Study Supports U.S. Kidney Registry

Thursday, October 12th 2000, 12:00 am
By: News On 6

A study on the importance of finding a well-matched kidney supports the contentious idea that distributing transplant organs nationwide improves the chances they will get to those who will benefit most.

The study compared 7,614 people who got a perfectly matched kidney transplant under a national distribution program with 81,364 who got a less-than-perfect match because that was all there was.

When kidney and recipient were perfectly matched, 52 percent of the transplants lasted at least 10 years, compared with 32 percent for those who got a mismatched kidney.

Each organ bank in the United States generally offers organs first locally, then regionally, then nationally. U.S. Health Secretary Donna Shalala ordered that changed in 1998 so that all organs would go first to the sickest people, no matter where they live. Louisiana and Wisconsin has gone to court to try to overturn the rules, which have yet to take effect.

The study in Thursday's New England Journal of Medicine looked at a program set up in 1987 by the United Network for Organ Sharing. It ships kidneys anywhere in the country to people considered perfect matches.

``The findings support that program. Conclusively, we feel,'' UCLA researcher David W. Gjertson said.

Since 1987, doctors have gotten better at suppressing organ rejection after transplants, the upper age for kidney donors has risen, and new research has made perfect matches easier to find.

But some argued that sending refrigerated kidneys across the country would result in cold damage and that finding a perfect match is not important anymore because of improvements in immune-system suppression.

UNOS and UCLA looked at the program's 12-year results to establish whether perfect matches really do make a difference.

That held true except, perhaps, in one group. For some reason — the researchers do not know why — a perfectly matched kidney transplanted into a black person does not survive longer than a mismatched one.

One reason may be that high blood pressure in blacks does more damage to the kidneys. Transplanted kidneys lasted an average of 5.2 years in blacks with high blood pressure, compared with 10.8 years for blacks with other kidney diseases, the study found.

High blood pressure did not make any difference in transplant survival among whites.


On the Net:

American Society for Transplantation:

United Network for Organ Sharing:—Default.asp