Detailed Abdominal Organ Inspection and Early Surgical Steps for Abdominal Organ Procurement

Abstract

Sternotomy is a mandatory surgical step for carefully inspecting the thorax and mediastinum.Accurately inspect all abdominal organs.Perform liver biopsy whenever liver steatosis is evident to have a better evaluation of macroscopic and microscopic steatotic components.Try to recognize an accessory or replaced right hepatic artery from the superior mesenteric artery and consider that it is present in approximately18 % of cases.Preserve a left accessory or replaced left hepatic artery from the left gastric artery running throughout the lesser sac.Polar renal arteries arising from the iliac arteries should be carefully checked. If present, care should be taken to preserve polar renal arteries; iliaccannulation before the origin of the polar artery must be performed.When the supraceliac abdominal aorta is difficult to control, consider cross-clamping the thoracic aorta as an alternative to supraceliac aortic crossclamping.In case of rapid donor destabilization during the procedure, consider quick cannulation of the inferior abdominal aorta above the iliac vessels anda blind cross-clamping of the descending thoracic aorta.Before perfusion, remember to flush the gallbladder and clear the common bile duct of retained bile.