Study reveals neonatal kidneys can ease organ shortage

Organ shortage crisis

The organ shortage is a major challenge for organ transplantation. In the US, 100,000 patients were waiting for a kidney transplant in January 2022, but only 24,669 kidneys were transplanted in 2021. As a result, 5,000 patients died while waiting for a donor.

This situation is similar in Europe, where the demand for organs exceeds the supply, and thousands of patients die every year while on the waitlist. The aging population and the rise of chronic diseases such as diabetes, obesity, and liver disease increase the need for transplants and reduce the number of available organs.

Kidneys are the most common organ transplanted in Europe, accounting for over 60% of all transplants in 2018. Previous studies have shown that kidneys from pediatric donors can work well in adults. Neonatal kidneys can grow and function better than living donor kidneys in the long run (>25 years).

Dr Dai Nghiem, the lead author of the study, says, “We believe that neonatal kidney transplantation offers a ‘game-changing’ solution to the organ shortage crisis. This study looked at the US alone, but if you replicate the findings across the globe then we have a huge untapped pool of available organs that can be used for transplants.

The ethical question

Indeed, pediatric organ donation poses unique ethical complexities, especially when dealing with newborn organs. 

Certainly, Dr. Dai Nghiem acknowledges that organ donation in children presents distinct ethical and societal issues when compared to those in adults. For family members and healthcare providers, choosing to donate can be an emotionally complex decision, particularly when it involves the organs of a newborn. There is also a level of apprehension within the transplant community about the procedure's challenging and experimental aspects.

However, Dr. Dai Nghiem maintains a hopeful outlook. By exchanging information among top medical centers, the goal is to alleviate these concerns and focus on this often-neglected group of possible donors.

Professor Gabriel Oniscu, ESOT President-Elect and Co-Chair of the ESOT Congress 2023, comments, “While respecting the emotional and sensitive nature of this issue and the ongoing ethical and legal considerations, the study’s findings highlight the importance of recognizing neonates as potential organ donors. To achieve this, every European country must have specific pediatric donation protocols that include neonatal organ donation procedures. This proactive approach aims to raise awareness among Neonatal Intensive Care Unit professionals about the possibilities of neonatal donation, and encourage discussions with parents that could help save many lives.”

Founded 40 years ago, ESOT has been a catalyst in propelling organ transplantation science forward. Hosting biennial congresses that draw around 3,500 global experts, it remains a nexus for scientific exploration and collaboration. As this year’s Congress wraps up, it's clear that the neonatal kidney transplantation study could be a turning point, not just for ESOT, but for the millions grappling with the life-or-death urgency of organ shortages.