Expanding the Kidney Chain

Kidney transplant donor chains may benefit minorities

(RxWiki News) When people with kidney disease need a new kidney, their family members may be able to offer that organ. But patients don't always have a relative that is a good match. This is where living donor chains come into play.

Almost half of kidney recipients in living donor chains are minorities - a finding that suggests that minority groups may benefit from expanding this type of donation.

"Consider becoming a kidney donor."

In living kidney transplant donor chains, kidney donors who do not match their relatives are paired with unknown patients who also were not matched with their relatives.

Through this process, relatives who wanted to donate can donate and get a much-needed kidney for their ill family members.

Jeffrey Veale, MD, of the University of California Los Angeles (UCLA), and colleagues found that 46 percent of recipients in living kidney donor chains were ethnic minority patients.

"Of all living donor kidney transplants performed in the United States in 2011, only 33 percent were to ethnic minorities," said Dr. Veale, who is also the director of the UCLA Kidney Exchange Program.

"So the fact that nearly 50 percent of the chain transplants were ethnic minorities is a real game changer," he said.

This finding suggests that donor chains may "broaden, increase and diversify the population of patients who can receive kidney transplants," he said.

In addition, the authors noted that a larger percentage of minority patients may have received living kidney transplants through chains because larger urban transplant centers - which have more ethnic diversity - may be participating more in donor chains.

According to study co-author Marc Melcher, MD, PhD, of Stanford University, "About 30 percent of patients needing a kidney transplant discover that their friends and relatives are incompatible as donors. Donor chains create opportunities for potentially endless donor-recipient pairings."

Donor chains are not only started by incompatible family members; generous and altruistic donors can also set the chain in motion. The longest kidney transplant chain - made possible by the National Kidney Registry - involved 60 patients.

Many patients on dialysis spend years on the transplant waiting list. In many cases, they never get a new kidney. Living donation is a way to get more kidneys to more patients at a faster rate, which saves lives.

If more kidney transplants are performed each year, health care costs may also go down, said Dr. Veale. While caring for dialysis patients costs about $70,000 a year, it costs about $20,000 a year to care for patients who have gone through transplantation.

What's more, living donor kidneys last about twice as long as kidneys that have come from dead donors. According to Dr. Veale, the health system saves about $500,000 every time a patient gets a transplant.

Now, said Dr. Veale, the goal is to link donors and patients from around the world.

"A kidney that could free a patient in California from the constraints of dialysis may be found in a donor who lives in London, Barcelona or Vancouver," he said.

For their research, Dr. Veale and colleagues studied 272 living donor transplants made possible through chain donation. The transplantations were performed at 57 centers between February 2008 and July 2011.

The study was published August 27 in the American Journal of Transplantation.

Review Date: 
September 19, 2012