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NDT Advance Access originally published online on February 23, 2009
Nephrology Dialysis Transplantation 2009 24(6):1992-1996; doi:10.1093/ndt/gfp070
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Early results of a controlled non-heart-beating kidney donor programme

Jacob A. Akoh1, Mark D. Denton1, Sharon B. Bradshaw1, Tahawar A. Rana1 and Martin B. Walker2

1 South West Transplant Centre, Surgery & Renal Services Directorate 2 Intensive Care Unit, Critical Care Directorate, Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth PL6 8DH, UK

Correspondence and offprint requests to: Jacob A. Akoh; E-mail: jacob.akoh{at}phnt.swest.nhs.uk



  Abstract

Background. We present our experience of a controlled non-heart beating donation (CNHBD) programme in a University Hospital.

Methods. Data from all referrals for CNHBD between January 2005 and January 2008 were collected prospectively. Donor and recipient data were analysed and compared to other cadaveric and HBD transplants performed during the same period.

Results. During the period, 79 donors were referred resulting in 35 proceeding to retrieval and 61 kidneys being successfully transplanted. The median time from withdrawal of therapy to asystole was 15 min (IQR 10.0–23.0). The median primary warm ischaemic time was 20 min (IQR 16.0–27.0). The mean cold ischaemia time was 16.6 ± 4.21 h for CNHBD (16.6 ± 5.91 for HBD) kidneys. Compared to HBD kidneys, CNHBD kidneys had more HLA mismatches and significantly more delayed graft function (44% versus 14%), and the mean time to halving of serum creatinine was significantly greater (12.8 versus 5 days). However, 1-year patient and graft survival (88% and 93%) were excellent and mean creatinine at 12 months for CNHB kidneys was not significantly different from HBD kidneys (141 µmol/l versus 131 µmol/l).

Conclusions. Structured implementation resulted in a successful CNHBD programme providing 61 successful renal transplants from 35 donors in 3 years—contributing to ~50% of the total number of cadaveric renal transplants during the period. At 12 months, CNHBD kidney graft function was equivalent to HBD organs.

Keywords: asystole; controlled non-heart beating donor; delayed graft function; discard rate; renal transplantation

Received for publication: 3.10.08
Accepted in revised form: 3. 2.09


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