Sunday, March 30, 2008

Imperfect kidneys

Transplant surgeons are making broader use of kidneys that would once have been discarded, according to an article in the Grand Forks Herald:

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.

People who need kidney transplants face a tough choice when offered an extended critieria kidney:
agreeing to an extended criteria kidney typically shaves a year off a patient’s wait. Higher-risk kidneys do tend to wear out sooner, lasting no more than eight years on average. A standard kidney transplant lasts an average of about 12 years.
We wouldn't have to use so many imperfect organs if Americans weren't burying or cremating 10,000 transplantable kidneys every year.

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Sunday, March 02, 2008

UNOS' strange priorities

In a story in today's Indianapolis Star, LifeSharers member Dan Emerson sums up the idea behind LifeSharers: "the golden rule is a good road map for life, and those who promise to donate ought to move ahead of those who don't."

United Network for Organ Sharing spokeswoman Amanda Claggett disagrees: "The LifeSharers approach would essentially punish transplant candidates who haven't made a particular personal decisiion. And while we value that particular decision, we believe that the transplant system should neither reward nor punish people for their personal decisions or beliefs."

Ms. Claggett's statement shows exactly why so many people die in the United States waiting for organ transplants. UNOS, which runs the national transplant waiting list, could reward registered organ donors by giving them first access to donated organs. If UNOS did this, the supply of organs would go way up and thousands of lives would be saved every year. But UNOS would apparently rather let these people die than "punish" non-donors.

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