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Treating the donor

Dermot W McKeown1, Jonathan Ball

  • 1aScottish Liver Transplant Unit, Edinburgh Royal Infirmary, Edinburgh bGeneral and Neurointensive Care, St George's Hospital and Medical School, London, UK.

Current Opinion in Organ Transplantation
|February 21, 2014
PubMed

Insights

Optimizing care for brain-dead organ donors (DBD) is crucial for increasing organ availability. Evidence-based critical care and early identification of potential donors lead to more transplantable organs.

Area of Science:

  • Critical care medicine
  • Transplantation science
  • Organ donation research

Background:

  • Increasing organ demand necessitates maximizing organ donation potential.
  • The donor population is aging with increased comorbidities.
  • Optimal management of donors after brain death (DBD) is vital for transplanting more organs per donor.

Purpose of the Study:

  • To review evidence-based drugs and techniques for optimizing donor management.
  • To define best practices for critical care in brain-dead organ donors.
  • To reassess the efficacy of previously recommended therapies.

Main Methods:

  • Review of current critical care practices for brain-dead donors.
  • Analysis of outcomes associated with specific supportive therapies.
  • Evaluation of emerging extracorporeal support techniques.

Main Results:

  • Targeted supportive therapy by experienced specialists improves donation outcomes.
  • Prolonged (>24h) ex-vivo organ conditioning shows significant benefits.
  • Extracorporeal support may identify new donor sources in non-responders.

Conclusions:

  • Early identification of potential DBD and best practice critical care increase transplantable organs.
  • Defined treatment goals are associated with better organ yield.
  • International efforts are underway to address challenges in donor management research.
Abstract

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