WORKLOAD GENERATED BY THE ESTABLISHMENT OF A NON-HEART-BEATING KIDNEY-TRANSPLANT PROGRAM

The work-load generated by a non-heart-beating donor (NHBD) kidney tra nsplant programme over a 3-year period is reported. A total of 73 refe rrals were made, 64 from the Accident depart ment and 9 from the wards . Organ procurement was performed in 24 cases (33 %) and resulted in t he retrieval of 44 kidneys. Reasons for failure to achieve organ procu rement were: refused consent (n = 13; 18 %), relatives unavailable to ask for consent (n = 9; 12 %), technical problems with catheter insert ion or perfusion (n = 10; 14 %), transplant staff unavailable (n = 1; 1 %), long asystolic period (n = 8; 11 %) and donor unsuitable for oth er reasons (n = 8; 11 %). Of the 44 kidneys retrieved, 30 were transpl anted locally, 8 were transplanted at other United Kingdom centres and 6 were discarded. Locally transplanted NHBD kidneys represented 21 % of the total transplant programme during the time period under study. We conclude that NHBD kidneys are a good source of additional organs f or transplantation, but only one-third of referrals result in a succes sful procurement procedure. Moreover, the setting up of a successful p rogramme is labour-intensive and requires a highly committed staff.