A Yale-led study confirms that kidneys from deceased donors that have acute injuries may be more viable than previously thought, and should be considered to meet the growing demand for organ transplants. These type of kidneys are generally discarded instead of being used for transplantation.
Kidneys with acute injury are mainly discarded for fear of poor outcomes such as delayed function and even premature kidney transplant failure. Given the extremely urgent need for more number of kidneys to transplant, the researchers have performed the largest multicenter observational study of its kind to date, including more than 1,600 deceased donors. They examined associations between acute kidney injury (AKI) in donors, rates of kidney discard, and recipient kidney function in the short term as well as 6 months after transplantation.
They found an association between AKI and organs discarded. They also found that injured kidneys were associated with “delayed graft function (DGF),” or the need for continued dialysis support in the first week after transplantation. But unexpectedly, the study did not find a link between deceased-donor kidney injury and poor kidney transplant function 6 months later.
“What we saw was, with worsening AKI in the donor, the six-month outcome was actually better for recipients who experienced DGF.” said Dr. Isaac E. Hall, investigator in the Program of Applied Translational Research at Yale School of Medicine and first author of the study.
“There appears to be room to attempt more transplants using these AKI kidneys rather than throwing them away. Even if it only means a few dozen more kidney transplants each year, those are patients who would come off of the waiting list for transplants sooner and have much better survival than continuing on dialysis in hopes of seemingly higher-quality kidney offers, which may never come in time.” said Dr. Chirag R. Parikh, director of the Program of Applied Translational Research and senior author of the study.
The original publication can be accessed here.