Prélèvements d’organes sur donneurs décédés après arrêt cardiaque

Abstract

The transplant of an allograft after cardiac arrest has been allowed in France since 2005 (decree of 2 august 2005: art R.1232-4-1, 2 and 3 of the public health code). Recently, according to the international scale, 4 situations that could lead to the realization of transplantable organs after cardiac arrest were identified according to a classification called "Maastricht" which describes the potential donors. In France the donors of class III (cessation of all medical care) were excluded. Ethical questions concerning this new practice come up. Are criteria adopted to define death enough sure? What is the place of non-heart beating donor transplantation with new technical resuscitation as extracorporeal life support for prolonged cardiac arrest? How does family and medical staff live this protocol? Despite this, non heart-beating donor kidney transplants offer the opportunity to compensate for the growing discrepancy between supply and demand for donor kidneys. Results from foreign studies have shown that they have the same survival and long term function as kidneys from traditional brain-stem dead donors. This practice is defined by legislation and supervised by the "Agence de la biomédecine" which guarantees technical efficiency and respect of ethics.