SUCCESSFUL EXTRARENAL TRANSPLANTATION FROM NON-HEART-BEATING DONORS

被引：162

作者：

DALESSANDRO, AM ^{[1
]}

HOFFMANN, RM ^{[1
]}

KNECHTLE, SJ ^{[1
]}

ECKHOFF, DE ^{[1
]}

LOVE, RB ^{[1
]}

KALAYOGLU, M ^{[1
]}

SOLLINGER, HW ^{[1
]}

BELZER, FO ^{[1
]}

机构：

[1] UNIV WISCONSIN,SCH MED,DEPT SURG,MADISON,WI 53792

来源：

TRANSPLANTATION | 1995年 / 59卷 / 07期

关键词：

D O I：

10.1097/00007890-199504150-00009

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

The current organ shortage has made utilization of organs from less-than-ideal donors more common, Although several transplant centers use kidneys from non-heart-beating donors (NHBDs), there has been reluctance to extend the use of these donors to extrarenal organs. Of the 130 donors referred to our organ procurement organization between January 1993 and May 1994, 16 (12.3%) were NHBDs. Organ retrieval from 10 of these resulted in extrarenal donation, 5 resulted in renal donation only, and 1 resulted in no retrieval as a result of prolonged warm ischemia (> 2 hr). A total of 39 organs were transplanted from these NHBDs. A rapid en bloc retrieval technique was used for extrarenal NHBDs. The mean warm ischemic time was 15.4 min; preservation times were similar for both NHBDs and heart-beating donors. After liver transplantation (n=5), one episode of primary nonfunction that was technical in origin required retransplantation. Following simultaneous pancreas-kidney transplantation (n=6), all patients were insulin independent and free of graft pancreatitis; one patient required hemodialysis (16.7%). After isolated renal transplantation (n=21), 3 patients (14.3%) required hemodialysis. Three of 4 liver recipients are alive after a mean follow-up period of 12.7 months; all simultaneous pancreas-kidney and renal transplant recipients are alive after a mean follow-up period of 8.4 and 8.3 months, respectively. Three liver allografts, 5 pancreas and kidney allografts, and 19 renal allografts are functioning. The lung allograft was lost to rejection 81 days after transplantation; however, the recipient is alive 3 months after retransplantation. Our results demonstrate that in controlled situations, extrarenal organs can be utilized from NHBDs and can be expected to function similarly to organs retrieved from heart-beating donors. We increased the number of transplanted organs by 8.6% using NHBDs for both renal and extrarenal donation. Continued application of these techniques will likely further increase the number of organs retrieved for transplantation.

引用

页码：977 / 982

页数：6

共 28 条

[11]

Evans R.W., The actual and potential supply of organ donors in the United States, Clinical transplants 1990, (1991)

[12]

Bart K.J., Macon E.J., Humphries A.L., Et al., Increasing the supply of cadaveric kidneys for transplantation, Transplantation, 31, (1981)

[13]

Council on Scientific Affairs, Organ donor recruitment, JAMA, 246, (1981)

[14]

Organ transplantation: Issues and recommendations, (1986)

[15]

Starzl T.E., Marchioro T.L., Von Kaulla K.N., Hermann G., Brittain R.S., Waddell W.R., Homotransplantation of the liver in humans, Surg Gynecol Obstet, 117, (1963)

[16]

Caine R.Y., Williams R., Liver transplantation in man: I. Observations on technique and organization in five cases, Br Med J, 4, (1968)

[17]

Bjorken C., Lundgren G., Ringden O., Groth C.G., A technique for rapid harvesting of cadaveric renal and pancreatic grafts after circulatory arrest, Br J Surg, 63, (1976)

[18]

Yanaga K., Kakizoe S., Ikeda T., Podesta L.G., Demetris A.J., Starzl T.E., Procurement of liver allografts from non-heart-beating donors, Transplant Proc, 22, (1990)

[19]

Ericzon B.G., Lundgren G., Wilczek H., Groth C.G., Experience with human liver grafts obtained after donor cardiac standstill, Transplant Proc, 19, (1987)

[20]

Starzl T.E., Iwatsuki S., Shaw B.W., Gordon R.D., Orthotopic liver transplantation in 1984, Transplant Proc, 17, (1985)

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