Expanding the Organ Donor Pool: Using En Bloc Kidneys in Pediatric Recipients

Abstract

The demand for renal allografts has so far outstripped the available organ donor pool that the gap between patients awaiting a transplant and those actually receiving a transplant seems to be forever widening. Renal transplantation is the ultimate treatment of choice for patients with end stage renal disease as it offers better long term survival and quality of life compared to dialysis [1]. Children with end stage renal disease are especially vulnerable to the organ shortage, since their psychosocial and neurodevelopmental functioning is adversely affected by the uremic environment and any delay in transplanting them can have long term ramifications. Moreover, pre-emptive transplantation has been shown to improve long term graft survival in children [2] . These considerations have made it critical for health-care providers to minimize wait times on dialysis. Among other strategies, expanding the deceased donor organ pool by using organs from donors previously thought of as unsuitable, has proven to be a successful strategy.