Thursday, May 12, 2016

Donor kidneys may be discarded due to 'weekend effect' at hospitals


Philadelphia, PA, May 12, 2016 -- Investigators have uncovered a "weekend effect" contributing to the worsening availability of donor kidneys in the United States. They found that kidneys that would normally be made available for transplantation were less likely to be procured from donors over the weekend (89.5% on the weekend vs. 90.2% during the week). Further, organs procured during the weekend were more than 20% more likely to be discarded than kidneys procured on other days, although the discarded kidneys were of higher quality on average than those discarded during the week, according to a new report in Kidney International.

Each year over 5,000 patients in the U.S. die waiting for a kidney transplant, while annually, nearly 2,700 kidneys procured for transplantation are discarded. There are currently no universal guidelines in the U.S. to recommend which kidneys should be used or rejected.

"This high discard rate is concerning especially given the worsening organ shortage in the U.S., but the factors contributing to this are poorly understood," explained lead investigator Sumit Mohan, MD, MPH, Assistant Professor of Medicine & Epidemiology at Columbia University Medical Center. "The most commonly cited reason for organ discard is organ quality, but recent analyses by our group suggest that even kidneys of acceptable quality are being discarded at an increasing rate."

Investigators hypothesized that there was a significant degree of transplant center-to-center variability, and analyzed whether the procurement and utilization of deceased donor kidneys varied by day of the week - specifically, whether it was different on weekends when compared to weekdays. Using data from the U.S. Scientific Registry of Transplant Recipients, they looked at records of more than 180,000 deceased donor kidneys recovered for transplantation between 2000 and 2013. More than 30,000 of these kidneys were discarded during this period. In addition to analyzing the impact of day of the week on donor kidney use or discard, they collected data on geographic variations. They also measured kidney quality using the Kidney Donor Profile Index (KDPI). Continue reading

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