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 Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill University

nachricht Direct conversion of non-neuronal cells into nerve cells
03.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz

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: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

Nano-kirigami: 'Paper-cut' provides model for 3D intelligent nanofabrication

16.07.2018 | Physics and Astronomy

New players, standardization and digitalization for more rail freight transport

16.07.2018 | Transportation and Logistics

Researchers discover natural product that could lead to new class of commercial herbicide

16.07.2018 | Agricultural and Forestry Science

VideoLinks
Science & Research
Overview of more VideoLinks >>>