Kootstra G, van Hooff J P
Afd. Heelkunde, Academisch Ziekenhuis, Maastricht.
Ned Tijdschr Geneeskd. 1998 Dec 26;142(52):2838-43.
Every year some 700 new patients and 150 patients in whom a transplanted kidney is no longer functioning are placed on the waiting list for kidney transplantation. Per year some 400 cadaver kidneys and 100 kidneys from relatives and partners are transplanted in the Netherlands, resulting in an annual shortage of 350 kidneys. By 'non-heart-beating donor' is meant a subject deceased after cardiac arrest, in contradiction to the brain-dead donor. In non-heart-beating donors it is possible via a catheter in the inguinal artery to occlude the aorta above and below the kidney level, following which the kidneys may be perfused with a refrigerated fluid and preserved. In this way, time is gained to obtain consent for transplantation from the relatives or to find it in the donor registration. A kidney originating from a non-heart-beating donor relatively often starts to function only late after transplantation, or even does not begin to function at all. Nevertheless, the number of kidneys becoming available in this way suffices to eliminate the current shortage of donor kidneys. The Organ Donation Law allows cooling of the kidneys in the cadaver in expectation of consent for organ donation. It appears necessary to carry out a test of kidneys of non-heart-beating donors to avoid transplantation of non-viable kidneys.
每年约有700名新患者以及150名移植肾不再发挥功能的患者被列入肾移植等候名单。在荷兰，每年约有400个尸体肾以及100个来自亲属和配偶的肾被移植，导致每年肾脏短缺350个。“非心脏跳动供体”指的是心脏骤停后死亡的个体，与脑死亡供体相对。对于非心脏跳动供体，可通过腹股沟动脉中的导管阻塞肾水平上方和下方的主动脉，随后可用冷藏液灌注肾脏并进行保存。通过这种方式，可以争取时间来获得亲属对移植的同意，或者在供体登记中找到合适的供体。源自非心脏跳动供体的肾脏相对经常在移植后很晚才开始发挥功能，甚至根本不开始发挥功能。然而，通过这种方式可获得的肾脏数量足以消除目前供体肾短缺的问题。《器官捐赠法》允许在尸体中冷却肾脏，以期获得器官捐赠的同意。为避免移植无活力的肾脏，对非心脏跳动供体的肾脏进行检测似乎是必要的。
