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Comment & Response
March 2020

The Number of Discarded Kidneys Is Likely Much Larger Than Reported—Reply

Author Affiliations
  • 1Paris Translational Research Center for Organ Transplantation, INSERM, UMR-S970, Paris, France
  • 2Department of Medicine, Renal-Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia
  • 3Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 4Department of Kidney Transplantation, Necker Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
JAMA Intern Med. 2020;180(3):467-468. doi:10.1001/jamainternmed.2019.6099

In Reply Our group recently examined the pool of kidneys procured from deceased organ donors from 2004 to 2014 and estimated that 17 435 kidneys discarded in the United States would have been transplanted had they been procured in France.1 Compared with the United States, French transplant centers are much more likely to accept kidneys from deceased donors who are older (mean (SD) donor age, 50.9 (17.3) years in France vs 36.5 (17.0) years in the United States) or have comorbidities including hypertension and diabetes. Our findings suggest a major missed opportunity to grow kidney transplantation that is available now if US centers were less risk-averse in terms of judgments they make about the acceptable biological characteristics of donated kidneys.2

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