Management of the multiple organ donor.
ABSTRACT The need for cadaveric organs for transplantation is increasing. This article provides guidelines for the identification of potential organ donors and suggests suitable principles of management. The physiological changes after brain death are briefly reviewed.
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Article: The health of the nationBMJ Clinical Research 08/1991; DOI:10.1136/bmj.303.6797.311-b · 14.09 Impact Factor
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ABSTRACT: The scarcity of multiple-organ donors for perfused organ transplantation requires cooperation between various transplanting teams to maximize organ retrieval. We have developed a technique for the extraction of a cardiac and separate pulmonary graft from the same donor. These grafts can then be successfully implanted into two separate recipients. Our experience with 9 successful extractions and implantations is recorded.The Annals of Thoracic Surgery 10/1988; 46(3):356-9. DOI:10.1016/S0003-4975(10)65948-6 · 3.85 Impact Factor
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ABSTRACT: Successful organ transplantation offers patients with end stage organ failure the chance of a normal life. The recognition of brain death allowed the use of beating heart donors and this has enabled multiple organ procurement from a single donor. Suitable patients with severe brain injury resulting in brain death, who may be potential organ donors, are to be found on both neurosurgical and general intensive care units. The pathophysiological results of brain death are similar, irrespective of the underlying cause. Severe brain injury may result in the loss of temperature regulation, and the development of diabetes insipidus and cardiovascular instability. The management of brain injury before death often results in abnormalities of fluid balance, due to fluid restriction and diuretic therapy. Other problems such as acute endocrine failure and the impact of their correction on ultimate organ function remains to be elucidated. Good donor maintenance in the intensive care unit and operating theatre is essential if optimal function of the transplanted organ is to occur.Intensive Care Medicine 02/1989; 15(6):340-8. DOI:10.1007/BF00261491 · 7.21 Impact Factor