Viable Donor Kidneys May Be Discarded Based on Biopsy
Most lower-quality kidneys also remained viable for nearly as long as the best kidneys, with 73.2% still working 5 years after transplant.
(HealthDay News) — Suboptimal kidneys from older donors with health problems perform much better than expected, and would preserve a patient's life much longer than dialysis, according to research published online in the Journal of the American Society of Nephrology.
Sumit Mohan, MD, MPH, an assistant professor at Columbia University's Mailman School of Public Health in New York City, and colleagues reviewed 975 kidney transplants that occurred at Columbia University Medical Center between 2005 and 2009. Kidneys from living donors provided the best outcome for patients, with 91.4% still viable 5 years after transplant regardless of whether the organ was damaged, the researchers found. But high-quality kidneys from deceased donors functioned well, with 81.7% still viable after 5 years.
Most lower-quality kidneys also remained viable for nearly as long as the best kidneys, with 73.2% still working 5 years after transplant, the investigators found. By 8 years after transplant, 62% of optimal kidneys and 53% of suboptimal kidneys from deceased donors still functioned, Mohan told HealthDay. By comparison, the 5-year survival rate for kidney patients on dialysis is about 35%, Mohan said.
Mohan believes that transplant doctors should rely more heavily on a donor's medical records to decide whether a kidney is viable, and use biopsies solely to help evaluate truly questionable donations. "If you know the age of the donor, the gender, the race, the clinical history, you pretty much already can guess 9 times out of 10 what the biopsy is going to show you," Mohan said. "Looking at a bad biopsy shouldn't sway you further away from using that kidney."
- Mohan S, Campenot E, Chiles MC, et al. Association between Reperfusion Renal Allograft Biopsy Findings and Transplant Outcomes. J Am Soc Nephrol. 6 July 2016. doi: 10.1681/ASN.2016121330