Maximizing the Use of Donated Organs
The quality of kidney and liver donations is fundamentally important for the longevity of transplants and the health of recipients. That’s why it’s critical to know which organs are suitable for transplantation, as well as to use techniques that preserve an organ’s function after donation. Several studies published in the British Journal of Surgery in April 2014address these issues and offer ways to maximize the use of donated organs.
A release from the journal reports that in the first study, Rajeev Desai MRCP of National Health Service Blood and Transplant in the UK led a team that assessed transplants from 17,639 donors, including 61 donors with cancer who were considered to have an unacceptable/high risk of transmitting cancer through their donated organs. The researchers found no cancer transmission in 133 recipients of organs from these 61 donors. At 10 years after transplantation, the organs from donors with unacceptable/high risk provided each recipient with more than 7 additional years of survival on average.
The release quotes Dr. Desai as saying, “The findings of our research indicate that the perceived risk of certain organ donors to their recipients is likely to have been over-estimated. Organ donors with a history of certain types of cancers who are excluded from transplantation in fact pose very little risk of cancer transmission to their recipients. These organs can be transplanted with very little risk to their recipients, resulting in significant improvement in the survival and health of the recipients.”
In another study, Olivier Detry, MD, PhD of the University of Liège, in Belgium and his colleagues revealed excellent results from liver transplants from deceased donors who were older than what is usually recommended. The study looked specifically at donation after circulatory death (DCD), in which circulation, heartbeat, and breathing have stopped (as opposed to brain death, in which all the functions of the brain have stopped). A total of 70 DCD liver transplants were performed at the investigators’ institution: 32 from donors aged 55 years and younger, 20 from donors between 56 and 69 years, and 18 from donors aged 70 years and older.
Organ and patient survival rates were not different at one and three years after transplantation between the three groups. “The use of DCD donors over the age of 60 is highly controversial, but we showed that excellent results could be expected if the cold ischemic time is limited to less than 6 hours,” said Dr. Detry. Cold ischemic time represents the time between the chilling of an organ after its blood supply has been cut off and the time it is warmed by having its blood supply restored. “As the population of Western countries is aging, we will have to consider older donors even more often in the future,” said Dr. Detry.