Case Report

Allocation of deceased donor

kidneys:
A review of international practices
-Lee, D., Kanellis, J., & Mulley, W. R. (2019). Nephrology, 24(6), 591-
598

指導老師 - VS 老師
報告人 - Clerk 陳威任
20xx-xx-xx
Patient profile
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
Chief complaint
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
Present illness
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
 Lab data
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
Image findings
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
Clinical course
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
Physical examination
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
 Diagnostic test
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
 Final diagnosis
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
 Further plan
 Deceased donor kidneys is a scarce source
 Examine the equity and utility in allocation systems
 Review of systems

 One of the lowest deceased donor rate throughout

the world
 Longevity matching is unlikely to achieve significant
changes due to its low rate
 Traditional culture may lead to the consequence

 Preferentially allocated to donor’s first-degree

relatives
 Impression

 One of the lowest deceased donor rate throughout

the world
 Longevity matching is unlikely to achieve significant
changes due to its low rate
 Traditional culture may lead to the consequence

 Preferentially allocated to donor’s first-degree

relatives
 General Approach: ROS, CMP, CBC/DC, ESR/CRP, C3/C4, Urine analysis

Neuro: seiures, hallucinations, HA, Gen: fever, wt loss, night

weakness. Sensory neuropathy, sweat, anorexia, fatigue
monomeuritis multiplex

HEENT: dry eye/mouth,

uveitis/episcleritis, scleritis, CV/Pulm: dyspnea, chest pain,
oral nasal ulcer, sinus disease, hemoptysis, URI, asthma
Jaw claudication, LAD

GU: hematuria, dysuria,

GI: dysphagia, IBD, recent urethritis
diarrhea, GI bleed

Skin: rashes,
petechiae/purpura, Heme: h/o DVT/PE, spontaneous abortion
photosensitivity, alopecia,
nodule, thick/tight skin,
Raynaud’s, psoriasis, nail
lesion, tophi
MSK: arthriagia, joint pain/
swelling, AM stiffness, back or
heel pain, tendinopathy,
enthisitis, dactylitis
General Approach: ROS, CMP, CBC/DC, ESR/CRP, C3/C4, Urine analysis

01 Slight change is enough. Watch out for trend.

02 Acute phase reactant

03 Complement level

04 UA: AIN, GN, renal infarct

 General Approach: ROS, CMP, CBC/DC, ESR/CRP, C3/C4, Urine analysis

Inflammatory arthritis Connective Tissue Disease

• RA • SLE/ DIL 01 ANA titer
• SpA • LSSc
• AS, Reactive, • DSSc
PsA, IBD • SjS
• Crystalline • MCTD
• Myositis: DM/ PM 02 ANA pattern and sub-serology
Cardinal
• MSK Diagnostics
• ANA
Diagnostics • Sub-serology
• RF • Myositis panel 03 Myositis
• Anti-CCP
• HLA-B27 (AS)
Connective Tissue Disease
• SLE/ DIL
01 ANA titer
• LSSc
• DSSc Titer Normal
• SjS
• MCTD 1/80 10%
• Myositis: DM/ PM
1/160 5%
Diagnostics
• ANA 1/320 2%
• Sub-serology
• Myositis panel
Thanks for your listening!!