An interview I did this week with Sridhar Tayur, the CEO of OrganJet alerted me to the problem that numerous kidneys get discarded every year despite the fact that more than 97,000 people are in need of one. But one nagging question that came out of that conversation was this: Exactly how many kidneys get discarded each year and why?
This is actually a growing problem. In 2002, 12.7 percent of kidneys were not used, but in 2011 that figure rose to 17.9 percent, according to data from a report by the United Network for Organ Sharing.
Frequently, there are some very good reasons why many donated kidneys can’t be used. Looking at 734 organ donors who donated at least one organ in 2011, the report lists reasons why the kidney was not removed. They include poor organ function (44.3 percent) followed by donor medical history (11.1 percent) and organ was refused by all national programs (9.3 percent).
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Another set of criteria highlights why the kidney was discarded after it was removed. Even if you take into account bad biopsy findings (37 percent), poor organ function (9.2 percent) and anatomical abnormalities (7 percent) 16 percent of kidneys were discarded because no recipient could be identified, according to the report. Donor kidneys are only discarded after being offered locally, regionally and nationally.
Each organ procurement organization is responsible for notifying the Organ Procurement Transplantation Network and explaining the reason for discard, the report said. Each center may turn down the same kidney for different reasons.
The report offers up some really bad news for people who need a kidney:
Increases in the number of candidates on the waiting list and relatively flat organ donation rates have resulted in steady decreases in transplant rates for adult wait-listed candidates since 1998 (Figure 1.7). In 1998, the deceased donor transplant rate was 20.6 transplants per 100 wait-list years, compared with 11.4 transplants per 100 wait-list years in 2011. As a consequence, in the past 3 years, more than 20,000 wait-listed candidates have been removed from the waiting list because they died or became too sick to undergo transplant.
All transplant centers and organ procurement organizations have access to the United Network for Organ Sharing’s computer portal. Transplant centers access the organization’s computer system to list patients and organ procurement organizations can enter information about deceased donors. Matches can be run for the organs that are able to be procured on the organ procurement side. The organ procurement organizations use the system to send electronic offers to the transplant centers of those patients who are on the match run, according to spokeswoman in an emailed response to questions.
[Image from OPTN/SRTR 2011 Annual Data Report: Kidney]
