For Multiple Organ Recovery

Osman Abbasoglu, Marlon F. Levy

The Role of the Anesthesiologist in Organ Procurement 114

Liver Procurement 114

Kidney Procurement 120

Pancreas Procurement 122

Small Bowel Procurement 124

Summary 126

The dramatic improvement in the quality of life after successful transplantation has increased demands for solid organ transplantation. In general only brain-dead donors are accepted for cadaveric transplantation. Despite all efforts to increase the organ procurement rate, the number of organs retrieved is still short of the needs. Because of organ shortage and the growth of transplantation of many solid organs including kidney, liver, pancreas, heart, lung and intestines, the number of donor organs should be maximized through multi-organ procurement.1,2 Currently, all donors are considered for multi-organ procurement unless specific contraindications exist.

Differences in the techniques for organ procurement among transplantation centers necessitate close cooperation and good communication between operative teams for optimal procurement without organ ischemia or injury.

Technical principles of abdominal procurement procedures are the same regardless of the organs removed.3 These are wide exposure, placement of cannulas for in situ perfusion, isolation of organs to be removed in continuity with their central vascular structures and orderly removal of the organs under cold perfusion protection. Organs are removed according to their susceptibility to ischemia, the need for their immediate function and their anatomic location.

In multiple organ procurement the order of organ removal is:

1. Heart

2. Lungs

3. Liver

4. Pancreas (or small intestine)

5. Kidney

Organ Procurement and Preservation, edited by Goran B. Klintmalm and Marlon F. Levy. © 1999 Landes Bioscience

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