Some Injured Kidneys May Be OK for Transplant, Study Finds

For reasons that are unclear, certain organs even performed better 6 months after transplant

By Robert Preidt

Thursday, March 12, 2015

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Kidney Transplantation

THURSDAY, March 12, 2015 (HealthDay News) -- People on the waiting list for a donor kidney may have some good news: A new study suggests that some injured kidneys might still be suitable for transplant.

"The waiting list has grown to over 100,000 patients as thousands more people are wait-listed each year than actually receive a transplant," study senior author Dr. Chirag Parikh, director of the Program of Applied Translational Research at Yale University in New Haven, Conn., said in a university news release.

"In addition, the median time it takes for an adult to receive a transplant in the United States increased from 2.7 to 4.2 years between 1998 and 2008, and more than 5,000 people die each year while waiting for a kidney," he said.

However, the Yale team noted that kidneys that are received in an injured state are often discarded, due to fears about potential problems such as delayed function and premature failure after transplant.

But are all of those organs necessarily useless? To find out, Parikh's team tracked kidneys from more than 1,600 deceased donors and, as expected, found an association between acute kidney injury and kidneys being discarded.

They also found a link between injured kidneys and a condition called "delayed graft function" (DGF), which means the patient requires continued dialysis support in the first week after transplantation.

However, some of those post-surgical issues may fade. The researchers said that patients who received injured kidneys were not at any higher risk for poor kidney function six months after their transplant.

"What we saw was, with worsening acute kidney injury in the donor, the six-month outcome was actually better for recipients who experienced DGF," first author Dr. Isaac Hall, an investigator in the Program of Applied Translational Research at Yale School of Medicine, said in the news release.

In fact, kidney function six months after transplant was worse for patients with DGF who received a kidney with no apparent injury, compared to those who got an injured kidney.

One possible reason for the finding is that while still in their donors, the injured kidneys may have developed a mechanism to protect themselves from the effects of further injury, Hall suggested.

All of this means that there may be more room "to attempt more transplants using these [acute injury] kidneys, rather than throwing them away," Parikh said.

"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," Parikh concluded.

The study was published March 11 in the American Journal of Transplantation.

SOURCE: Yale University, news release, March 10, 2015

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