Kidneys from deceased donors with ARF could probably increase the donor pool

Acute renal failure (ARF) is said to be a quick loss of renal function due to damage to the kidneys, ensuing in withholding nitrogenous and non-nitrogenous waste products that are usually excreted by the kidney.

This news may surprise everybody. Every year, millions of people wait for a donor for kidney transplant. In the future, more kidneys could be available.

Apparently kidneys recovered from deceased donors with acute renal failure (ARF) seem to function just as well as kidneys transplanted from deceased donors who did not develop kidney problems before organ donation. This is claimed by a study which was conducted at Wake Forest University Baptist Medical Center.

The findings propose the option of carefully increasing the donor kidney pool by at least 10 to 15 percent. Due to this, more 1000 kidneys or more per year may be available to those who are waiting for a donor organ.

“There is a critical shortage of donor organs and we are continually making efforts to expand the donor pool. While kidneys from deceased donors with ARF have been considered unusable in the past, our study shows they can work quite well. The function of the new kidney may be slow or delayed – and patients may have to continue dialysis for a week or two until the kidney is up and running – but that’s really the only downside. Choosing to utilize these kidneys will greatly shorten the waiting time for people who are willing to accept a kidney from this kind of donor”, commented, Robert J. Stratta, M.D., professor of surgery and director of transplantation at Wake Forest Baptist and senior investigator on the study.

About 25 kidneys were transplanted by Stratta and colleagues from around 17 deceased donors with ARF. Stratta mentioned that unlike chronic kidney failure, ARF could frequently be reversed, if the original cause is treated or removed.

It was seen that for the patients, an average time of 24 months was the waiting time until a door kidney was made available. All of them apparently chose to accept the organ. All of the recipients were supposedly supervised for at least 11 months after the transplant. At an average follow-up of 20 months, patient and graft survival rates were apparently 100 percent and 92 percent, respectively. It may be similar to the result usually seen when healthy deceased donor kidneys are transplanted.

Stratta remarked, “As long as the donor kidneys are still producing urine and do not have evidence of scarring from pre-existing conditions such as diabetes or a history of high blood pressure, they appear to restore to a healthy condition when transplanted.”

Stratta added, “Each transplant center has its own level of comfort regarding the criteria they use to determine what organs they will and will not accept for transplant. In the past, kidneys from donors with ARF were considered an absolute ‘no’. Then they became a relative ‘no’. After this study, I think it’s safe to say that they are a relative ‘yes’ – there is a subset of these donor kidneys that can be safely and successfully transplanted with very good short-term results.”

Stratta remarked, “Now that we know we can successfully transplant these kidneys and they will work just as well as other deceased donor kidneys, it becomes a decision of personal preference – the transplant center’s level of comfort with using these kidneys, the patient’s preference with accepting the kidney, and the general public’s decision on whether or not to donate life.”

Over the last decade, the amount of patients waiting for a kidney transplant has apparently outpaced growth in the number of transplants conducted every year. Between 1997 and 2006, the number of patients waiting for a kidney transplant supposedly rose by 81 percent from 49,208 to 88,877.

At the same time, the quantity of annual kidney transplants conducted in the United States apparently rose by only 41 percent from 11,703 to 16,483. This increasing inequality in the amount of end stage renal disease patients on the waiting list relative to those essentially receiving kidney transplants has supposedly been escorted by a surprising raise in the quantity of deaths while waiting for transplants, from 2,184 in 1997 to 4,456 in 2006.

Moreover, median waiting times for kidney transplants have apparently increase twofold during the last decade.

The findings are reported in the October issue of Surgery.