Breaking News
February 22, 2019 - Phase 1 data reinforce safety profile of new drug for treating Duchenne muscular dystrophy
February 22, 2019 - Vitamin D supplementation less effective in the presence of obesity, shows study
February 22, 2019 - Sarepta Announces FDA Acceptance of Golodirsen (SRP-4053) New Drug Application for Patients with Duchenne Muscular Dystrophy Amenable to Skipping Exon 53
February 22, 2019 - An institutional effort to reduce the amount of opioids prescribed following lumbar surgery
February 22, 2019 - Failure to take statins leads to higher mortality rates | News Center
February 22, 2019 - Novel preclinical model mimics persistent interneuron loss seen in preterm infants
February 22, 2019 - Global health burden of glaucoma has increased, study reveals
February 22, 2019 - A holistic approach key to minimize treatment complexity in patients with interstitial lung disease
February 22, 2019 - 1 in 10 middle-aged Chinese adults are at high risk for heart disease, finds study
February 22, 2019 - More than half a million breast cancer patient’s lives saved by improvements in treatment
February 22, 2019 - Study finds no evidence that tougher policies prevent teenage cannabis use
February 22, 2019 - New blood test detects genetic disorders in fetuses
February 22, 2019 - Lower Self-Perception Observed in Children With Amblyopia
February 22, 2019 - Up to 15 percent of children have sleep apnea, yet 90 percent go undiagnosed
February 22, 2019 - Rare pulmonary defect prompts parents’ nationwide search for answers | News Center
February 22, 2019 - Lesbian and bisexual women at greater risk of being overweight, study finds
February 22, 2019 - UQ research may explain why vitamin D is essential for brain health
February 22, 2019 - Heart Attacks Rising Among Younger Women
February 22, 2019 - How your smartphone is affecting your relationship
February 22, 2019 - Orthopaedic surgeon receives prestigious award, $10 million grant | News Center
February 22, 2019 - New sepsis test could save thousands of lives
February 22, 2019 - Cervical cancer could be eradicated by 2100
February 21, 2019 - Sustained smoking cessation can lower risk of seropositive RA
February 21, 2019 - Thousands with chronic UTIs are not receiving the treatment they need
February 21, 2019 - Are teens getting high on social media? The surprising study seeking the pot-Instagram link
February 21, 2019 - Stanford expands biobank services | News Center
February 21, 2019 - Scientists identify link between drinking contexts and early onset intoxication among adolescents
February 21, 2019 - Strong social support may reduce cardiovascular disease risk in postmenopausal women
February 21, 2019 - Rapid expansion of interventions could prevent up to 13 million cases of cervical cancer within 50 years
February 21, 2019 - Motif Bio Receives Complete Response Letter From The FDA
February 21, 2019 - Researchers map previously unknown disease in children
February 21, 2019 - A skeptical look at popular diets: Going gluten-free
February 21, 2019 - Podcast: KHN’s ‘What The Health?’ How Safe Are Your Supplements?
February 21, 2019 - Factors associated with increased risk of developing surgical site infections
February 21, 2019 - Anticipatory signals in eye movements can help measure attentive capacity, learning with greater precision
February 21, 2019 - Study explores daily exposure to indoor air pollutants
February 21, 2019 - Evening exercise does not negatively affect sleep, may also reduce hunger
February 21, 2019 - Artificial intelligence technique can be used to identify alcohol misuse in trauma setting
February 21, 2019 - Overweight, obesity in adolescence associated with increased risk of renal cancer later in life
February 21, 2019 - BGU develops new AI platform for monitoring and predicting ALS progression
