Role of the accident and emergency department in the non-heart-beating donor programme in Leicester.

OBJECTIVE To describe the development of a non-heart-beating donor (NHBD) programme in an accident and emergency (A&E) department over a three year period. BACKGROUND AND METHODS The A&E department at the Leicester Royal Infirmary at present deals with approximately 200 prehospital cardiopulmonary arrests per year. A programme of kidney retrieval from non-heart-beating donors was started in April 1992. Strict criteria for admission to the programme, appropriate consent procedures, facilities, lines of communication, and feedback were developed to enhance its success. RESULTS Of 66 patients referred to the NHBD programme over a three year period from 1 April 1992, 51 sets of relatives were available to be asked for possible organ donation, and 34 sets (66%) gave their consent. Twenty five patients had successful in situ perfusion of the kidneys. Forty seven organs were retrieved and 34 went on to be transplanted. To date, 27 kidneys are still working. As a result, 23.8% of kidneys transplanted in Leicester over this time period have been from the NHBD programme. CONCLUSIONS The NHBD programme in Leicester has proved very successful, requiring organisation of resources and personnel both from the transplant service and the A&E department. The programme has provided such a significant boost to the renal transplant rate in Leicester that other hospitals with large A&E departments should consider setting up similar programmes.