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Expanding the donor pool
1Department of Internal Medicine, University of Cincinnati Medical Center, OH 45267-0585, USA.
Abstract:
Advances in techniques and the development of new immunosuppressive drugs have made it possible to transplant a large number of patients throughout the world. However, the shortage of cadaveric organ donors remains the major obstacle for the full development of organ transplantation, imposing a severe limit to the number of patients who could benefit from this therapy. Although transplants save thousands of lives and transform the quality of life of thousands more, many people will die or remain on renal replacement therapy because the organ supply falls drastically short of actual demand. In the US, the number of organ donors has increased approximately 20% over the past 5 years, but this increase has been brought about largely by the use of older donors and other donors considered by some to be marginal. In the 6 years from 1988 to 1994, the waiting list for kidneys grew by 76% in the US. By the end of August 1996, there were 33,339 patients registered for kidneys on the national transplant waiting list. This report examines the issue of the elderly donor, the role of living-unrelated kidney transplantation, and proposes various strategies to enhance procurement of cadaver kidneys.
Insights
Organ transplantation is limited by donor shortages. This report explores using elderly donors and living-unrelated kidney transplants to increase organ availability and reduce waiting lists.
Area of Science:
- Nephrology
- Transplant Surgery
- Public Health
Background:
- Organ transplantation has advanced significantly with new drugs and techniques.
- A critical shortage of cadaveric organ donors severely limits the number of patients benefiting from transplantation.
- The demand for organs, particularly kidneys, far exceeds the available supply, leading to long waiting lists.
Purpose of the Study:
- To examine the challenges and potential of using elderly donors for organ procurement.
- To evaluate the role and feasibility of living-unrelated kidney transplantation.
- To propose strategies for increasing the availability of cadaveric kidneys for transplantation.
Main Methods:
- Review of current organ donor statistics and trends in the US.
- Analysis of the increasing use of marginal donors, including the elderly.
- Examination of the potential for living-unrelated kidney donation as an alternative source.
- Exploration of policy and logistical strategies to enhance cadaveric kidney procurement.
Main Results:
- Despite a 20% increase in organ donors over 5 years, the supply remains insufficient.
- The waiting list for kidneys grew by 76% between 1988 and 1994 in the US.
- By August 1996, over 33,000 patients were on the national kidney transplant waiting list.
- Increased reliance on older and marginal donors is a current trend.
Conclusions:
- The shortage of organ donors remains a critical barrier to expanding organ transplantation.
- Utilizing elderly donors and exploring living-unrelated kidney donation are potential avenues to address the donor deficit.
- Developing enhanced strategies for cadaver kidney procurement is essential to meet patient demand.