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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Kidney Transplant II: Surgical Procedure01:26

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
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Liver transplantation in Spain.

Gloria de la Rosa1, Constantino Fondevila2, Miquel Navasa2

  • 1Spanish National Transplant Organization, Barcelona, Spain.

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
|May 21, 2016
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Summary

Spain has performed over 23,700 liver transplants (LT) since 1984, with over 1000 annually. Efforts focus on improving extended criteria donor livers, especially from donation after circulatory death (DCD), using advanced preservation techniques.

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Area of Science:

  • Hepatology
  • Transplant Surgery
  • Public Health Policy

Background:

  • Liver transplantation (LT) in Spain began in 1984, with over 23,700 procedures performed to date.
  • The Spanish National Transplant Organization (ONT) centralizes organ procurement, allocation, and waiting list management.
  • Transplant center authorization and regulation are governed by national and regional laws, including Real Decreto 1723/2012.

Purpose of the Study:

  • To provide an overview of liver transplantation activity in Spain.
  • To detail the regulatory framework and operational structure of LT in the country.
  • To highlight current challenges and future directions in expanding the donor pool.

Main Methods:

  • Analysis of national LT statistics and regulatory documents.
  • Description of the centralized organ allocation system managed by the ONT.
  • Review of common and uncommon indications for LT and emerging strategies for donor organ utilization.

Main Results:

  • Spain performs over 1000 LTs annually across 24 adult and 5 pediatric centers.
  • The primary indications for LT are non-biliary cirrhosis (60%) and hepatocellular carcinoma (19%).
  • Ongoing initiatives focus on enhancing the use of extended criteria donor livers, particularly from DCD donors, through improved preservation techniques like machine perfusion.

Conclusions:

  • Spain has a robust and well-regulated liver transplantation program with high annual activity.
  • Addressing the donor organ shortage requires optimizing the use of extended criteria donors and implementing advanced preservation technologies.
  • The focus on DCD donors and innovative perfusion techniques represents a significant opportunity to expand the donor pool and improve LT access.