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Health

Study Reinforces Growing Belief: Surgeons Can Safely Accept More Kidneys for Transplant

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The study looked retrospectively at more than 1,600 kidney donations at several centers across the country.

New research out of Yale says doctors should accept more types of kidneys for organ transplant. The study comes at a time when there's a growing need for kidneys.

The research, which was published in the American Journal of Transplantation, centered around kidneys with what doctors call "acute kidney injury."

These are organs with varying degrees of damage that would, given time, generally heal themselves.

In the past, these kidneys would have been discarded from a deceased organ donor. But recently, scientists have slightly loosened their requirements, accepting some of these damaged kidneys.

"The problem is the median time to get the organ is about three to five years and it varies across the United States," said ChiragParikh, a doctor at Yale and one of the co-authors of the study with Isaac Hall.

They looked retrospectively at large sample base: more than 1,600 kidney donations at several centers across the United States, examining the level of acute injury in the kidney before transplant and tracking how those organs functioned down the road.

They found the kidneys took time to work in the donor recipient and often required short-term dialysis. But, surprisingly, after six months, many of these injured kidneys worked just as well as a normal one.

"The big finding for us which will be very exciting for the transplant world, is the surgeons and people who are making decisions around discard and around allocation can cautiously expand into this pool of kidneys which are discarded because of acute kidney injury," Parikh said.

"I will personally be a little bit more aggressive in accepting kidney donors that have some degree of acute injury," said Matthew Brown, a transplant surgeon at Hartford Hospital, who wasn't involved with the study. "I think it's an important article because we do everything we can in transplantation to try to make up for the inequity in supply and demand for these transplanted kidneys."

UConn surgeon Brian Shames said transplant surgeons have been using some of these damaged kidneys for years, and that this reinforces what they've been doing. "I think this opens up more surgeons' eyes to say that we should consider these kidneys," he said. "In selected pools of patients -- young healthy ones with acute kidney injuries -- these are very usable."

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