The role of the urological surgeon in the expansion of the cadaveric donor pool.

The next several years will bring into sharp focus the effects of the increasing demand for cadaveric donor organs in the face of a limited donor pool. Until xenotransplantation becomes a viable option, and unless kidneys can be cloned, we will continue to depend on the cadaveric-donor pool as a source of organs for renal replacement therapy. It is up to us as urological transplant surgeons to not only enhance public awareness of the organ shortage crisis but to continue to provide leadership in improving the techniques of organ recovery and expanding the limits of organs that were once considered to be marginal for transplantation. It is clear that advances in the surgical techniques, preservation solutions, and methods for predicting eventual long-term renal function from marginal donors will be critical in allowing precise selection criteria for kidneys for transplantation, resulting in the optimum use of a scarce and precious resource.