Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Matching method helps doctors successfully transplant higher-risk kidneys

18.05.2004


By carefully matching the estimated function of kidneys from deceased donors with the needs of potential recipients, surgeons can successfully transplant kidneys that would otherwise be discarded, according to a report from Wake Forest University Baptist Medical Center. The center was able to double its transplant volume within a year.



In addition, a second report concludes that age alone shouldn’t prohibit older adults from being organ donors – or having a kidney transplant themselves – success rates are similar in older and younger patients.

"There is a critical shortage of kidneys for transplantation, which puts us in the difficult situation of rationing organs," said Robert Stratta, M.D., director of Transplantation Services at Wake Forest Baptist. "Newer ways to match organs to recipients allow us to use kidneys that once were considered unsuitable."


In the May issue of Annals of Surgery, Stratta and colleagues reported on their experience using kidneys under a new system that was implemented by the United Network for Organ Sharing (UNOS) in 2001. It allows the use of kidneys from deceased donors over age 60, as well as from donors over age 50 with at least two of the following: high blood pressure, fatal stroke, or certain levels of a protein called creatinine. Levels of creatine, which is produced by muscle, are used to determine kidney function.

Using kidneys from these donors, which UNOS calls expanded criteria donors (ECDs), permits more patients to benefit from transplantation, Stratta said, without affecting either patient survival or short-term survival of the transplanted kidney.

Transplant centers across the nation are working to determine how to use the organs most effectively. Wake Forest Baptist’s approach is to estimate the function of a donated kidney and to match it with the needs of a potential recipient.

"In the past, kidneys were matched exclusively by blood and tissue type," said Stratta. "Now, we are matching based on age, weight and kidney function. Someone who weighs less doesn’t need as much transplanted kidney capacity; it is a concept that is in evolution."

Stratta and colleagues compared survival rates and other measures of success in 53 patients who received kidneys from standard criteria donors (SCDs) and 37 patients who received kidneys from ECDs. Patients were followed for an average of 16 months. Patient and kidney graft survival rates were similar between the two groups.

"The use of ECD kidneys at our center doubled our transplant volume within one year," said Stratta. "A systematic approach to matching ECD kidneys that is based on kidney function seems to provide short-term outcomes that are comparable to SCD kidneys."

The transplant team will continue to follow these patients to assess long-term kidney function and survival. Stratta believes that with careful patient selection, the kidneys from expanded criteria donors may function for as long as kidneys donated under the standard criteria, about eight to 12 years.

Stratta and colleagues are also studying the issue of transplantation and the aging American population. There are more elderly kidney donors, as well as older adults who need kidney transplants, than ever before.

"Controversy exists regarding the optimal approach to the elderly donor or recipient," said Stratta.

In a separate study of 129 transplant patients who received kidneys from deceased donors, Stratta and colleagues compared 96 patients ages 19 to 59 to 33 transplant patients who were 60 years of age and older.

"An average followup of 17 months showed no difference in patient survival or kidney survival," said Stratta, who reported the results today at the American Transplant Congress in Boston. "You can no longer make the argument that transplanting a kidney into an older recipient is a wasted organ."

About 66 percent of patients in the older group received kidneys from ECDs, compared to 30 percent of patients in the younger group.

"The older group did equally well, in spite of the fact that they usually received kidneys from older donors," said Stratta, who has performed transplants in patients as old as 76.

Patients receiving the ECD kidneys did have slightly higher rates of viral infection, which could affect hospital readmission rates, and this finding needs to be explored, said Stratta.

Karen Richardson | EurekAlert!
Further information:
http://www.wfubmc.edu/

More articles from Health and Medicine:

nachricht A 'half-hearted' solution to one-sided heart failure
24.11.2017 | Boston Children's Hospital

nachricht New study points the way to therapy for rare cancer that targets the young
22.11.2017 | Rockefeller University

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: New proton record: Researchers measure magnetic moment with greatest possible precision

High-precision measurement of the g-factor eleven times more precise than before / Results indicate a strong similarity between protons and antiprotons

The magnetic moment of an individual proton is inconceivably small, but can still be quantified. The basis for undertaking this measurement was laid over ten...

Im Focus: Frictional Heat Powers Hydrothermal Activity on Enceladus

Computer simulation shows how the icy moon heats water in a porous rock core

Heat from the friction of rocks caused by tidal forces could be the “engine” for the hydrothermal activity on Saturn's moon Enceladus. This presupposes that...

Im Focus: Nanoparticles help with malaria diagnosis – new rapid test in development

The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.

Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

IceCube experiment finds Earth can block high-energy particles from nuclear reactions

24.11.2017 | Physics and Astronomy

A 'half-hearted' solution to one-sided heart failure

24.11.2017 | Health and Medicine

Heidelberg Researchers Study Unique Underwater Stalactites

24.11.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>