In BriefBecause of kidney scarcity, doctors are unable to keep up with the number of people on the national kidney organ waiting list. However, new research suggests the shortage is due to an egregious number of discarded kidneys.
How to Save a Life
If someone is suffering from kidney failure, one available option is dialysis. While it may sometimes be the treatment recommended to such failed organs, it can become expensive over time, and may not be the decisive solution they were expecting.
An alternative option is to get a kidney transplant, with successful operations resulting in the extension of a patient’s life. Unfortunately, kidneys are in short supply, as the most in-demand organ: according to OrganDonor, nearly 116,000 people are on the national transplant waiting list as of August 2017, 82.9 percent of which are waiting for a kidney organ.
The main reason for the kidney shortage lies in the fact that nearly one out of five kidneys recovered are actually discarded, and in recent years, the number of discarded organs has only increased. New research suggests this probably shouldn’t be as big of a problem as it is, and many of the discarded kidneys could actually be used by patients desperate for one.
Led by Dr. Sumit Mohan, MD, and Dr. S. Ali Husain, MD, from the Columbia University Medical Center, the study analyzed information gathered between 2000-2015 on the deceased who had both kidneys recovered, but with only one transplanted.
“It is obviously impossible to tell with certainty what would have happened to any discarded kidney if it had been used instead,” explained Dr. Sumit Mohan. “As a result, it has been difficult to categorize these discards as ‘appropriate’ or ‘inappropriate.’”
Mohan continued, adding, “We therefore aimed to identify kidney donors from whom one kidney was used but the partner kidney in the pair was discarded. By doing so, we could control for donor characteristics to better understand the reasons for discard, and whether concerns about using certain kidneys were justified.”
The team analyzed information on 88,209 donors — amounting to 176,418 kidneys — and discovered the reason to discard certain kidneys was due to “unappealing” traits. However, the partner kidneys used for transplants contained some, if not all, of the same traits, and performed well in spite of that. Based on Mohan’s prior explanation, it’s possible that thousands of usable kidneys were mistakenly discarded, causing leaving many to die without a whisper of hope, according to Dr. Husain and the rest of the team:
“We therefore concluded that many of these discarded kidneys were in fact quite usable, and that systems-level changes are needed to encourage better utilization of this valuable but scarce resource,” said Dr. Husain.
According to Kidney.org, 4,761 patients died while waiting for a transplant in 2014, with another 3,668 eventually becoming too sick to receive a transplant.
In a separate paper, Matthew Kadatz, MD and John Gill, MD from the University of British Columbia noted how Mohan and Husain’s research makes a strong argument to address the policies in place that allow so many organs to go unused.
“The current discard of kidneys would be hard to explain to the families of deceased donors and is a disservice to the thousands of older age and diabetic wait-listed patients who would benefit from transplantation with these higher risk kidneys and who have consented to receive them,” the pair wrote.
Only time will tell if this work ensures that every healthy kidney is fully utilized. Such a change wouldn’t completely eliminate the demand for kidneys, but it would certainly go a long way to save thousands of lives. Especially the lives of those who have been waiting multiple years for a chance to return to a normal life.