title: Non-heart beating donors.
abstract: BACKGROUND
  Several groups have demonstrated that non-heart beating donation is a viable source of organs for transplantation. However, the theoretically worse graft function and survival of the kidneys obtained from non-heart beating donors (NHBDs) is still a matter of debate that has led to consider them as marginal donors for kidney transplantation.
  
  
  METHODS
  In this report, we compare the outcome and course of 83 kidney transplants from NHBDs with those corresponding to 3177 adult cadaveric heart beating donor (HBD) transplants performed over the same period in our country. Graft and patient survival were estimated by means of Kaplan-Meier analysis. In addition, groups were compared using Cox proportional regression.
  
  
  RESULTS
  The delayed graft function (DGF) rate was higher on NHBD transplants than in HBD kidneys (58.8 vs 28.9%, P<0.0001). However, in 1998, where the highest number of NHBD transplants was performed, graft function estimated by serum creatinine levels at 3 months and 1 year, was significantly better in the NHBD transplant group (1.42+/-0.45 vs 1.66+/-0.66 and 1.45+/-0.59 vs 1.62+/-0.64, respectively, P = 0.01 and 0.07). Graft survival at 2 years was 97%, 95% at 4 years and 84% at 6 years for NHBDs and 97, 90 and 84%, respectively, for HBDs. Interestingly, DGF was a risk factor for worse graft survival in HBDs but not on NHBDs.
  
  
  CONCLUSIONS
  We conclude that, in our study, both graft function and graft survival of NHBD kidney transplants are at least similar to those from HBD transplants. Therefore, NHBDs should be considered as a viable source of non-marginal kidneys for transplant.
authors.affiliation: Nephrology Department Hospital, Clinico San Carlos, Madrid, Spain. asanchez.hcsc@salud.madrid.org
authors.forename: Ana
authors.initials: A
authors.lastname: Sánchez-Fructuoso
authors.forename: Dolores
authors.initials: D
authors.lastname: Prats Sánchez
authors.forename: María
authors.initials: M
authors.lastname: Marqués Vidas
authors.forename: Eduardo
authors.initials: E
authors.lastname: López De Novales
authors.forename: Alberto
authors.initials: A
authors.lastname: Barrientos Guzmán
mesh_terms: D003643:Death; D005260:Female; D006085:Graft Survival; D006321:Heart / Q000503:physiopathology; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014019:Tissue Donors