Long-term outcome after combined pancreas and kidney transplantation from non–heart-beating cadaver donors

Tojimbara, Tamotsu; Teraoka, Satoshi; Babazono, Tetsuya; Sato, Shotaro; Nakamura, Michio; Hoshino, T; Nakagawa, Yuki; Fujita, Shogo; Fuchinoue, S; Nakajima, Ichiro; Koike, Toshiharu; Abe, Machiko; Takahashi, Osamu; Agishi, T

doi:10.1016/s0041-1345(98)01239-1

Cited by 24 publications

(12 citation statements)

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“…Use of NHBD could contribute to an increase in the number of solid organs for transplantation including 20% or more to the supply of kidneys, and increasing the supply of other solid organs including liver, pancreas or pancreatic islet cells. [21][22][23][24][25][26][27] Successful heart and lung transplants have been performed in animal models, and appear to be technically feasible. [28][29][30] Recently, one centre has reported the retrieval and transplant of a lung from a controlled NHBD.…”

Section: Conclusion : Les Centres Canadiens Peuvent Apprendre à Partimentioning

confidence: 99%

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues

Doig

Rocker

2003

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : The increasing gap between numbers of individuals awaiting organ replacement surgery and the supply of organs available for transplant underpins attempts to increase the number of organs available. One practice, used in other countries, is the recovery of organs from non-heart-beating organ donors (NHBD). The purpose of this review is to discuss ethical issues surrounding the use of organs from these donors.S So ou ur rc ce e: : Narrative review from selected Medline references, and other published reports.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : NHBD protocols have been established in many countries including the United States. Despite numerous publications, and extensive debate in the literature, significant ethical issues remain unresolved in the retrieval of organs from donors that have died from cessation of cardiac activity. The ethical concerns primarily arise in the determination of death, the tension between the time constraints on recovering organs viable for transplantation, and procedures to enhance organ viability. Despite a concerted effort in the United States, less than half of the organ procurement organizations have NHBD protocols.

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Section: Conclusion : Les Centres Canadiens Peuvent Apprendre à Partimentioning

confidence: 99%

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues

Doig

Rocker

2003

Can J Anesth/J Can Anesth

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“…One important point is that a mandatory 'no touch' period of 5 minutes after cardiac arrest has to be followed in order to declare a patient clinically dead before the initiation of organ recovery (16,17). DCD donors are a potential source for a variety of solid organs for transplantation, including pancreases (14,(18)(19)(20)(21)(22). The use of DCD donors is increasing, constituting a greater number of deceased organ donation in the United States (23,24).…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Pancreas Transplantation in the United States Using Cardiac-Death Donors

Salvalaggio

Davies²,

Fernández

et al. 2006

American Journal of Transplantation

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Recipients of a SPK transplants from DCD and DBD donors had equivalent patient and graft survival rates at 1, 3 and 5 years. For recipients of SPK transplants, the wait for organs from DCD donors was significantly shorter than that for organs from DBD donors. SPK recipients of organs from DCD donors had longer hospital stays than did recipients of organs from DBD donors. With renal allografts, the incidence of delayed graft function was almost four times higher with organs from DCD donors than with organs from DBD donors.Selective use of organs from DCD donors is safe for pancreas transplantation.

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“…However, routine implementation of DCD recovery at many centers has been impeded by ethical concerns, logistical considerations, and fear of poor functional outcomes. Limited experience with DCD pancreas transplantation is available, and this is primarily short term follow-up in a small number of patients [12,13] . In comparison to a contemporaneous cohort of recipients of conventional heart-beating donors organs, SPK transplantation from selected DCD donors resulted in similar excellent patient, kidney, and pancreas graft survival [14] .…”

Section: Discussionmentioning

confidence: 99%

“…Since pancreas is a limited national resource our proposal is: (1) Improve the organ donation campaign; (2) Concentrate funding resources in public university hospitals in order to improve PK performance; and (3) Expand the donor pool using less-than-ideal donors such as: DCD [12][13][14] , living donors [18][19][20] and pediatric donors [21] . In this study, we simulated a hypothetical increase of 50% in the number of PK transplantations and we found that the waiting list demand will meet the number of PK transplantations by the year 2022 (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

A mathematical model for shortening waiting time in pancreas-kidney transplantation

Chaib¹,

Ribeiro²,

Santos³

et al. 2011

WJGS

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AIM:To simulate a hypothetical increase of 50% in the number of pancreas-kidney (PK) transplantations using less-than-ideal donors by a mathematical model. METHODS:We projected the size of the waiting list by taking into account the incidence of new patients per year, the number of PK transplantations carried out in the year and the number of patients who died on the waiting list or were removed from the list for other reasons. These variables were treated using a model developed elsewhere. RESULTS:We found that the waiting list demand will meet the number of PK transplantation by the year 2022. CONCLUSION:In future years, it is perfectly possible to minimize the waiting list time for pancreas transplantation through expansion of the donor pool using lessthan-ideal donors.

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Long-term outcome after combined pancreas and kidney transplantation from non–heart-beating cadaver donors

Cited by 24 publications

References 1 publication

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues

Outcomes of Pancreas Transplantation in the United States Using Cardiac-Death Donors

A mathematical model for shortening waiting time in pancreas-kidney transplantation

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