Oh Suhyun, Kim Keonhwa, Na Omi, Ha Juhyung, Koo Tai Yeon, Yang Jaeseok
Division of Nephrology, Department of Internal Medicine, College of Medicine, Yonsei University Severance Hospital, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Department of Nephrology, Korea University Anam Hospital, Seoul, Republic of Korea.
Sci Rep. 2025 Jan 20;15(1):2588. doi: 10.1038/s41598-025-86998-6.
Considering the low deceased donation rates despite increasing rates of end-stage kidney disease in Asia, minimizing donor kidney discard is important. This study aimed to investigate the current situation of donor kidney discard in Korea. This nationwide study included deceased donor kidneys of candidates for kidney transplantation (KT) between 2013 and 2018 in Korea. Kidney discard was defined as no procurement or discarding after procurement of kidneys. Among 5592 deceased donor kidneys, no-procurement, single-procurement, and double-procurement were 385, 63, and 5144, respectively. All unilaterally procured kidneys, except for one, were transplanted. Bilaterally procured kidneys were accompanied by two KT (n = 5058), one KT with the other kidney discarded (n = 33), or both kidneys discarded (n = 20). The overall kidney discard rate was 7.9%. The cause of non-procurement was universally organ damage, and the common causes of kidney discard after procurement were organ damage, absence of available candidates, and malignancy. While the kidney donor profile index was higher in the discarded group than in the KT group, a large overlap was observed. The risk factors for kidney non-utilization were old age, hypertension, diabetes mellitus, high serum creatinine levels, low hemoglobin levels, and non-cerebrovascular causes of death. KT using contralateral kidney in the discard group showed graft failure and mortality rates comparable to those of KT in the no-discard group. The discard rate of deceased donor kidneys was low, and the discard of one kidney does not necessarily rule out the utilization of contralateral kidney, especially in Korea with a long waiting time.
鉴于亚洲终末期肾病发病率不断上升，但死者器官捐赠率却很低，尽量减少供肾丢弃至关重要。本研究旨在调查韩国供肾丢弃的现状。这项全国性研究纳入了2013年至2018年韩国肾移植（KT）候选者的死者供肾。供肾丢弃定义为未进行获取或获取后丢弃。在5592个死者供肾中，未获取、单肾获取和双肾获取的分别为385个、63个和5144个。除一个外，所有单侧获取的肾脏均进行了移植。双侧获取的肾脏中，有两个用于KT的（n = 5058），一个KT且另一个肾丢弃的（n = 33），或两个肾均丢弃的（n = 20）。总体供肾丢弃率为7.9%。未获取的原因普遍是器官损伤，获取后供肾丢弃的常见原因是器官损伤、无合适候选者和恶性肿瘤。虽然丢弃组的肾脏供者特征指数高于KT组，但观察到有很大重叠。肾脏未利用的危险因素包括老年、高血压、糖尿病、血清肌酐水平高、血红蛋白水平低以及非脑血管性死亡原因。丢弃组中使用对侧肾脏进行KT的移植物失败率和死亡率与未丢弃组中KT的相当。死者供肾的丢弃率较低，而且丢弃一个肾脏不一定排除对侧肾脏的利用，尤其是在等待时间较长的韩国。
