title: Outcome of kidney transplantation from nonheart-beating versus heart-beating cadaveric donors.
abstract: BACKGROUND
  This study aimed to assess outcomes of kidney transplants from nonheart-beating (NHB) compared with heart-beating (HB) cadaveric donors with meta-analytical techniques.
  
  
  METHODS
  A literature search was performed for studies comparing kidney transplants from NHB vs. HB cadaveric donors between 1992 and 2005. The following outcomes were evaluated: warm and cold ischemia times, primary nonfunction, delayed graft function, length of hospital stay, acute graft rejection, patient and graft survival, and post-transplant serum creatinine.
  
  
  RESULTS
  Eighteen comparative studies of 114,081 patients matched the selection criteria; 1,858 received kidney from NHB and 112,223 from HB donor. Warm ischemia time was significantly longer for the NHB group by 24 min (P<0.001). Cold ischemia time was similar for the two groups (P=0.97). The incidence of primary nonfunction and delayed graft function was 2.4 times (P<0.001) and 3.6 times (P<0.001) greater, respectively, in the NHB group. Length of hospital stay was longer for the NHB group by 4.6 days (P<0.001). The 6-month, 2-year, and 5-year patient survival were similar between the two groups. The incidence of acute rejection was similar between the two groups whereas the initial graft survival advantage in favor of the HB group diminished gradually over the course of time. There was no statistically significant difference between the two groups for the recipient serum creatinine levels at 3 and 12 months after transplantation.
  
  
  CONCLUSIONS
  NHB donors carry the potential of expanding the cadaveric kidney pool. Although, transplants from NHB donors are associated with a greater incidence of early adverse events, long-term outcomes appear comparable with those of transplants from HB donors.
authors.affiliation: Imperial College London, Department of Biosurgery and Surgical Technology, St Mary's Hospital, London, United Kingdom.
authors.forename: Constantinos
authors.initials: C
authors.lastname: Kokkinos
authors.forename: David
authors.initials: D
authors.lastname: Antcliffe
authors.forename: Theodore
authors.initials: T
authors.lastname: Nanidis
authors.forename: Ara W
authors.initials: AW
authors.lastname: Darzi
authors.forename: Paris
authors.initials: P
authors.lastname: Tekkis
authors.forename: Vassilios
authors.initials: V
authors.lastname: Papalois
mesh_terms: D000208:Acute Disease; D002102:Cadaver; D050377:Cold Ischemia / Q000706:statistics & numerical data; D051799:Delayed Graft Function / Q000453:epidemiology; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006321:Heart / Q000503:physiopathology*; D006323:Heart Arrest; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D017594:Publication Bias; D016019:Survival Analysis; D014019:Tissue Donors; D016896:Treatment Outcome; D052096:Warm Ischemia / Q000706:statistics & numerical data