Historically, more than 20% of deceased donor kidneys are not used each year, largely due to concerns that acute kidney injury (AKI) and dialysis used to treat the donors renders the kidneys too damaged for transplantation.

A new retrospective study by Johns Hopkins researchers, published in JAMA, concludes: Not so fast. The scientists found that while those who received such kidneys experienced a “significant delay” in the function of the transplanted organ compared with those whose donors did not have dialysis, there was no significant difference in rates of transplant failure or death.

For the study, researchers analyzed medical records for 1,944 kidney transplant patients gathered from 58 U.S. organ transplant organizations from 2010 to 2018.

Results showed there was higher incidence of delayed graft function in patients who received kidneys from deceased donors who had undergone dialysis than there was for patients with kidneys from deceased donors who did not receive dialysis. However, the kidney recipients with higher delayed graft function did not show any significant differences in long-term graft failure (permanent loss of function of the transplanted organ).

“With patients waiting many years to receive a kidney, and a significant portion of them deteriorating or succumbing to their condition while on the waiting list, we need to rapidly increase the pool of available kidneys,” says study key investigator Chirag Parikh, director of the Division of Nephrology.

“The findings from this study should encourage organ procurement organizations and transplant professionals to cautiously bring kidneys with severe AKI from deceased donors who received dialysis into the allocation pool.”