Compelling Evidence of the Need for Policy Change to Decrease Deceased Donor Kidney Discard in the United States: Waste Not Want Less

Clinical Journal of the American Society of Nephrology

Matthew Kadatz and John Gill

Summary by Aiza Waheed, UBC Nephrology Fellow

The Kidney Donor Profile Index (KDPI) is a score that utilizes donor factors to assess the quality of donor organs. A large proportion of deceased donor kidneys are discarded in the United States as they are considered high risk for poor outcomes given high KDPI values.  Recent studies have looked at organs from donors, from whom one of two kidneys has been utilized and the other discarded due to their high-risk nature. Thirty percent of these discards were due to factors isolated to the discard kidney, whereas the majority (70%) were due to factors that would impact both kidneys equally. Outcomes in such recipients are not different from cases where both kidneys were utilized (i.e. kidneys with higher KDPI did not do more poorly). In this editorial, Drs. Kadatz and Gill discuss the factors involved in donor kidney discard and the benefits and limitations of utilizing high KDPI organs, and advocate for policy change in the use of these organs in the United States.

Policy Change in Kidney Transplant CJASN (PDF)