Conclusion

The increasing demand for transplantable organs is a major challenge. As pressures to expand the donor pool continue, we will be faced with donors with additional medical problems that might impact upon donor management. Numerous studies have defined donor age as an independent risk factor in determining outcomes. Are organs from older donors or those donors with comorbid medical conditions less tolerant to hypotension and ischemia, reperfusion injury and prolonged cold storage? Should procedures for organ recovery be altered based upon these variables? The answers to these questions and many more must be forthcoming as we attempt to maximize organ retrieval and maintain and improve our current patient and graft survival.

References

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Justice AD, DiBenedetto RJ, Stanford E. Significance of elevated pancreatic enzymes in intracranial bleeding. Southern Med J 1994; 87(9):889-893. Mor E, Klintmalm GB, Gonwa TA et al. The use of marginal donors for liver transplantation. A retrospective study of 365 liver donors. Transplantation 1992; 53:383-386.

Power BM, Van Heerden PV. The physiological changes associated with brain death-current concepts and implications for treatment of the brain dead organ donor. Anaesth Intens Care 1995; 23:26-36.

Scheinkestel CD, Tuxen DV, Cooper DJ, Butt W. Medical management of the (potential) organ donor. Anaesth Intens Care 1995; 23:51-59. Solomon R, Werner C, Mann D, D'Elia J, Silva P. Effects of saline, mannitol and furosemide on acute decreases in renal function induced by radiocontrast agents. N Eng J Med 1994; 331(21):1416-1420.

15. Terasaki PI, Cecka M, Gjertson DW, Takemoto S. High survival rates of kidney transplants from spousal and living unrelated donors. N Eng J Med 1995; 333(6):333-336.

16. Troppmann C, Gruessner AC, Benedetti E et al. Vascular graft thrombosis after pancreatic transplantation: Univariate and multivariate operative and nonoperative risk factor analysis. J Am Coll Surg 1996; 182:285-316.

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