It is important for all Chronic Kidney Disease and Dialysis patients to remember that the Chronic Kidney Disease Community is ever changing as it strives to improve the lives of those with Chronic Kidney Disease and Dialysis patients. Research is often used to shape policy, and findings from the University of British Columbia (Canada) come with a bit of controversy as researchers suggest that kidneys from older Deceased Donors (65 and older) no longer be discarded and instead used in patients 60 years and older while challenging "the policy in the United States of allowing patients younger than 50 years to receive an Expanded Criteria Donor transplant."
An Expanded Criteria Donor (ECD) is any donor over the age of 60, or a donor over the age of 50 with two of the following complications: (1) A history of High Blood Pressure, (2) a Creatinine (blood test that shows kidney function) greater than or equal to 1.5, or (3) death from a stroke. Most will be surprised to learn that even with over 100,000 Chronic Kidney Disease patients awaiting a Kidney Transplant, Expanded Criteria Donor kidneys are typically discarded. However, according to a new study published in the Journal of the American Society of Nephrology, kidneys from older donors are suitable for older patients because of their shorter life expectancy.
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Although, a single kidney from an Expanded Criteria Donor may be effective for older Recipients, sometimes the function of a single kidney from an Expanded Criteria Donor is not sufficient. In this case, a Chronic Kidney Disease patient may still be able to use an Expanded Criteria Donor in a procedure known as, Dual Kidney Transplant, where a pair of Expanded Criteria Donor kidneys with limited function are transplanted into a single patient.
Were you aware of these options? Given that the incidence of Chronic Kidney Disease is increasing most rapidly in people ages 65 and older, this could very well be a viable option to cut the Kidney Transplant Waiting List. Rather than discarding Expanded Criteria Donor kidneys, the Chronic Kidney Disease Community may effectively address the shortage of kidneys by utilizing these "less desirable" kidneys in willing Kidney Transplant Recipients.
Transplant Centers such as the University of California Davis (leads Northern California in the use of Expanded Criteria Donor kidneys) must receive written permission from its Chronic Kidney Disease patients before offering an Expanded Criteria Donor kidney. Ultimately, the decision to accept an Expanded Criteria Donor kidney is personal, but according to the University of California Davis Transplant Center, "Accepting an Expanded Criteria Donor kidney may significantly decrease the amount of time a person waits for transplant."
Risks associated with Expanded Criteria Donor kidneys are not fully known, but it is safe to say that after 5 years, half of Expanded Criteria Donor kidneys will still be functioning compared to 7 of 10 Standard Criteria Donor kidneys. Still, studies have shown that on average Chronic Kidney Disease patients who receive either kidneys from Standard Criteria Donors or Expanded Criteria Donors have a superior survival when compared to remaining on Dialysis.
If you are considering using Expanded Criteria Donor kidneys for transplantation then talk to your Nephrologists about whether to consent given various possible complications and your personal health status. First, however, weigh-in: Would you ever consider accepting an Expanded Criteria Donor kidney, and should patients less than 50 years old be eliminated from potentially accepting an Expanded Criteria Donor? Share your thoughts on the rapidly growing KidneyBuzz.com Facebook Fan Page with over 18,000 other Chronic Kidney Disease patients and Friends (click here).
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