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1.
Transplantation ; 95(11): 1306-12, 2013 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-23644753

RESUMO

By 2005, human organ trafficking, commercialization, and transplant tourism had become a prominent and pervasive influence on transplantation therapy. The most common source of organs was impoverished people in India, Pakistan, Egypt, and the Philippines, deceased organ donors in Colombia, and executed prisoners in China. In response, in May 2008, The Transplantation Society and the International Society of Nephrology developed the Declaration of Istanbul on Organ Trafficking and Transplant Tourism consisting of a preamble, a set of principles, and a series of proposals. Promulgation of the Declaration of Istanbul and the formation of the Declaration of Istanbul Custodian Group to promote and uphold its principles have demonstrated that concerted, strategic, collaborative, and persistent actions by professionals can deliver tangible changes. Over the past 5 years, the Declaration of Istanbul Custodian Group organized and encouraged cooperation among professional bodies and relevant international, regional, and national governmental organizations, which has produced significant progress in combating organ trafficking and transplant tourism around the world. At a fifth anniversary meeting in Qatar in April 2013, the DICG took note of this progress and set forth in a Communiqué a number of specific activities and resolved to further engage groups from many sectors in working toward the Declaration's objectives.


Assuntos
Ética Profissional , Cooperação Internacional , Turismo Médico/ética , Transplante de Órgãos/ética , Obtenção de Tecidos e Órgãos/ética , China , Colômbia , Egito , Humanos , Índia , Turismo Médico/legislação & jurisprudência , Transplante de Órgãos/legislação & jurisprudência , Paquistão , Filipinas , Catar , Sociedades Médicas , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Turquia
2.
Nephrol Dial Transplant ; 28(8): e1-5, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22822091

RESUMO

World Kidney Day on March 8(th) 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end-stage kidney disease include the economic limitations which, in some countries, place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high-income countries, the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Saúde Global , Humanos
3.
Curr Opin Organ Transplant ; 17(4): 362-7, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22790070

RESUMO

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost-effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end-stage kidney disease include the economic limitations that in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high-income countries, the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions that involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Falência Renal Crônica/cirurgia , Análise Custo-Benefício , Saúde Global/economia , Saúde Global/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Falência Renal Crônica/economia , Falência Renal Crônica/epidemiologia , Transplante de Rim/economia , Transplante de Rim/ética , Transplante de Rim/legislação & jurisprudência , Transplante de Rim/estatística & dados numéricos , Saúde Pública/economia , Qualidade de Vida , Diálise Renal/economia
4.
Iran J Kidney Dis ; 6(2): 81-7, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22388602

RESUMO

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end-stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation, and vaccination. Even in high-income countries, the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical, and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental, and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim/estatística & dados numéricos , Saúde Global , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Humanos , Transplante de Rim/ética , Transplante de Rim/legislação & jurisprudência , Resultado do Tratamento
5.
J Bras Nefrol ; 34(1): 1-7, 2012 Mar.
Artigo em Inglês, Português | MEDLINE | ID: mdl-22441175

RESUMO

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Saúde Global , Disparidades em Assistência à Saúde , Humanos , Transplante de Rim/ética
7.
J. bras. nefrol ; 34(1): 1-7, jan.-fev.-mar. 2012. graf
Artigo em Português | LILACS | ID: lil-623348

RESUMO

O Dia Mundial do Rim, em 8 de março de 2012, oferece uma chance para refletir sobre o sucesso do transplante renal como um tratamento para a doença renal em estágio terminal, que supera os tratamentos de diálise tanto pela qualidade quanto pela quantidade de vida, fornecida por estes, e devido ao custo-benefício. Qualquer coisa que seja tanto mais barata quanto melhor, mas que não seja realmente o tratamento dominante, deve ter outras desvantagens que previnam a substituição do tratamento da diálise pelo transplante. As barreiras para o transplante universal como a terapia para a doença renal em estágio terminal incluem as limitações econômicas, as quais, em alguns países, classificam o transplante, adequadamente, com prioridade inferior do que os fundamentos da saúde pública, tais como água limpa, saneamento e vacinação. Até mesmo em países de alta renda, os desafios técnicos da cirurgia e as consequências da imunossupressão restringem o número de receptores apropriados, mas as principais restrições limitadas das taxas de transplante renal são: a escassez de órgãos doados e a limitada mão de obra médica, cirúrgica e de enfermeiros com os conhecimentos necessários. Esses problemas têm soluções que envolvem um conjunto total dos ambientes social, profissional, governamental e político. O Dia Mundial do Rim é uma chamada para fornecer a terapia de transplante a um milhão de pessoas por ano, as quais têm o direito de se beneficiarem.


