[Non-heart-beating-donor transplant: the first experience in Italy].
A promising way to increase the number of kidneys for transplantation is to expand the donor pool by including non-heart-beating donors (NHBDs). The centers involved in NHBD transplantation programs have reported a 16-40% increase in kidney transplants. A key issue with NHBD is the significantly higher rate of delayed graft function (DGF) and primary non-function (PNF) compared with that associated with heart-beating donor (HBD) transplants. However, although transplants from NHBD are associated with a greater incidence of early adverse events, long-term graft survival appears to be similar to that observed after transplants from HBDs. In addition, the use of extracorporeal membrane oxygenation and mechanical perfusion, the careful selection of recipients and donors, and an adequate therapeutic strategy may at least partially reduce the risk of PNF and DGF and improve transplant outcome.
Rampino
Teresa
T
Unità di Nefrologia, Dialisi e Trapianto, Fondazione IRCCS Policlinico San Matteo e Università degli Studi, Pavia. t.rampino@smatteo.pv.it
Abelli
Massimo
M
Ticozzelli
Elena
E
Gregorini
Marilena
M
Bosio
Francesca
F
Piotti
Giovanni
G
Bedino
Giulia
G
Esposito
Pasquale
P
Balenzano
Chiara Teresa
CT
Geraci
Paolo
P
Dal Canton
Antonio
A
D001926:Brain Death; D051799:Delayed Graft Function; D006085:Graft Survival; D006323:Heart Arrest; D006801:Humans; D007558:Italy; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality; D009926:Organ Preservation / Q000379:methods; D012307:Risk Factors; D013997:Time Factors; D020858:Tissue and Organ Harvesting; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome