Many donor kidneys that are discarded may be suitable for transplantation

December 7, 2017

When researchers examined information on pairs of kidneys from the same donor in which 1 kidney was used but the other was discarded, the kidneys that were used tended to perform well even though they were similar in quality to their partner kidneys that were not used. The findings, which come from a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN), provide further evidence that many of the donated kidneys that are discarded are in fact suitable for use.

Research has shown that transplantation results in longer survival, better quality of life, and long-term cost savings compared with dialysis for patient with . Unfortunately, because of a shortage of available kidneys, there is a long waitlist to receive a transplant, and approximately 5000 patients in the Unites States die each year waiting for a kidney transplant. Despite this shortage, almost 1 out of every 5 kidneys that are recovered from possible donors ends up being discarded— a proportion that has risen over the past decade. To understand why these kidneys are not being used, with the goal of improving kidney utilization, reducing wait times, and providing transplants to more patients, a team led by Sumit Mohan, MD, MPH and S. Ali Husain, MD, MPH (Columbia University Medical Center) analyzed information on deceased donors from whom both kidneys were procured but only one was transplanted from 2000-2015

"It is obviously impossible to tell with certainty what would have happened to any discarded kidney if it had been used instead. As a result, it has been difficult to categorize these discards as 'appropriate' or 'inappropriate.' We therefore aimed to identify from whom 1 kidney was used but the partner kidney in the pair was discarded," Dr. Mohan explained." By doing so, we could control for characteristics to better understand the reasons for discard, and whether concerns about using certain kidneys were justified."

After analyzing information on 88,209 donors (176,418 kidneys), the researchers found that although the discarded kidneys in these pairs frequently had traits that are typically considered unappealing, the partner kidneys that shared many, if not all of the same traits performed well after being used for transplantation despite being used in older recipients with more medical problems. "We therefore concluded that many of these discarded kidneys were in fact quite usable, and that systems-level changes are needed to encourage better utilization of this valuable but scarce resource," said Dr. Husain.

In an accompanying editorial, Matthew Kadatz, MD and John Gill, MD, MS (University of British Columbia) noted that the study provides compelling evidence of the need for policy change to ensure that all safely transplantable kidneys are used for transplantation. "The current discard of kidneys would be hard to explain to the families of deceased donors and is a disservice to the thousands of older age and diabetic wait-listed patients who would benefit from transplantation with these higher risk kidneys and who have consented to receive them," they wrote.

Explore further: Biopsy tests may lead to inappropriate discards of donated kidneys

More information: Waste not want less: Compelling evidence of the need for policy change to decrease deceased donor kidney discard in the United States, Clinical Journal of the American Society of Nephrology (2017). DOI: 10.2215/CJN.06550617

Related Stories

Biopsy tests may lead to inappropriate discards of donated kidneys

July 6, 2017
Researchers have found that discarding donated kidneys on the basis of biopsy findings may be inappropriate. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), may ...

Donor organs may be discarded due to 'weekend effect' at hospitals

November 7, 2015
Deceased donor kidneys are increasingly being discarded, and efforts to boost their use for transplantation are needed. A new study indicates that organs are more likely to be discarded on weekends than on weekdays. The findings, ...

Study offers insights on how to decrease the discard rate of donated organs

October 5, 2017
A new study indicates that many donated organs that are discarded might be suitable for transplantation if certain steps are taken to limit damage following donation. The findings appear in an upcoming issue of the Journal ...

Kidneys from diabetic donors may benefit many transplant candidates

May 25, 2017
A new study indicates that receiving donor kidneys from individuals with diabetes may offer a greater survival benefit than remaining on the waitlist for many transplant candidates. The findings, which appear in an upcoming ...

What to do with kidneys from older deceased donors?

March 26, 2015
A new study highlights the best way to use kidneys from older deceased donors, providing the most benefits to patients and addressing the worsening organ shortage. The study's findings, which appear in an upcoming issue of ...

US transplant centers frequently refuse deceased donor kidneys

July 27, 2017
A new study indicates that deceased donor kidneys are typically offered and declined many times before being accepted for transplantation. The study, which appears in an upcoming issue of the Clinical Journal of the American ...

Recommended for you

Lactic acid bacteria can protect against Influenza A virus, study finds

December 13, 2017
Lactic acid bacteria, commonly used as probiotics to improve digestive health, can offer protection against different subtypes of influenza A virus, resulting in reduced weight loss after virus infection and lower amounts ...

Aging impairs innate immune response to flu

December 13, 2017
Aging impairs the immune system's response to the flu virus in multiple ways, weakening resistance in older adults, according to a Yale study. The research reveals why older people are at increased risk of illness and death ...

Lyme bacteria survive 28-day course of antibiotics months after infection

December 13, 2017
Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, today announced results of two papers published in the peer-reviewed journals PLOS ONE and American Journal of Pathology, that seem to support ...

Drug blocks Zika, other mosquito-borne viruses in cell cultures

December 12, 2017
If there was a Mafia crime family of the virus world, it might be flaviviruses.

Study seeks to aid diagnosis, management of catatonia

December 11, 2017
Catatonia, a syndrome of motor, emotional and behavioral abnormalities frequently characterized by muscular rigidity and a trance-like mental stupor and at times manifesting with great excitement or agitation, can occur during ...

New compound stops progressive kidney disease in its tracks

December 7, 2017
Progressive kidney diseases, whether caused by obesity, hypertension, diabetes, or rare genetic mutations, often have the same outcome: The cells responsible for filtering the blood are destroyed. Reporting today in Science, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.