Long-term results of renal transplantation using kidneys harvested from non-heartbeating donors: a 15-year experience.
OBJECTIVE
To expand the pool of suitable organ donors we developed an organ procurement program of non-heartbeating donors during the last 15 years. We compare graft survival in patients receiving renal transplants procured from non-heartbeating with recipients of kidneys from heartbeating donors.


METHODS
From 1986 to 1999, 60 renal transplantations were performed with kidneys harvested from non-heartbeating donors (Mastrich category IV). Kidneys were procured using a double balloon triple lumen catheter inserted into the femoral artery. The 60 kidneys were selected from 70 non-heartbeating donors based on age younger than 50 years, warm ischemia less than 30 minutes, creatinine less than 200 micromol./l., and no hypertension or major histological lesions. Long-term results of graft survival and complications were compared with a series of 1,065 renal transplantations performed during the same period with kidneys procured from heartbeating donors.


RESULTS
Mean age of the recipients was statistically different as non-heartbeating donors were older. However, the 10-year graft survival rates were similar in both groups (50% versus 53%). Incidence of ureteral stenosis and fistula, arterial stenosis and thrombosis was not statistically different in both groups. On the other hand, delay graft function was more frequent in non-heartbeating donors (60% versus 40%, p = 0.01).


CONCLUSIONS
Despite a high rate of acute tubular necrosis, kidneys harvested from non-heartbeating donors had the same graft survival rates as those procured from heartbeating donors. Surgical complications were not different. Transplantation of selected kidneys procured from non-heartbeating donors should be promoted as a response to organ shortage.
Droupy
Stephane
S
Department of Urology, Hospital de Bicêtre, University Paris Sud, Kremlin-Bicêtre, France.
Blanchet
Pascal
P
Eschwège
Pascal
P
Hammoudi
Yacine
Y
Joseph
Liliane
L
Kriaa
Fayçal
F
Bedossa
Pierre
P
Duranteau
Jacques
J
Charpentier
Bernard
B
Benoît
Gérard
G
D000328:Adult; D002102:Cadaver; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D019520:Living Donors; D014019:Tissue Donors