What Did We Really Learn From the Collaborative? Is It In Our Best Interest to Use “Every Organ Every Time” in Kidney Transplantation?

The Organ Donation Breakthrough Collaborative (ODBC) was formed in 2003 in response to a widening gap between the number of available organs and the number of patients wait listed for transplantation, as well as recognition of a potential to avail a large pool of donor organs. It made an immediate impact by increasing the number of donations and of organs procured. As the bulk of the organs came from an expanded donor pool, the impact on organ use varied somewhat. The discard rates for kidneys, a life-sustaining organ, increased significantly. A substantial effort to decrease organ discards has raised questions over whether “every organ every time” is in the best interest of kidney transplantation. This article is based on currently available data and reviews the circumstances that led to the formation of the ODBC and its short- and long-term impact on kidney transplantation. We question whether this is the right direction for the current situation and discuss whether there might be other potential avenues to pursue in bridging this divide.