Kidney transplantation from donors without a heartbeat.
BACKGROUND
The dramatic shortage of kidney donors has triggered interest in other sources of organs, such as donors without a heartbeat. Accumulating evidence suggests that the short-term survival of cadaveric kidneys from such donors is similar to that of cadaveric kidneys from donors with a heartbeat. However, no data from large, matched studies with long-term follow-up are available. We conducted a matched, single-center study of kidney transplants obtained from donors without a heartbeat and those from donors with a heartbeat, with a 15-year follow-up period.


METHODS
Between 1985 and 2000, 122 kidney transplantations involving donors without a heartbeat were performed at the University of Zurich, in Switzerland. Outcomes of these procedures were compared with those of 122 transplantations of kidneys from donors with a heartbeat. The recipients were matched according to age, sex, number of transplantations, and calendar period of transplantation.


RESULTS
The characteristics of the recipients did not differ significantly between the two groups. We observed a significantly higher incidence of delayed graft function among the patients who received kidneys from donors without a heartbeat (48.4 percent) than among the patients who received kidneys from donors with a heartbeat (23.8 percent) (P<0.001). However, the long-term rate of graft survival was similar in the two groups (P=0.98): at 10 years, the rate of graft survival was 78.7 percent for kidneys from donors without a heartbeat and 76.7 percent for kidneys from donors with a heartbeat.


CONCLUSIONS
Although the incidence of delayed graft function is significantly higher with kidneys from donors without a heartbeat than with kidneys from donors with a heartbeat, there is no difference in long-term outcome between the two types of graft.
Department of Visceral Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
Markus
M
Weber
Daniel
D
Dindo
Nicholas
N
Demartines
Patrice M
PM
Ambühl
Pierre-Alain
PA
Clavien
D000328:Adult; D000704:Analysis of Variance; D001926:Brain Death; D002102:Cadaver; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006323:Heart Arrest; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D016019:Survival Analysis; D014019:Tissue Donors