The situation of children with kidney failure in low and middle income countries is particularly dire. Most transplants in LMICs are from living donors. Here's a recent paper on that, with a case report that makes clear the need for kidney exchange, and for a relaxation of the policies that limit access to transplantation generally.
Pais, Priya, and Aaron Wightman. "Addressing the Ethical Challenges of Providing Kidney Failure Care for Children: A Global Stance." Frontiers in Pediatrics 10 (2022).
"Case 2: An 11 year old boy with kidney failure due to FSGS* has been on the deceased donor wait-list for 5 years without receiving a transplant. He has no compatible living donors and paired exchange, or ABO incompatible transplants are not accessible. National transplant policies do not allow unrelated living organ donation. The deceased donor transplant rates in the country are very low ..."
HT: Martha Gershun
*Focal segmental glomerulosclerosis
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