Marginal Donors ― Current Status and Future

In response to persistent donor organ shortages, organs from marginal donors, such as expanded criteria donors (ECD) and donation after cardiac death (DCD) donors, are now accepted and have been successfully transplanted, reducing the waiting times for transplantation. Especially in Japan, DCD kidneys have historically been transplanted for a long time because of a national difficulty in accepting brain death, which has allowed us to accumulate considerable clinical experience. Thus, the current organ shortage has stimulated interest in the use of marginal donors for transplantation. On the other hand, however, it is known that these organs have a high rate of delayed graft function and a more complicated postoperative course. This has been the greatest clinical challenge in transplantation to date because of the current shortage and limitations of donors using ECD and DCD.

This book is intended for clinicians and researchers. It highlights the use of marginal donors as a comparatively novel source of transplantation organs and provides a thorough overview of marginal donors from their historical origins to recent clinical applications, including the state-of-the-art science of organ/donor management, procurement and preservation, prepared by distinguished authorities in their field. Each chapter offers an individual analysis of the optimal requirements for the safe management and preservation of organs, such as the heart, lung, liver, kidney, pancreas, and pancreatic islets.