In US, 84% of donated kidneys are rejected, study shows

WASHINGTON—When a patient dies waiting for a kidney in the United States, they are generally considered the unfortunate victim of a growing donor shortage.

But the reality is more troubling: in the vast majority of such cases, patients had multiple opportunities to receive a transplant, but the organs were declined by their transplant team for being of low quality.

“What we found is 84 percent of kidneys in the United States get turned down at least one time, which is crazy,” Sumit Mohan,  author of a study published on Friday in the Jama Network Open journal, told Agence France-Presse (AFP).

It comes on the heels of another paper this week that found the US rejects about 3,500 kidneys each year because of the donors’ advanced age, even though 60 percent of these would be used in France where they prolong life and are useful especially for older recipients.

Excessive focus on score

The new analysis found that for each patient who received a kidney from 2008 to 2015, their medical team rejected a median of 17 organs before finally accepting one.

The teams of patients who died while waiting received a median average of 16 offers that they turned down. Overall, 10 candidates with at least one previous offer died each day during the study period.

“What’s more problematic is that people are saying no without talking to the patients,” Mohan said.

When a potential donor dies, their kidney is removed and offered to dialysis patients on a waiting list. It is sent to the patient’s hospital, which is given one hour to respond.

Most of the time, hospitals will reject the offer in the hope that another of a higher quality score comes along.

For Mohan and his colleagues, the excessive focus on this score is a problem because patients would be more inclined to accept a kidney with a lower score if it means being able to get off dialysis, a procedure that requires multiple hospital visits per week and has an average life expectancy of five to 10 years.