The Perfect Kidney
When it comes to organ donations and transplants, the imperfect kidney is better than death.

So it seems to me, especially in light of how there are 93,000 people on the transplant list in the U.S., waiting for perfect kidneys that may never come.

The thing is, CNN's Jen Christensen reports that "at least 3,500 donated kidneys are discarded every year, according to a study published Monday in the journal JAMA Internal Medicine":

More than 37 million Americans have chronic kidney disease and roughly 5,000 die each year while on the kidney waiting list. That's about 12 people each day, making kidney disease the ninth leading cause of death in the United States.

In this new study, researchers looked at the number of deceased donors with organs offered to kidney transplant centers between 2004 and 2014. Over that time period, 156,089 kidneys were donated; 128,102 were transplanted; 27,987 were discarded. That means more than 17% of kidneys donated in this United States were discarded.

Since the end of the study period in 2014, the number of discarded kidneys has increased. In 2016, 3,631 donated kidneys -- about 20% -- were discarded, according to the researchers.

In comparison, in France, only about 9% of donated kidneys were discarded during the study period. The difference was because, in France, doctors were more willing to use older kidneys and kidneys from people who had other ailments such as diabetes or hypertension.

Research has found that new treatment approaches to manage the complications of donated organs make the transplant even of a lesser quality organ, a better option than dialysis, but US policies haven't kept up.

One of the main drivers of this trend, the authors say, is that there is "intense regulatory scrutiny of US transplant programs, which may lose credentials if their one-year death and graft failure outcomes exceed predicted outcomes." In other words, if the organ isn't in the best shape, transplant centers may be risk averse and reluctant to take a chance.

People die so transplant centers can keep their good grades and their credentials.

There are some caveats -- and then again...!

An older kidney or one with comorbidities costs more to transplant, because a patient is hospitalized longer and it takes a patient longer to recover.

Some regions discard more kidneys than others, the study said, suggesting that a decision to keep or discard a donated organ is at least somewhat subjective.

A 2016 study of discarded kidneys deemed unfit for transplant was reviewed by a panel of transplant experts that found as many as 50% of the kidneys that were discarded could have been transplanted, according to the National Kidney Foundation.

Of course, markets in organs would make a difference, too.