Organ transplantation is one of the groundbreaking achievements in medicine in the 20th century. In the early days of transplantation, organs were obtained from non-heartbeating (NHB) cadavers. With time, better options for organ sources became available (for example, living-related and "brain dead" donors), and the practice of obtaining organs from NHB cadavers fell out of favor. Improvements in the field of transplantation have led to an increased demand for organs. Various strategies have been employed recently to increase the supply, one of them being non-heartbeating organ donation (NHBOD). NHBOD can take place in controlled or uncontrolled circumstances. Recently, national organizations have supported and proposed guidelines for NHBOD and to aid clinicians in identifying potential donors. Outcomes of organs obtained from NHB cadavers are comparable to those obtained from heartbeating donors. The practice of NHBOD is increasing and has proven that it can contribute to increasing organ availability.
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Lung transplantation from nonheparinized category III non-heart-beating donors. A single-centre report.
Transplantation
February 2010
Department of Cardiothoracic Surgery, Division of Organ Donation, University of Groningen, Hanzeplein 1 PO Box 30001, 9700RB Groningen, The Netherlands.
Background: Despite the increasing use of extended lung donors, the shortage of lung donors remains. Usage of non-heart-beating (NHB) lung donors contributes to fight this shortage. We describe our experience in 21 consecutive adult lung transplantations using nonheparinized category III NHB donors and standard flush preservation.
View Article and Find Full Text PDFA free radical scavenger, edaravone, prevents ischemia-reperfusion injury in liver grafts from non-heart-beating donors.
Transplant Proc
September 2008
Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Background: Due to the increase in liver transplantation, the donor shortage has become a serious problem, requiring marginal, non-heart-beating donors (NHBDs). The aims of this study were to evaluate the cytoprotective effect of edaravone, a free radical scavenger, on warm ischemia-reperfusion (I/R) injury of liver grafts from NHBDs.
Methods: Rat livers were harvested from heart-beating donors (HB group) or from NHBDs undergoing cardiac arrest for 30 minutes led by thoracotomy (NHB group), and reperfused for 60 minutes with Krebs-Henseleit bicarbonate buffer after cold preservation for 6 hours.
Non-heart-beating lung donation: how big is the pool?
J Heart Lung Transplant
September 2008
Department of Surgery, Division of Organ Donation, University Medical Center Groningen, Groningen, The Netherlands.
Lungs from non-heart-beating (NHB) donors are seldom used in The Netherlands despite the good quality of these organs. Based on a retrospective analysis of 162 NHB donor procedures we found that only 5% of the lungs were actually utilized, but that 30% of the lungs were suitable for transplantation. Not recognizing the suitability of NHB lungs is likely the main reason for their non-availability.
View Article and Find Full Text PDFOutcome of kidney transplantation from nonheart-beating versus heart-beating cadaveric donors.
Transplantation
May 2007
Imperial College London, Department of Biosurgery and Surgical Technology, St Mary's Hospital, London, United Kingdom.
Background: This study aimed to assess outcomes of kidney transplants from nonheart-beating (NHB) compared with heart-beating (HB) cadaveric donors with meta-analytical techniques.
Methods: A literature search was performed for studies comparing kidney transplants from NHB vs. HB cadaveric donors between 1992 and 2005.
Non-heartbeating donation of kidneys for transplantation.
Nat Clin Pract Nephrol
March 2007
University of Maastricht, Maastricht, The Netherlands.
There is a persistent shortage of kidneys available for transplantation. In the early 1980s, therefore, we published the concept of non-heartbeating (NHB) donation; that is, procurement of kidneys from donors whose death has been accompanied by irreversible circulatory arrest. NHB donors are generally categorized using four definitions; category III (awaiting cardiac arrest) and category IV (cardiac arrest while braindead)--or 'controlled'--donors are the most suitable for initiating NHB donation programs.
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