Haemodynamic responses to surgery in brain-dead organ donors

In a prospective study we documented the haemodynamic response to surgery in 14 brain-dead organ donors. The haemodynamic responses to the first 30 min of surgery were predominantly due to alterations in vascular resistance. The mean systemic vascular resistance increased significantly (p = < 0.01) from 936 to 1217 dyn.s.cm-5 after 6 min, then decreased significantly (p = < 0.001) to 642 dyn.s.cm-5 after 30 min of surgery. In two patients, the decrease in systemic vascular resistance was associated with haemodynamic decompensation. The left cardiac work index increased significantly (p = < 0.05) during surgery. We conclude that retrieval surgery causes significant haemodynamic effects. The early effects are predictable and may jeopardise organ perfusion. We advance arguments that organ preservation may be compromised by the use of inotropic agents. When practical, we suggest that a pulmonary artery catheter should be used during retrieval surgery in multi-organ donors to facilitate a reduction in the use of inotropic drugs.