February 21, 2019 - Researchers discover a new promising target to improve HIV vaccines
February 21, 2019 - Brief Anesthesia in Infancy Does Not Mar Neurodevelopment
February 21, 2019 - Gaming system helps with autism diagnosis
February 21, 2019 - Heart Disease: Six Things Women Should Know
February 21, 2019 - More States Say Doctors Must Offer Overdose Reversal Drug Along With Opioids
February 21, 2019 - Researchers explore case studies focused on industries that kill more people than employed
February 21, 2019 - Only half of GP practice buildings are fit for purpose
February 21, 2019 - Intense exercise, fasting and hormones can enhance waste-protein removal, study shows
February 21, 2019 - Scientists can monitor brain activity to predict epileptic seizures few minutes in advance
February 21, 2019 - Study quantifies hepatic and intestinal mRNA expression of Ugt isoforms in rats
February 21, 2019 - ‘Apple-Shaped’ Body? ‘Pear-Shaped’? Your Genes May Tell
February 21, 2019 - Can we repair the brain? The promise of stem cell technologies for treating Parkinson’s disease
February 21, 2019 - Trump Plan To Beat HIV Hits Rough Road In Rural America
February 21, 2019 - PENTAX Medical introduces new electrosurgical and argon plasma coagulation platforms
February 21, 2019 - Trump plan to beat HIV hits rough road in rural America
February 21, 2019 - Eating blueberries every day could help decrease blood pressure
February 21, 2019 - ‘No Second Chances’ report calls for new measures to combat cardiovascular disease in Australia
February 21, 2019 - Mayo clinic researchers discuss local case studies of leprosy
February 21, 2019 - Scientists demonstrate key role of salt in allergic immune reactions
February 21, 2019 - Experts propose revising the criteria for diagnosis of Parkinson’s disease
February 21, 2019 - The med student and the machine
February 21, 2019 - Hey, Hey! Ho, Ho! Is Striking For School Nurses The Way To Go?
February 21, 2019 - Latest research encourages children to move out and learn through physical activity
February 21, 2019 - Proper oral hygiene and regular visits to dentist can promote heart health
February 21, 2019 - New, versatile technique for remote control of transplanted cells in Parkinson’s
February 21, 2019 - Why melanoma tumors in the brain may be worse?
February 21, 2019 - New project aims to improve lung disease care in Appalachia
February 21, 2019 - Drug increases melanin production in some people with albinism
February 21, 2019 - Over 1 in 3 adults miss the mark on protein, finds study
February 21, 2019 - CymaBay Therapeutics Announces Seladelpar Granted Breakthrough Therapy Designation by the FDA for the Treatment of Primary Biliary Cholangitis
February 21, 2019 - A correlation between obesity and income has only developed in the past 30 years
February 21, 2019 - Baby, then work: An effort to help resident-parents in emergency medicine
February 21, 2019 - Heavy cigarette smoking could damage vision, say researchers
February 21, 2019 - Some drug combinations may be more effective than others for schizophrenic patients
February 21, 2019 - Combination of common antibiotics can eliminate multi-drug resistant E. coli
February 21, 2019 - Number of calls to U.S. Poison Control regarding kratom exposure increased
February 21, 2019 - New computational tool searches for factors that cause specific diseases
February 21, 2019 - New method to assess effectiveness of psychotherapies for social anxiety disorder
February 21, 2019 - New technology measures hormones that influence reproductive health efficiently
February 21, 2019 - Bat influenza viruses could potentially attack the cells of humans and livestock
Acutely injured deceased-donor kidneys are suitable for transplant, study suggests

