[When to place a patient on the kidney transplantation waiting list?].
Practices for enrollment on kidney transplantation waiting lists are variable between geographical areas and centers. Early referral of patients with chronic renal failure (CRF) to a nephrologist, particularly one practicing in a transplantation center, is a prerequisite to early enrollment. Despite improved survival in elderly transplant recipients, being aged over 65 years is still a barrier against enrollment. Furthermore certain comorbid conditions such as diabetes mellitus are often wrongly considered as contraindications for transplantation. If nephrological management is initiated early, enrollment could (should?) be considered before the terminal phase of CRF, with the hope of preemptive transplantation with the known advantages not only for the individual recipient but also for the community in general. Glomerular filtration rate below 20 ml/minute could be a reasonable cutoff for enrollment. Patients referred late to a nephrologist will require dialysis. Dialysis center staff should be well trained in delivering appropriate information on kidney transplantation and initiating evaluation. A consultation with a transplantation specialist should be rapidly scheduled.
Kessler
Michèle
M
Service de néphrologie, CHU de Nancy-Brabois, 4, rue du Morvan, 54500 Vandoeuvre-les-Nancy, France. m.kessler@chu-nancy.fr <m.kessler@chu-nancy.fr>
Büchler
Mathias
M
Durand
Dominique
D
Kolko-Labadens
Anne
A
Lefrançois
Gaelle
G
Menoyo
Victorio
V
Mourad
Georges
G
Peraldi
Marie-Noelle
MN
Pouteil-Noble
Claire
C
Yver
Laurent
L
Zins
Brigitte
B
Hourmant
Maryvonne
M
D000075202:Contraindications; D003657:Decision Making; D006801:Humans; D016030:Kidney Transplantation; D018579:Patient Selection; D014850:Waiting Lists