. This year, 517 kidney transplants were performed, and only 40% were female. CONCLUSION: In Colombia, there are proportionally more females with CKD and precursor comorbidities. Nevertheless, there are fewer females on the waiting list and transplanted annually.

Transplantation in the Context of Migration and Refugees: A Summary of the DICG and TTS Ethics Committee Workshop, Buenos Aires, Argentina, September 2022.

Global conflicts and humanitarian crises have resulted in an unprecedented number of refugees and migrants. This challenges the limited resources of health care systems and jeopardizes the availability of transplant care for these deserving migrants and refugees. This was the basis for a workshop held during the Congress of the Transplantation Society (Buenos Aires, 2022). We elaborate on the proceedings of the workshop entitled "Transplantation in the Context of Migration and Refugees," organized by the Ethics Committee of The Transplantation Society and Declaration of Istanbul Custodian Group. Transplant providers from around the world shared strategies of how each region has responded to providing access to care for refugees and migrants in need of transplant services. The potential exploitation of this vulnerable group leading to illicit organ removal was addressed for each region. The Transplantation Society, Declaration of Istanbul Custodian Group, and global transplant community should continue to focus on the status of refugees and migrants and collaborate on strategies to provide access to transplant care for this deserving population. Global cooperation will be essential to provide vigilant oversight to prevent exploitation of this vulnerable population.

Recomendaciones de la Academia Nacional de Medicina de Colombia para enfrentar los conflictos éticos secundarios a la crisis de COVID-19 en el inicio y mantenimiento de medidas de soporte vital avanzado / Recommendations of the National Academy of Medicine of Colombia to face the ethical conflicts secondary to the COVID-19 crisis in the initiation and maintenance of advanced life support measures

La profesión médica, fiel a su compromiso de buscar el beneficio de los pacientes y lograr los mejores resultados posibles en el proceso de atención, respetando sus derechos y voluntad, se enfrenta al reto de la pandemia de COVID-19 y la consecuente situación de emergencia sanitaria, la cual conlleva un estado de excepcionalidad que modifica de manera fundamental algunos elementos tradicionales de la práctica médica.

Trasplante simultaneo de rinon y pancreas en la Clinica San Pedro Claver del ISS / Simultaneous kidney and pancreas transplantation in Clinica San Pedro Claver del ISS

Se informa sobre los tres primeros casos de trasplante simultaneo de rinon-pancreas en la Clinica San Pedro Claver del ISS. Se presentan los criterios de seleccion de los pacientes y se discuten la valoracion pretrasplante del receptor, la tecnica quirurgica utilizada, las soluciones con las que se preservaron los organos, las complicaciones que se presentaron y los resultados obtenidos en cuanto a sobrevida del injerto y del paciente. Se concluye que el trasplante simultaneo de rinon-pancreas controla efectivamente los niveles de glicemia en los diabeticos insulinodependientes y que este procedimiento es una alternativa eficaz en el tratamiento de la diabetes mellitus tipo I con nefropatia a pesar de que aun es prematuro evaluar la evolucion de los danos previos al trasplante producidos por esta grave entidad nosologica

Trasplante renal en la Clinica San Pedro Claver / Renal transplantation in Clinica San Pedro Claver

Se presenta la experiencia de los primeros 40 trasplantes renales de la Clinica San Pedro Claver, que junto con otros 14 pacientes trasplantados en otros centros, han seguido siendo controlados por el mismo grupo de trabajo. Se muestran las principales pautas del protocolo de tratamiento de los pacientes y se analizan los resultados obtenidos desde el punto de vista de rechazo, necrosis tubular aguda, complicaciones y sobrevida del injerto y de los pacientes