Cadaveric kidneys for transplantation: is there a need for more?

The paper questions the need for more cadaveric kidneys for transplantation. After establishing such need, it points out the inability of current supply to meet demand. Theoretically, enough kidneys should be available to meet all demand, so the various reasons for discrepancies between theoretical supply and the lesser actual one are discussed. The medical profession is aware of the insufficient supply of kidneys, and several avenues are currently being pursued to increase procurement. The paper reviews these activities and looks into possible future ones, mainly along the line of creating incentives, not necessarily financial, for more donations and procurement. Some experimentation may be necessary to identify more promising activities and to eliminate inefficient ones. Finally, the paper looks into the somewhat controversial problem of allowing living donors to participate in kidney banks. It argues that sometimes it may be immoral to prohibit a living donor from selling a kidney if this kidney has the prospect of offering excellent prognosis to a needy patient.