[Renal transplantation using a Maastricht category III non-heartbeating donor: First French experience and review of the literature]

Abstract

In 2015, Annecy Hospital was the first French hospital to perform non-heartbeating organ donation from a Maastricht category III donor (patient awaiting cardiac arrest after withdrawal of treatment). Non-heartbeating organ donation (NHBD), performed in France since 2006, had initially excluded this category, due to ethical questions concerning end of life and treatment withdrawal, as well as technical specificities linked to this procedure. Grenoble University Hospital and Edouard-Herriot Hospital in Lyon then performed the first kidney transplants, with satisfactory outcomes in both recipients. This article presents the details and results of this new experience, challenging both on a deontological and organizational level. Functional outcomes of kidney grafts from NHBD are now well known in the literature and confirm their benefit for patients, with similar results to those from heartbeating donors (HBD). International experiences concerning specifically Maastricht category III NHBD are encouraging and promising.

Keywords: Classification de Maastricht; DDAC; Donneurs décédés par arrêt circulatoire; Kidney transplantation; Maastricht category; NHBD; Non-heartbeating organ donation; Organ donation; Prélèvement d’organes; Transplantation rénale.