Renal Transplantation from Non-heart Beating Donors: A Promising Alternative to Enlarge the Donor Pool

Kim, Young Hoon

Abstract

In spite of efforts to promote organ donation through media campaigns, educating the public and improved organization for organ retrieval, the number of donors has remained relatively stable over the past few years. On the contrary, adverse scandals such as "buying & selling organs" or "The Exodus to China" for renal transplantation are recent issues in the field of organ transplantation". It has been suggested that non-heart beating donors (NHBD) could bridge the gap between supply and demand for renal transplantation; however, NHB donation is being used to a limited degree. This article reviews the selection criteria, technical approaches and logistical organization, the graft function and survival in NHBD. Actually, the primary non-function of grafts is significantly worse for NHBD kidneys, but the result could be improved by utilizing better patient selection and retrieval team organization. Delayed graft function is also more frequent in NHBD kidneys. This poses problems in the short term, but in the long term it does not seem to influence the outcome. Indeed, NHBD has consistently increased the number of available kidneys and it has no effect on heart beating (HB) donations.