June 3, 2003

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Johns Hopkins Researchers Report from the American Transplant Congress Meeting

The following news tips are based on abstracts or posters to be presented at the annual meeting of the American Transplant Congress, May 30-June 4 in Washington..


Most African-American kidney dialysis patients know about live donor transplants and might be interested, but they may not discuss those wishes with their health care providers, a Johns Hopkins research report shows.

Trying to account for why fewer African-Americans get kidney transplants, the research team queried 124 African-American dialysis patients and their families (124 spouses and 44 children) on their knowledge of live donor transplantation, whether they had discussed transplantation among themselves or with health care providers, and whether the patients were interested in receiving a transplant. They compared the relationship between a patient's knowledge and communication with preference for transplant, and assessed children's willingness to donate.

Some 88 percent of kidney dialysis patients, 93 percent of spouses and 91 percent of children were aware of live donor transplants. Though 72 percent of patients said they desired a transplant, only 65 percent discussed that
with their doctors. Even fewer spouses (39 percent) and children (37 percent) discussed transplant with their loved ones' health care providers.

In families whose children had discussed transplantation with parents, 82 percent were very willing to become kidney donors, in contrast with only 50 percent among children who had not had such a discussion. Also, in families where patients and spouses discussed transplant with the doctors, 88 percent of patients desired a transplant, compared with 68 percent of those who did not have the discussion.

"Better communication between health care providers and African-American kidney patients' family members may improve not only their preferences for transplantation but also family members' willingness to donate," says L. Ebony Boulware, M.D., lead author of the study and assistant professor of medicine. "Still, more research needs to be done to understand these communication patterns among patients and their families, and how patients' preferences are related to those discussions."

Boulware's collaborators were Nancy Fink, M.P.H.; Rulan Parekh, M.D.; W. H. L. (Linda) Kao, Ph.D.; Lucy Meoni, Sc.M.; Michael J. Klag, M.D.; and Neil R. Powe, M.D.


Use of a machine that pumps chilled fluid through a cadaveric kidney prior to the time it is transplanted can significantly improve the organ's function after transplant surgery and improve its survival, according to a study done by researchers at Johns Hopkins and Organ Recovery Systems Inc.

Traditionally, kidneys are stored in a chilled fluid on ice after being procured. In the new study, scientists studied outcomes from more than 40,000 kidney transplants nationwide, examining the impact of the preservation method on kidney function and survival. Patients who received kidneys that had been preserved on the machine had significantly better early kidney function after transplant and improved kidney survival two years later. This study is the first to document an improvement in kidney survival using machine preservation, which currently is used at several centers around the country, the authors say.

"The use of machine preservation is associated with a marked improvement in early kidney function, which offers an enormous benefit by allowing patients to stop dialysis immediately after transplant surgery," says
Robert A. Montgomery, M.D., Ph.D., study co-author and director of Johns Hopkins' specialized kidney transplant programs. "This technique may allow us to use more 'extended criteria donor kidneys,' organs from older donors
with existing medical conditions. These organs had been slower to function following transplantation."

Study coauthors were Christopher Sonnenday, M.D., of Hopkins and Louise Jacobbi and Fred Gage of Organ Recovery Systems.

Related links:

The Johns Hopkins Comprehensive Transplant Center

American Transplant Congress