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The Scope of Kidney Disease and the Organ Shortage

We all have heard about the shortage of organs available for transplantation. Unfortunately, the number of deceased donor organs has remained stagnant over the last several years, and this trend is expected to continue. As can be seen from the facts below, there is a great need to increase transplant opportunities for patients with kidney disease.

Although the 16,000+ kidney transplants performed each year in the United States may sound like a lot, the number is small compared to the number of people who are on dialysis, which is more than 500,000. It is also quite small when compared to the number of people waiting for a kidney (more than 80,000) and those never even referred for transplant evaluation (130,000). Given the high rate of complications and death while on dialysis, an increase in living donor kidney transplants holds the only hope for improving the ability to transplant people who need a kidney.

Statistics

  • There are approximately 650,000 people in the United States who have reached end stage kidney failure and require dialysis to survive
    • This number is expected to increase to 800,000 by the year 2020
  • Currently, there are more than 80,000 people on the waiting list for kidney transplantation
    • Visit the United Network for Organ Sharing website (www.unos.org) for the most up-to-date statistics
  • Despite the fact that the number of deceased donor organs has been optimized as much as possible in the past several years, you can see from the graphic below that the total number of donors has remained fairly stable in recent years.

Benefits of Living Donor Over Deceased Donor Kidney Transplantation

In addition to increasing the number of kidney transplants, living donation also provides the following benefits:

  • Ability to schedule the transplant at a time that is convenient for both the donor and recipient helps to facilitate pre-emptive transplantation (transplant before the recipient needs dialysis), which is associated with better outcomes for the recipient
  • Superior quality of living donor organs (as compared to deceased donor organs) leads to:
    • Better function of the transplanted organ (immediate in the overwhelming majority of cases)
    • Longer survival of the transplanted organ (see graphic below, which shows that Living Donor (LD) transplants last longer than deceased donor transplants)

References

  • Organ Procurement and Transplantation Network
  • United States Renal Data System, USRDS 2009 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2009.
  • United Network for Organ Sharing
  • Terasaki, PI ed. Clinical Transplants 2005. Los Angeles: UCLA Immunogenetics Center

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