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Experiences learned in the successful establishment of a nonheart beating donor program for renal transplantation

Lookup NU author(s): David Talbot, Dr Brian Shenton, Muhammed Gok


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Purpose: With the continuing shortage of suitable donors increasing interest is being shown in nonheart beating donation. Such a resource is a new and, therefore, an underused source of donor organs. However because of the nature of such donors, the kidneys so derived have been damaged by primary warm ischemia, and so potentially they may never function. We introduced viability testing to identify such organs and, thus, avoid transplantation. We reviewed sentinel cases in our developing program from which we have learned. Materials and Methods: Machine perfusion was developed locally and used to test the kidneys derived from such donors. Flow characteristics and enzyme analysis were used to define usable kidneys. The definitions of acceptable criteria evolved through the study during a 3-year period. Results: As previously defined, acceptable criteria were initially adhered with decreasing resistance and a glutathione S-transferase of less than 200 IU/l/100 gm. After the series described acceptable limits were changed in favor of a high perfusion flow index, low temperature, low weight increase and low glutathione S-transferase. Conclusions: If such criteria are adhered to, graft survival becomes reliable from such donors.

Publication metadata

Author(s): Talbot D, Shenton BK, Buckley PE, Gok MA

Publication type: Article

Publication status: Published

Journal: Journal of Urology

Year: 2003

Volume: 170

Issue: 4

Pages: 1088-1092

ISSN (print): 0022-5347

ISSN (electronic): 1527-3792

Publisher: Elsevier


DOI: 10.1097/01.ju.0000086774.12582.0f


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