The demand for organ transplantation has been rapidly increasing as a resultof rising incidence of end-stage organ failure while the supply of cadaver organs from "ideal" or optimaldonors has remained low and inadequate to meet the increasing demand. Yet many so called "marginal" or"suboptimal" organs have been discarded by many centers when many patients die each day while on thewaiting list. In this review important data from our experience and that of several other centers haveconfirmed that using such marginal organs can provide a viable solution to organ shortage. Such organsinclude those from donors > 55 years, children < 5 years, diabetics, non-heart beating cadavers, andorgans with extended preservation. Such organs can be successfully used with appropriate surgical techniquesand immunosuppression protocols and the supply of donor organs can be increased by 25% to 30%.

Keywords: Kidney Transplantation - economics, Renal Artery - abnormalities