Expanding the Donor Pool: Effect on Graft Outcome

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Expanding waiting lists have pushed healthcare professionals to find additional solutions. A variety of potential solutions, including dual transplant, use of organs with anatomical anomalies, and transplantation from hepatitis C-positive patients, are explained below. Dual transplant uses both kidneys from a single donor with impaired renal function. This technique is common in pediatric cases and could be expanded to adults as well. Successful repair of some anatomical anomalies prior to transplant have yielded positive results and could also be considered more widely. Hepatitis C is a virus causing liver disease and risk of liver failure. A few studies have investigated use of infected donor kidneys for hepatitis C-positive recipients with positive results. Recipients without hepatitis C should not receive an infected organ for fear of liver failure. Other possibilities suggested include kidney exchange and donors whose hearts have stopped beating. For more information, please see other articles devoted to these topics on our site. These donor pool expansion methods would be allocated according to a new government protocol, granting first priority to zero-antigen mismatch recipients (a measure of organ compatibility), then to patients with limited life expectancy due to transplant failure, and finally to those who have been on the waiting list longest. Results for many of these extended criteria populations look promising, both to save lives and improve quality of life. Patients should remember that extended criteria organs have higher rates of complication and failure. These risks should be weighed carefully in order to maximize the number of lives saved.