Transplant Experts Blame Allocation System for Discarding Kidneys
Transplant Experts Blame Allocation System for Discarding Kidneys
Last year, 4,720 people died while waiting for kidney transplants in the United States. And yet, as in each of the last five years, more than 2,600 kidneys were recovered from deceased donors and then discarded without being transplanted, government data show.
Those organs typically wound up in a research laboratory or medical waste incinerator.
In many instances, organs that seemed promising for transplant based on the age and health of the donor were discovered to have problems that made them not viable.
But many experts agree that a significant number of discarded kidneys — perhaps even half, some believe — could be transplanted if the system for allocating them better matched the right organ to the right recipient in the right amount of time.
The current process is made inefficient, they say, by an outdated computer matching program, stifling government oversight, the overreliance by doctors on inconclusive tests and even federal laws against age discrimination. The result is a system of medical rationing that arguably gives all candidates a fair shot at a transplant but that may not save as many lives as it could.
“There is no doubt that organs that can help somebody and have a survival benefit are being discarded every day,” said Dr. Dorry Segev, a transplant surgeon at Johns Hopkins University School of Medicine.
For 25 years, the wait list for deceased donor kidneys — which stood at 93,413 on Wednesday — has remained stubbornly rooted in a federal policy that amounts largely to first come first served. As designed by the government’s Organ Procurement and Transplantation Network, which is managed under federal contract by the nonprofit United Network for Organ Sharing, the system is considered simple and transparent. But many in the field argue that it wastes precious opportunities for transplants.