[Stabilization of the cardiovascular system in organ donors]

Every intensive care patient is a potential organ donor. For preserving organs, an aggressive shock therapy and controlled volume adaptation using the alpha-blocker hydergine is necessary. Minimal therapy is not allowed until it is decided whether the patient will survive or will become an organ donor. A vasopressor therapy for normalisation of blood pressure must not be carried out. Renal function (30 ml per hour are sufficient) must be achieved by improving perfusion with alternating infusions of dextran or hydroxyethyl starch and Ringer solution. Dopamine should not be used. The application of hyperosmolar/hyperoncotic solution (250 ml 7.5% sodium chloride in 6% dextran 70) gives a new chance for rapid restoration of perfusion in all vascular districts. This solution will also be prized by those who until now believed a vasopressor was indispensable. The number of organ donors will increase according to the reduction of vasopressor therapy.