Most renal transplant candidates are ready to receive a kidney from a donor at increased risk of viral infection, according to a study published in an upcoming issue of Clinical Journal of the American Society of Nephrology (CJASN). The results suggest that patients with kidney disease can make rational compromise between the strengths and risks are conferred by the kidneys donated.
Since thousands of patients die each year in the United States awaiting a kidney transplant, greater efforts are needed to expand the pool of kidneys for transplantation. These efforts could include allowing patients to receive organs less than ideal, for example, people died at a greater risk of viral infection.
In these cases, patients must weigh the benefits of receiving a transplant against the small risk of serious infection such as HIV. Dialysis patients average 20% chance of dying each year, similar to the rate of death from metastatic cancer.
Therefore, patients may decide it’s better to accept an organ from a donor with an increased risk of viral infection to stay on dialysis.
Peter Reese, MD, Scott Halpern, MD, Ph.D. (Pennsylvania State University) and colleagues conducted a study to determine what proportion of renal transplant candidates would accept a kidney from a donor with an increased risk of viral infection. They also examined the factors that have influenced this decision.
The researchers studied 175 kidney transplant candidates who responded to hypothetical scenarios that tested their willingness to accept a kidney from a donor at high risk of viral infection. Each scenario has changed donor age (as proxy for the quality of the kidney), the risk of contracting HIV and wait until the next offer of a kidney transplant. Among the 175 respondents, 42 (24.0%) rejected donor kidneys increased risk of viral infections in all conditions, 103 (58.9%) accepted under certain conditions, and 31 (17, 7%) always accepted.
Patients were more likely to accept a kidney from donors with increased risk of viral infection when the donor was younger, HIV risk was lower, and when the waiting time was longer. In addition, patients on dialysis and patients most commonly accepted age as the kidneys. Increase the use of kidneys from donors with increased risk of viral infections could improve access to kidney transplant if the transplant candidates are willing to accept these organs.
“Our study shows that the majority of renal transplant candidates to accept the time commitment for the time – that is, they would accept a kidney transplant, although the risk of HIV infection is slightly higher,” said Dr . Reese.
The authors suggest that transplant physicians should talk with their patients about the possibility of receiving organs from donors at increased risk of viral infection, without fear that those conversations will harm the ability to place these organisms.
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