Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Kidney transplants: Expanding the pool of available organs

20.05.2010
In the United States over 80,000 people are on the kidney transplant waiting list, and thousands die each year waiting for transplants. For most dialysis patients, kidney transplantation increases their chances of survival.

In the last decade physicians and surgeons began using organs from donors who suffered cardiac death [donors after cardiac death (DCD)] as an alternative to organs transplanted after donor brain death (DBD). DBD kidneys are believed to be superior for successful transplant. In DBD transplants, the circulatory system is maintained until the organ is preserved. In contrast, with DCD organs, the shutdown of the circulatory system and the attendant loss of blood supply to the kidney may cause damage to the transplant organ.

In a study appearing in an upcoming issue of the Journal of the American Society of Nephrology, Maarten G. Snoeijs, MD (Maastricht University Medical Center, the Netherlands) and co-authors analyzed 2,575 Dutch transplant candidates to see how receiving a DCD kidney affected their overall chances of survival.

"Over the past decade, DCD has evolved into an important new source of donor kidneys," Snoeijs explained. "However, in many countries the large donor pool of DCD kidneys has not been fully utilized." That is because questions remain as to the benefits of DCD transplants. Are patients better off receiving a DCD kidney or waiting for a kidney donated after brain death?

Kidneys donated after brain death are "generally believed to be superior," according to Snoeijs. However, of the 2,575 wait-listed patients in this study, 26 percent received a DBD kidney and 18 percent received a DCD organ, so more than half either died or remained on the waiting list.

When DCD kidneys were transplanted, the failure rate in the first few months was nearly twice as high as for DBD kidneys. However, patients who received DCD kidneys had a 56 percent higher chance of survival, compared to those who stayed on dialysis waiting for a DBD kidney.

"We think these results may have a large influence on DCD kidney transplantation, which may eventually lead to a substantial reduction of the waiting list and improved survival of patients with end-stage renal disease," said Snoeijs.

The study adds to "the preponderance of evidence" in favor of using DCD organs, according to an accompanying editorial by Nicholas Shah, MD, and Anthony Langone, MD (Vanderbilt University School of Medicine, Nashville, TN). They conclude, "Transplant centers should maximally utilize DCD kidneys to optimize the quality of life and minimize mortality of their patients on the waiting list."

Like other observational studies, the current study is limited by the possibility of selection bias. "Due to careful statistical corrections, however, we consider it unlikely that the effect of DCD kidney transplantation on survival has been overestimated because of patient selection bias," according to Snoeijs.

Disclosures: Dr. Snoeijs was supported by a clinical research trainee grant from the Netherlands Organization for Health Research and Development. Development of the statistical methodology and analysis was supported by National Institutes of Health grant R01 DK-70869 to Douglas E. Schaubel. The authors of the study and editorial declare no conflicts of interest.

Study co-authors were Douglas E. Schaubel, PhD (University of Michigan), Ronald Hené, MD, PhD (University Medical Center Utrecht), Andries J. Hoitsma, MD, PhD (Radboud University Medical Center), Mirza M. Idu, MD, PhD (Academic Medical Center), Jan N. Ijzermans, MD, PhD (Erasmus University Medical Center), Rutger J. Ploeg, MD, PhD (University Medical Center Groningen), Jan Ringers, MD (Leiden University Medical Center), Maarten H Christiaans, MD, PhD, Wim A Buurman, MD, and L.W. Ernest van Heurn, MD (Maastricht University Medical Center).

The article, entitled "Kidneys from Donors after Cardiac Death Provide Survival Benefit" (doi 10.1681/ASN.2009121203) and accompanying editorial, "Renal Donation after Cardiac Death" (doi 10.1681/ASN.2010040415) will appear online at http://jasn.asnjournals.org/ on May 20, 2010.

The American Society of Nephrology (ASN) does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, ASN is the world's largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.

Shari Leventhal | EurekAlert!
Further information:
http://www.asn-online.org

More articles from Health and Medicine:

nachricht Correct connections are crucial
26.06.2017 | Charité - Universitätsmedizin Berlin

nachricht One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Touch Displays WAY-AX and WAY-DX by WayCon

27.06.2017 | Power and Electrical Engineering

Drones that drive

27.06.2017 | Information Technology

Ultra-compact phase modulators based on graphene plasmons

27.06.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>