Concept

Non-heart-beating donation

Summary
Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs). Donors after brain death (DBD) (beating heart cadavers), however, led to better results as the organs were perfused with oxygenated blood until the point of perfusion and cooling at organ retrieval, and so NHBDs were generally no longer used except in Japan, where brain death was not legally or culturally recognized, until very recently. However, a growing discrepancy between demand for organs and their availability from DBDs has led to a re-examination of using non-heart-beating donations, DCD (Donation after Circulatory Death, or Donation after Cardiac Death), and many centres are now using such donations to expand their potential pool of organs. Tissue donation (corneas, heart valves, skin, bone) has always been possible for NHBDs, and many centres now have established programmes for kidney transplants from such donor
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