Washington (AFP)

Americans could save more lives if they agreed to transplant kidneys from donors as old as France, concludes a French study published Monday in the United States.

Researchers at Inserm's Center for Organ Transplantation in Paris compared 10 years of transplant data in both countries (2004-2014), and found that the average age of a deceased donor kidney was 39 years in the United States in 2014, against 56 years in France.

"They are nearly twenty years older on average, it's colossal," says AFP Professor Alexandre Loupy, lead author of the study.

Over the years, in the face of a shortage of organ donations, France has deliberately raised the risk threshold to accept older donor kidneys for older patients on waiting lists.

The reason: patients live longer with an "old" kidney than if they stayed on dialysis, with a higher quality of life, says Professor Loupy.

In contrast, the US centers have retained an excessive caution, say in substance the French researchers. Americans place greater importance on the age of the donor when assessing graft quality, and as a result they have excluded twice as many kidneys as French centers (18 versus 9%) over the study period.

"There are budgetary constraints and performance indicators that prevent them from performing transplants at risk," says Alexandre Loupy. "They take kidneys and put 3,500 per year in the trash, which is the equivalent of what is transplanted to the scale of France".

Both countries have different health systems and populations, which limits comparisons.

But the researchers simulated what would happen if the Americans adopted the French criteria. They calculate that they could have grafted 17,000 more kidneys in ten years ... and save 132,000 years of life accumulated between 2004 and 2014, according to this study published in a review of the American Association of Medicine (Jama Internal Medicine).

"A 70-year-old patient does not need a graft that works for 30 years," says Loupy, who hopes the study will lead the US to soften its policy.

A fortiori after a decree signed by President Donald Trump on July 10 which sets the goal of doubling the number of kidneys available for transplants by 2030.

© 2019 AFP