Deceased Organ Donor Characteristics and Clinical Interventions Associated with Organ Yield

Selck, F. W.; Deb, Partha; Grossman, E.

doi:10.1111/j.1600-6143.2008.02205.x

Cited by 55 publications

(40 citation statements)

References 14 publications

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“…Typically 1-2 μg IV are required every 6 hours (137). Retrospective studies have suggested that desmopressin administration in the potential adult or pediatric organ donor with DI is associated with hemodynamic stability and perhaps increased yield of donor organs (150,151).…”

Section: How Should Avp Deficiency In the Organ Donor Be Treated?mentioning

confidence: 99%

Management of the Potential Organ Donor in the ICU

Kotloff

Blosser

Fulda

et al. 2015

Critical Care Medicine

279

150

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This document was developed through the collaborative efforts of the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations. Under the auspices of these societies, a multidisciplinary, multi-institutional task force was convened, incorporating expertise in critical care medicine, organ donor management, and transplantation. Members of the task force were divided into 13 subcommittees, each focused on one of the following general or organ-specific areas: death determination using neurologic criteria, donation after circulatory death determination, authorization process, general contraindications to donation, hemodynamic management, endocrine dysfunction and hormone replacement therapy, pediatric donor management, cardiac donation, lung donation, liver donation, kidney donation, small bowel donation, and pancreas donation. Subcommittees were charged with generating a series of management-related questions related to their topic. For each question, subcommittees provided a summary of relevant literature and specific recommendations. The specific recommendations were approved by all members of the task force and then assembled into a complete document. Because the available literature was overwhelmingly comprised of observational studies and case series, representing low-quality evidence, a decision was made that the document would assume the form of a consensus statement rather than a formally graded guideline. The goal of this document is to provide critical care practitioners with essential information and practical recommendations related to management of the potential organ donor, based on the available literature and expert consensus.

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Section: How Should Avp Deficiency In the Organ Donor Be Treated?mentioning

confidence: 99%

Management of the Potential Organ Donor in the ICU

Kotloff

Blosser

Fulda

et al. 2015

Critical Care Medicine

279

150

View full text Add to dashboard Cite

show abstract

“…Aggressive donor management (ADM) improves both quality and quantity of organs available for transplant [198]. Current ADM recommendations include early identification of potential donors, ICU admission, pulmonary artery catheterisation, aggressive fluid management, vasopressors, hormonal resuscitation therapy, pulmonary toilet, and bronchoscopy [148, 199–202].…”

Section: Management Implications and Potential Future Directionsmentioning

confidence: 99%

Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury

Watts

Thom

Fraser

2013

Journal of Transplantation

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Brain death is associated with dramatic and serious pathophysiologic changes that adversely affect both the quantity and quality of organs available for transplant. To fully optimise the donor pool necessitates a more complete understanding of the underlying pathophysiology of organ dysfunction associated with transplantation. These injurious processes are initially triggered by catastrophic brain injury and are further enhanced during both brain death and graft transplantation. The activated inflammatory systems then contribute to graft dysfunction in the recipient. Inflammatory mediators drive this process in concert with the innate and adaptive immune systems. Activation of deleterious immunological pathways in organ grafts occurs, priming them for further inflammation after engraftment. Finally, posttransplantation ischaemia reperfusion injury leads to further generation of inflammatory mediators and consequent activation of the recipient's immune system. Ongoing research has identified key mediators that contribute to the inflammatory milieu inherent in brain dead organ donation. This has seen the development of novel therapies that directly target the inflammatory cascade.

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“…7 Standard pretreatment regimens to counteract the effects of brain death on organ function and transplant outcome usually include the administration of methyl prednisolone and vasopressin. 7 Brain death is character ized by severe cardiovascular dysregulation. Ischaemia and malperfusion in the cardiovascular nuclei of the medulla oblongata lead to massive catecholamine release and hypertension.…”

Section: Pretreatment Measuresmentioning

confidence: 99%

Advances in the management of the explanted donor liver

Nebrig

Pascher

2014

Nat Rev Gastroenterol Hepatol

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Liver transplantation is the best therapy in end-stage liver disease. Donor organ shortage and efforts to expand the donor organ pool are permanent issues given that advances in perioperative management and immunosuppressive therapy have brought the procedure into widespread clinical use. The management of organ procurement, including donor preconditioning and adequate organ storage, has a key role in transplantation. However, the organ procurement process can differ substantially between transplant centres, depending on local and national preferences. Advances in the field have come from experimental and clinical research on dynamic storage systems, such as machine perfusion devices, as an alternative to static cold storage. Determination of the clinical significance of these new systems is a topic worthy of future investigations.

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Deceased Organ Donor Characteristics and Clinical Interventions Associated with Organ Yield

Cited by 55 publications

References 14 publications

Management of the Potential Organ Donor in the ICU

Management of the Potential Organ Donor in the ICU

Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury

Advances in the management of the explanted donor liver

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