Kidneys Initially Deemed Unfit For Transplant Prove Viable, Study Shows

The first study to track outcomes of transplanted kidneys that were previously deemed unfit for transplant shows a more than 90 percent graft survival rate for these kidneys a year after patients received them.

The study results, presented at the National Kidney Foundation 2018 Spring Clinical Meetings in Austin, highlights how a lack of standardization across transplant centers could be depriving patients of life-saving organs.

Currently 121,000 people are awaiting organ transplants in the United States, but nearly one out of every five organs that becomes available is discarded, said the study's authors, who are based at the University of Texas Medical Branch in Galveston, Texas. Annually, thousands of people suffering from kidney failure die while waiting for a compatible kidney to become available.

The authors call for transplant centers to develop more robust and uniform measures of organ suitability, to systematically guide this critical decision.

"Rethink before you turn down an organ for quality using refusal codes," said Vishy Chaudhary, M.D., lead author of the study and a clinical fellow in nephrology at the University of Texas Medical Branch at Galveston. "The importance of our findings is to educate the transplant community that organs discarded by another center, especially using the code 830, deserve a thorough evaluation as it may still be acceptable for transplantation to a suitable donor. There is a need to redefine codes," he added.

The study tracked 291 kidneys that became available from 172 deceased donors but were at first rejected for transplant between January 2014 and December of 2016. The kidneys were initially refused using code 830, which indicates that the organ was of low quality or the donor's age was too advanced. The organs were subsequently procured by Southwest Transplant Alliance in Dallas and transplanted into patients on the kidney waitlist.

Donors were matched with recipients for age and health. Researchers tracked kidney recipients' post-transplant health indicators, such as median serum creatinine, at discharge and at one year; incidence of delayed graft function; and Kaplan-Meier graft survival rates. Uncensored Kaplan-Meier graft survival at 90 days, 180 days, and 365 days was 95.8 %, 94.6%, and 90.66%, respectively.

The manuscript detailing the findings has been accepted for publication in the American Journal of Kidney Diseases.

NKF Spring Clinical Meetings
For the past 27 years, nephrology healthcare professionals from across the country have come to NKF's Spring Clinical Meetings to learn about the newest developments related to all aspects of nephrology practice; network with colleagues; and present their research findings. The NKF Spring Clinical Meetings are designed for meaningful change in the multidisciplinary healthcare teams' skills, performance, and patient health outcomes. It is the only conference of its kind that focuses on translating science into practice for the entire healthcare team.

Kidney Disease Facts
30 million American adults are estimated to have chronic kidney disease--and most aren't aware of it. 1 in 3 American adults are at risk for chronic kidney disease. Risk factors for kidney disease include diabetes, high blood pressure, heart disease, obesity and family history of kidney failure. People of African American, Hispanic, Native American, Asian or Pacific Islander descent are at increased risk for developing the disease. African Americans are 3 times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop end-stage renal disease (kidney failure).

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