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Assessment, Monitoring, and Management of Brain-Dead Potential Organ Donors in the USA

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The Brain-Dead Organ Donor

Abstract

Severe head trauma and nontraumatic intracranial hemorrhages can cause major systemic dysfunction, which may affect every system of the potential organ donor. Without early and adequate support, these physiological changes can rapidly lead to the loss of potential organ donors or deterioration of the number and quality of procured organs. Good knowledge of these physiological changes, early and aggressive monitoring, and timely, appropriate management remain the cornerstone for optimal organ donation.

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References

  1. Roth BJ, Sher L, Murray JA, et al. Cadaveric organ donor recruitment at Los Angeles county hospital: improvement after formation of a structured clinical, educational and administrative service. Clin Transplant. 2003;17:52–7.

    Article  PubMed  Google Scholar 

  2. Salim A, Velmahos GC, Brown C, Belzberg H, Demetriades D. Aggressive organ donor management significantly increases the number of organs available for transplantation. J Trauma. 2005;58:991–4.

    Article  PubMed  Google Scholar 

  3. Salim A, Martin M, Brown C, Rhee P, Demetriades D, Belzberg H. The effect of a protocol of aggressive donor management: implications for the national organ donor shortage. J Trauma. 2006;61:429–35.

    Article  PubMed  Google Scholar 

  4. Rosendale JD, Chabalewski FL, McBride MA, et al. Increased transplanted organs from the use of a standardized donor management protocol. Am J Transplant. 2002;2:761–8.

    Article  PubMed  Google Scholar 

  5. Wheeldon DR, Potter CD, Oduro A, Wallwork J, Large SR. Transforming the “unacceptable” donor: outcomes from the adoption of a standardized donor management technique. J Heart Lung Transplant. 1995;14:734–42.

    PubMed  CAS  Google Scholar 

  6. Wood KE, Becker BN, McCartney JG, D’Alessandro AM, Coursin DB. Care of the potential organ donor. N Engl J Med. 2004;351:2730–9.

    Article  PubMed  CAS  Google Scholar 

  7. Schnuriger B, Inaba K, Branco BC, et al. Organ donation: an important outcome after resuscitative thoracotomy. J Am Coll Surg. 2010;211:450–5.

    Article  PubMed  Google Scholar 

  8. Christmas AB, Bogart RA, Etson KE, et al. The reward is worth the wait: a prospective analysis of 100 consecutive organ donors. AAST 69th Annual Meeting, Boston MA, Sept 21–24, 2010.

    Google Scholar 

  9. Inaba K, Branco BC, Lam L, et al. Organ donation and time to procurement: late is not too late. J Trauma. 2010;68:1362–6.

    Article  PubMed  Google Scholar 

  10. Salim A, Martin M, Brown C, et al. Complications of brain death: frequency and impact on organ retrieval. Am Surg. 2006;72:377–81.

    PubMed  Google Scholar 

  11. Abdelnour T, Rieke S. Relationship of hormonal resuscitation therapy and central venous pressure on increasing organs for transplant. J Heart Lung Transplant. 2009;28:480–5.

    Article  PubMed  Google Scholar 

  12. Novitzky D, Horak A, Cooper DK, Rose AG. Electrocardiographic and histopathologic changes developing during experimental brain death in the baboon. Transplant Proc. 1989;21:2567–9.

    PubMed  CAS  Google Scholar 

  13. Novitzky D, Cooper DK, Rosendale JD, Kauffman HM. Hormonal therapy of the brain-dead organ donor: experimental and clinical studies. Transplantation. 2006;82:1396–401.

    Article  PubMed  CAS  Google Scholar 

  14. Cooper DK, Novitzky D, Wicomb WN. The pathophysiological effects of brain death on potential donor organs, with particular reference to the heart. Ann R Coll Surg Engl. 1989;71:261–6.

    PubMed  CAS  Google Scholar 

  15. Zaroff JG, Rosengard BR, Armstrong WF, et al. Consensus conference report: maximizing use of organs recovered from the cadaver donor: cardiac recommendations, March 28–29, 2001, Crystal City, VA, USA. Circulation. 2002;106:836–41.

    Article  PubMed  Google Scholar 

  16. Hadjizacharia P, Salim A, Brown C, et al. Does the use of pulmonary artery catheters increase the number of organs available for transplantation? Clin Transplant. 2010;24:62–6.

