At the end of 2004, 5299 patients in the United Kingdom were waiting for kidneys from deceased donors, and during that year 1427 transplants from dead donors and 463 from living donors were performed.1 The gap between supply and demand for kidney transplants continues to increase, but several important initiatives are under way to attempt to increase the total number of kidneys available and also to change the way donated organs are allocated.

Several centres are now retrieving organs from non-heart beating donors as well as conventional brain dead donors. These organs come from patients who have a cardiac arrest and cannot be resuscitated, whose kidneys are flushed with a cold preserving solution so that the kidneys can then be removed before irreversible damage occurs. With careful selection of donors and appropriate infrastructure these kidneys have been shown to perform as well as kidneys from brain dead donors.2

The drive to increase the number of kidney transplants from living donors has also …