Kidney transplants from cardiac deaths could reduce waiting lists

Scientists found kidneys from patients who have suffered a cardiac arrest perform just as well as those from “brain-dead” donors.

Previously it was widely assumed heart death kidneys were inferior.

Doctors believe the new evidence could double their numbers, greatly relieving the pressure on transplant waiting lists and offering new hope to thousands of patients.

More than 7,000 men and women in the UK are waiting for a kidney transplant. Each year, almost one in 10 of these patients die because a healthy kidney cannot be found for them.

Researchers examined data from more than 9,134 kidney transplants conducted in 23 UK centres. Of these, 8,289 kidneys were donated after brain death and 845 after heart death.

The findings were published today in an early online edition of The Lancet medical journal.

Study leader Professor Andrew Bradley, from the department of surgery at Cambridge University, said: “Cardiac death donors represent an extremely important and overlooked source of high-quality donor kidneys and have the potential to increase markedly the number of kidney transplants performed in the UK.”

Since the 1970s, the vast majority of transplant organs have been taken from deceased donors who have suffered massive and irreversible brain injuries. Over the past decade their numbers have fallen, due to better treatment of head injuries and fewer deaths from traffic accidents.

Currently, kidneys from heart death donors are not allocated as effectively as those from brain-dead donors, which are subject to a national points-based system.

Professor James Neuberger, from NHS Blood and Transplant, which oversees transplant services, said: “Donation after cardiac death has been increasing steadily in the UK for some years. NHSBT has invested in several schemes in the wider NHS in order to help facilitate this type of donation.

“It is not a substitute for donation after brain stem death but another way that organs can be retrieved, particularly kidneys, but also livers, and in a small number of cases, lungs. The process also enables even more people to have their wish to donate fulfilled.

“NHSBT is currently working with the Department of Health, British Transplantation Society, the emergency department and intensive care communities on reviewing existing guidelines relating to donation after cardiac death with a view to producing national clinical guidelines.”