People who need a new kidney may need to look no farther than across the dining room table, according to a new study that shows that spouses are good potential sources for so-called living-unrelated organ donation.

Due to a worldwide shortage of organs available for transplant from people who have died, living organ donors have become a major source of organs for transplantation.

And while a well-matched donor organ from a sibling, parent or other close relative has the highest likelihood of surviving in the recipient, there is also evidence that organs from living-unrelated donors such as spouses yield similar survival rates to those from well-matched living-related donors.

However, transplant patients may be reluctant to consider an organ from their spouses because the organs may not be well-matched in terms of blood and tissue type. Such poor matching can cause the immune system to reject the organ.

Against this backdrop, Dr. Yu-Ji Lee and colleagues from Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea Lee reviewed the medical records of 185 people who successfully underwent living-unrelated kidney transplantation at their institution. A total of 55 out of the 185 transplant patients received kidneys from their spouses.

They report in the journal Dialysis and Transplantation that kidney transplantation from spousal donors has comparable outcomes to those of other living-unrelated donors, and shortens the time spent on the waiting list.

While the incidence of acute rejection of the kidney in the first year after transplantation was more frequent in people who received a kidney from a spouse, the survival rates at 1 and 5 years for spousal and other living-unrelated kidneys were both high and were not significantly different.

Spouses are important potential donors for living-unrelated kidney transplantation, the investigators note in their report, and should be considered as a useful source to overcome an organ shortage.

Spousal donors have a strong emotional bond with their recipients, Lee and colleagues point out, and some investigators have found that spousal donor transplantation improved family relationships. There is also evidence, they say, that such a strong emotional bond may be related to the high survival rate of kidneys from spouses.

SOURCE: Dialysis and Transplantation, June 2009.