[Preventive renal transplantation: considerations and future plans].
A kidney transplant before the start of dialysis or after only a short period of dialysis is acknowledged as the best therapeutic option for the uremic patient. However, the number of patients in Italy waiting for a kidney is stable (around 6,400 at the latest report) and the annual number of transplants is not increasing (a slight decrease is forecast for 2007). Opening the deceased-donor waiting list to patients who are not yet on dialysis remains a matter of debate and has been possible only in Tuscany thanks to the high rate of kidney procurement in this region. As far as the Piedmont region is concerned, the balance between performed transplants and new candidates for transplantation is stable, with a mean waiting time of nearly 2 years. Taking into account also the current decline in donations, the possibility of placing pre-dialytic patients on the waiting list requires further evaluation. Nevertheless, some strategies may be within reach. Above all, the use of kidneys from living donors, which represents the ideal condition for preventive transplantation, should be extended. For patients lacking a suitable living donor, a program of earlier admission to waiting lists should be activated.
Segoloni
G P
GP
SCDU Nefrologia Dialisi e Trapianto, ASO S. Giovanni Battista, S. Giovanni di Torino, Turin, Italy. giusepppe.segoloni@unito.it
D006801:Humans; D007558:Italy; D016030:Kidney Transplantation / Q000379:methods / Q000639:trends; D019520:Living Donors; D008485:Medical Audit; D006435:Renal Dialysis; D009927:Tissue and Organ Procurement / Q000639:trends; D014511:Uremia / Q000601:surgery; D014850:Waiting Lists