Non-heart-beating donors

Overview

Since the 1990s the continuous quest for new organ resources for transplantation has re-evoked the interest in non-heart-beating donors (NHBD). The method was pioneered in the Netherlands and nowadays NHBDs are accepted in a wide range of countries. Since 2002 the Czech Republic has joined these countries in accepting this group of donors. The basic medical problem related to NHBD is the duration of the warm ischaemic time and the ischaemic-reperfusion syndrome. NHBDs remain a very specific group even from the ethical and legal aspects. Legislation of individual countries varies as much as the protocols of the individual transplantation centres. The Transplantation Centre of The University Hospital Hradec Králové began accepting organs from NHBDs in compliance with the Czech Transplantation Act 285/2002. The methods of termination of resuscitation and follow-up care of NHBDs are regulated by guidelines that were created as a result of the co-operation between The Transplantation Centre Hradec Králové and the Department of anaesthesia, resuscitation and intensive medicine at the University Hospital Hradec Králové. The most common organs donated from NHBDs are the kidneys followed by the liver, pancreas and lungs. Published studies agree on reporting a delayed return of renal function whereas long-term grafts survival varies by centre. In spite of this NHBD remains promising in the field of transplantation in the Czech Republic and worldwide.

Key words:
transplantation – non-heart-beating donors – Maastricht categorization – warm ischaemic time – explicit and presumed consent – no-touch interval – graft outcome after NHBD retrieval