How to Select The Non-Heartbeating Donors Suffering from CPR

Abstract

Objective To investigate perioperative treatment method and the early clinical effect of kidney transplantation from non-heartbeating donors suffering from cardiopulmonary resuscitation(CPR). Methods A retrospective review of clinical data of 41 donors and 73 recipients' kidney transplantation from non-heartbeating donors performed from December 2011 to June 2017 in kidney transplantation department of the first affiliated hospital of Xi’an Jiaotong university. Analysis of CPR’s impact on the prognosis of non-heartbeating donors renal transplant recipients. Results There were three groups divided by the time of CPR:<10min, 10-30min, >30min. Delayed graft function(DGF)of three groups recipients were 3.1%, 17.4% and 100% respectively. Early survival rate of human with kidney were 96.9%, 86.9% and 61.1% respectively. 1 year survive of kidney and recipients was 82.2/93.2% totally. The difference of three groups’ prognosis had statistical significance. Conclusions Our center summarized the following principles: If the time of CPR was less than 10 minutes and renal function was normal, we will implement organ donation directly; If the time of CPR was 10-30 minutes, we will assess blood pressure, kidney function and urine volume comprehensively and discuss the risk of operation; If the time of CPR was more than 30 minutes, we will suggest to give up donating. In addition, repair and maintenance of the donors of the primary diseases and organs function are very important. Especially, it is necessary to pay attention to potential infectious donors, observe the change of the urine and kidney function dynamically and application of hormone, heparin and urokinase before organ procurement. Application of lifepot, anti-infection and postoperative follow-up are all keys to assure outcomes of kidney transplantation.