Expanding the Donor Pool

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Abstract
To deal with the widening gap between supply and demand of cadaveric organs for renal transplantation, efforts to expand the organ donor pool have received increased attention. In this regard, alternative approaches to traditional organ donor selection have been proposed (Table1). These measures may be beneficial in terms of increasing the number of donors and decreasing the waiting time. However, deviation from the standard method of cadaver donor selection is not without possible negative impact on graft survival. Despite the fact that these nontraditional or expanded criteria donors (ECD) are more expensive to obtain and use than ideal cadaveric renal transplantation, it is a less expensive alternative for renal replacement therapy than dialysis in the long run, even when the improved quality of life after transplantation is not considered (2). Thus, we will review the potential impact of the expansion of the organ donor pool on renal graft function and survival. In addition, we will also review the impact of newer approaches to living donor kidney transplantation.