What are non–heart beating donors (NHBDs) and what are the risks in liver transplantation for cirrhosis?

Updated: Jul 30, 2018
  • Author: David C Wolf, MD, FACP, FACG, AGAF, FAASLD; Chief Editor: BS Anand, MD  more...
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Answer

The shortage of donor organs has spurred interest in the use of liver allografts from non–heart beating donors (NHBDs). Typically, an NHBD is an individual who has sustained irreversible neurologic damage but whose clinical condition does not meet formal brain death criteria. Knowing this, a prospective donor's family will give consent for withdrawal of care and for organ donation. The donor is then brought to the operating room, with the anticipation that withdrawal of ventilator support will result in the cessation of the patient's cardiopulmonary function. Once death is declared, organ procurement surgery can proceed.

In contrast to the organ procured from a heart-beating donor (HBD), the allograft obtained from an NHBD may be subject to considerable warm ischemia time before it is perfused with the cold preservative solution.


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