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Matching method helps doctors successfully transplant higher-risk kidneys

WINSTON-SALEM, N.C. By carefully matching the estimated function of kidneys from deceased donors with the needs of potential recipients, surgeons can successfully transplant kidneys that would otherwise be discarded, according to a report from Wake Forest University Baptist Medical Center. The center was able to double its transplant volume within a year.

In addition, a second report concludes that age alone shouldn't prohibit older adults from being organ donors or having a kidney transplant themselves success rates are similar in older and younger patients.

"There is a critical shortage of kidneys for transplantation, which puts us in the difficult situation of rationing organs," said Robert Stratta, M.D., director of Transplantation Services at Wake Forest Baptist. "Newer ways to match organs to recipients allow us to use kidneys that once were considered unsuitable."

In the May issue of Annals of Surgery, Stratta and colleagues reported on their experience using kidneys under a new system that was implemented by the United Network for Organ Sharing (UNOS) in 2001. It allows the use of kidneys from deceased donors over age 60, as well as from donors over age 50 with at least two of the following: high blood pressure, fatal stroke, or certain levels of a protein called creatinine. Levels of creatine, which is produced by muscle, are used to determine kidney function.

Using kidneys from these donors, which UNOS calls expanded criteria donors (ECDs), permits more patients to benefit from transplantation, Stratta said, without affecting either patient survival or short-term survival of the transplanted kidney.

Transplant centers across the nation are working to determine how to use the organs most effectively. Wake Forest Baptist's approach is to estimate the function of a donated kidney and to match it with the needs of a potential recipient.

"In the past, kidneys were matched exclusively by blood and tissue type,"
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Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4587
Wake Forest University Baptist Medical Center
17-May-2004


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