Availability of suitable kidney transplant donors from an ICU population - abstract

In establishing a renal transplant service in the Bahamas, a review of the availability of suitable cadaveric organ donors in the Intensive Care Unit (ICU) was carried out over the period January, 1988 to October, 1988. Clinical criteria for suitable organ donation and brain deaths were applied to all patients who died in the ICU. Over the nine-month period, 351 patients were admitted to the ICU and 107 died; 8 of 107 deaths fulfilled the criteria for cadaveric organ donation. All suitable victims succumbed to head inury. The mean age was 27 years with 6 to 8 deaths occuring within 4 days of admission. Issues affecting donor procurement rate in major transplant centres are not applicable in the centralized stem under study where all patients requiring critical care are referred to the ICU. It is concluded that cadaveric organ donation alone is inadequate to fulfill the criteria for cadaveric organ donation. All suitable victims succumbed to head injury. The mean age was 27 years with 6 to 8 deaths occuring within 4 days of admission. Issues affecting donor procurement rate in major transplant centres are not applicable in the centralized stem under study where all patients requiring critical care are referred to the ICU. It is concluded that cadaveric organ donation alone is inadequate to fulfill the organ demand for renal transplantation. In the Bahamas a policy of using living related donor organs whenever possible is favoured. Casual observation of road traffic and ICU mortalities fosters an erroneous assumption of potential donor organs (AU)

Renal transplantation in Jamaica

In a ten-year period beginning in 1970, twenty-five cadaver renal transplants were performed in Jamaica. Kidneys were transplanted with only short ischaemia times, and early function was a feature in most cases. Patient and graft survival were comparable with results obtained in larger centres even though tissue typing was not used to match donors and recipients. This experience shows that transplantation is an effective and suitable form of therapy for chronic renal failure in developing countries. Increasing awareness by the medical profession of the benefits of renal transplantation may increase the supply of donor kidneys and enable more patients with end-stage renal failure to receive treatment (AU)