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Screened 'high-risk' kidneys safe for organ transplant

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Many kidneys from deceased donors that are classified as "high-risk" are safe if the organs are screened using current methods, according to a small new study.

About 10% of kidneys from dead donors are considered to have a high risk for infection with HIV (the virus that causes AIDS) and hepatitis C and B, and for disease transmission, according to the US Centres for Disease Control and Prevention.

However, the new study concluded that many of these kidneys are safe and therefore should not be labelled as high-risk.

Researchers looked at 170 patients at Columbia University Medical Centre who received kidneys that met CDC's high-risk criteria. Among the donors, about 57% had a history of injection drug use, about 26% had high-risk sexual behaviour, about 12% were in jail, about 7% were men who had sex with men, and about 5% had received multiple blood transfusions.

About 78% of the donor kidneys came from other medical centres, indicating that those centres refused to use the kidneys, according to the study to be presented in early November at the meeting of the American Society of Nephrology (ASN), in Atlanta.

After an average 2.4 years of follow-up, 86.5% of the transplanted kidneys were functioning and none of the patients had been infected with HIV or hepatitis C or B, the investigators found.

Relative safety

The findings demonstrate the relative safety of so-called high-risk kidneys when they are screened using current methods, the researchers said. They suggested that these organs should probably be labelled as "identified-risk" rather than "high-risk".

Because this study will be presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

"Utilisation of these organs represents an opportunity for shortening wait time for patients while providing good outcomes and an extremely low level of risk for transmission of infections," study leader Moya Gallagher, at the New York-Presbyterian Hospital/Columbia University Medical Centre, said in an ASN news release.

"For most deceased organ donors, the medical/social history is obtained second- or third-hand, and it is erroneous to assume that some of these patients do not fall into the groups that constitute the 'high-risk' classification. Therefore, we believe that the current... classification [division] is misleading and does a disservice to those patients on the waiting list," Gallagher added.

More information

The National Kidney Foundation has more about kidney transplantation.

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