ROLE OF THE ACCIDENT AND EMERGENCY DEPARTMENT IN THE NON-HEART-BEATING DONOR PROGRAM IN LEICESTER

Objective-To describe the development of a non-heart-beating donor (NH BD) programme in an accident and emergency (A&E) department over a thr ee year period. Background and methods - The A&E department at the Lei cester Royal Infirmary at present deals with approximately 200 prehosp ital cardiopulmonary arrests per year. A programme of kidney retrieval from non-heart-beating donors was started in April 1992. Strict crite ria for admission to the programme, appropriate consent procedures, fa cilities, lines of communication, and feedback were developed to enhan ce its success. Results - Of 66 patients referred to the NHBD programm e over a three year period from 1 April 1992, 51 sets of relatives wer e available to be asked for possible organ donation, and 34 sets (66%) gave their consent. Twenty five patients had successful in situ perfu sion of the kidneys. Forty seven organs were retrieved and 34 went on to be transplanted. To date, 27 kidneys are still working. As a result , 23.8% of kidneys transplanted in Leicester over this time period hav e been from the NHBD programme. Conclusions-The NHBD programme in Leic ester has proved very successful, requiring organisation of resources and personnel both from the transplant service and the A&E department. The programme has provided such a significant boost to the renal tran splant rate in Leicester that other hospitals with large A&E departmen ts should consider setting up similar programmes.