J Korean Soc Transplant.  2010 Sep;24(3):165-172. 10.4285/jkstn.2010.24.3.165.

The Use of Non-Heart Beating Donors to Expand the Donor Pool

• Kim JM
• Kim SJ

• KMID: 1464309
• DOI: http://doi.org/10.4285/jkstn.2010.24.3.165

Abstract

There is a persistent shortage of allografts available for transplantation, so we envisioned using non-heart beating donation to expand the donor pool. Non-heart beating donors (NHBD) were categorized using four definitions. Controlled donors, consisting of categories III and IV, are the most suitable for NHBD. Delayed graft function is associated with the use of kidneys from such donors, but had no difference on graft survival in the long-term results compared with heart beating donors. The proportion of NHBD of deceased donors differs considerably among countries, but national programs in many nations have now been initiated to increase the rate of non-heart beating donation. In most cases, the organs from NHBD are not available for transplantation in Korea because of legal restrictions. The use of controlled NHBD is encouraged to expand available allografts in Korea, due to the shortage of such allografts

Keyword

Deceased donor; Delayed graft function; Graft survival; Maastricht classification; Non-heart beating donor; Primary non-function; Warm ischemic time

MeSH Terms

Delayed Graft Function
Graft Survival
Heart
Humans
Kidney
Korea
Tissue Donors
Transplantation, Homologous
Transplants
Warm Ischemia

Figure

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  Fig. 1. The number of kidney and liver transplantation in Korea. Abbreviations: DDKT, deceased donor kidney transplantation; DDLT, deceased donor liver transplantation; LDKT, living donor kidney transplantation; LDLT, living donor liver transplantation. Adapted from reference [23].

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  Fig. 2. Transplant numbers by donation type. Abbreviations: SCD, standard criteria donor; ECD, extended criteria donor; DCD, deceased cardiac death donor. Reprinted from Fig. III-3 of reference [10].

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  Fig. 3. (A) Long-term outcome for deceased donor by donor type, (B) The graft survival rate by donor type. Abbreviations: NHBD, non-heart beating donor; HBD, heart beating donor; SCD, standard criteria donor; ECD, extended criteria donor; DCD, deceased cardiac death donor.

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  Fig. 4. Waiting lists and the number of deceased donor in Korea. Adapted from reference [23].

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  Fig. 5. The number of non-heart beating donation (NHBD) and dead donor for evaluating brain death between 2006 and 2009.

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  Fig. 6. Non-heart beating donation (NHBD) at Samsung Medical Center. Abbreviation: DDKT, deceased donor kidney transplantation.

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  Fig. 7. Serum creatinine levels by donor type at Samsung Medical Center (means, 95% confidence intervals) (P＜0.05). Abbreviations: SCD, standard criteria don; ECD, extended criteria donor; NHBD, non-heart beating donor.

Reference

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