title: [Deceased donation in renal transplantation].
abstract: OBJECTIVE
  To review epidemiologic data's and medical results of deceased donation in renal transplantation.
  
  
  METHODS
  Relevant publications were identified through Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) database using the following keywords, alone or in association, "brain death; cardiac arrest; deceased donation; organ procurement; transplantation". Articles were selected according to methods, language of publication and relevance. The reference lists were used to identify additional historical studies of interest. Both prospective and retrospective series, in French and English, as well as review articles and recommendations were selected. In addition, French national transplant and health agencies (http://www.agence-biomedecine.fr and http://www.has-sante.fr) databases were screened using identical keywords. A total of 2498 articles, 8 official reports and 17 newspaper articles were identified; after careful selection 157 publications were eligible for our review.
  
  
  RESULTS
  Deceased donation may involve either brain death or non-heartbeating donors (NHBD). Organ shortage led to the procurement of organs from expanded-criteria donors, with an increased age at donation and extended vascular disease, leading to inferior results after transplantation and underlining the need for careful donor management during brain death or cardiac arrest. Evolution of French legislation covering bioethics allowed procurement from Maastricht categories II and recently III non-heartbeating donors.
  
  
  CONCLUSIONS
  The increase of organ shortage emphasizes the need for a rigorous surgical technique during procurement to avoid loss of transplants. A history or current neoplasm in deceased-donors, requires attention to increase the pool of organs without putting the recipients at risk for cancer transmission. French NHBD program, especially from Maastricht category III, may stand for a potential source of valuable organs.
authors.affiliation: Service d'urologie et transplantation rénale, CHU de Montpellier, 34090 Montpellier, France; Université de Montpellier, 34090 Montpellier, France. Electronic address: r-thuret@chu-montpellier.fr.
authors.forename: R
authors.initials: R
authors.lastname: Thuret
authors.affiliation: Service d'urologie et transplantation rénale, CHRU de Besançon, 25030 Besançon, France; Université de Franche-Comté, 25030 Besançon, France; Inserm UMR 1098, 25030 Besançon, France.
authors.forename: F
authors.initials: F
authors.lastname: Kleinclauss
authors.affiliation: Service d'urologie et transplantation rénale, CHU de Grenoble, 38000 Grenoble, France.
authors.forename: N
authors.initials: N
authors.lastname: Terrier
authors.affiliation: Service d'urologie, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France; Université Paris Descartes, 75006 Paris, France.
authors.forename: M O
authors.initials: MO
authors.lastname: Timsit
mesh_terms: D000465:Algorithms; D001926:Brain Death; D002985:Clinical Protocols; D046148:Donor Selection / Q000379:methods / Q000592:standards; D006323:Heart Arrest; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D014019:Tissue Donors / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000600:supply & distribution; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence / Q000379:methods / Q000592:standards
keywords: Arrêt cardiaque; Brain death; Cardiac arrest; Donneur décédé; Epidemiology; Mort cérébrale; Organ donation; Prélèvement d’organes; Transplantation; Épidémiologie