Critical Care (SA Mayer, Section Editor)

Current Neurology and Neuroscience Reports

, Volume 12, Issue 4, pp 456-465

Critical Care of the Potential Organ Donor

  • Anna J. DareAffiliated withDepartment of Surgery, Auckland City Hospital, University of Auckland & New Zealand Liver Transplant Unit
  • , Adam S. BartlettAffiliated withDepartment of Surgery, Auckland City Hospital, University of Auckland & New Zealand Liver Transplant Unit
  • , John F. FraserAffiliated withCritical Care Research Group, The Prince Charles Hospital Email author 

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Abstract

Organ transplantation represents one of the great success stories of 20th century medicine. However, its continued success is greatly limited by the shortage of donor organs. This has led to an increased focus within the critical care community on optimal identification and management of the potential organ donor. The multi-organ donor can represent one of the most complex intensive care patients, with numerous competing physiological priorities. However, appropriate management of the donor not only increases the number of organs that can be successfully donated but has long-term implications for the outcomes of multiple recipients. This review outlines current understandings of the physiological derangements seen in the organ donor and evaluates the available evidence for management strategies designed to optimize donation potential and organ recovery. Finally, emerging management strategies for the potential donor are discussed within the current ethical and legal frameworks permitting donation after both brain and circulatory death.

Keywords

Brain death Organ donation Cytokine storm Hormone resuscitation Donation after circulatory death Donation after brain death Transplantation Critical care