Everyone with kidney failure deserves a transplanted kidney that works well. But because children with the disease have the greatest long-term potential for a healthy future, in 2005 the United Network for Organ Sharing instituted a policy, Share 35, to preferentially offer kidneys from younger (

What effects have Share 35 had on kidney transplantation? For example, in the past, black and Hispanic children with kidney failure experienced reduced access to transplantation compared with white children. Has Share 35 had an impact on these racial disparities? Also, has Share 35 inadvertently promoted deceased organ donation over living donation for children in need of a kidney transplant?

To answer these and other questions, Sandra Amaral, MD (The Children's Hospital of Philadelphia) and her colleagues analyzed data from the US Renal Data System before and after Share 35. These data applied to 2,299 pediatric kidney failure patients who received a transplant before Share 35 and 2,467 patients who received one after.

Among the major findings:

• On average, patients were 46% more likely to receive a deceased-donor kidney transplant after Share 35 was implemented, with increases of 81% for Hispanics, 45% for blacks, and 37% for whites.
• Patients received a deceased-donor kidney transplant earlier after Share 35: 201 days earlier for Hispanics, 90 days earlier for blacks, and 63 days earlier for whites.
• All races experienced a shift from living- to deceased-donor sources after Share 35, with a 48% reduction in living donors for Hispanics, a 46% reduction for blacks, and a 25% reduction for whites.

"Reduced racial disparities in access to deceased donor kidney transplant for children with end-stage kidney disease is a very positive step toward achieving equity in overall transplant access for all children; however, greater declines in living donors for all pediatric patients, particularly for those of black or Hispanic ethnicity, may be a concern," said Dr. Amaral. "Less access to living donors for children with end-stage kidney disease may mean that these patients have less access to the best quality kidneys and less potential for the best graft survival," she explained. More studies are needed to understand how these changes will impact racial differences in the long-term health of transplanted kidneys.

More information: The article, entitled "Racial Disparities in Access to Pediatric Kidney Transplantation Since Share 35," will appear online on April 26, 2012, doi: 10.1681/ASN.2011121145

Provided by American Society of Nephrology (news : web)

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Regional News of Thursday, 26 April 2012

Source:GNA

Mr Mohammed Alhassan, Deputy Inspector General of Police, has said providing quality health care in the contemporary era required the collective effort of all stakeholders in the sector.

He said there was the need for deeper support and collaboration between the private sector and public institutions including the police service to bring about quality and affordable healthcare delivery to people in the country.

Mr Alhassan said this when inaugurating a Dialysis Centre at the Police Hospital, adding that, the creation of the centre was as a result of a private-public endeavour between the Police Hospital and Health-On-Wheels.

Health-On-Wheels is an NGO based in the United States of America that specialises in health education on diabetes, hypertension, HIV and AIDS and Family Planning to some communities in Africa, including the management of renal failure.

He said over the years, the Police Administration had embarked on various policy interventions aimed at improving the infrastructural and service delivery capacity and scope of the Police Hospital.

“As law enforcement agencies, we believe that a sound health support service is critical to a sound mind and improved professional service delivery, that meets the growing expectation of our people and community,” he added.

Mr Alhassan said the centre though located in the Police Hospital, was open to the general public and that other organisations and well meaning people in the country should emulate the gesture of Health-On-Wheels, to improve healthcare delivery in the country.

He appealed to the Medical Director and Staff of the hospital to exhibit the highest sense of care and maintenance for the centre so that the dreams of those who contributed their resources to the accomplishment of the facility would remain relevant at all times.

Brigadier General Dr J. H. Wadhwani, Acting Medical Director of Police Hospital, said the centre being the second in the southern sector of the country was to help alleviate the plight of people with failing renal function or renal failure.

He said the centre was established at a time when renal failure from various causes appeared to be on the increase in the country, saying the collaboration would help improve the capacity of the hospital as a health provider to be able to deliver quality service to those who would patronise it and help reduce the queue and pressure on the Korle-Bu Teaching Hospital Renal Centre.

He said the NGO’s choice of the Police Hospital in this project was based on the unique and strategic role of the hospital in promoting good healthcare and the disciplined professional staff who always seek to deliver efficient healthcare services to the people of Ghana.

Brigadier General Dr Wadhwani said the centre would go a long way to awaken Police-Private partnership concepts in meeting health and other security needs of Ghanaians in the country and pave way for other well meaning individuals and corporate organisations to extend a helping hand to the hospital to acquire modern diagnostic and curative equipments.

Dr Samuel Anim-Addo, Chief Executive Officer of Health-On-Wheels, said hospitals needed to be turned into modern centres that would provide quality and affordable renal care to people with renal failure.

He said renal failure had become a household discussion in recent times, and most people were dying due to unaffordable and inaccessible health care.

Dr Anim-Addo urged government to support people with renal failure by giving them assistance to subsidise the pressure they endured.**

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Renal disease better treated with intensive kidney dialysis

Wednesday 25th April 2012

A series of intensive kidney dialysis at home could improve survival rates for patients suffering from end-stage renal disease.

The condition, also referred to as chronic kidney disease, is normally treated by those in hospital doctor jobs where the patient has to visit a clinic at a set time and date for dialysis to help combat the disease. However, a team of researchers at the Lawson Health Research Institute believe that having an intensive course of treatment within the home can significantly improve a patient's a survival rates compared to the more conventional method.

During a series of studies Dr Gihad Nesrallah, the lead author of the report, conducted tests both at home and at clinics. It was found that those who had the more intensive range of dialysis at home showed better signs of recovery, improved blood pressure results and biomedical test values than those who had undergone the more conventional treatment.

Dr Nesrallah said: "Strategies to improve survival for persons with end-stage renal disease are needed, and more intensive dialysis represents one of the more promising options that had emerged in the last two decades. We think that patients may wish to seriously consider intensive hemodialysis where possible."

Chronic kidney disease is relatively common in the UK with the NHS stating that one in five men and one in four women aged between 65 and 74 have some form of the condition. As it worsens the need for dialysis is imperative and the normal clinical procedures are what many patients experience.

While the conventional method is conducted in less than five hours, over three days, the intensive home care procedure, championed by the Lawson research team will mean that sufferers are subject to eight hours of treatment three to seven nights a week and the team concluded that patients will stand a better chance of surviving via this treatment.

by Mathew Horton

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