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Compares the allograft fibrosis in kidneys transplanted from non-heart-beating donors (NHBD) and conventional heart-beating donors. Performance of protocol renal transplant biopsies at six and 12 months after transplantation; Mean first warm ischemia time for kidneys from NHBD; Acceptability of kidneys from NHBD as alternative to those from heart-beating-donors.

Aims: Although kidney transplants from non-heart beating donors (NHBD) yield acceptable renal function and allograft survival rates in the medium term, the longterm results are less certain and there is a paucity of information relating to the development of chronic allograft nephropathy. The aim of this study was to compare the development of renal allograft fibrosis in kidneys transplanted from NHBD and conventional heart beating cadaveric donors (HBD). Methods: A series of 36 NHBD and 74 HBD renal transplants were studied. Protocol needle core renal transplant biopsies were performed pre-perfusion and at 6 and 12 months post transplant. Biopsy sections (4 µm) were stained with Sirius red to determine the level of interstitial extracellular matrix deposition. Renal allograft fibrosis was quantified using a computerized image analysis system. Results: (see graph): The mean warm ischemic time for NHBD kidneys was 25 minutes. Delayed graft function (DGF) occurred in 24% of HBD and 87% of NHBD. There were no significant differences in the level of renal allograft fibrosis between NHBD and HBD kidneys at any time point. The level of renal fibrosis in 6 month biopsies was positively correlated with serum creatinine levels at 12 and 24 months post transplant (P = 0·005). Conclusions: Despite sustaining a prolonged period of warm ischemic injury leading to high rates of DGF, NHBD kidneys do not appear to be more susceptible to the development of renal allograft fibrosis. This study supports the growing body of evidence that NHBDs are a practical and viable alternative to HBD kidney transplants. [ABSTRACT FROM AUTHOR]