Procurement and preservation of cadaver kidneys

Improved patient survivals following failed kidney transplants, increasing cadaver kidney transplantation in high risk patients, and the reluctance of transplant teams to use a kidney from a living related donor unless graft success can be reasonably assured have resulted in an increasing need for cadaver kidneys. Although brain-death legislation, public education, professional education, kidney sharing among transplant centers, and health care legislation supporting cadaver kidney retrieval centers have resulted in an increasing number of available cadaver kidneys, there is a continuing shortage. In our opinion the shortage can be alleviated by the extensive recruitment of community urologists and general surgeons as cadaver kidney retrieval teams and by the simplification of donor criteria, prenephrectomy management, surgical technique, and kidney preservation.