Renal Transplantation from Non-Heart Beating Donors

Abstract

The aim of this study was to compare the survival and midterm function of kidneys from non-heart beating donors (NHBD) with those of kidneys from heart beating donors (HBD). From 1989 to 1998, 144 kidneys were procured from NHBD at the Hospital Clínico San Carlos in Madrid, of which 95 were transplanted. The kidney grafts were maintained from the moment of the diagnosis of cardiac arrest until the time of procurement by cardiopulmonary bypass. There was no significant difference in renal function and the number of rejection episodes between the NHBD and HBD transplants. The NHBD kidneys showed a 5.73-fold increase in the incidence of delayed graft function (adjusted relative risk 95% confidence interval, 2.82 to 11.62). One- and five-year survival rates for NHBD grafts were 84.6 and 82.7%, respectively, compared with 87.5 and 83.9% for HBD (P = 0.5767). Cox analysis showed that the predictive factors for worse NHBD graft survival were type of NHBD donor and the occurrence of corticoresistant rejection. Ninety of the NHBD organs were procured from subjects suffering irreversible cardiac arrest on the street who were transferred to our center for the sole purpose of donation. Fifty-four of these kidneys were transplanted and all showed primary function. When a strict protocol is adhered to, the outcome of renal transplant from NHBD compares well with that from HBD. It is believed that the high number of organs obtained from subjects undergoing irreversible cardiac arrest on the street might encourage the adoption of new criteria for the management of this type of pathology with the ultimate goal of kidney donation.

Single center utilization and post‐transplant outcomes of thoracoabdominal normothermic regional perfusion deceased cardiac donor organs

“…Nonetheless, the findings of overall favorable outcomes are in alignment with studies conducted in the United Kingdom and Europe where NRP has been used since 1989. 11,24,26,[29][30][31][32] Certain limitations of this single-center study must be acknowledged. While our study may be limited in terms of generalizability due to its design, our center was among the first to perform TA-NRP in the United States, and thus may have informed TA-NRP procurement protocols at other centers nationwide.…”

Effect of Perioperative Dexmedetomidine on Delayed Graft Function Following a Donation-After-Cardiac-Death Kidney Transplant

“…The procedures of organ donation and transplant conformed to the National Guidelines for Donation after Cardiac Death in China . All of the donors were controlled donors after cardiac death . Apnea test was performed to determine donor suitability for DCD .…”

Organ Donation after Cardiac Death: A New Trend in Pediatrics

“…Despite the living donor option and the efforts by health care practitioners and organ procurement organizations (OPOs) to increase brain dead donations, 6439 potential transplant recipients in the U.S. died in 2001 while waiting for solid organs (3). The increasing success of solid organ transplantation and the stagnant donor pool has sparked a renewed interest in DCD (4)(5)(6)(7)(8)(9).…”