A study by Johns Hopkins University researchers suggests that transplanting a kidney to an incompatible donor is preferable to the donor remaining on a waiting list for an ideal match.
Scientists from the Hopkins School of Medicine examined the survival rates of more than 1,000 incompatible kidney transplant recipients at 22 centers across the U.S., then compared them to similar patients that remained on waiting lists. The study — the first of its kind to examine outcomes of those transplants nationwide — found that the transplant recipients survived at a rate of 76.5 percent.
The rate for those that remained on dialysis and awaited a transplant, meanwhile, was less than 44 percent, and the rate climbed to just less than 63 percent if a compatible organ became available. About 20,000 patients on kidney donor waiting lists developed antibodies to critical immune system components and, as a result, are very difficult to match with a living donor. “That’s a lot of people who could have a better chance at surviving if they are allowed to move forward with incompatible live donor transplantation,” said lead author Dorry Segev.
Although the researchers warned that immune system complications raised the risk of serious side effects and organ failure, the only other realistic option, Segev said, is to remain on the waiting list. Segev added that although treatment for the immune antibodies is expensive, continued dialysis essentially becomes 10 times that cost. “For the first time, we have definitively shown that incompatible live donor kidney transplantation provides almost twice the survival of a patient’s next best option,” he said.
The study was published in The New England Journal of Medicine.