The Jordanian Kidney Transplant Experience: A Glorious Past and a Challenging Present

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Abstract

Jordan was one of the first Arab countries to enact legislation governing organ donation and transplantation. Jordan has seen an increase in the frequency of kidney transplants performed utilizing organs from living donors since that time. Jordan has been a reputable regional center for kidney transplantation and has a long history of excellence in the field. Jordan's low rate of kidney transplants from deceased donors, Despite the legality of the Jordanian constitution, the availability of highly skilled nephrologists and transplant surgeons as well as advanced health care is quite alarming and could be caused by a number of different factors. The absence of a formal government plan to control brain death donation is the most important factor. The goals of this study are to provide a description of the current state of kidney transplantation in Jordan, a summary of the most significant barriers to expanding kidney transplantation efforts that focus on kidneys donated by deceased donors, and suggestions for increasing the number of kidney transplants from brain dead donors.

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Most cited references 18

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Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant.

Robert A. Wolfe, Valarie B. Ashby, Edgar L. Milford … (1999)

The extent to which renal allotransplantation - as compared with long-term dialysis - improves survival among patients with end-stage renal disease is controversial, because those selected for transplantation may have a lower base-line risk of death. In an attempt to distinguish the effects of patient selection from those of transplantation itself, we conducted a longitudinal study of mortality in 228,552 patients who were receiving long-term dialysis for end-stage renal disease. Of these patients, 46,164 were placed on a waiting list for transplantation, 23,275 of whom received a first cadaveric transplant between 1991 and 1997. The relative risk of death and survival were assessed with time-dependent nonproportional-hazards analysis, with adjustment for age, race, sex, cause of end-stage renal disease, geographic region, time from first treatment for end-stage renal disease to placement on the waiting list, and year of initial placement on the list. Among the various subgroups, the standardized mortality ratio for the patients on dialysis who were awaiting transplantation (annual death rate, 6.3 per 100 patient-years) was 38 to 58 percent lower than that for all patients on dialysis (annual death rate, 16.1 per 100 patient-years). The relative risk of death during the first 2 weeks after transplantation was 2.8 times as high as that for patients on dialysis who had equal lengths of follow-up since placement on the waiting list, but at 18 months the risk was much lower (relative risk, 0.32; 95 percent confidence interval, 0.30 to 0.35; P<0.001). The likelihood of survival became equal in the two groups within 5 to 673 days after transplantation in all the subgroups of patients we examined. The long-term mortality rate was 48 to 82 percent lower among transplant recipients (annual death rate, 3.8 per 100 patient-years) than patients on the waiting list, with relatively larger benefits among patients who were 20 to 39 years old, white patients, and younger patients with diabetes. Among patients with end-stage renal disease, healthier patients are placed on the waiting list for transplantation, and long-term survival is better among those on the waiting list who eventually undergo transplantation.

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Systematic review: kidney transplantation compared with dialysis in clinically relevant outcomes.

M. Tonelli, N. Wiebe, G. Knoll … (2011)

Individual studies indicate that kidney transplantation is associated with lower mortality and improved quality of life compared with chronic dialysis treatment. We did a systematic review to summarize the benefits of transplantation, aiming to identify characteristics associated with especially large or small relative benefit. Results were not pooled because of expected diversity inherent to observational studies. Risk of bias was assessed using the Downs and Black checklist and items related to time-to-event analysis techniques. MEDLINE and EMBASE were searched up to February 2010. Cohort studies comparing adult chronic dialysis patients with kidney transplantation recipients for clinical outcomes were selected. We identified 110 eligible studies with a total of 1 922 300 participants. Most studies found significantly lower mortality associated with transplantation, and the relative magnitude of the benefit seemed to increase over time (p < 0.001). Most studies also found that the risk of cardiovascular events was significantly reduced among transplant recipients. Quality of life was significantly and substantially better among transplant recipients. Despite increases in the age and comorbidity of contemporary transplant recipients, the relative benefits of transplantation seem to be increasing over time. These findings validate current attempts to increase the number of people worldwide that benefit from kidney transplantation. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

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An economic assessment of contemporary kidney transplant practice

David A Axelrod, Mark Schnitzler, Huiling Xiao … (2018)

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Author and article information

Contributors

Firas Alabidi: (View ORCID Profile)

Journal

Title: JAP Academy Journal

Abbreviated Title: JAPAJ

Publisher: Jordanian American Physician Academy

ISSN (Electronic): 2836-3620

Publication date Created: October 12 2023

Publication date (Electronic): October 12 2023

Volume: 1

Issue: 3

Article

DOI: 10.58877/japaj.v1i3.82

SO-VID: c1591171-32ed-4dba-8053-48b579de364c

License:

https://creativecommons.org/licenses/by/4.0

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