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Transplant centers reject potentially usable kidneys as patients die, study says

Roughly 9 percent of people on the kidney waitlist die, and about 84 percent of once rejected kidneys end up being used with somebody -- suggesting some of the deaths could be prevented.

By
Tauren Dyson
Researchers say that unnecessarily high standards for donor kidneys is causing people to die, and that many of those rejected organs could have saved their lives. Photo by scotth23/Pixabay
Researchers say that unnecessarily high standards for donor kidneys is causing people to die, and that many of those rejected organs could have saved their lives. Photo by scotth23/Pixabay

Aug. 30 (UPI) -- Transplant centers are rejecting viable kidneys on behalf of patients whose lives might have been saved by the organs, a new study says.

Roughly 9 percent of all people looking for a kidney died on the waitlist, according to research published Friday in Jama Open Network. Meanwhile, doctors declined 84 percent of kidneys for use on behalf of at least one patient before ultimately being transplanted to another.

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In all, nearly 26,000 died while waiting for a kidney during the study period. The researchers argue that many of the rejected kidneys could have saved the lives of at least some of these people, even before considering that the requirements in the United States result in many more organ rejections than in other countries.

"This study is important because it demonstrates the highly variable practice of accepting or declining deceased donor kidneys and that many kidney offers are being declined for patients in need of life-saving organs," Sumit Mohan, a researcher at Columbia University and study author, told UPI. "In the majority of cases, these decisions appear to be made without the knowledge or awareness of the affected patients."

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The study included more than 280,000 kidney transplant candidates at an average age of 51 between 2008 and 2015. About 61 percent were men.

Only about 29 percent, or 82,095, of those patients received kidneys from deceased donors while 11 percent, or 30,870, received organs from living donors.

Concerns over organ or donor quality accounted for about 93 percent of all declined donor kidney offers. Study authors report patients who received a deceased donor kidney had a median of 17 organ offers before transplant, those who died on the waiting list had a median of 16 offers and those removed from the list had a median of 15 offers -- all of which the researchers say suggests some rejected kidneys may have been a successful match for the first round of patients.

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Additionally, 21 percent of the patients were taken off the waiting list. On average, 10 recipient candidates died each day through the study period.

"For the patients who died waiting for a transplant after multiple offers were declined, it is difficult to argue that waiting instead for the 'perfect kidney' was truly in their best interest," Mohan said.

The United States lags behind other developed countries in kidney transplantation rates. It rejects more than twice as many kidneys for transplant than France, for example.

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Mohan attributes this disparity to France's willingness to use organs the United States would consider substandard, oftentimes from older donors.

"There are many missed opportunities for kidney transplant in the United States with far too many kidneys being declined by transplant centers for reasons that are not clear," Mohan said. "More needs to be done to maximize the use of these precious lifesaving organs."

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