Background: Despite the decline in the number of uncontrolled donors worldwide due to complex logistics and good results in organ transplantation from controlled donors, we reasonably believe that uncontrolled donation has enormous potential, sometimes being the only additional source of obtaining organs, especially in the absence of a law permitting controlled donation. In Russian Federation, this type of donation is relevant, and we have begun its active development. The most effective and sustainable development is taking place in Moscow.
Methods: The retrospective study included 103 potential uncontrolled donors (Maastricht Classification II) for the period 2021-2023. 32 were Maastricht IIb, and 71 Maastricht IIa. We used NRP in 48 cases, 10 in IIb donors and 38 in IIa. The effective donors have become 6 in IIb group and 19 in IIa group. A unique organizational model is used, when a donor team urgently goes to an uncontrolled donor with an ECMO device and after the donor’s death is confirmed and the non-touch period of 5 minutes has expired, fully provides donor NRP procedure.
Results: The median no flow time in IIb group was 1 min, in IIa group (out of hospital) was 12 min. There was no difference in the total WIT - 103 min in group IIb and 110 min in IIa donors. A higher proportion of PNF was detected in intrahospital group comparing to outhospital (27.3% vs 14.3%, p=0.02). On the contrary, there were less cases of DGF in IIb group (18.2% vs 65.7%, p=0.02). The annual survival rate in group IIb comparing to group IIa consisted of 72.7% vs 85.7% (p=0.34), respectively.
Conclusions: Despite the extremely complex organizational issues, we find the results of uncontrolled donation acceptable. However, according to uncontrolled survival rate results, further work requires a stricter selection of in-hospital donors.