Nonheart-beating kidney donation: Current practice and future developments

Abstract

Despite being associated with poorer initial graft function, the long-term allograft survival of NHBD kidneys does not differ from the results of transplantation from cadaveric kidneys. Further, serum creatinine levels are generally equivalent. Constant reassessment of the ethical issues is required for donation to be increased while respecting public concerns. Use of viability assessment and tailoring of immune suppression for NHBD kidneys may allow a further increase in donation from this source.

Comparison of protective effects of trimetazidine against experimental warm ischemia of different durations: early and long-term effects in a pig kidney model

“…In addition, our model allows designing a study with a long-term follow-up compared with most experimental studies, which focused on a short-term effect in the first days following an ischemic insult. TMZ could be particularly efficient in "controlled donors" (type III and IV from the Maastricht group) as an early single perfusion could limit fibrosis development (4,16). It would be useful to address the best regimen of TMZ to be used and to check whether sequential administration to the recipient of the graft could restore renal function.…”

Donation after cardiocirculatory death in Canada

“…[8][9][10] Organs contaminated with hepatitis B, C or HIV may be transplanted into recipients already infected with these same viruses. Infections with human T-cell leukemia-lymphoma virus, systemic viral infection (e.g., measles, rabies, adenovirus), prion-related disease and herpetic meningoencephalitis are contraindications for organ donation.…”

A p38 mitogen-activated protein kinase inhibitor protects against renal damage in a non-heart-beating donor model

“…The use of non-heart-beating donors (NHBD) has been proposed to help curtail the universal shortage of transplantable organs, especially kidneys. Reluctance to accept NHBD as a source of kidneys is due to the higher rates of primary failure (PF) and delayed graft function (DGF) compared with conventional heart-beating cadaveric donors (4,37).…”

“…Kidneys from NHBD are exposed to warm ischemia (WI) followed by cold ischemia (CI), and free radical release from organ tissue is enhanced after reperfusion (4,7). Inflammatory response to renal IR injury (IRI) results in endothelial cell activation and injury, enhanced leukocyte adhesion, leukocyte entrapment, and a compromise in microvascular blood flow (3,27).…”

“…FR167653 (1-{7-(4-fluorophenyl)-1,2,3,4-tetrahydro-8-(4-yridyl)-pyrazolo [5,1c] [1,2,4]triazin-2-yl}-2-phenylethanedione sulfate monohydrate), a synthesized organic compound, was originally discovered to be a selective inhibitor of IL1-␤ and TNF-␣ production mediated by p38-MAPK inhibition ( Fig. 1) (42)(43)(44)(45)(46)(47).…”