As patients deal with a shortage of kidneys for transplantation, physicians in the United States reject organs that doctors in France think work perfectly fine, new research shows.
Based on the country's medical criteria, France would have transplanted over 60 percent of kidneys the United States rejected for the procedure between 2004 and 2014, according to a study published Monday in JAMA Internal Medicine.
That disparity in transplantation rates is largely due to age requirements for kidney donors in the United States, the researchers say.
"Our study provides fresh evidence that organs from older deceased donors are a valuable, underused resource -- particularly for people on the waitlist who otherwise may not receive a transplant at all," study co-author Peter Reese, a researcher at the University of Pennsylvania and study co-author, said in a news release.
For the study, researchers analyzed data on acceptance and use of kidneys donated in France and the United States between 2004 and 2014. Through that period, about 156,089, or 18 percent, of deceased donor kidneys in the United States were discarded. That's twice the rate of France, who regularly accepts kidneys from older donors and other groups the United States would reject.
Through the study period, France relaxed its standards for kidney donations. Now, the average donor age in France is 56, about 17 years older than the average U.S. donor.
Meanwhile, kidney transplant recipients are getting older. The percentage of people over age 60 receiving new kidneys has risen sharply, from 22 percent in 2004 to 32 percent in 2017.
The researchers think if the United States adopted a more lax policy, it could reduce the more than 35,000 of people over age 60 in the United States waiting on a kidney. They say that would give more than 10,000 years of life to people who would otherwise die in need of a kidney.
Overall, this is important since the National Kidney Foundation estimates that more than 37 people in the country has chronic kidney disease.
"This study demonstrates that there is more the U.S. can do to prevent the deaths of thousands of Americans each year who are waiting for a transplant," said Alexandre Loupy, who runs the Paris Transplant Group and is a study co-author. "Our findings reinforce how collaboration between countries can lead to a concrete, new direction on how to help address a global health problem and advance care for wait-listed kidney patients in the United States."
Brian P. McDonough, MD, FAAFPPeer
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