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Donor acute kidney injury and kidney transplant outcomes
Book chapter

Donor acute kidney injury and kidney transplant outcomes

Bhavna Chopra and Kalathil K Sureshkumar
Cutting Edge Advances in Transplantation, pp 1-14
01 Jan 2026
DOI: https://doi.org/10.1016/B978-0-443-19093-3.00004-6

Abstract

Currently, there are over 90,000 patients on the kidney transplant waitlist in the United States. There is a continuously growing demand and a limited supply of organs. On average, about 20,000 kidney transplants occur each year. In the year 2022, around 21,000 kidney transplants were completed. Annually, over 5000 patients die while awaiting a lifesaving organ transplant, and about 4000 patients get removed from the waitlist as they were deemed too sick for transplantation. About 10.5% of those removed from the waitlist for being too sick died within 60 days of delisting. Pretransplant mortality was on its decline over the last decade, but it rose in 2020 to 5.7 deaths per 100 waitlist years, which was the highest value since 2012. Pretransplant mortality was highest among those who had end-stage kidney disease due to diabetes, where reported death increased to as high as 8 per 100 waitlist years. Despite the increasing gap between demand and supply of organs for kidney transplants, the number of living donor transplants per year increased marginally from 5538 in 2014 up to 6867 in 2019. Unfortunately, the COVID-19 pandemic slowed the growth trajectory, and the number of living kidney transplants was down to 5234 the year 2020. Globally, 1.2 million people die each year from kidney failure. There is a growing list of patients awaiting a kidney transplant, but there is a limited supply of organs, increasing the gap between demand and supply. Minimizing organ non-utilization and promoting living donation are the best ways to bridge the increasing gap between supply and demand in kidney transplantation.

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