Spring Break
JHU surgeons expand kidney donor list
Issue date: 9/13/07
- Page 1 of 1
The number of people on the kidney transplant list has grown by 260 percent over the past 10 years, but the number of kidneys available for transplant has not grown in response to demand. A new study by researchers from the Hopkins School of Medicine demonstrates that kidneys from a donor pool currently considered substandard may be more viable for transplant than previously believed.
Renal failure can be caused by a number of different conditions, but is most often the result of diabetes or high blood pressure, both common illnesses in the United States. Kidney transplants are one of two treatments for renal failure, along with dialysis. In many cases a successful kidney transplant can almost completely reverse the original disease. The hard part is finding a suitable organ match.
Kidneys for transplant can come from either living or deceased donors. Kidneys from living donors are preferred, because the kidney is outside a living person for as short a time as possible. A healthy person should be able to function with only one kidney.
Kidneys can also be donated from deceased individuals. The preferred kidneys from deceased donors are those donated after brain death, which is called DBD. Another group of kidney donors are individuals who die of cardiac or pulmonary failure (DCD). Kidneys donated after cardiac deaths are regarded as "marginal" because the kidney once transplanted might take longer to function properly. It has generally been accepted that DCD kidneys have a higher rate of failure compared to DBD kidneys.
Given the increasing demand for kidneys, the authors of the study challenged conventional wisdom by analyzing kidney transplant data to determine whether DCD kidneys could safely be added to the donor pool. The researchers are in the Department of Surgery at the Johns Hopkins School of Medicine and Johns Hopkins Hospital.
The researchers collected and performed statistical analyses on data about kidney transplants from a national registry. Over 78,000 records of DBD and DCD transplants performed between 1993 and 2005 were included in the analysis. The results were published in the July 2007 issue of the American Journal of Transplantation.
The researchers' analysis found that long-term survival rates for patients with DCD kidneys from donors under 50 were the same as DBD donors who had been healthy individuals between the ages of 18 and 60 before brain death. This finding led the researchers to recommend that DCD kidneys be viewed as equally preferable to those DBD kidneys.
Previous data suggested that DCD kidneys had delayed function post-transplant as compared to other transplanted kidneys. As predicted, rates of delayed function were higher in DCD kidneys than in DBD kidneys.
The researchers found that, overall, DCD kidney transplants did have a higher risk of failure than kidneys obtained from previously healthy DBD donors, but actually had a lower incidence of failure than DBD kidneys obtained from donors with a history of high blood pressure or stroke.
Renal failure can be caused by a number of different conditions, but is most often the result of diabetes or high blood pressure, both common illnesses in the United States. Kidney transplants are one of two treatments for renal failure, along with dialysis. In many cases a successful kidney transplant can almost completely reverse the original disease. The hard part is finding a suitable organ match.
Kidneys for transplant can come from either living or deceased donors. Kidneys from living donors are preferred, because the kidney is outside a living person for as short a time as possible. A healthy person should be able to function with only one kidney.
Kidneys can also be donated from deceased individuals. The preferred kidneys from deceased donors are those donated after brain death, which is called DBD. Another group of kidney donors are individuals who die of cardiac or pulmonary failure (DCD). Kidneys donated after cardiac deaths are regarded as "marginal" because the kidney once transplanted might take longer to function properly. It has generally been accepted that DCD kidneys have a higher rate of failure compared to DBD kidneys.
Given the increasing demand for kidneys, the authors of the study challenged conventional wisdom by analyzing kidney transplant data to determine whether DCD kidneys could safely be added to the donor pool. The researchers are in the Department of Surgery at the Johns Hopkins School of Medicine and Johns Hopkins Hospital.
The researchers collected and performed statistical analyses on data about kidney transplants from a national registry. Over 78,000 records of DBD and DCD transplants performed between 1993 and 2005 were included in the analysis. The results were published in the July 2007 issue of the American Journal of Transplantation.
The researchers' analysis found that long-term survival rates for patients with DCD kidneys from donors under 50 were the same as DBD donors who had been healthy individuals between the ages of 18 and 60 before brain death. This finding led the researchers to recommend that DCD kidneys be viewed as equally preferable to those DBD kidneys.
Previous data suggested that DCD kidneys had delayed function post-transplant as compared to other transplanted kidneys. As predicted, rates of delayed function were higher in DCD kidneys than in DBD kidneys.
The researchers found that, overall, DCD kidney transplants did have a higher risk of failure than kidneys obtained from previously healthy DBD donors, but actually had a lower incidence of failure than DBD kidneys obtained from donors with a history of high blood pressure or stroke.
Be the first to comment on this story