SUCCESSFUL EXTRARENAL TRANSPLANTATION FROM NON-HEART-BEATING DONORS

Citation
Am. Dalessandro et al., SUCCESSFUL EXTRARENAL TRANSPLANTATION FROM NON-HEART-BEATING DONORS, Transplantation, 59(7), 1995, pp. 977-982
Citations number
28
Categorie Soggetti
Immunology,Surgery,Transplantation
Journal title
ISSN journal
00411337
Volume
59
Issue
7
Year of publication
1995
Pages
977 - 982
Database
ISI
SICI code
0041-1337(1995)59:7<977:SETFND>2.0.ZU;2-6
Abstract
The current organ shortage has made utilization of organs from less-th an-ideal donors more common, Although several transplant centers use k idneys from non-heart-beating donors (NHBDs), there has been reluctanc e to extend the use of these donors to extrarenal organs. Of the 130 d onors referred to our organ procurement organization between January 1 993 and May 1994, 16 (12.3%) were NHBDs. Organ retrieval from 10 of th ese resulted in extrarenal donation, 5 resulted in renal donation only , and 1 resulted in no retrieval as a result of prolonged warm ischemi a (> 2 hr). A total of 39 organs were transplanted from these NHBDs. A rapid en bloc retrieval technique was used for extrarenal NHBDs. The mean warm ischemic time was 15.4 min; preservation times were similar for both NHBDs and heart-beating donors. After liver transplantation ( n=5), one episode of primary nonfunction that was technical in origin required retransplantation. Following simultaneous pancreas-kidney tra nsplantation (n=6), all patients were insulin independent and free of graft pancreatitis; one patient required hemodialysis (16.7%). After i solated renal transplantation (n=21), 3 patients (14.3%) required hemo dialysis. Three of 4 liver recipients are alive after a mean follow-up period of 12.7 months; all simultaneous pancreas-kidney and renal tra nsplant recipients are alive after a mean follow-up period of 8.4 and 8.3 months, respectively. Three liver allografts, 5 pancreas and kidne y allografts, and 19 renal allografts are functioning. The lung allogr aft was lost to rejection 81 days after transplantation; however, the recipient is alive 3 months after retransplantation. Our results demon strate that in controlled situations, extrarenal organs can be utilize d from NHBDs and can be expected to function similarly to organs retri eved from heart-beating donors. We increased the number of transplante d organs by 8.6% using NHBDs for both renal and extrarenal donation. C ontinued application of these techniques will likely further increase the number of organs retrieved for transplantation.