Kidney transplant function using organs from non-heart-beating donors maintained by mechanical chest compressions.
OBJECTIVE
This study aims to determine the failure rate of transplanted kidney grafts in recipients of organs from non-heart beating donors (NHBDs) who have had mechanical chest compressions to maintain a circulation before organ retrieval.


METHODS
A retrospective observational study based on review of the emergency medical service database and case histories of NHBDs, and information periodically sent by transplant units about donors and organs. The following variables were studied: age, sex, transfer hospital, time to arrival on the scene of cardiopulmonary arrest, time to arrival in hospital, number and type of organs retrieved, use of mechanical chest compression devices, and kidney function in graft recipients. The study covered the period between January 2008 and November 2009. During 2008 standard manual chest compressions were used and during 2009 mechanical chest compression devices were used.


RESULTS
In 39 transplanted kidneys from donors receiving mechanical chest compressions primary failure was documented in recipients on two occasions (5.1%). Kidneys transplanted from donors who had manual chest compressions resulted in three primary failures in recipients (9.1%). The difference between the two groups was not significant (p=0.5). Three patients achieved successful return of spontaneous circulation in the mechanical chest compression group after initiation of the NHBD donor protocol.


CONCLUSIONS
We have described our experience and protocol for non-heart beating donation using victims of out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation has been unsuccessful as donors. Primary kidney graft failure rates in organs from non-heart beating donors is similar when manual or mechanical chest compression devices are used during cardiopulmonary resuscitation.
Mateos-Rodríguez
Alonso
A
Servicio de Urgencias Médicas de Madrid SUMMA112, Spain. amateo.summa@salud.madrid.org
Pardillos-Ferrer
Luis
L
Navalpotro-Pascual
José María
JM
Barba-Alonso
Carlos
C
Martin-Maldonado
María Eugenia
ME
Andrés-Belmonte
Amado
A
D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D016009:Chi-Square Distribution; D016208:Databases, Factual; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage / Q000379:methods; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000295:instrumentation* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D035441:Thoracic Wall; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement