Rule Changes for Donor Organs Could Increase U.S. Kidney Transplants

Greater acceptance of organs from deceased donors who were older and had comorbidities could provide survival benefits among individuals awaiting kidney transplant in the United States, according to a study published online in JAMA Internal Medicine.

Olivier Aubert, M.D., Ph.D., from the Paris Translational Research Center for Organ Transplantation, and colleagues used validated registries of deceased donors with organs offered to kidney transplant centers in the United States and France to examine the effects of more aggressive allograft acceptance practices.

The researchers found that 17.9 percent of 156,089 kidneys were discarded in the United States from 2004 to 2014 compared with 9.1 percent of 29,984 kidneys in France. The mean age of kidneys transplanted was 36.51 and 50.91 years in the United States and France, respectively. Over time, there was little change in kidney quality in the United States (mean kidney donor risk index [KDRI], 1.30 to 1.32), while in France, there was a steady increase in KDRI reflecting more aggressive organ use (mean KDRI, 1.37 to 1.74). Sixty-two percent of kidneys discarded in the United States would have been transplanted with application of the French-based allocation model. During the study period, a system with more aggressive organ acceptance policies would generate 132,445 additional allograft life-years in the United States.

"This study demonstrates that there is more the United States can do to prevent the deaths of thousands of Americans each year who are waiting for a transplant," a coauthor said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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