Neonatal kidney transplantation a solution for organ shortage: Study

LONDON: Neonatal kidney transplantation can offer a 'game-changing' solution to the pressing organ shortage crisis, suggests a study.

While previous research confirmed the viability of transplanting kidneys from paediatric donors into adults, making the decision to donate can be an incredibly tough process for families and caregivers, especially the organs of their newborn.

A team from the Drexel University in the US, analysed neonatal mortality in the country and the long-term development of these kidneys after transplantation as well as the ethical and social considerations surrounding the procedure.

The research, presented at the ongoing European Society for Organ Transplantation (ESOT) Congress 2023 in Athens, Greece, revealed that out of the 21,000 infants who lost their lives in 2020, more than 12,000 could have been considered as viable organ donors.

The organ shortage is one of the greatest challenges facing the field of organ transplantation, across the globe. As human life expectancy increases whilst chronic conditions like diabetes, obesity and liver disease become more prevalent, there is an increased need for transplants and a reduction in the number of available organs.

Notably, neonatal kidneys have demonstrated catch-up growth and excellent long-term performance (more than 25 years), exceeding that of living donors. Current transplantation techniques have also proved to be safe and effective for neonatal kidneys.

“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,” said lead author Dr Dai Nghiem, from the varsity.

“Understandably, paediatric organ donation presents distinct ethical and social challenges compared to adult donation.

“There is also a concern amongst the transplant community about the difficulty of the procedure along with its experimental nature. Through the exchange of experience among pioneering centres, we hope to address these concerns, foster acceptance of this forgotten source of organ donors and ultimately save more lives through organ transplantation,” Dr Nghiem added.

Professor Gabriel Oniscu, ESOT President Elect and Co-Chair of the ESOT Congress 2023, said: “While recognising the highly emotive nature of this issue and the ongoing ethical and legal considerations, the study’s findings underscore the importance of acknowledging neonates as potential organ donors.

“To achieve this, it is imperative that every European country has dedicated paediatric donation protocols in place that encompass neonatal organ donation procedures. This proactive approach aims to heighten awareness among Neonatal Intensive Care Unit professionals regarding the possibilities of neonatal donation, promoting discussions with parents that could help save many lives,” he said.