| 1. |
- Biró, Péter, et al.
(författare)
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Building Kindey Exchange Programmes in Europe - An Overview of Exchange Practice and Activities
- 2019
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Ingår i: Transplantation. - 1534-6080. ; 103:7, s. 1514-1522
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Tidskriftsartikel (refereegranskat)abstract
- Bakgrund: Considerable differences exist among the living donor Kidney Exchange Programmes (KEPs) that are in use and being built in Europe, contributing to a variation in the number of living donor transplants [6]. Efforts of European KEPs to exchange (best) practices and share approaches to address challenges have, however, been limited.Methods: Experts from 23 European countries, collaborating on the ENCKEP COST Action, developed a questionnaire to collect detailed information on the functioning of all existing KEPs in Europe, as well as their opportunities and challenges. Following a comparative analysis, results were synthesised and interpreted by the same experts.Results: The practices, opportunities and challenges reported by 17 European countries reveal that some of the 10 operating programmes are mature, while others are in earlier stages of development. Over 1300 transplants were performed through existing KEPs up to the end of 2016, providing approximately 8% of their countries’ living kidney donations in 2015. All countries report challenges to either initiating KEPs or increasing volumes. Some challenges are shared, whilst others differ because of differences in context (eg, country size, effectiveness of deceased donor programme) and ethical and legal considerations (eg, regarding living donation as such, nonrelated donors, and altruistic donation). Transnational initiatives have started in Central Europe, Scandinavia, and Southern Europe.Conclusions: Exchange of best practices and shared advancement of national programmes to address existing challenges, aided by transnational exchanges, may substantially improve access to the most (cost) effective treatment for the increasing number of patients suffering from kidney disease.
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| 2. |
- Biró, Péter, et al.
(författare)
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Modelling and optimisation in European Kidney Exchange Programmes
- 2021
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Ingår i: European Journal of Operational Research. - : Elsevier BV. - 0377-2217. ; 291:2, s. 447-456
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Tidskriftsartikel (refereegranskat)abstract
- The complex multi-criteria optimisation problems arising in Kidney Exchange Programmes have received considerable attention both in practice and in the scientific literature. Whereas theoretical advancements are well reviewed and synthesised, this is not the case for practice. We present a synthesis of models and methods applied in present European Kidney Exchange Programmes, which is based on detailed descriptions we created for this purpose. Most descriptions address national programmes, yet we also present findings on emerging cross-national programmes. The synthesis provides a systematic and detailed description of the models and methods the programmes use, revealing important commonalities as well as considerable variation among them. Rather than distilling a single best practice from these results, we find that the variation in models and methods arises because of variation in country characteristics, policies, and ethics. The synthesised state of the art may benefit future national and cross-national initiatives and direct future theoretical contributions within and across the boundaries of the Operations Research discipline.
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| 3. |
- Shaw, David, et al.
(författare)
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When is directed deceased donation justified? Practical, ethical, and legal issues
- 2024
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Ingår i: JOURNAL OF THE INTENSIVE CARE SOCIETY. - 1751-1437. ; 25:3
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores whether directed deceased organ donation should be permitted, and if so under which conditions. While organ donation and allocation systems must be fair and transparent, might it be "one thought too many" to prevent directed donation within families? We proceed by providing a description of the medical and legal context, followed by identification of the main ethical issues involved in directed donation, and then explore these through a series of hypothetical cases similar to those encountered in practice. Ultimately, we set certain conditions under which directed deceased donation may be ethically acceptable. We restrict our discussion to the allocation of organs to recipients already on the waiting list.
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