Compared to dialysis, kidney transplantation is an effective treatment that offers considerable survival benefits, better quality of life and substantial cost saving for the health care system.
However, due to a persistent shortage of suitable donor organs worldwide and a growing number of patients on transplant waiting lists, kidney transplantation is far from being accessible to all patients. Without an equivalent increase in organ donors, patients face increasing severity of their illness and ultimately the risk of dying while waiting for a kidney transplantation.
To increase organ availability, most transplant centers have not only implemented living-donor transplant programs but also widened the deceased-donor pool by accepting higher numbers of donors with sub-optimal organ quality such as elderly donors, donors with pre-excising conditions and donors after cardiac death. Consequently, the increasing utilization of these donor sources has negatively affected both the short- and the long-term transplant outcomes.
To date, all transplant centers around the world face the major challenge to balance the urgency to utilize sub-optimal donor sources with the necessity to ensure best possible transplant outcome.