Renal transplantation is the best treatment modality for replacement of lost renal function in patients with end-stage renal disease. Nevertheless, the gap between the number of kidneys available for donation and the number of patients waiting for an organ is increasing due to an increase in the number of patients with renal failure and, simultaneously, a shortage of kidneys for transplant.
Objective
To review the policies available for kidney donation.
Evidence acquisition
A review of literature was performed to describe the available policies. Rates of donation were compared according to the different policies for several Western countries.
Evidence synthesis
The classical donor type is the deceased heart-beating donor after brain death; however, shortage of organs forced the expansion of the criteria for donation. The concepts of expanded criteria donation and donation after circulatory death have been adopted more recently. Scores based on donor characteristics and histology criteria from kidney biopsies are also used to refine the quality of organs used for transplantation. Live donation is still marginal in many countries.
Conclusions
There is an urgent need to increase public awareness of kidney transplantation, to improve strategies to identify new potential donors, and to master the techniques of retrieving and preserving organs. Increasing live donation is also essential to overcome organ shortage.
Patient summary
There is an urgent need to increase public awareness of kidney transplantation, to improve strategies to identify new potential donors, and to master the techniques of retrieving and preserving organs. Increasing live donation is also essential to overcome organ shortage.
