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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.
RESUMO
PURPOSE: Active bleeding due to abdominal trauma is an important cause of mortality in childhood. The aim of this study is to demonstrate the advantages of early percutaneous transcatheter arterial embolization (PTAE) procedures in children with intra-abdominal hemorrhage due to blunt trauma. METHODS: Children with blunt abdominal trauma were retrospectively included. Two groups were identified for inclusion: patients with early embolization (EE group, n=10) and patients with late embolization (LE group, n=11). Both groups were investigated retrospectively and statistically analyzed with regard to lengths of stay in the intensive care unit and in the hospital, first enteral feeding after trauma, blood transfusion requirements, and cost. RESULTS: The duration of stay in the intensive care unit was greater in the LE group than in the EE group (4 days vs. 2 days, respectively). The duration of hospital stay was greater in the LE group than in the EE group (14 days vs. 6 days, respectively). Blood transfusion requirements (15 cc/kg of RBC packs) were greater in the LE group than in the EE group (3 vs. 1, respectively). The total hospital cost was higher in the LE group than in the EE group (4502 USD vs. 1371.5 USD, respectively). The time before starting enteral feeding after first admission was higher in the LE group than in the EE group (4 days vs. 1 day, respectively). CONCLUSION: Early embolization with PTAE results in shorter intensive care and hospitalization stays, earlier enteral feeding, and lower hospital costs for pediatric patients with intra-abdominal hemorrhage due to blunt trauma.