Increasing The Crop Of Donated Kidneys

By Judy Siegel-Itzkovich

The severe shortage of donated organs, especially kidneys, has forced transplant surgeons to think of ways to increase the supply. One way, which has been successfully adopted in Spain, is to up the age limit for donors.

Some donated kidneys come from patients who died from stroke, which - unlike road accidents - leaves their kidneys intact. While strokes occasionally occur in patients under 50, most potential kidney donors are middle aged or beyond - so the supply is automatically limited.

Doctors at the Rabin Medical Center, Sheba Hospital, Ichilov Hospital, Hadassah-University Hospital, Rambam Hospital, and Soroka Hospital, along with experts from Israel Transplant, write in the May issue of IMAJ, the English-language Israel Medical Association Journal, that the extension of the age for donating a kidney permits a significant increase in the number of transplants.

Unselective use of kidneys from donors over 50, however, is associated with higher risk of delayed function and less-than-optimum functioning of the organ. A more careful functional assessment of kidneys from "aged" donors by conducting various measurements can help select suitable donors from this age group, they write.

Many older people suffer from atherosclerosis, high blood pressure, and diabetes, and these disorders can reduce kidney function; when their kidneys are transplanted, there may be a poorer outcome than when the donor was below 50.

In Spain, the use of organs from older donors has led to a significant increase in the number of transplants.

Israel Transplant studied the Spanish model for organ donation and assigned a nurse coordinator to each of the 22 general hospitals around Israel with the aim of increasing the use of kidneys from older donors.

After studying such transplants over a year, the team concluded that there is a poorer outcome using kidneys from elderly donors, but long-term graft function and survival can be achieved if candidates are chosen carefully.

The faster the organ is transplanted after the donor's death, the better.

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This article posted July 1, 2000.