Restored organs key to shortage

USING "RESTORED" kidneys in transplants could help address a global shortage of donor organs, according to new medical reports.

Surgeons in Australia and Japan have successfully repaired diseased kidneys removed from living donors because of cancer or other disorders, and then transplanted them successfully into other patients.

The technique has generated controversy, according to last week's edition of New Scientistmagazine. But considering marginal organs for transplant could be a clever approach, and patients should be further consulted on the matter, the Irish Kidney Association (IKA) told The Irish Times.

"The whole story is that the patient has been repaired," said the IKA's chief executive officer, Mark Murphy, of reports that 42 patients in Japan and 49 patients in Australia had received restored kidneys in transplants. "And it's better than getting no kidney at all."

In Japan, where patients could wait up to 16 years for a healthy donor kidney, 79 per cent of recipients of restored kidneys were still alive after five years. Four patients on the Australian study died within about three years of receiving a previously diseased kidney, but the study's leader estimated that 10 patients per year would have died without a transplant.

Despite the success, the surgeons have come up against ethical concerns, including the risk of a kidney which had a cancerous growth removed once again developing the disease in the transplant recipient. But people need to look at the whole context and at the impact of not getting any transplant, according to the IKA's chief executive.

"Let's not kid ourselves. Kidney transplant patients are more susceptible to cancer as a side effect of immunosuppressant drugs," he said. "And you cannot survive indefinitely on dialysis. It's a hard regime and if you start dialysis at 50, the life expectancy is 10 years; if you start at 65, the life expectancy is four to five years."

At the end of last year, 1,520 adult patients in Ireland were being treated by dialysis, and 146 kidney transplants were performed here last year, according to the IKA. And the average expectancy for a transplanted kidney here is 14 years, noted Mr Murphy.

He described the newly published studies on restored kidneys as short but encouraging, and called for more discussion on using marginal organs for transplant that would otherwise be discarded.

"You are making a person healthy again - why wouldn't you do that?" he asked, noting that any decision to remove a diseased kidney from a patient would have to be made independently of the organ's later use in transplant.

He also said: "We need more patient involvement. Bring patients into the discussion, let's hear their view."