World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Humanos , Transplante de Rim , Falência Renal Crônica/cirurgia , Saúde Global , Disparidades em Assistência à Saúde , Transplante de Rim
8.
Rev. nefrol. diál. traspl. (En línea) ; 32(1): 51-58, mar. 2012. graf
Artigo em Espanhol | BINACIS | ID: bin-128380

RESUMO

El Día Mundial del Riñón (DMR), el 8 de Marzo de 2012, brinda la oportunidad de mostrar el éxito del trasplante renal como terapéutica de la insuficiencia renal crónica (IRC) terminal, tratamiento que supera al dialítico por la calidad y cantidad de vida que brinda y su menor costo. Tratamiento más económico y mejor, no es actualmente la terapia dominante, lo que sugiere que debe haber otros inconvenientes que evitan que todo el tratamiento dialítico sea reemplazado por el trasplante. Las barreras para el trasplante universal como terapia de la IRC terminal incluyen las limitaciones económicas que, en algunos países, ubican apropiadamente al trasplante renal como una prioridad menor que otras necesidades fundamentales de la salud pública, como son el acceso al agua potable, el saneamiento ambiental y la vacunación masiva. Aún en países con alto ingreso económico, los desafíos técnicos de la cirugía y las consecuencias de la inmunosupresión restringen el número de receptores adecuados, pero las mayores restricciones sobre las tasas de trasplante renal lo constituyen la escasez de órganos donados y la insuficiencia de recursos humanos médicos, quirúrgicos y de enfermería, con entrenamiento y experiencia adecuados. Estos problemas tienen soluciones que involucran un amplio rango de políticas sociales, profesionales, gubernamentales y políticas. El Día Mundial del Riñón es un llamado a brindar el tratamiento de trasplante al millón de personas por año que tienen derecho a ese beneficio.(AU)


Assuntos
Transplante de Rim/ética , Transplante de Rim/história , Transplante de Rim/legislação & jurisprudência , Política de Saúde
9.
Rev. nefrol. diál. traspl ; Rev. nefrol. diál. traspl. (En línea);32(1): 51-58, mar. 2012. graf
Artigo em Espanhol | LILACS | ID: lil-696359

RESUMO

El Día Mundial del Riñón (DMR), el 8 de Marzo de 2012, brinda la oportunidad de mostrar el éxito del trasplante renal como terapéutica de la insuficiencia renal crónica (IRC) terminal, tratamiento que supera al dialítico por la calidad y cantidad de vida que brinda y su menor costo. Tratamiento más económico y mejor, no es actualmente la terapia dominante, lo que sugiere que debe haber otros inconvenientes que evitan que todo el tratamiento dialítico sea reemplazado por el trasplante. Las barreras para el trasplante universal como terapia de la IRC terminal incluyen las limitaciones económicas que, en algunos países, ubican apropiadamente al trasplante renal como una prioridad menor que otras necesidades fundamentales de la salud pública, como son el acceso al agua potable, el saneamiento ambiental y la vacunación masiva. Aún en países con alto ingreso económico, los desafíos técnicos de la cirugía y las consecuencias de la inmunosupresión restringen el número de receptores adecuados, pero las mayores restricciones sobre las tasas de trasplante renal lo constituyen la escasez de órganos donados y la insuficiencia de recursos humanos médicos, quirúrgicos y de enfermería, con entrenamiento y experiencia adecuados. Estos problemas tienen soluciones que involucran un amplio rango de políticas sociales, profesionales, gubernamentales y políticas. El Día Mundial del Riñón es un llamado a brindar el tratamiento de trasplante al millón de personas por año que tienen derecho a ese beneficio.


Assuntos
Transplante de Rim/história , Transplante de Rim/legislação & jurisprudência , Transplante de Rim/ética , Política de Saúde
10.
Arch Iran Med ; 15(2): 102-6, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22292582

RESUMO

World Kidney Day on March 8th, 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Disparidades em Assistência à Saúde , Falência Renal Crônica/economia , Falência Renal Crônica/terapia , Transplante de Rim/economia , Saúde Pública/economia , Aniversários e Eventos Especiais , Análise Custo-Benefício , Países Desenvolvidos/economia , Países em Desenvolvimento/economia , Saúde Global , Humanos , Transplante de Rim/ética , Transplante de Rim/legislação & jurisprudência , Transplante de Rim/estatística & dados numéricos , Diálise Renal/economia , Obtenção de Tecidos e Órgãos
11.
Kidney Blood Press Res ; 35(5): 299-304, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22353691

RESUMO

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Saúde Global/tendências , Falência Renal Crônica/mortalidade , Falência Renal Crônica/cirurgia , Transplante de Rim/tendências , Adulto , Idoso , Feminino , Saúde Global/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Custos de Cuidados de Saúde/tendências , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/tendências , Disparidades em Assistência à Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/tendências , Humanos , Falência Renal Crônica/economia , Transplante de Rim/economia , Transplante de Rim/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Am J Nephrol ; 35(3): 259-64, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22353799

RESUMO

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Países Desenvolvidos , Países em Desenvolvimento , Disparidades em Assistência à Saúde/economia , Falência Renal Crônica/cirurgia , Transplante de Rim/economia , Aniversários e Eventos Especiais , Análise Custo-Benefício , Saúde Global , Humanos , Transplante de Rim/ética , Transplante de Rim/legislação & jurisprudência , Saúde Pública/economia , Qualidade de Vida , Resultado do Tratamento
13.
Nephron Clin Pract ; 120(2): c101-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22353880

RESUMO

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.


