NHBD ( Non Heart Beating Donor) is a marginal donor with high risk of delayed graft function due to long warm ischemia time.To be able to exclude the high risk kidneys we used the method of multiple kidneys monitoring and all the NHBD kidneys were evaluated by the following techniques :
1/ Clinical evaluation ( color, oedema, turgor )
2/ Pulsatile hypotermic perfusion with monitoring of renal resistance as index of the vascular damage
3/ Total Glutathion S Tranferase as index of prox. tubular damage
4/ Early biopsy with results within an 8 hours
5/ pH, color and p02 of perfusate
6/ Kidney weight before and after perfusion
Between 2002 - 2005 the total No of 20 kidneys from 10 NHBD were harvested.
Excluded: 10 kidneys (HBsAg+ 2x,high renal resist. 1x, non AB recipient 1x and for high GST and poor bioptical finding 4x)
Transplanted: 10 kidneys from 6 NHBD
Function: Immediate 8x (80%), DGF 2x (20%)
Long time survival: Excellent function 9x ( 90%) with normal sCr, 1x graftectomy after heavy surgical bleeding. The method of multiple kidneys monitoring help us to exclude the high risk kidney and lead to better posttransplant results