Key messages

• The increase in organ donors has failed to keep pace with the accumulation of patients with endstage organ failure who might benefit from transplantation.

• Retrieval of multiple organs should now be the objective in all brain-dead potential donors.

• Assiduous supportive treatment is essential to prevent deterioration of initially suitable donors. This will both increase donation rates and improve graft survival and function.

• The incidence of complications increases progressively after brain death and and although adequate time must be allowed to confirm the diagnosis, unnecessary delays must be avoided.

• Aggressive supportive treatment of the donor should be continued intraoperatively.

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