Assuntos
Saúde Global , Falência Renal Crônica/mortalidade , Falência Renal Crônica/cirurgia , Transplante de Rim/mortalidade , Transplante de Rim/tendências , Complicações Pós-Operatórias/mortalidade , Comorbidade , Humanos , Prevalência , Resultado do Tratamento
14.
J Nephrol ; 25(1): 1-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22307406

RESUMO

World Kidney Day on March 8, 2012, provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage kidney disease, which surpasses dialysis treatments both for the quality and quantity of life it provides and for its cost effectiveness. Anything that is both cheaper and better but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end-stage kidney disease include the economic limitations, which in some countries, place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high-income countries, the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the 1 million people a year who have a right to benefit from it.


Assuntos
Acessibilidade aos Serviços de Saúde , Falência Renal Crônica/cirurgia , Transplante de Rim , Países em Desenvolvimento , Saúde Global , Disparidades em Assistência à Saúde , Humanos , Transplante de Rim/economia , Transplante de Rim/ética , Obtenção de Tecidos e Órgãos/ética
16.
Am J Kidney Dis ; 59(3): 319-24, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22340905

RESUMO

There remain major challenges to providing optimal treatment for ESRD worldwide and a need, particularly in low-income economies, to mandate more focus on community screening and implementation of simple measures to minimize progression of chronic kidney disease. The recent designation of renal disease as an important noncommunicable disease at the United Nations High Level Meeting on Noncommunicable Diseases is one step in this direction.(32) But early detection and prevention programs will never prevent ESRD in everyone with chronic kidney disease, and kidney transplantation is an essential, viable, cost-effective, and life-saving therapy which should be equally available to all people in need. It may be the only tenable long-term treatment option for ESRD in low-income countries since it is both cheaper and provides a better outcome for patients than other treatment for ESRD. However, the success of transplantation has not been delivered evenly across the world and substantial disparities still exist in access to transplantation.We remain troubled by commercialization of living donor transplantation and exploitation of vulnerable populations for profit. There are solutions available. These include demonstrably successful models of kidney transplant programs in many developing countries; growing availability of less-expensive generic immunosuppressive agents; improved clinical training opportunities; governmental and professional guidelines legislating prohibition of commercialization and defining professional standards of ethical practice; and a framework for each nation to develop self-sufficiency in organ transplantation through focus on both living donation and especially nationally managed deceased organ donation programs. The Transplantation Society and the ISN have pledged to work together in coordinated joint global outreach programs to help establish and grow appropriate kidney transplant programs in low- and middle-income countries utilizing their considerable joint expertise. World Kidney Day 2012 provides a focus to help spread this message to governments, all health authorities and communities across the world.


Assuntos
Saúde Global , Promoção da Saúde , Falência Renal Crônica/cirurgia , Transplante de Rim , Humanos
17.
Transplantation ; 93(4): 337-41, 2012 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-22245880

RESUMO

World Kidney Day on March 8, 2012, provides a chance to reflect on the success of kidney transplantation as a therapy for end-stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost-effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end-stage kidney disease include the economic limitations which in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation, and vaccination. Even in high-income countries, the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical, and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental, and political environments. World Kidney Day is a call to deliver transplantation therapy to the 1 million people a year who have a right to benefit.


Assuntos
Saúde Global , Falência Renal Crônica/cirurgia , Transplante de Rim , Acessibilidade aos Serviços de Saúde , Humanos , Transplante de Rim/economia , Transplante de Rim/ética , Avaliação de Resultados em Cuidados de Saúde , Fatores Socioeconômicos , Organização Mundial da Saúde
18.
J Nephropathol ; 1(2): 69-76, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24475391

RESUMO

World Kidney Day on March 8th 2012 provides a chance to reflect on the success of kidney transplantation as a therapy for end stage kidney disease that surpasses dialysis treatments both for the quality and quantity of life that it provides and for its cost effectiveness. Anything that is both cheaper and better, but is not actually the dominant therapy, must have other drawbacks that prevent replacement of all dialysis treatment by transplantation. The barriers to universal transplantation as the therapy for end stage kidney disease include the economic limitations which, in some countries place transplantation, appropriately, at a lower priority than public health fundamentals such as clean water, sanitation and vaccination. Even in high income countries the technical challenges of surgery and the consequences of immunosuppression restrict the number of suitable recipients, but the major finite restrictions on kidney transplantation rates are the shortage of donated organs and the limited medical, surgical and nursing workforces with the required expertise. These problems have solutions which involve the full range of societal, professional, governmental and political environments. World Kidney Day is a call to deliver transplantation therapy to the one million people a year who have a right to benefit.

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