Acutely injured deceased-donor kidneys are suitable for transplant, study suggests

image_pdfDownload PDFimage_print

Organ procurement teams are sometimes leery of accepting kidneys from deceased donors with acute kidney injury (AKI), fearing they will harm the recipients. However, a national study chaired by a Johns Hopkins kidney specialist suggests these fears may be unfounded.

In medical chart reviews of 2,430 kidneys transplanted from 1,298 donors–585 (24 percent) of them with AKI–researchers say they found no significant differences in rates of organ rejection among kidneys from deceased donors with or without AKI. They also report they found no evidence that factors such as the amount of time an organ is chilled and left without blood supply before transplantation had any impact on recipient outcomes for those who received AKI kidneys.

Results of the study, published Nov. 20 in the journal Kidney International, suggest that patients in need of kidney transplant could have access to more kidneys–potentially shortening organ waiting list times, the investigators say.

With the field of medicine moving toward a system that focuses on the improvement of patient safety while reducing health care costs, this research is a step forward in the high-value health care movement.

“Our results should add to evidence and reassure the general public and the transplant community that acutely injured deceased-donor kidneys appear to have the same success rates as noninjured kidneys from otherwise similar donors,” says Chirag R. Parikh, M.B.B.S., Ph.D., director of the Division of Nephrology at the Johns Hopkins University School of Medicine and senior study author. “Even transplanted kidneys with the highest severity of AKI did not have worse outcomes, so we should bring these kidneys into the donor pool with confidence,” Parikh adds.

An estimated 95,000 Americans are on the national kidney transplant waiting list, according to the U.S. Organ Procurement and Transplantation Networks. Given the organ shortage, says Parikh, the transplant community should pursue measures to increase use of kidneys from deceased donors with AKI.

AKI affects about one-third of patients in intensive care units, Parikh says. Hospitalized patients are likely to develop AKI as a complication resulting from reduced blood supply, or administration of medications to increase blood pressure, or from being placed on ventilators. Deceased donors are likely to develop AKI if they spent time in an ICU following a trauma or other medical or surgical complications.

Physicians worry about patients who develop AKI because they are more likely to have negative long-term consequences, such as chronic kidney disease or premature death, Parikh says. It remains unclear if transplanting a kidney from a donor with AKI would have similar consequences.

Nationwide, the discard or rejection rate for all potential donor kidneys is approximately 18 percent, and for AKI kidneys about 30 percent, Parikh says. “We estimate there may be approximately 500 kidneys a year with AKI that are currently discarded, but can be transplanted.” Some criteria that surgeons use around decisions for kidney discard include the presence of diabetes, hypertension or poor kidney donor profile index–a standard measure of how likely a kidney is to function over time.

The current study had two parts. In the first section, researchers conducted transplant chart reviews for kidneys from 1,298 donors in five regional organ procurement organizations (Philadelphia, Michigan, New York, New Jersey and New England) from 2010-2013, and linked them to 2,430 single kidney transplant recipients via the Organ Procurement and Transplantation Network’s national transplant registry. Donors with AKI, compared with donors without AKI, were more often African-American (24 percent versus 13 percent), more likely to have hypertension (36 percent versus 29 percent), and had a higher average kidney donor profile index (56 versus 46).

Recipients of AKI kidneys versus non-AKI kidneys were more often older (55 versus 52 years old), and donor AKI kidney transplants had longer mean cold ischemia time (16.4 hours versus 14.9 hours)–the amount of time an organ is chilled before transplantation. The AKI kidneys also were more likely to undergo machine perfusion (a technique to push fluids through the organ to preserve it), a difference of 46 percent versus 37 percent, and slightly more likely to have human leukocyte antigen mismatches–a measure of how compatible a donor and recipient will be based on cell proteins.

During an average follow-up period of four years, there were 623 (26 percent) kidneys that had permanent failure, so-called graft failures. This occurred in 475 (26 percent) recipients of AKI kidneys and 148 (25 percent) recipients of non-AKI kidneys. The severity of AKI did not impact graft failure rates.

In the second part of the study, investigators examined recipient charts from a subgroup of 739 kidneys from 601 donors transplanted at 12 medical centers. They found graft failures or progression to kidney disease in 143 (19 percent) of the recipients (40 recipients received AKI kidneys and 103 received non-AKI kidneys).

Kidney transplant potentially saves the health care system more than $250,000 per year for each patient in costs related to dialysis treatments, medications and hospitalizations, says Parikh: “Hopefully this study will provide confidence to surgeons that they can transplant these kidneys and expect good outcomes.”

The researchers caution it is possible that donor AKI kidneys selected for transplant have a more favorable risk factor distribution than the donor kidneys without AKI. In addition, donor AKI kidneys may be less likely to be selected for transplant unless they have other, more favorable characteristics such as younger age and an absence of other chronic health conditions.

Source:

https://www.hopkinsmedicine.org/news/newsroom/news-releases/medical-records-study-suggests-kidneys-from-deceased-donors-with-acute-kidney-injury-are-suitable-for-transplant

Tagged with:

About author

Related Articles