Hospitals less finicky about kidneys

From the Chicago Tribune:
By Jean P. Fisher | The News & Observer, North Carolina
11:46 AM CST, March 6, 2008

RALEIGH, N.C. — Deaths among patients awaiting lifesaving kidney transplants fell nationally last year amid rising organ donation and broader use of kidneys that would once have been discarded.

Patients who would otherwise face long waits for a kidney are now often encouraged to consider organs from deceased donors older than age 60 or from younger patients who died of stroke or suffered from high blood pressure. Many transplant centers will now give a patient two low-functioning kidneys instead of one higher-functioning organ, as is customary.

"In a perfect world, it would be nice to get everyone a kidney from a younger donor," said Dr. Robert Stratta, director of transplants at Wake Forest Baptist University Medical Center in Winston-Salem since 2001. "But we don't live in a perfect world. Getting a kidney is better than not getting a kidney."

So-called expanded-criteria donor organs are more likely to fail than kidneys from younger, healthier donors. Traditionally, such organs were considered unsuitable for transplant. But as the gap continues to widen between the number of patients seeking transplants and the number of organs available to them, Stratta and other transplant experts increasingly see them as an untapped resource.

The use of expanded criteria donor kidneys has increased about 30 percent since 2002, when the United Network for Organ Sharing (UNOS) set criteria for their use. These kidneys now account for nearly 11 percent of all kidney transplants.

The number of patients seeking kidney transplants is rising by an average of 7 percent to 10 percent a year, in part because of rising rates of Type 2 diabetes, which damages the kidneys. Meanwhile, as the number of organs from both living and deceased donors has increased modestly, the supply of kidneys available for transplant has only inched up. According to UNOS, only about a quarter of patients waiting for kidneys nationally got a transplant last year.

"Hardly a week goes by that I'm not notified that someone on our waiting list has died," Stratta said. Read the full article.

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