The emergency physician and organ donation

The introduction of public funding for treatment of patients with endstage renal disease has greatly increased the number of patients who can benefit from kidney transplantation. The emergency physician should be alert for the type of trauma victim suitable for organ donation. Moreover, it is important that the physician understand the concept of brain death so that the removal of organs can take place as soon as possible. Certain aspects of kidney maintenance can begin before death has been declared but the total care of the patient must remain foremost. Management of the precadaveric organ donor is identical to that of any patient in a life-threatening situation. In the cadaver stage, the main difference is an increase in fluid input. The emergency physician should be aware of state laws regarding brain death and permission from the next of kin to harvest an organ.