A new study led by Johns Hopkins Medicine has shown that hundreds of deceased donor kidneys can be transplanted safely and effectively, even those discarded after being deemed unsuitable under current medical criteria.

The research team has strongly recommended that harvested kidneys with acute kidney injury (AKI) should no longer be rejected outright to reduce the shortage of organs available for transplantation in the United States. The national discard rate for all potential donor kidneys is approximately 18%; for AKI kidneys, it is 30%.

In 2018, around 2500 kidneys transplanted from approximately 1300 deceased donors were analyzed. In the latest study, researchers expanded this number, evaluating 13,444 organs from deceased donors that were transplanted into 25,323 end-stage renal disease patients in the United States between January 1, 2010, and December 31, 2013.

Out of the 25,323 patients, 12,810 had received kidneys with AKI and 12,513 were given kidneys without any signs of acute injury, and that had been matched to the AKI kidneys on other criteria.

Each AKI kidney was paired at the beginning of the study with a non-AKI kidney using a statistical method that mathematically linked as many donor characteristics as possible. This included age, sex, ethnicity, and any medical conditions other than AKI. The investigators could then measure the impact more accurately, if any, or just AKI on transplant success.

After surgery, the transplant recipients were monitored for 4 to 6 years. To establish how many potentially viable kidneys with AKI were lost during the study period, the researchers looked at how many deceased donor kidneys with AKI were recovered, then either transplanted or discarded.

"We estimate there may hundreds of kidneys with AKI each year that are going unused but could be transplanted," Chirag Parikh, MD, PhD, MBBS, director of the Division of Nephrology at the Johns Hopkins University School of Medicine and senior author of the JAMA Network Open paper, said in a press release. "Therefore, we are urging the transplant community to bring AKI kidneys into the donor pool with more confidence."

REFERENCE

Less-than-perfect kidneys can be successfully used for transplants, study shows. ScienceDaily. https://www.sciencedaily.com/releases/2020/01/200109130222.htm. Published January 9, 2020. Accessed January 10, 2020.