Offers of Viable Deceased Donor Kidneys Frequently Refused

Transplant candidates receive a large number of offers of viable deceased donor kidneys that are refused on their behalf, according to a study published online in JAMA Network Open.

S. Ali Husain, M.D., M.P.H., from the Columbia University Medical Center in New York City, and colleagues analyzed data for 280,041 adult patients who were wait-listed for a kidney transplant and received at least one allograft offer between Jan. 1, 2008, and Dec. 31, 2015.

The researchers found that 29.2 percent of patients in the cohort received a deceased donor kidney allograft, and 9.3 and 21.2 percent died while on the waiting list and were removed from the waiting list, respectively. During the study period, 10 candidates with at least one previous allograft offer died each day. The time to first offer was similar for candidates who received a deceased donor kidney allograft and for those who died while waiting (median time, 79 versus 78 days). A median of 17 offers over 422 days were received by deceased donor allograft recipients compared with 16 offers over 651 days among candidates who died while waiting. Before being accepted, 84 percent of kidneys were declined on behalf of at least one candidate.

"It's better to get a less-than-perfect kidney sooner than to wait years for the perfect kidney to come along," a coauthor said in a statement. "Better communication between patients and transplant centers may prompt a reconsideration of how and when to decline offers."

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