This article is the second in a series of Kidney News articles addressing ways to increase kidney donation on the basis of the deliberations at a December 2016 Rogosin Institute Roundtable on increasing the rate of kidney transplantation.
The first article in this series addressed five ways that the rate of kidney transplantation in the US could be increased to save more lives and provide a better quality of life to those patients with kidney failure: 1) decreasing the need for transplant through health promotion and disease prevention, 2) increasing the supply of deceased donor kidneys, 3) decreasing the kidney discard rate, 4) increasing living donation, and 5) increasing kidney paired donation.
Of these, one immediate and practical solution is to decrease the discard rate of donor kidneys: 20 percent of kidneys procured are never used. Here, we interview 3 experts about why this discard rate is so high and what might be done to decrease it. These panelists include a transplant surgeon (Sandip Kapur, MD), a transplant recipient and patient advocate (Kevin Fowler), a pretransplant coordinator (Christa Lawson), a nephrologist who is vice chair of the board of a dialysis company (Doug Johnson, MD), and a clinical services director of an organ procurement organization (Deana Clapper).
Schold JD, et al.. The association of center performance evaluations and kidney transplant volume in the United States. Am J Transplant 2013; 13:67–75.
Schold JD, et al.. Association of candidate removals from the kidney transplant waiting list and center performance oversight. Am J Transplant 2016; 16:1276–1284.
Bae S, et al.. Changes in discard rate after the introduction of the Kidney Donor Profile Index (KDPI). Am J Transplant 2016; 16:2202–2207.
Mohan S, et al.. The weekend effect alters the procurement and discard rates of deceased donor kidneys in the United States. Kidney Int 2016; 90:157–163.
Schold JD, et al.. Association between kidney transplant center performance and the survival benefit of transplantation versus dialysis. Clin J Am Soc Nephrol 2014; 9:1773–1780.
Haller MC, et al.. Dialysis vintage and outcomes after kidney transplantation: A retrospective cohort study. Clin J Am Soc Nephrol 2017; 12:122–130.