A call to action: Feasible strategies to reduce the discard of transplantable kidneys in the United States. Clin Transplant 2020 Sep;34(9):e13990
Date
07/06/2020Pubmed ID
32621660DOI
10.1111/ctr.13990Scopus ID
2-s2.0-85087460652 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
Changes to the United States kidney allocation system targeted at reducing organ discard have failed to improve organ utilization. High Kidney Donor Profile Index kidneys continue to be discarded at high rates as a result of the regulatory and financial barriers to widespread utilization of these organs. However, there are potential changes to clinical practice that could improve organ utilization. Expediting the time from initial offer to final organ acceptance would reduce cold ischemic time and should improve utilization. Implementation of procurement biopsy standards to avoid biopsy of low risk organs may prevent organ discards due to inaccurate data or excessive cold ischemia time. Further, standardization of procurement biopsy pathological interpretation coupled with electronic accessibility would enable early acceptance of difficult to transplant organs. These changes to allocation practice patterns are vital given proposals to expand the geographic sharing of deceased donor kidneys. Implementation of new allocation policies must be evaluated to ensure they result in higher transplant rates and acceptable post-transplant outcomes.
Author List
Stewart ZA, Shah SA, Formica RN, Kandaswamy R, Paramesh AS, Friedman J, Squires R, Cooper M, Axelrod DAAuthor
Matthew Cooper MD Chief, Director, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Donor SelectionHumans
Kidney
Kidney Transplantation
Retrospective Studies
Risk Factors
Tissue Donors
Tissue and Organ Procurement
United States
