Open AccessOrgan Donors: Heartbeating and Non‐heartbeating
Author(s) -
Kootstra Gauke,
Kievit Jur,
Nederstigt Arjen
Publication year - 2002
Publication title -
world journal of surgery
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-001-0205-2
Subject(s) - contraindication , medicine , organ donation , donation , kidney , cardiac surgery , cardiothoracic surgery , liver transplantation , transplantation , surgery , pathology , alternative medicine , economics , economic growth
The limits of organ donation from heart-beating (HB) donors reached a plateau illustrated by the number of postmortem kidneys for transplantation. Programs such as the European Donor Hospital Education Program (EDHEP) and Donor Action have helped to stop a further decrease in the number instead of an expected increase. For kidneys, heart, liver, and lungs one must also explore the use of marginal donors as a possible additional source. Examples are donors with a horseshoe kidney, those at both ends of the age spectrum, and those with medical contraindication such as diabetes. We have enlarged our kidney donor pool considerably with non-heart-beating(NHB) donors. Because we preserve these kidneys in a preservation machine, we are able to perform viability testing. With glutathione S-transferase (GST) as a measure of tubular damage, we now decide whether to transplant based on GST values. For other organs, NHB donation does not seem to be an option other than for the liver when the warm ischemia time is short.