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Updated: Jan 6, 2026

Ex Situ Normothermic Machine Perfusion of Donor Livers
Published on: May 26, 2015
Physiological Care of the Organ Donor
David Larkin1, Ned Gilbert-Kawai2, Hugh Montgomery3
1Department of Anaesthetics, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Abstract:
Since the advent of the first successful organ transplant, year-on-year recipient numbers have steadily increased in the UK. Unfortunately, however, for each organ transplanted there necessitates an organ to be donated and as such these are extremely precious commodities. This article aims to summarise the management of potential organ donors following brainstem death in the intensive care setting from a UK perspective. A series of predictable pathophysiological changes occur following brainstem death, which if left untreated, can have a catastrophic impact on donor organs and result in them becoming unsuitable for transplantation. The article details the aforementioned pathophysiological changes in order of occurrence, and then discusses their management in line with the recommendations from the NHS Blood and Transplant authority and current literature.
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