Organ donationClinical considerationRenal Transplantation From Non–Heart-Beating Donors: A Single-Center 10-Year Experience
Section snippets
Patients and methods
Between 1990 and 2004, we performed 100 renal transplants from 68 NHBD, both controlled and types I, II and IV, uncontrolled donors, classified according to the Maastricht categories. Age at death ranged from 17 to 70 years (mean 37 ± 14 years). We considered NHBD acceptable when warm ischemia time (WIT) was shorter than 120 minutes from the start of cardiac arrest to the start of perfusion. Only one patient of more than 65 years was accepted. Donor and recipient data are shown in Table 1.
NHBD
Renal Transplant From NHBD
Of 136 kidneys procured, 100 were transplanted. The remaining kidneys (26%) were discarded because of trauma, poor perfusion, atheromatosis, neoplasia, and other causes. Mean donor age was 37 ± 14 years (range, 17 to 70 y). WIT was 64 ± 52 minutes, and in situ cold perfusion time was 118 ± 79 minutes. Cold ischemia time was 23 ± 5 hours. The incidence of primary nonfunction (PNF) was 16%. However, the incidence of PNF was only 5.5%, for 17 kidneys transplanted from 1998, supported by mechanical
Discussion
The number of patients awaiting organs and the waiting time before transplantation have increased during the last decade. There is, therefore, a continuing challenge to maximize donor organ availability. In this framework, the retrieval of kidneys from NHBD has regained interest.5, 6, 7 NHB donation is still limited to a few transplantation centers.1, 7, 8, 9 In units in which an NHB program exists, a 7% to 50% increase in the number of renal transplants has been realized.1, 2, 4, 5, 6 From a
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