Non-heart-beating donors: an excellent choice to increase the donor pool

Area of Science:

• Transplantation Medicine
• Organ Donation
• Public Health

Background:

• Sudden deaths outside hospitals represent a largely untapped resource for organ donation.
• Current organ donor pools are insufficient to meet transplantation demands.
• Non-heart-beating donors (NHBD) offer a viable alternative to increase organ availability.

Purpose of the Study:

• To establish and evaluate a program for obtaining organs from non-heart-beating donors (NHBD) who experience sudden death outside a hospital setting.
• To increase the organ donor pool by utilizing organs from well-selected NHBDs.
• To compare transplant outcomes from NHBDs with those from encephalic death donors (EDD).

Main Methods:

• Implementation of pre-hospital advanced life support (ALS) and cardiopulmonary resuscitation (CPR) for potential NHBDs.
• In-hospital organ preservation techniques and protocols for family assessment and consent.
• Development of specific NHBD subprograms for kidney, lung, and liver transplantation.

Main Results:

• Kidney transplants from NHBDs demonstrated superior outcomes compared to those from EDD.
• A dedicated NHBD lung transplant subprogram yielded excellent results.
• NHBDs are a significant source for various organs and tissues, including pancreas islets.

Conclusions:

• NHBD programs are crucial for expanding organ availability for transplantation.
• The described pre- and in-hospital program effectively utilizes organs from sudden death donors.
• Establishing NHBD programs is recommended in countries with supportive legal frameworks to enhance transplant success.