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 Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM

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: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Fighting drug resistant tuberculosis – InfectoGnostics meets MYCO-NET² partners in Peru

28.04.2017 | Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

 
Latest News

Wireless power can drive tiny electronic devices in the GI tract

28.04.2017 | Medical Engineering

Ice cave in Transylvania yields window into region's past

28.04.2017 | Earth Sciences

Nose2Brain – Better Therapy for Multiple Sclerosis

28.04.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>