Monday, June 6, 2016

Gridlock: The Inability to do Research in Deceased Donors to Improve Transplant Organ Quality and Quantity

Dr. Sandy Feng: Abdominal transplant surgeon and clinical trials researcher at UCSF; advocate for research-based solutions to solve transplant problems

As a practicing organ transplant surgeon, I am struck every day by how many people I could help, if only...

That’s both the hardest and most important thought to finish. I’ve tried to take it in so many different directions, but there’s only one that I’m sure is actually right: ... if only we had enough organs to transplant. Transplantation is unlike any other area of U.S. medicine in that, among patients who gain access to a therapy (i.e. they are placed on the transplant wait list), the majority wait a (very) long time and may never even be treated. The imbalance of the increasing demand for transplantation and decreasing supply of organs is worsening: the current waiting list for transplants exceeds 120,000 Americans, and 22 of them die each day.

If only we had enough organs to transplant.

The obvious next question is: how might we do that? While great efforts exist to increase organ donation rates, parallel efforts should be undertaken to increase the donor potential; that is, only a fraction of deaths even medically qualify for donation, but there is a significant opportunity to increase this number through scientific research. Recently, there was an example of how incredibly effective a very simple research intervention in deceased donors — cooling by 2-3°C — can be to improve the function of kidneys after transplantation. Kidneys from “cool” donors were 60 percent more likely to work right away such that the recipients never required dialysis after transplantation. A treatment such as cooling the donor that clearly improves transplant organ function might enable us to accept organs for transplantation that we are currently turning down. Continue reading
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