Kidneys from deceased donors previously on dialysis may be tied to delayed graft function
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Key takeaways:
- From 2010 to 2018, 1.4% of deceased kidney donors had dialysis before donation.
- Overall, 969 kidneys were transplanted and 641 were discarded.
Receiving a kidney transplant from a deceased donor who had dialysis before donation may be tied to a higher rate of delayed graft function, according to a published study.
However, researchers found no significant difference in graft failure or death at follow-up compared with patients who received a kidney from a deceased donor who was not on dialysis.
“With patients waiting many years to receive a kidney, and a significant portion of them deteriorate or succumb to their condition while on the waiting list, we need to rapidly increase the pool of available kidneys,” Chirag Parikh, MD, PhD, professor of medicine and director of the nephrology division at Johns Hopkins Medicine, said in a press release.
Using data from 58 U.S. organ procurement organizations on deceased kidney donors and kidney transplant recipients from the Organ Procurement and Transplantation Network provided in July 2023, Parikh and colleagues identified 805 deceased donors who underwent dialysis prior to kidney donation. That group was matched 1:1 with donors not on dialysis before donation. Researchers evaluated 1,944 transplant recipients.
Main outcomes were delayed graft function of dialysis receipt by the kidney recipient 1 week after transplant, all-cause graft failure, death-censored graft failure and death.
From 2010 to 2018, 1.4% of deceased donors had dialysis before donation, according to the researchers. Among those donors, 523 (65%) donated at least one kidney. Overall, during the study, 969 kidneys (60%) were transplanted and 641 (40%) were discarded.
Of the kidney recipients with transplants from donors who had dialysis, 59.2% were associated with a higher risk of delayed graft function compared with 24.6% of kidney recipients with transplants from donors who did not undergo dialysis, findings showed.
At a median 34.1 months follow-up, incidence rates did not significantly differ for all-cause graft failure, death-censored graft failure or death between groups, Parikh and colleagues found.
“There is significant variability in the utilization of kidneys from high risk deceased donors across the country,” Parikh said. “The findings from this study should encourage organ procurement organizations and transplant professionals to cautiously bring kidneys with severe AKI, from deceased donors who received dialysis, into the allocation pool.”
Reference:
New research supports expansion of kidney donation to include organs from deceased patients who once had dialysis. https://www.hopkinsmedicine.org/news/newsroom/news-releases/2024/05/new-research-supports-expansion-of-kidney-donation-to-include-organs-from-deceased-patients-who-once-had-dialysis. Published May 28, 2024. Accessed May 29, 2024.
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