Outcome of transplantation using kidneys from controlled (Maastricht category 3) non-heart-beating donors

Clin Transplant. 2003 Apr;17(2):93-100. doi: 10.1034/j.1399-0012.2003.00014.x.


Background: Many renal transplant centres are reluctant to use kidneys from non-heart-beating (NHB) donors because of the high incidence of primary non-function and delayed graft function reported in the literature. Here, we report our favourable experience of using kidneys from Maastricht category 3 donors (controlled NHB donors).

Materials and methods: From January 1996 to June 2002, 42 renal transplants using kidneys from 25 controlled NHB donors were undertaken at our centre. The rates of primary non-function, delayed graft function (DGF), rejection and long-term graft and patient survival were compared with those of 84 recipients of grafts from heart-beating (HB donors) transplanted contemporaneously.

Results: Primary non-function did not occur in recipients of grafts from NHB donors but was seen in two grafts from HB donors. DGF occurred in 21 of 42 (50%) kidneys from NHB donors and 14 of 84 (17%) kidneys from HBD donars (p < 0.001). The acute rejection rates in the two groups were similar (33% for grafts from NHB donors vs. 40% from HB donors). By 1 month after transplantation, there was no significant difference in serum creatinine concentration between the two groups. Over a median follow-up period of 32 months (range 2-75 months), the actuarial graft survival rates at 1, 3 and 5 yr after transplantation were 84, 80 and 74% for recipients of kidneys from NHB donors, compared with 89, 85 and 80% for kidneys from HB donors.

Conclusion: Controlled NHB donors are a valuable and under-used source of kidneys for renal transplantation. The outcome for recipients of kidney allografts from category 3 NHB donors is similar to that seen in recipients of grafts from conventional HB cadaveric donors.

MeSH terms

  • Adult
  • Case-Control Studies
  • Creatinine / blood
  • Female
  • Follow-Up Studies
  • Graft Rejection
  • Graft Survival*
  • Heart Arrest
  • Humans
  • Kidney Transplantation*
  • Male
  • Survival Analysis
  • Time Factors
  • Tissue Donors / classification*
  • Treatment Outcome


  • Creatinine