This book describes the different uses of donors of organs after cardiac death around the world, based on different laws and logistical issues around the world. Developments have allowed these programmes to flourish such that in 2006 25% of UK kidney transplants were from such donors.
With the success of organ transplantation and the declining number of heart beating cadaver donors, the number of patients awaiting a transplant continues to rise. This means that alternative sources of donors have been sought, including donors after cardiac death. Such donors sustain rapid damage to their organs due to ischaemia, and as a consequence some organs do not work initially and some none at all. The proportion of such transplants has increased dramatically in recent years- 25% of kidney transplants in the UK were from such donors in 2006 highlighting how much progress has been made. Written by international experts, this book lays out the moral, legal and ethical restraints to using such donors for organ transplant together with the techniques that have been adopted to improve their outcome. The different approaches and results of renal transplant according to country are covered together with the procedures and outcomes adopted to use other organs, notably the liver and lungs.
1. History of non-heart-beating donation; 2. Legal, moral, and ethical issues; 3. History of organ perfusion in organ transplantation; 4. Viability testing of kidneys from non-heart-beating donors; 5. Perfusate development for the NHBD; 6. Thrombolysis in the non-heart-beating donor; 7. Supplemental cryopreservation of the donor by peritoneal cooling; 8. Gaseous oxygen to improve viability of marginal or pre-damaged organ grafts during hypothermic storage; 9. Extracorporeal circulatory-assisted non-heart-beating organ donation; 10. Patient selection and management; 11. The renal biopsy in non-heart-beating organ transplantation; 12. Early results for renal transplants from non-heart- beating donors; 13. Liver transplantation using non-heart-beating donors; 14. Lung transplantation from non-heart-beating donors; 15. Donors without a heart beat in the United States; 16. Non-heart-beating donation in Europe; 17. Renal and islet transplantation from non-heart-beating donors in Japan; 18. The current situation and further development