[In-situ preservation of kidneys of 'non-heart-beating' donors: a possible way to offset the shortage of donor kidneys].

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.