Response to organ shortage: kidney retrieval programme using non-heart beating donors

Abstract

Two sources of potential donors were identified. In the accident and emergency department patients aged under 65 in whom resuscitation after cardiorespiratory arrest or trauma had failed were referred to the transplant team providing not longer than 30 minutes without cardiac massage had elapsed. On the medical wards elective ventilation4 of donors is not always possible if there are no intensive care beds. In these circumstances arrangements were made for in situ perfusion, on the ward, after death. Requests for donation were made only by a senior member of the accident and emergency, medical, or transplant team. When relatives were not available in the accident and emergency department in situ perfusion was started as a temporising measure and withdrawn if permission was subsequently not obtained. This aspect of the protocol was discussed with the local ethics committee and soundings taken in the local press to assess public response. No significant adverse correspondence was received.