[Kidney transplantation with donors in heart block. Long-term results].
OBJECTIVE
The shortage of renal grafts has led to the search for other alternatives. The use of grafts from non-heart-beating donors (NHBD) can increase the number of transplants 8% to 20%. Clinical studies conducted by different groups, have found that the long-term graft and patient survival are not different from those of recipients of kidneys from heart-beating donors (HBCD).


RESULTS
The long-term results of a group of 52 recipients of NHBD kidneys were compared with those of 98 recipients of HBCD grafts. There were no differences in donor and recipient ages, HLA compatibility, reperfusion and cold ischemia times. There were no differences in the incidence of rejection episodes or non-functioning kidneys. Warm ischemia between 30 to 60 min or < 30 min did not influence the incidence of non-functioning kidneys. However, NHBD graft recipients had a higher incidence of acute tubular necrosis (67% versus 46%), recovers of renal function was slower, the duration of oliguria was longer and dialysis was required. The 8-year actuarial survival data were similar for both groups; 65% for the NHBD and 70% for the HBCD graft recipients.


CONCLUSIONS
We can conclude that NHBDs are an important source of donor kidneys. The 12 points established by The First International Workshop on Non-Heart-Beating Donors which appear at the end of the present article are embodied in the Treaty of Maastricht regulations of organ transplantation from non-heart-beating donors.
Serrallach Mila
N
N
Servicio de Urología, Ciudad Sanitaria y Universitaria de Bellvitge, Barcelona, España.
Franco Miranda
E
E
Riera Canals
L
L
Aguiló Lucía
F
F
López-Costea
M A
MA
Martínez Castelao
A
A
Griñó Boira
J M
JM
Gil-Vernet Cebrián
S
S
González Segura
Y C
YC
D000206:Actuarial Analysis; D000328:Adult; D006085:Graft Survival; D006327:Heart Block; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality; D019520:Living Donors; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors