Undoubtedly Lastly there are reports that up to two

Undoubtedly solid organ transplantation
remains the ultimate management of end-stage
organ failure. As an example, the treatment of choice for end-stage
renal disease is kidney transplantation. 
The kidney is the commonest
transplanted organ with a long history of research. However, the number of
patients who need kidney transplant is expanding quicker than the availability
of organs. This imbalance between the supply and demand and the global shortage
of donors is seen in other organs too.

 

According
to the
latest UK transplant activity report (covering 2016 – 2017) the number of
patients on the kidney transplant list currently is 5,233 whereas the number of
deceased kidney donors was 1,336 
and  those from living donors was
1,009 1. Overall, for every lucky patient that receives a transplanted
kidney, there are three to four more on the waiting list. According to the above-mentioned
source, the average waiting time for a kidney only transplant in the UK
currently is 864 days for an adult patient. Lastly there are reports that up to
two patients die every day in the UK while waiting for a transplant sadly
making it a “waiting to die” list 2 3.

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Similar
is the situation in the USA. According to the United Network for organ sharing
as of November 2017 there are 116,000 patients on the waiting lists with 96,000
waiting for a kidney transplant. 4 As per the National Kidney Foundation, the
average waiting time for an individual’s first kidney transplant is 3.6 years
but this obviously may vary depending on general health, compatibility and availability
of organs. Also, each month more than 3,000 new patients are added to the kidney waiting list which
makes it one every fourteen minutes and each day 13 people die while waiting. Lastly of those waiting around
4,000 become too ill to receive any transplant and are removed from the list
each year.  5

 

The
huge pressure to compensate for the above shortage has led to intense research
in kidney transplantation. This has been largely focusing on use of marginal
quality grafts. The idea is to expand the donor pool and at the same time to
optimize those grafts’ viability. To achieve the first, organs donated after
cardiac death (DCD) and expanded criteria donors (ECD) are currently extensively
accepted. Those include advanced age, other medical conditions such as HTN, CKD
etc. In order to optimize those grafts’ viability new technologies are utilized
such as machine perfusion preservation, viability assessment and recondition. 6,