Kidney transplant function using organs from non-heart-beating donors maintained by mechanical chest compressions

Area of Science:

• Nephrology
• Transplantation
• Emergency Medicine

Background:

• Non-heart beating donors (NHBDs) are a valuable source of organs for transplantation.
• Maintaining circulation in NHBDs before organ retrieval is crucial for graft viability.
• The use of mechanical chest compression devices during cardiopulmonary resuscitation (CPR) in NHBDs is an evolving protocol.

Purpose of the Study:

• To determine the failure rate of transplanted kidney grafts from NHBDs.
• To compare graft failure rates between donors receiving mechanical versus manual chest compressions.
• To evaluate the efficacy of a protocol for NHBD organ donation after out-of-hospital cardiac arrest.

Main Methods:

• Retrospective observational study analyzing emergency medical service and transplant unit data.
• Inclusion of NHBDs from January 2008 to November 2009.
• Comparison of kidney graft primary failure rates based on the use of manual (2008) versus mechanical (2009) chest compression devices.

Main Results:

• Primary kidney graft failure occurred in 5.1% of recipients from donors with mechanical chest compressions (n=39).
• Primary kidney graft failure occurred in 9.1% of recipients from donors with manual chest compressions (n=3).
• The difference in failure rates between the two groups was not statistically significant (p=0.5).

Conclusions:

• Kidney graft failure rates are similar whether mechanical or manual chest compressions are used in NHBDs.
• The described protocol for NHBDs using out-of-hospital cardiac arrest victims is feasible.
• Mechanical chest compression devices may be a viable option in NHBD protocols.