Organ procurement--strategies to optimize donor availability

Increasing donor availability for organ transplantation requires attention to factors that are potentially modifiable. The potential pool of available organs can theoretically be enlarged by considering new sources of organs, including non-beating heart donors, live donor lobar transplants, xenotransplants, and in vitro organ culture. Increased utilization of the current pool of organs can be achieved by creating a system that identifies, considers, and optimizes all possible donors. Although protocols have been drawn up regarding general and specifically lung donor acceptance criteria, many of these can be now recognized as unduly conservative and without a proven clinical basis. Careful reanalysis of these acceptance criteria and active donor management can be balanced against the particular circumstance of an individual potential recipient to increase lung transplantation rates.