Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Double transplants may offer one solution to short supply of donated kidneys

13.03.2006


Transplanting a pair of kidneys with limited function into one patient can be just as successful as the standard procedure in which a patient receives a single kidney, according to new research at Wake Forest University Baptist Medical Center.



"Performing double transplants using kidneys that would otherwise be discarded may be one viable solution to the growing shortage of organs for transplantation," said Robert Stratta, M.D., co-author of a study being presented today at a meeting of the Central Surgical Association in Louisville, Ky.

During the 45-month study period, 19 patients underwent double transplants using organs from deceased donors that had been turned down by other centers because of limited function. The kidneys had marginal filtering capacity either because they were very small – from children – or they were from older adults who had begun to lose some kidney function.


"Patients who received double kidney transplants had similar short-term outcomes to patients who received single transplants," said Stratta. "In our short-term followup, we found that we could achieve excellent patient survival and kidney function using marginal kidneys if they are both transplanted into a single recipient."

The mean ages of the donors were 22 months for the pediatric kidneys and 65 years for the adult kidneys. Patient survival in both groups was 100 percent during a followup period of 20 months for those receiving adult kidneys and 10 months for those receiving pediatric kidneys. Kidney graft survival rates were 87 percent and 100 percent, respectively.

Stratta said a key to success is selecting patients with a lower risk of rejection and matching the estimated function of the kidneys to the needs of the recipient. People are normally born with two kidneys but require only about half the capacity of one kidney, depending on their age, size and other factors.

With a traditional single transplant, a donated kidney is placed in the abdomen and connected to the iliac artery and vein, major vessels in the abdomen. The failed kidneys are left in place and eventually shut down and shrivel in size.

With the double transplant surgery, two donated kidneys from a single donor are placed in the abdomen. In the case of very small kidneys from pediatric donors, organs are transplanted "en bloc," which means that the kidneys are left attached to their vessels and are transplanted as one unit.

While double transplants have been performed since the mid-1990s, they are not common. The significance of the current study was that it used kidneys from donors at the extremes of age. Stratta, a professor of surgery at Wake Forest University School of Medicine, said the use of dual transplants from these donors is part of an ongoing effort to learn more about which kidneys are suitable for transplant to make the best use of the limited number of organs from deceased donors.

About 67,000 people are on the national waiting list for a kidney transplant and only about 25 percent on the list receive a transplant each year.

In October 2002, the United Network for Organ Sharing (UNOS) implemented a new system for allocating higher-risk kidneys that were once considered unsuitable for transplantation and discarded. Referred to as expanded criteria donors (ECD), these include kidneys from deceased donors over age 60 or those over age 50 with health conditions such as high blood pressure, stroke or elevated levels of a protein called creatinine. Levels of creatinine, which is produced by muscle, are used to determine kidney function.

Wake Forest Baptist adopted a policy of routinely transplanting kidneys from ECDs and was able to double its annual transplant activity. Now, the center is one of the 50 most active kidney transplant centers in the country, according to the November issue of Nephrology News and Issues. About 40 percent of its deceased donor transplants are from ECDs. Waiting times for the ECD transplants average 20 months, compared to 30 months for standard transplants.

Stratta and colleagues have reported success using organs at the outer limits of acceptance criteria, which Stratta refers to as organs from "extreme" donors. These include donors older than 70 years, having high levels of creatinine, dying from cardiac arrest prior to organ donation, or prolonged storage time for the organ.

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

More articles from Health and Medicine:

nachricht Study tracks inner workings of the brain with new biosensor
16.08.2018 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht Foods of the future
15.08.2018 | Georg-August-Universität Göttingen

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: It’s All in the Mix: Jülich Researchers are Developing Fast-Charging Solid-State Batteries

There are currently great hopes for solid-state batteries. They contain no liquid parts that could leak or catch fire. For this reason, they do not require cooling and are considered to be much safer, more reliable, and longer lasting than traditional lithium-ion batteries. Jülich scientists have now introduced a new concept that allows currents up to ten times greater during charging and discharging than previously described in the literature. The improvement was achieved by a “clever” choice of materials with a focus on consistently good compatibility. All components were made from phosphate compounds, which are well matched both chemically and mechanically.

The low current is considered one of the biggest hurdles in the development of solid-state batteries. It is the reason why the batteries take a relatively long...

Im Focus: Color effects from transparent 3D-printed nanostructures

New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference

Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...

Im Focus: Unraveling the nature of 'whistlers' from space in the lab

A new study sheds light on how ultralow frequency radio waves and plasmas interact

Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...

Im Focus: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

LaserForum 2018 deals with 3D production of components

17.08.2018 | Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

 
Latest News

Quantum bugs, meet your new swatter

20.08.2018 | Information Technology

A novel synthetic antibody enables conditional “protein knockdown” in vertebrates

20.08.2018 | Life Sciences

Metamolds: Molding a mold

20.08.2018 | Information Technology

VideoLinks
Science & Research
Overview of more VideoLinks >>>