Chapter 16 : Allocation of Resources: Scarcity and Triage

Section 5. Case Study

Cadaver Kidneys Effective


July 25, 2002


Kidneys transplanted from a cadaver keep working just as long as those taken from a brain-dead patient with a still-beating heart, according to a Swiss study that offers a promising way to ease the severe shortage of donor organs.

Some doctors have long believed that if they wait until a person's heart has stopped to remove the kidneys, the organs will become damaged from lack of oxygen and will not last as long when they are transplanted.

By using organs from "cardiac death" donors, the number of kidneys available could increase up to 30 percent, meaning about 1,000 or more extra U.S. donors a year, experts estimate.

In the first long-term study comparing the two approaches, doctors at University Hospital Zurich followed nearly 250 transplant patients for up to 15 years and found nearly identical survival rates.

Half had agreed to get kidneys from cardiac death donors, under strict rules requiring a doctor other than the transplant surgeons to wait 10 minutes after the heart stops to declare death. At 10 years, 79 percent of those patients were alive, as were 77 percent of patients whose organ came from a brain-dead donor whose heart was beating.

"That tells us that we should use these 'non-heart-beating donors,' absolutely no doubt," said Dr. Pierre-Alain Clavien, chairman of surgery at the Swiss university.

This study was a head-to-head comparison of the two approaches and was the first to follow patients for many years. It was published in today's New England Journal of Medicine.

As of 2001, only about 2 percent of U.S. kidney transplants were done with organs taken from people whose hearts had stopped. The United Network for Organ Sharing estimates nearly 53,000 Americans are waiting for a kidney transplant. Fewer than 15,000 each year get a kidney; 2,800 others die waiting.

Copyright 2002, Newsday, Inc.

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Copyright Philip A. Pecorino 2002. All Rights reserved.

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