Lives of kidney disease patients could be saved by international changes to donor policy

Thousands of kidney disease patients' lives around the world could be saved every year if countries adopted the UK's rules on organ donation, a new study has found.

In most countries, organs from donors without a heartbeat can only be donated if the donor dies within one hour of organ removal. In the UK, you can donate your kidney up to three hours after you stop this support.

Now, in the laboratory published in JAMA network openScientists at the University of Newcastle, UK, have shown that the quality of a donor's kidney is not affected by the time between life support being withdrawn and the donor's death.

Experts are now calling on international organ donation organizations to consider changing their policies to increase the number of organs available.

Time to death rules

Most countries have strict time-to-death regulations, and if the donor does not die within an hour of being taken off life support, the donor team leaves and the organ is not used for transplantation.

But in the UK, teams have been waiting for a minimum of three hours, and scientists have found it would be beneficial to wait a few more hours to save as many lives as possible.

Based on current trends in the United States, if only this country adopted the 3-hour rule, the United States would likely receive 1,000 additional kidney transplants per year and many more kidney transplants worldwide. there is.

Samuel Tingle, clinical research fellow at the University of Newcastle, who led the study, said: “Our study supports the idea that an hour before death is important for maintaining organ health. “We have debunked it. What we are showing is that it takes longer to die.” Deaths do not affect kidney quality or success, but increase the number of donated kidneys, which is a benefit for patients on the waiting list, potential organ donors, and donor families.

“Increasing the number of kidneys internationally could have a major impact on transplant waiting lists and save more lives. Also, taking patients off dialysis could significantly improve their quality of life. Increasing the number of successfully donated kidneys from consenting donors also respects the wishes of donors and their families wherever possible.”

This study was a statistical analysis of data from the UK Transplant Registry. Researchers used de-identified information obtained from 7,183 kidney transplant recipients between 2013 and 2021.

This is the largest study to date specifically focused on time-to-death policies for kidney donation. Previous research led by the same Newcastle team has shown that the longer wait time for death does not cause damage to the liver or pancreas.

“A surprisingly simple change”

Mr Tingle, who is also an honorary clinical research fellow at Newcastle upon Tyne Hospitals NHS Foundation Trust, said: 'International organ donation organizations are following the UK policy of waiting a minimum of three hours after removing life support from a potential donor. I think we should implement this,” he said. This is a surprisingly simple change that can be made around the world to safely increase the number of kidneys available for transplant. ”

The research was led by Newcastle University and involved the University of Cambridge, the University of Wisconsin, Guy's Hospital and NHS Blood and Transplant.

Further research will be carried out in collaboration with NHS blood and transplant organizations to examine whether waiting times for death can be extended beyond three hours while maintaining organ quality.

Dale Gardiner, Associate Medical Director for Deceased Organ Donation at NHS Blood and Transplant, said: “The UK has been a world leader in this type of organ donation for over 10 years and we are delighted to be able to share this expertise with the world. I'm honored.'' We hope that the gift of organ donation will save more lives. ”