    Article  PubMed  Google Scholar 

  17. Chen JM, Cullinane S, Spanier TB, et al. Vasopressin deficiency and pressor hypersensitivity in hemodynamically unstable organ donors. Circulation. 1999;100:II244–6.

    Google Scholar 

  18. Talving P, Benfield R, Hadjizacharia P, Inaba K, Chan LS, Demetriades D. Coagulopathy in severe traumatic brain injury: a prospective study. J Trauma. 2009;66: 55–62.

    Article  PubMed  Google Scholar 

  19. Lustenberger T, Talving P, Kobayashi L, et al. Time course of coagulopathy in isolated severe traumatic brain injury. Injury. 2010;41:924–8.

    Article  PubMed  Google Scholar 

  20. Novitzky D, Cooper DK, Reichart B. Hemodynamic and metabolic responses to hormonal therapy in brain-dead potential organ donors. Transplantation. 1987; 43:852–4.

    PubMed  CAS  Google Scholar 

  21. Novitzky D, Cooper DK, Morrell D, Isaacs S. Change from aerobic to anaerobic metabolism after brain death, and reversal following triiodothyronine therapy. Transplantation. 1988;45:32–6.

    Article  PubMed  CAS  Google Scholar 

  22. Rosendale JD, Kauffman HM, McBride MA, et al. Hormonal resuscitation yields more transplanted hearts, with improved early function. Transplantation. 2003;75:1336–41.

    Article  PubMed  Google Scholar 

  23. Rosendale JD, Kauffman HM, McBride MA, Chabalewski FL, et al. Aggressive pharmacologic donor management results in more transplanted organs. Transplantation. 2003;75:482–7.

    Article  PubMed  Google Scholar 

  24. Salim A, Vassiliu P, Velmahos GC, et al. The role of thyroid hormone administration in potential organ donors. Arch Surg. 2001;136:1377–80.

    Article  PubMed  CAS  Google Scholar 

  25. Van Bakel AB, Pitzer S, Drake P, Kay NA, Stroud M, Sade RM. Early hormonal therapy stabilizes hemodynamics during donor procurement. Transplant Proc. 2004;36:2573–8.

    Article  PubMed  Google Scholar 

  26. Salim A, Martin M, Brown C, et al. Using thyroid hormone in brain-dead donors to maximize the number of organs available for transplantation. Clin Transplant. 2007;21:405–9.

    Article  PubMed  Google Scholar 

  27. Venkateswaran RV, Dronavalli V, Lambert PA, et al. The proinflammatory environment in potential heart and lung donors: prevalence and impact of donor management and hormonal therapy. Transplantation. 2009;88:582–8.

    Article  PubMed  CAS  Google Scholar 

  28. Venkateswaran RV, Steeds RP, Quinn DW, et al. The haemodynamic effects of adjunctive hormone therapy in potential heart donors: a prospective randomized double-blind factorially designed controlled trial. Eur Heart J. 2009;30:1771–80.

    Article  PubMed  CAS  Google Scholar 

  29. Vairetti M, Ferrigno A, Rizzo V, et al. Liver damage during ischemia/reperfusion and glutathione: implications for potential organ donors. Transplant Proc. 2007;39:1768–70.

    Article  PubMed  CAS  Google Scholar 

  30. Ellett JD, Evans ZP, Fiorini JH, et al. The use of the Papworth cocktail is detrimental to steatotic livers after ischemia-reperfusion injury. Transplantation. 2008;86:286–92.

    Article  PubMed  Google Scholar 

  31. Iltis AS, Rie MA, Wall A. Organ donation, patients’ rights, and medical responsibilities at the end of life. Crit Care Med. 2009;37:310–5.

    Article  PubMed  Google Scholar 

  32. Simpkin AL, Robertson LC, Barber VS, Young JD. Modifiable factors influencing relatives’ decision to offer organ donation: systematic review. BMJ. 2009;339:b991.

    Article  Google Scholar 

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Correspondence to Lydia Lam M.D. .

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Demetriades, D., Lam, L. (2013). Assessment, Monitoring, and Management of Brain-Dead Potential Organ Donors in the USA. In: Novitzky, D., Cooper, D. (eds) The Brain-Dead Organ Donor. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4304-9_17

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  • DOI: https://doi.org/10.1007/978-1-4614-4304-9_17

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  • Publisher Name: Springer, New York, NY

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