Non-heart beating donors

Abstract

Background: Several groups have demonstrated that non-heart beating donation is a viable source of organs for transplantation. However, the theoretically worse graft function and survival of the kidneys obtained from non-heart beating donors (NHBDs) is still a matter of debate that has led to consider them as marginal donors for kidney transplantation.

Methods: In this report, we compare the outcome and course of 83 kidney transplants from NHBDs with those corresponding to 3177 adult cadaveric heart beating donor (HBD) transplants performed over the same period in our country. Graft and patient survival were estimated by means of Kaplan-Meier analysis. In addition, groups were compared using Cox proportional regression.

Results: The delayed graft function (DGF) rate was higher on NHBD transplants than in HBD kidneys (58.8 vs 28.9%, P<0.0001). However, in 1998, where the highest number of NHBD transplants was performed, graft function estimated by serum creatinine levels at 3 months and 1 year, was significantly better in the NHBD transplant group (1.42+/-0.45 vs 1.66+/-0.66 and 1.45+/-0.59 vs 1.62+/-0.64, respectively, P = 0.01 and 0.07). Graft survival at 2 years was 97%, 95% at 4 years and 84% at 6 years for NHBDs and 97, 90 and 84%, respectively, for HBDs. Interestingly, DGF was a risk factor for worse graft survival in HBDs but not on NHBDs.

Conclusions: We conclude that, in our study, both graft function and graft survival of NHBD kidney transplants are at least similar to those from HBD transplants. Therefore, NHBDs should be considered as a viable source of non-marginal kidneys for transplant.