Kidneys for transplant are often damaged during organ retrieval, an increasing but underreported problem that may be exacerbating the drastic shortage of transplant organs.

A research team in Edinburgh analysed data from the UK National Transplant Database on all cadaveric kidneys donated over a five-year period in the UK. Their search revealed that of 9014 kidneys retrieved, 19 per cent were damaged.

Several factors contributed to the likelihood of damage. The most important was the type of surgical team who retrieved the kidney. Surprisingly, damage was more likely when the kidney was taken out by a specialist team. The likelihood of damage was lowest when a specialist liver team retrieved both liver and kidney at the same time, or when the operation was carried out at a centre which performed a high number (50 or more) of retrievals each year.

Interestingly, kidney damage did not preclude the possibility of transplant; 94 per cent of the damaged kidneys were still transplanted. In addition, the age of the donor had an influence on how damaged the kidney was likely to be; 62 per cent of damaged kidneys were from donors aged 40 years and older. This fact is important because there is an increasing pressure to increase the donor pool by taking organs from older, marginal donors.

In this study, the donors' age also had a significant effect on both one-year and three-year survival for the person on the receiving end of the transplant; the older the donor, the less likely the recipient was to survive (Lancet, 1999; 354: 1143-6).