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.