Optimal Management

for Abdominal Organ Donation SC

Allan M. Roza, Christopher A. Johnson, Mark B. Adams

Introduction SC

Hemodynamic Monitoring Sl

Management of Hypertension Si

Management of Hypotension S2

Management of Electrolyte Disorders SS

Management of Coagulopathy S6

Management of Hypothermia S7

Management of Hypoxemia SS

Management of Arrhythmias SS

Management of Hyperglycemia S9

Nutritional Support of the Abdominal Organ Donor S9

Modulation of the Inflammatory Response in the Abdominal Organ Donor S9

Organ Specific Issues 9C

Conclusion 92

7. Optimal Thoracic Organ Donor Management 94

Dan M. Meyer, Michael A. Wait, Michael E. Jessen, W. Steves Ring

Donor Selection (General) 96

Donor Selection (Organ Specific) 1C1

Donor Preoperative Management ICS

S. Surgical Technique for Multiple Organ Recovery 113

Osman Abbasoglu, Marlon F. Levy

The Role of the Anesthesiologist in Organ Procurement 114

Liver Procurement 114

Kidney Procurement 12C

Pancreas Procurement 122

Small Bowel Procurement 124

Summary 126

9. Surgical Technique for Thoracic Organ Recovery 12S

Michael A. Wait, Dan M. Meyer, Michael E. Jessen, W. Steves Ring

Thoracic Organ Procurement Technique 12S

Isolated Donor Cardiectomy 129

Combined Donor Cardiectomy and Pneumonectomy 131

Principles of Lung Preservation 134

Perfusate Composition 134

Prostaglandins 136

Preservation Temperature, Ventilation Volume and Composition 136

Bronchial Arterial Perfusion 137

Retrograde vs. Antegrade Flush Administration 137

Principles of Myocardial Preservation 13S

Cardiopulmonary Bypass and Procurement 139

Adenosine 140

Impact of Brain Death on the Heart 141

Reimplantation-Reperfusion 142

Summary 142

10. The Role of the Recovery Services Coordinator 147

Cindy Morphew-Magie, Alison B. Smith

Interviewing/Hiring 148

Training 149

Referral Process 149

Evaluation Process 150

Consent 151

Medical/Social History 151

Medical Examiner Release 152

Saying Good-Bye 152

Donor Management 153

UNOS 153

Organ Placement 154

Organ Allocation 155

Operating Room 156

Arranging Transportation 157

Marketing Department 157

Donor Family Follow-Up 157

Other Job Duties 158

Conclusion 158

11. Ethical Issues in Organ Donation 159

L.S. Rothenberg

Introduction 159

Methods of Obtaining Natural Organs for Transplantation 160

Special Issues Concerning Living Donors 164

Special Issues Concerning the Determination of Death 165

Artificial Organs and Other Body Parts 167

Index 171

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