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Strategy for eliminating the kidney shortage
Clinical Transplants
|January 1, 1997
Summary
Kidney transplants are projected to increase significantly, reaching 18,000 annually within 14 years. This rise is driven by an increase in non-heart-beating donors (NHBD) and optimized donor utilization, leading to "transplant nirvana."
Area of Science:
- Nephrology and Transplant Surgery
- Organ Donation and Transplantation Science
Background:
- Anticipates stable kidney numbers from donors under 55 (approx. 8,000/year).
- Projects a natural increase in older and living donors, raising total transplants to 14,000/year within 8 years.
- Proposes a temporary 4-year acceleration phase to boost older cadaver, related, and unrelated living donors.
Discussion:
- Recommends increasing non-heart-beating donors (NHBD) by 700/year, reaching 10,000 NHBD kidneys in 14 years.
- NHBD will gradually replace kidneys from accelerated efforts, living donors, and older heart-beating donors.
- An increased kidney supply will accommodate current waitlisted patients, those needing retransplants, and potentially new candidates.
Key Insights:
- Aims for 18,000 available kidneys annually within 14 years.
- NHBD are projected to constitute 60% of the kidney supply, with heart-beating donors making up 40%.
- This strategy aims to eliminate the need for living donors, older donors, and xenotransplantation (pig donors).
Outlook:
- Achieving a state of 'transplant nirvana' with abundant kidney supply.
- Potential to encourage more patients to become transplant candidates.
- Sufficient capacity to meet the needs of increasing transplant candidates and retransplant patients.