An Overview of Anesthetic Management for the Brain-Dead Donor and Organ Recovery

Transplantation of tissue is playing an increasing role in modern therapeutics. Survival of recipients and transplanted organs is excellent, making transplantation of many major organs a very successful therapeutic option. Evidence shows that a multidisciplinary approach to managing the brain-dead donor (BDD) offers a better opportunity for successful organ survival after transplantation. Organ procurement procedures are most commonly performed in community hospitals and rural settings. The anesthesia provider's role in organ procurement procedures and BDD management is essential for maintaining allograft organ survival and the CRNA may be asked to assume a collaborative role in nontertiary hospitals in community or rural settings. The perioperative role of the CRNA immediately before and during organ procurement is an important piece in the progression to a successful outcome. The CRNA therefore must understand the overall process to guide appropriate BDD treatment and allograft protection. The focus of this article is to present a historical overview of organ donation and procurement, and an evidence-based examination of clinical management of the BDD from diagnosis to organ procurement, including anesthetic management.