The Asystolic, or Non-Heartbeating, Donor

Kootstra, G.

doi:10.1097/00007890-199704150-00001

Cited by 150 publications

(67 citation statements)

References 17 publications

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“…We have not adopted a so-called 'dead donor rule' (e.g. 2 min rule or 10 min rule) because a definition for the duration between the cessation of the heartbeat and the declaration of death is not established in our country (8,9). However, we usually declare death about 5 min after the cessation of the heartbeat.…”

Section: Procurement Techniques For Kidney Graftsmentioning

confidence: 99%

“…We have performed renal transplantation (RTx) from DCD donors with an in situ cooling technique using a double balloon catheter for organ procurement since the 1970s. This catheter is specifically designed for selective in situ perfusion of the intraabdominal organs with cold solution that was originally described by Garcia-Rinaldi et al (7,8). In this study, the short-and long-term outcomes of RTx from DCD donors over 30 years were retrospectively analyzed.…”

Section: Introductionmentioning

confidence: 99%

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Improved Outcomes of Renal Transplantation from Cardiac Death Donors: A 30-Year Single Center Experience

Tojimbara

Fuchinoue

Iwadoh

et al. 2007

American Journal of Transplantation

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Of the 256 transplanted kidneys from DCD donors, 38 (15%) functioned immediately after transplantation. The incidence of delayed graft function (DGF) was 72%. Warm ischemic time and total ischemic time were 7.4 ± 9.4 min and 11.9 ± 5.6 h, respectively. The overall graft survival rates at 1, 5 and 10 years were 80%, 72% and 53%, respectively. Graft survival rates in each group have continually improved over time (5-year graft survival; 23% vs. 64% vs. 74% vs. 91%, respectively). However, there was no significant difference in graft survival rates between the groups of patients who survived with a functioning graft for more than 1 year. A multivariate Cox regression analysis showed acute rejection and donor age to be independently associated with graft outcome. DCD donors are a valuable source of kidneys for transplantation with promising long-term outcomes.

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Section: Procurement Techniques For Kidney Graftsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Improved Outcomes of Renal Transplantation from Cardiac Death Donors: A 30-Year Single Center Experience

Tojimbara

Fuchinoue

Iwadoh

et al. 2007

American Journal of Transplantation

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“…Since brain death was introduced and widely accepted in North America and Europe in the early 1980s, virtually all lung transplants have been performed using organs retrieved from circulation-intact, brain-dead organ donors. Considerable experience with transplantation of kidneys retrieved from NHBDs is being accrued, with reports of equivalent or better long-term function of kidneys from NHBDs compared with conventional heart-beating donors (16,17). A much smaller experience exists with liver transplants from NHBDs (16,18,19).…”

Section: Inadequate Number Of Lungs For Transplantmentioning

confidence: 99%

Lung Transplantation: Opportunities for Research and Clinical Advancement

Wilkes¹

2006

Am J Respir Crit Care Med

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Lung transplantation is the only definitive therapy for many forms of end-stage lung diseases. However, the success of lung transplantation is limited by many factors: (1 ) Too few lungs available for transplantation due to limited donors or injury to the donor lung; (2 ) current methods of preservation of excised lungs do not allow extended periods of time between procurement and implantation; (3 ) acute graft failure is more common with lungs than other solid organs, thus contributing to poorer short-term survival after lung transplant compared with that for recipients of other organs; (4 ) lung transplant recipients are particularly vulnerable to pulmonary infections; and (5 ) chronic allograft dysfunction, manifest by bronchiolitis obliterans syndrome, is frequent and limits long-term survival. Scientific advances may provide significant improvements in the outcome of lung transplantation. The National Heart, Lung, and Blood Institute convened a working group of investigators on June 14-15, 2004, in Bethesda, Maryland, to identify opportunities for scientific advancement in lung transplantation, including basic and clinical research. This workshop provides a framework to identify critical issues related to clinical lung transplantation, and to delineate important areas for productive scientific investigation. Keywords: allograft dysfunction; infection; ischemia-reperfusion injury; lung transplantation; obliterative bronchiolitis; rejectionThe transplantation of organs offers the promise of life-saving and life-enhancing therapy for a variety of ailments. Lung transplantation (LTx) has become an acceptable therapy to palliate patients with a variety of end-stage lung diseases. However, lung transplantation has not turned out to be a panacea for chronic lung disease because of significant limitations in the entire transplant process (Figure 1). First, there are not nearly enough suitable donor lungs to meet the needs of all patients with end-stage lung disease. As a result, more patients die waiting for transplants than from mortality associated with a lung transplant. Second, early graft survival after LTx is worse than for other types of organs transplanted (1). Finally, late survival after successful LTx is hampered by the development of chronic allograft dysfunction and by the life-limiting complications associated with conventional immunosuppressive medications. Two factors impede progress to address these problems: (1 ) lung transplant centers lack the infrastructure to facilitate prospective, multicenter clinical studies of sufficient power to address clinical questions and (2 ) there are too few investigators studying the biology of lung transplantation.The NHLBI convened a workshop on June 14-15, 2004, to better understand these complex problems and to identify strategies to address these and prioritize them. The topics addressed by participants were wide-ranging. They included the following: lung use rates from conventional brain-dead organ donors; safe limits for donor lung function; consideration o...

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“…12,13 A more practical classification may be "uncontrolled" or "controlled" NHBD depending on whether cardiopulmonary function ceases spontaneously or after medical therapy is withdrawn. For controlled NHBD (Maastricht category III), the potential donor is identified after a decision has been made to withdraw life-sustaining medical therapy, and usually when the patient is in a critical care unit.…”

Section: Conclusion : Les Centres Canadiens Peuvent Apprendre à Partimentioning

confidence: 99%

“…These interventions may include the ante-mortem administration of drugs such as heparin or phentolamine, or placement of vascular catheters used for in situ organ preservation. 17 In situ organ preservation requires a catheter with proximal and distal occlusion balloons to be placed in the aorta. The balloons are inflated and preservative is instilled.…”

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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The Asystolic, or Non-Heartbeating, Donor

Cited by 150 publications

References 17 publications

Improved Outcomes of Renal Transplantation from Cardiac Death Donors: A 30-Year Single Center Experience

Improved Outcomes of Renal Transplantation from Cardiac Death Donors: A 30-Year Single Center Experience

Lung Transplantation: Opportunities for Research and Clinical Advancement

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

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