Tired of seeing patients dying of kidney failure, a California surgeon has made an unprecedented move: He has begun reusing kidneys that have already been in two bodies.
A second recycling of organs is rare, but the surgeon, Jeffrey Veale of the Ronald Reagan UCLA Medical Center, estimates that a quarter of people who die after kidney transplants die with perfectly re-usable kidneys. Now, with three such surgeries behind him, he is pushing for other transplant centers to follow his lead—in the hopes that keeping healthy kidneys in circulation will help pull desperate patients off years-long waitlists.
In general, transplant surgeons are wary of the idea. As they see it, living through the death of two bodies is traumatic for organs, and transplant surgery can cause kidneys further injury, as they get artificially flushed, cooled, and infused with drugs to keep bodies from rejecting them. But Veale argues that judging a kidney based on the lives it’s lived disqualifies some organs unnecessarily, leading to preventable loss of life.
Today, the U.S. has more than 74,000 people on waiting lists for kidney transplants—a wait that often outlasts their ability to survive kidney failure. Hundreds of thousands of people are currently surviving on dialysis, a several-hour treatment multiple times a week that does the kidneys’ job of flushing waste from the body. However, only a third of people survive more than three years on dialysis—meaning many never live to see their turn for a transplant.
Whether it’s a literal lifesaver or an immense reprieve from time-consuming dialysis, a donor kidney can make all the difference in someone’s life. Here’s Usha Lee McFarling, reporting for STAT News:
Vertis Boyce of Las Vegas is thrilled with the “pre-owned” kidney she received in July, which allowed her to stop the dialysis treatments she’d been on for nine years and start traveling again. She recently attended a nephew’s wedding in North Carolina.
“I feel free again,” she said. “I can do all those normal things you take for granted.”
At the moment, it’s too soon—and there are too few cases—to tell how the performance of twice-reused kidneys compares to ordinary transplants, which typically last up to 12 years. But all three of Veale’s patients now living with twice-recycled kidneys are doing well, months after surgery.
Now, “pre-owned” kidneys are not the only kidneys being reconsidered for transplants. Around the country, surgeons are successfully transplanting kidneys from HIV- and other disease-infected donors into similarly infected patients.
In light of his preliminary success, Veale stands by his hunch—that the best way to determine a kidney’s suitability for transplant, he says, is how it performs in a lab test, not its history.