The Japanese Journal of Clinical Dialysis Vol.13 No.12(8-2)

Theme Renal Transplantation under New Organ Sharing System in Japan
Title The indications for kidney donation
Publish Date 1997/11
Author Norio Yoshimura The Second Department of Surgery, Kyoto Prefectural University of Medicine
Author Takahiro Oka The Second Department of Surgery, Kyoto Prefectural University of Medicine
[ Summary ] Kidney donation from a brain dead patient mainly consists of the following 2 processes: 1) evaluation of patients before intracorporeal perfusion, and 2) perfusion and extirpation of the kidneys. During the former process, whether or not the kidneys are suitable for transplantation must be evaluated not. Briefly, after confirming that the donor has no abnormal findings on routine general examination, they should be evaluated according to the following selection criteria: a. age of less than 60 years; b. evident causes of death; and c. renal function tests with in normal limits. Relative ineligibility criteria include a. the presence of persistent diabetes, hypertension or vascular lesions including arteriosclerosis, b. prolonged hypotension prior to cardiacarrest and c. abdominal trauma. Absolute contraindications include a. malignant tumor, b. severe systemic infection, c. refractory urinary tract infection, d. positive hepatitis virus or anti-HIV antibody and e. primary renal diseases. Management of donors before cardiac arrestis based on that of general patients, including maintenance of respiratory, and circulatory function, and infection prevention. In surgical procedures for donor bilateral nephrectomy, close attention should be paid, to injuring the kidneys, renal vessels and ureters.
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