Developments in Brief : Kidney Matching Cited in Transplant Failures

Up to 70% of transplanted kidneys will probably fail over 10 years, but the long-term outlook could be improved if donated organs were better matched to the recipients, says a UCLA researcher.

Surgery Prof. Paul Terasaki said the shortage of donated organs, difficulty in transporting them and the lack of a formal nationwide network to allocate donations are the most frequent reasons patients might not get a good match.

“There’s also a bit of parochialism” in that medical personnel might prefer to reserve an organ for use nearby rather than attempt to offer it for use far away, he said. “We need to think nationally. We also have to think internationally.”

Terasaki told an opening session of an International Organ Transplant Forum in Pittsburgh last week that a study of 8,100 kidney transplants done from 1983 to the present and using data going back a decade found only 30% of kidney transplants could be expected to continue functioning after 10 years.

“If you’re mismatched, you get organ failure,” Terasaki said.

Matching is done in a process known as tissue, or HLA, typing. HLA stands for human leukocyte antigen. Researchers using studies of white blood cells have found about 90 different tissue types and this variety makes tissue typing for organ donation a time-consuming and difficult job, Terasaki said.

His team made its projections about 10-year survival using data from 66,000 organ transplants done over a decade.