[Deceased donation in renal transplantation]

Area of Science:

• Nephrology
• Transplantation Immunology
• Public Health Policy

Background:

• Organ shortage is a significant challenge in renal transplantation.
• Deceased donation is a primary source of organs, encompassing brain death and non-heartbeating donors (NHBD).
• Evolving legislation impacts organ procurement practices.

Purpose of the Study:

• To review epidemiologic data and medical outcomes of deceased donation in renal transplantation.
• To assess the impact of donor criteria and management on transplant results.
• To examine the role of non-heartbeating donors in addressing organ scarcity.

Main Methods:

• Comprehensive literature search of Medline and Embase databases.
• Inclusion of French national agency databases and screening of identified articles.
• Selection based on relevance, methodology, and publication language (French/English).

Main Results:

• Deceased donation includes brain death and NHBD, with expanded criteria donors being utilized due to organ shortages.
• Procurement from older donors or those with vascular disease can lead to inferior transplant outcomes.
• French legislation has evolved to permit organ procurement from Maastricht categories II and III NHBDs.

Conclusions:

• Rigorous surgical techniques during procurement are essential to maximize transplant success and minimize organ loss.
• Careful consideration of donor history, particularly neoplasms, is necessary to balance organ pool expansion with recipient safety.
• The French NHBD program, especially Maastricht category III, represents a promising source of viable organs for transplantation.