title: Strategies to increase the donor pool and access to kidney transplantation: an international perspective.
abstract: In this position article, DESCARTES (Developing Education Science and Care for Renal Transplantation in European States) board members describe the current strategies aimed at expanding living and deceased donor kidney pools. The article focuses on the recent progress in desensitization and kidney paired exchange programmes and on the expanded criteria for the use of donor kidneys and organs from donors after circulatory death. It also highlights differences in policies and practices across different regions with special regard to European Union countries. Living donor kidney paired exchange, the deceased donor Acceptable Mismatch Programme and kidneys from donors after circulatory death are probably the most promising innovations for expanding kidney transplantation in Europe over the coming decade. To maximize success, an effort is needed to standardize transplant strategies, policies and legislation across European countries.
authors.affiliation: Department of Nephrology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Maggiore
authors.affiliation: KH Elisabethinen Linz and Department of Nephrology, Medical University of Vienna, Vienna, Austria.
authors.forename: Rainer
authors.initials: R
authors.lastname: Oberbauer
authors.affiliation: Department of Nephrology, Hospital del Mar, Barcelona, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Pascual
authors.affiliation: Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Viklicky
authors.affiliation: Richard Bright Renal Unit, Bristol, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Dudley
authors.affiliation: Department of Nephrology, Charité Medical University Berlin, Berlin, Germany.
authors.forename: Klemens
authors.initials: K
authors.lastname: Budde
authors.affiliation: Department of Nephrology P, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Soren Schwartz
authors.initials: SS
authors.lastname: Sorensen
authors.affiliation: Service de Néphrologie, Univ Lille Nord de France, Lille, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Hazzan
authors.affiliation: Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
authors.affiliation: Department of Nephrology, Antwerp University Hospital, Antwerp, Belgium.
authors.forename: Daniel
authors.initials: D
authors.lastname: Abramowicz
mesh_terms: D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D038622:Internationality; D016030:Kidney Transplantation; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
keywords: antibody-incompatible kidney transplantation; donation after circulatory death; kidney transplantation; marginal donor; paired donation