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There is a serious shortage of kidneys in the United States.
According to the Organs Supply and Transplantation Network, a federal database on organ transplantation, nearly 100,000 Americans are currently on the waiting list. kidney. So far this year, only about 16,000 people on this list have received a kidney.
But about 2,000 kidneys of deceased donors are rejected each year in the United States – kidneys likely to be transplanted, according to a new study from an international team of researchers presented Oct. 27 to the American Society of Nephrology, Kidney Week 2018, a kidney expert medical conference in San Diego. [The 9 Most Interesting Transplants]
According to the researchers, the United States must take advice from France, a country where fewer kidneys are deemed "unsustainable" and discarded. In other words, the United States should stop throwing as many kidneys as some of these kidneys could save the lives of their patients.
When a kidney is considered for a transplant, the doctor must determine its quality. To do this, they use a quality standard called the Kidney Donor Profile Index, or KDPI. The determination of KDPI depends on a number of factors regarding the donor, including his age and health status, such as high blood pressure or diabetes.
In the United States, an elderly donor kidney, for example, is considered a high-risk organ and of lower quality for transplantation, said co-author of the study, Dr. Peter Reese, kidney transplant specialist and professor of medicine at Perelman. School of Medicine at the University of Pennsylvania in Philadelphia.
Reese told Live Science that these inferior kidneys would never have been accepted for a transplant in the United States and that they would have been discarded, although there is a glaring lack of donor kidneys. This attitude could stem from the belief of some kidney specialists that the use of high-risk kidneys is not as effective for patients or that it costs more to transplant inferior kidneys. , he added. Another factor is that specialists in the United States are rather opposed to risk, he said.
In France, however, kidney transplant specialists are more willing to accept lower quality kidneys, according to the study. This raises the question: is the acceptance of these substandard kidneys harmful to patients? And if not, why can not we do it here in the United States?
When in France …
As part of this study, Reese collaborated with a team from the Center for Translational Research for Organ Transplantation in Paris, led by Dr. Olivier Aubert. Together, they analyzed data from organ transplant registries in the United States and France between 2004 and 2014, a decade in which nearly 156,000 kidneys in the United States and about 30,000 kidneys in France were taken for transplant from deceased donors.
The team found that the average age of the deceased kidney donor in the United States was 36, but 51 in France. It's a big difference in terms of kidney quality, said Reese.
In addition, the average age of deceased donors in the United States remained virtually the same throughout the decade, but the age of deceased donors has gradually aged in France, he said.
The results suggest that French transplant centers have taken up the challenge of increasing waiting lists for kidneys by developing a more aggressive transplantation system that accepts older kidney donors, while the United States maintain the status quo, said Reese.
This risk seemed to be paying off: the study estimated that if American transplant centers were willing to accept lower quality kidneys than the French, 17,000 additional kidney transplants would have been performed during the first half of the year. 'study, said Reese. The researchers also estimated that French patients receiving inferior kidneys had similar results to those of high quality kidneys; in other words, the patients had the same results after their surgeries.
Indeed, the study provides good evidence that older deceased donor organs could be an underutilized valuable resource for kidney transplantation, Reese said.
The results have not yet been published in a peer-reviewed journal.
Originally published on Science live.
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