Dialysis patients feasible for kidney donation, transplant outcome study suggests

Editor's Note

A retrospective cohort study found transplanting kidneys from donors who underwent dialysis resulted in no long-term differences in graft failure, kidney function, or death, but recipients had significantly higher risk for delayed graft function (DGF).

According to a May 23 MedPage Today report on the study, originally published in JAMA, DGF was substantially more common among 954 recipients of pre-dialyzed kidneys than a matched group of 990 recipients of kidneys from donors who had not undergone dialysis. However, at a median follow-up of 34 months, there were no significant differences in risk for graft failure or death, and the two groups exhibited no difference in kidney function after 12 months.

"Given the severe shortages of organs and the increases in the rates of discarded kidneys from potential donors, there is growing interest in using less-than-ideal donor kidneys (such as kidneys from deceased donors with AKI [acute kidney injury])," the researchers wrote."Considering the high incidence of DGF after receiving kidneys from donors who underwent dialysis, kidneys from these donors should be considered for recipients who may be sufficiently healthy to tolerate repeated hemodialysis sessions after the transplant if DGF occurs."

However, the an editorial accompanying the study “urged careful donor selection despite this demonstration of feasibility,” MedPage reports. Additionally, researchers point out that “the study was subject to confounding and selection bias, as kidneys from younger and healthier donors were more likely to be selected for transplant.”