How to control the shortage of kidney graft in 2013? Urologist's point of view

Aim of the study. - To overview the demographics data leading to organ shortage and to determine the possible solutions. Materials and methods. - A review of the literature on kidney transplant shortage was performed using PubMed (articles in English and French). The annual reports of the Agence de la Biomedecine on renal transplantation and the rapport on ``Chronic kidney disease'' of the ``Haute Autorite de sante'' were included. Results. - The fight against kidney grafts shortage of is multifactorial. Improving the identification of potential donors with a national and hospital policy promulgation of organ donation and a better understanding of the reasons for refusal are one of the solutions. The number of organs can also be increased through expanded criteria donors (selection of adapted recipients), the donors deceased from cardiac arrest (with adequate use of machine perfusion), the living donor transplant (including cross donation) and derogatory transplantation (hepatitis B, hepatitis C, HIV). Conclusion. - There are several ways to fight the shortage of graft. It is a set of measures that should be implemented and the reflection must be comprehensive to allow the fight against organ shortage. In France, among the different strategies, the development of graft living donor should be a national priority. (C) 2013 Published by Elsevier Masson SAS.