Children who need kidney transplants have better long-term outcomes when the donor is a living person, according to results published in Pediatric Transplantation. Lavjay Butani, MD, and colleagues compared rates of graft failure and death among 12,089 children during a 20-year study. Most children (N=7,413) received kidneys from a deceased donor. Another 4,349 received a kidney from a living, related donor; 327 children received a kidney from a living, unrelated donor. Deceased donor transplants had the poorest graft survival after the first year, at 4.0%, compared with 2.8% of living related donors and 3.3% of living unrelated donors. Infants and preteens had a higher risk for graft failure during the first post-transplant year than did teens, though infants and preteens had a lower risk for graft failure after the first post-transplant year compared with teens. The number of living unrelated donors increased from 1.3% in 1987 to 31.4% in 2017. ““The findings of our study should lay to rest any fears and concerns that centers have about accepting organs from unrelated living donors,” Dr. Butani said.