Could Kidney Transplant Waiting Lists Soon Get Shorter?
Donor kidneys are safe to use for transplants even if they aren’t in tip-top shape, according to new research.
There’s a serious shortage of kidneys available for transplants—in fact, 13 people die every day while waiting for a kidney transplant, according to the National Kidney Foundation. But one change could save significantly more of the 95,000 Americans with kidney failure awaiting donor kidneys, according to new research.
Many kidneys from deceased organ donors are thrown away every year after they don’t pass inspection based on current medical criteria—yet, a study from Johns Hopkins Medicine finds that hundreds of these less-than-perfect discarded kidneys could actually be used in transplants—safely and effectively.
Kidneys harvested from donors that have what’s called acute kidney injury (AKI)—a sudden episode of kidney damage or failure mostly seen in hospitalized patients undergoing medical and surgical complications and other stressors, according to the National Kidney Foundation—are rejected based on current guidelines, but the authors of this study strongly recommend this practice stop. The study, published in JAMA Network Open, confirms a previous Hopkins study that found that AKI kidneys don’t get rejected or fail after transplantation any more than non-injured kidneys do.
The researchers looked at medical records for kidneys from 13,444 donors that were transplanted into 25,323 kidney failure patients in 2013, 12,513 of whom received kidneys without AKI. Each kidney without AKI was matched with an AKI kidney from a medically similar donor (for example, the two donors would have similar age, sex, ethnicity, medical conditions, and more). After following each kidney recipient for four to six years after their transplant, researchers found no significant differences in the organ rejection rates between AKI and non-AKI kidneys.
"We found that deceased-donor AKI had no association with either short-term or long-term survival of the organ, strongly supporting our idea that kidneys with AKI should be actively harvested and transplanted," said senior study author Chirag Parikh, M.D., Ph.D., director of the division of nephrology at the Johns Hopkins University School of Medicine
With the need for donor kidneys rising 8% each year, per the National Institute of Diabetes and Digestive and Kidney Diseases, and 9,000 Americans dropping off the donor waiting list yearly due to death or worsening health, the need for more donor kidneys is at an all-time high.
"We estimate there may be hundreds of kidneys with AKI each year that are going unused but could be transplanted," said Dr. Parikh. "Therefore, we are urging the transplant community to bring AKI kidneys into the donor pool with more confidence."
Organ Donation Basics You Should Know
It’s not just kidneys that can help save lives—other organs and tissues can be donated, too, including the heart, lungs, liver, skin, cornea, and more. And a new person is added to the organ transplant waiting list every 10 minutes, according to the Health Resources and Services Administration (HRSA). Anyone over the age of 18—and, in some states, people under 18—can sign up to be an organ donor. Even if you have a medical condition, you may still be able to become an organ donor.
Want to become an organ donor and potentially save lives? It’s simple—sign up with your state’s organ donor registry on the government website OrganDonor.gov. You can also sign up at your local Department of Motor Vehicles. Having an organ donor card isn’t typically enough, HRSA says.
Kidney Transplant Statistics: Organ Donation and Transplantation Statistics. (2016). National Kidney Foundation. kidney.org/news/newsroom/factsheets/Organ-Donation-and-Transplantation-Stats
Study on AKI Kidneys and Transplant Success: JAMA Network Open.(2020.) “Association of Deceased Donor Acute Kidney Injury With Recipient Graft Survival.” jamanetwork.com/journals/jamanetworkopen/fullarticle/2758404
Hopkins News Release on Kidney Transplant Study: Less-Than-Perfect Kidneys Can be Successfully Used For Transplants, Study Shows. (2020. John Hopkins Medicine. hopkinsmedicine.org/news/newsroom/news-releases/less-than-perfect-kidneys-can-be-successfully-used-for-transplants-study-shows
Organ Donation Information: Organ Donation FAQs. (2020). Health Resources and Services Administration. organdonor.gov/about/facts-terms/donation-faqs.html