Utilization of a living related donor instead of a cadaver donor is no longer an advantage in renal transplantation because:
- Public recognition of transplantation as a successful therapy has facilitated obtaining family permission for recovery of transplantable organs. Thus, because sufficient kidneys are available from “brain-dead” accident victims, there is no need to use rel
- Cyclosporine therapy after cadaveric renal transplants has improved their outcome, which is now comparable to related-donor transplants
- Modern preservation techniques can maintain viability of kidneys from cadaver donors for many hours, consistently allowing their early function to be as good as that of kidneys from living donors.
- None of the above.
Medicine
D. None of the above.
DISCUSSION: It is generally accepted that transplantation is a useful therapy; however, the number of recipients continues to greatly exceed the number of suitable cadaver donors whose families grant permission for organ recovery. Thus, availability of a living donor may shorten the waiting period for a transplant by several years. Cyclosporine has improved the short-term results of cadaveric transplantation, but the attrition of these grafts is greater than that for living-donor transplants, especially those with close histocompatibility. The predicted 10-year survival of grafts from HLA-identical siblings is 80%, whereas for cadaver grafts it is only 40%. Although preservation techniques can maintain viability of kidneys for 36 to 48 hours, cadaver kidneys suffer a much higher rate of posttransplant acute tubular necrosis than those from related donors. Acute tubular necrosis has been shown to have a definite detrimental effect on long-term graft survival.
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