Idea could boost kidney giving

4/20/2005

More people waiting for a donated kidney would be able to find a match if the nation adopted a computerized "paired" kidney donation program, according to a study in today's Journal of the American Medical Association.

Ohio, spurred by efforts at the Medical College of Ohio, is already pursuing a similar paired kidney exchange program. The Ohio system works like this: Someone is willing to donate a kidney to a loved one or friend, but the kidney doesn't match. Instead, they offer to donate to anyone, as long as that person has someone willing to donate a kidney back to the original person in need.

However, unlike the system studied by researchers at the Johns Hopkins University School of Medicine in Baltimore and described in today's issue of JAMA, Ohio does solely look at the maximum number of possible matches it can come up with. Instead, Ohio gives more weight to characteristics such as time on a waiting list or age of the donor because Ohio officials feel that's more fair.

Johns Hopkins researchers instead tackled the issue by saying what if donor centers only looked at the maximum number of matched donations that could be achieved, and did not consider other factors such as time on a waiting list.

Dr. Dorry Segev, lead author of the study, said that using what he called an "optimized" computer matching program the nation could find matches for 47 percent of people waiting for kidneys compared to what he predicted would be a 42 percent match rate using other existing matching systems like those in Ohio.

If an optimized system were done nationwide, that small difference would translate into thousands more people getting a donated kidney, he said.

Dr. Michael Rees, an MCO kidney transplant surgeon who helped develop Ohio's program, said he's glad the Johns Hopkins paper has been published, because "I think paired donation is a great thing, and taking it to a national level will only make it better."

But he said the Johns Hopkins research was a simulation only and not done using real-world examples or results, so he's cautious about whether he'd embrace their approach. Johns Hopkins researchers used a computer program to simulate the results of their optimized matching program. "At the end of the day, what's more important: getting the maximum number of transplants or giving them in a way we all think is fair?" Dr. Rees asked.

Despite those differences, Dr. Rees said anything that gets organ transplant officials talking about paired exchange programs is good. "The Ohio program hopes to work with the authors of this paper to improve paired donation for both strategies," he said.

Contact Luke Shockman at:

lshockman@theblade.com

or 419-724-6084.