Uncontrolled non-heartbeating donors (types i-ii) with normothermic recirculation vs. heartbeating donors: evaluation of functional results and survival

Actas Urol Esp. 2015 Sep;39(7):429-34. doi: 10.1016/j.acuro.2015.01.005. Epub 2015 Mar 5.
[Article in English, Spanish]

Abstract

Objective: Non-heartbeating donors (NHBD) are an alternative to heartbeating donors (HBD). Our objective was to compare functional results and kidney survival from NHBDs and HBDs.

Material and methods: A retrospective study comparing the results of 236 normothermically preserved kidneys from type i and ii type NHBDs with the results of 250 from HBDs that were transplanted in our center between 2005 and 2012. Homogeneity between groups was tested and we evaluated the presence of delayed graft function (DGF) associated with pretransplant variables of the donor and recipient.

Results: Both groups show homogeneity in pretransplant characteristics in terms of: age, HLA incompatibilities, and recipient hemodialysis time. Average follow-up time was 33 months (range 0-87) for NHBDs and 38 months (range 0-90) for HBDs. 5.5% of NHBDs showed primary non-function (PNF) vs. 4% of HBDs (P=.42) and 80.9% of DGF vs. 46.8% of HBDs (P<.001). At the end of the follow-up, there were no statistically significant differences in the survival of grafts (92.8% for NHBD vs. 93.6% for HBD, P=.71) and recipients (99.1% NHBD vs. 98.6% HBD, P=.28).

Conclusions: Although the DGF percentage was greater for NHBDs, final creatinine as well as graft and recipient survival were similar for both groups. Therefore, in our experience, kidneys from NHBDs have similar results to those from HBDs and are an excellent source of organs for transplantation.

Keywords: Brain-dead donors (BDD); Delayed graft function; Donación en asistolia; Donación en muerte cerebral; Donation after the circulatory determination of death (DCDD); Graft survival; No función primaria; Normotermia; Normothermia; Primary non-function; Renal transplant; Retraso en la función de injerto; Supervivencia del injerto; Trasplante renal.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Brain Death / physiopathology
  • Female
  • Graft Survival
  • Heart Arrest
  • Humans
  • Kidney / blood supply
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Recovery of Function
  • Regional Blood Flow
  • Retrospective Studies
  • Tissue Donors / classification
  • Tissue and Organ Procurement*