Non-heart-beating donors: is it worthwhile?

Due to organ shortage in renal transplantation, many transplant centers attempt to increase the donor pool. Non-heart-beating donors seem to be a promising alternative.

We performed 14 renal transplantations from 8 non-heart-beating donors. 2, 1, 3 and 2 donors were from groups 1, 2, 3 and 4, respectively, according to Maastricht classification.

In 6 of the patients' warm ischemia time was over 30 minutes. Three of them had primary non-function. In 6 patients delayed graft function was seen. The remaining 5 kidneys functioned immediately. Two patients whose kidney functioned returned to hemodialysis in the I I and 13th months after their transplantations. One of the patients with primary non-function died. 9 kidneys function well in their follow-up period between 5-111 months. 1 and 5-year graft survival rates were 69.8 and 61.1 percent, respectively. The mean graft survival time is 69.9 +/- 14.5 months.

Despite the high primary non-function rate, we think that non-heart-beating donors especially in Maastricht classification 3 and 4 should be used due to dramatic shortage of organs.