Non-heart-beating Donation

Non-heart-beating Donation

Prior to the introduction of Brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart beating donors (NHBDs).

Donors after brain-dead (DBD),(beating heart cadavers), however, led to better results as the organs were perfused with oxygenated blood until the point of perfusion and cooling at organ retrieval, and so non-heart beating donors were generally no longer used except in Japan, where brain-death was not legally (until very recently) or culturally (still) recognized.

However, a growing discrepancy between demand for organs and their availability from DBDs has led to a re-examination of using non-heart beating donors, donors after circulatory death (DCDs), and many centres are now using such donors to expand their potential pool of organs.

Tissue donation (corneas, heart valves, skin, bone) has always been possible for non-heart beating donors, and many centres now have established programmes for kidney transplants from such donors. A few centres have also moved into DCD liver and lung transplants. Many lessons have been learnt since the 1970s, and results from current DCDs transplants are comparable to transplants from DBDs.