Coordination Of Multiorgan Retrieval

OPOs serve several vital functions in the organ procurement process including donor referrals, donor family request and consent, and donor management. Additionally, OPOs coordinate the donation process once consent is obtained. Since the majority of organ donations are multiorgan, OPOs must coordinate assessment of each organ system as well as assessing donor history, laboratory values, including ABO type and tissue type, and any noninvasive testing. If an OPO serves one transplant center, coordination is easier since communication is facilitated among the different transplant teams. However, most OPOs serve more than one center and organ placement and team coordination is logistically more challenging. It is not unusual to have several teams present at an organ procurement including teams for the heart, lungs, liver, pancreas, kidneys, and small bowel as well as teams for tissue donation. Communication is extremely important in facilitating organ procurement in such a way that donor hospitals remain committed to organ donation in their communities. Since most of the techniques for organ procurement are fairly standard with minor center variation in techniques, early communication between teams via the OPO will also help to facilitate a smooth recovery. As a general rule, after the donor is brought to the operating room, dissection of the heart and lungs is followed by dissection of the liver and pancreas, small bowel, and kidneys. Removal of organs usually follows the same sequence as the dissection of the specific organs. Alternatively, all intraabdominal organs may be removed en bloc without in situ dissection of the individual organs. This technique is mandatory in organ retrieval from DCDs. Eye, bone, and tissue donation follows removal of all solid organs.

OPOs also serve a vital postrecovery function at donor hospitals by providing feedback on the ultimate placement and transplantation of the organs retrieved. Also, continued community visibility of the OPO and transplant centers through educational programs will help to maintain and increase organ donation so that more patients will ultimately undergo transplantation. Likewise, donor and recipient families, by interfacing with their communities, can have a profound effect on helping to increase awareness and, ultimately, organ donation.

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