Experiences in the development of non-heart beating organ donation scheme in a regional neurosciences intensive care unit.
BACKGROUND
In the UK demand for organ transplantation continues to outstrip supply and one strategy aimed at reversing this trend is the introduction of non-heart beating donor (NHBD) schemes. In this paper we describe our experience after the introduction of the NHBD scheme at a regional neuroscience intensive care unit (ICU) that also provides general intensive care.


METHODS
We describe the steps taken to establish the scheme and present our results from the time of its implementation in July 2002 until March 2007.


RESULTS
Of the 100 patients whom we referred to the transplant co-ordinators, 71 were identified as potential NHBDs and of these 29 went on to become actual donors (conversion rate of 40.8%). Fifty-six kidneys were retrieved and 53 successfully transplanted. In addition, two livers were retrieved but subsequently found to be unsuitable for transplantation, while eight pancreas were retrieved and used for islet cell research. The serum creatinine at 1 yr demonstrates that there is no significant difference between transplanted kidney function from NHBDs and heart-beating donors (HBDs).


CONCLUSIONS
We believe that by establishing the NHBD organ donation scheme we are able to fulfil the wishes of more patients who have indicated that they would like to donate their organs while increasing the availability of solid organs for transplantation. With careful preparation, audit, and communication our experience demonstrates that the NHBD scheme can be successfully introduced in an ICU and expanded to other ICUs in a region.
Thomas
I
I
The Intensive Care Unit, Frenchay Hospital, Frenchay Park Road, Bristol BS16 1LE, UK.
Caborn
S
S
Manara
A R
AR
D000293:Adolescent; D000328:Adult; D004739:England; D006302:Health Services Research; D006323:Heart Arrest; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D016030:Kidney Transplantation; D008485:Medical Audit; D008875:Middle Aged; D016377:Organ Transplantation; D018579:Patient Selection; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014019:Tissue Donors / Q000706:statistics & numerical data / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000379:methods / Q000458:organization & administration*; D016896:Treatment Outcome