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Donor Procurement After Brain Death

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Transplantation of the Pancreas

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Abstract

Expert pancreas procurement is essential to successful transplantation of the pancreas. It requires excellent anatomical knowledge and perfect synchronization between procurement surgeons. The quality of the donor graft remains key to minimize the rate of early postoperative complications such as graft thrombosis, pancreatitis, and infection. Donation after brain death (DBD) permits anatomically precise dissection in the presence of intact blood circulation in the donor. Despite the shared blood supply of abdominal organs, improvements in procurement techniques have led not only to standard pancreas and liver recovery, but also to combined procurement of the pancreas, liver, and intestines. Efficient communication and cooperation between the different procurement teams is crucial to the recovery of excellent quality donor organs. Competent teamwork and surgical proficiency can also result in a decrease in the relatively high pancreas discard rates due to anatomical variations. Rapid (en bloc) DBD procurement techniques as well as other procurement modifications are described in detail.

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References

  1. Starzl TE, Hakala TR, Shaw BW Jr, et al. A flexible procedure for multiple cadaveric organ procurement. Surg Gynecol Obstet. 1984;158:223–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Nghiem DD, Schulak JA, Corry RJ. Duodenopancreatectomy for transplantation. Arch Surg. 1987;122:1201–6.

    Article  CAS  PubMed  Google Scholar 

  3. Faure JL, Takvorian PH, Champetier P, et al. Combined liver and pancreas harvesting from cadaveric donors. Transplant Proc. 1988;20:994–6.

    CAS  PubMed  Google Scholar 

  4. Marsh CL, Perkins JD, Sutherland DE, Corry RJ, Sterioff S. Combined hepatic and pancreaticoduodenal procurement for transplantation. Surg Gynecol Obstet. 1989;168:254–8.

    CAS  PubMed  Google Scholar 

  5. Delmonico FL, Jenkins RL, Auchincloss H Jr, et al. Procurement of a whole pancreas and liver from the same cadaveric donor. Surgery. 1989;105:718–23.

    CAS  PubMed  Google Scholar 

  6. Sollinger HW, Vernon WB, D’Alessandro AM, Kalayoglu M, Stratta RJ, Belzer FO. Combined liver and pancreas procurement with Belzer–UW solution. Surgery. 1989;106:685–90.

    CAS  PubMed  Google Scholar 

  7. Dunn DL, Morel P, Schlumpf R, et al. Evidence that combined procurement of pancreas and liver grafts does not affect transplant outcome. Transplantation. 1991;51:150–7.

    Article  CAS  PubMed  Google Scholar 

  8. Gruessner RWG, Sutherland DER. Pancreas transplantation: Part I—the donor operation. Surg Rounds. 1994;17:311–24.

    Google Scholar 

  9. Alfrey EJ, Dafoe DC, Perloff LJ, Naji A, Barker CF. Use of the vascular stapling device in procurement of the pancreatic allograft. Surg Gynecol Obstet. 1990;171:77–8.

    CAS  PubMed  Google Scholar 

  10. Shaffer D, Lewis WD, Jenkins RL, Monaco AP. Combined liver and whole pancreas procurement in donors with a replaced right hepatic artery. Surg Gynecol Obstet. 1992;175:204–7.

    CAS  PubMed  Google Scholar 

  11. Schroering JR, Kubal CA, Fridell JA, Hathaway TJ, Robinson RC, Mangus RS. Impact of variant donor hepatic arterial anatomy on clinical graft outcomes in liver transplantation. Liver Transplant. 2018;24(10):1481–4.

    Article  Google Scholar 

  12. Perosa M, Genzini T, Ferreira CC, Gil AO, Engler-Pinto P, Gama-Rodrigues JJ. A welcome arterial variation for pancreas transplantation. Transplant Proc. 1999;31:2148–9.

    Article  CAS  PubMed  Google Scholar 

  13. Nghiem DD, Cottington EM. Pancreatic flush injury in combined pancreas–liver recovery. Transplant Int. 1992;5:19–22.

    Article  CAS  Google Scholar 

  14. Starzl TE, Miller C, Broznick B, Makowka L. An improved technique for multiple organ harvesting. Surg Gynecol Obstet. 1987;165:343–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Squifflet JP, de Hemptinne B, Gianello P, Balladur P, Otte JB, Alexandre GP. A new technique for en bloc liver and pancreas harvesting. Transplant Proc. 1990;22:2070–1.

    CAS  PubMed  Google Scholar 

  16. Imagawa DK, Olthoff KM, Yersiz H, et al. Rapid en bloc technique for pancreas–liver procurement. Improved early liver function. Transplantation. 1996;61:1605–9.

    Article  CAS  PubMed  Google Scholar 

  17. Nomoto K, Soejima Y, Fishbein T, Miller CM. Technical comparison of liver–pancreas procurement. Transplant Proc. 1999;31:2002–3.

    Article  CAS  PubMed  Google Scholar 

  18. Abu-Elmagd K, Fung J, Bueno J, et al. Logistics and technique for procurement of intestinal, pancreatic, and hepatic grafts from the same donor. Ann Surg. 2000;232:680–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Nakazato PZ, Concepcion W, Bry W, Limm W, Tokanaga Y, Itasaka H, Feduska N, Esquivel CO, Collins GM. Total abdominal evisceration: en bloc technique for abdominal organ harvesting. Surgery. 1992;111:37–46.

    CAS  PubMed  Google Scholar 

  20. de Ville de Goyet J, Hausleithner V, Malaise J, et al. Liver procurement without in situ portal perfusion. A safe procedure for more flexible multiple organ harvesting. Transplantation 1994;57:1328–1332.

    Google Scholar 

  21. Dodson F, Pinna A, Jabbour N, Casavilla A, Khan F, Corry R. Advantages of the rapid en bloc technique for pancreas/liver recovery. Transplant Proc. 1995;27:3050.

    CAS  PubMed  Google Scholar 

  22. D’Alessandro AM, Odorico JS, Knechtle SJ, et al. Simultaneous pancreas–kidney (SPK) transplantation from controlled non-heart-beating donors (NHBDs). Cell Transplant. 2000;9:889–93.

    Article  PubMed  Google Scholar 

  23. Tojimbara T, Teraoka S, Babazono T, et al. Strategy in combined pancreas and kidney transplantation from non-heart-beating deceased donors. Transplant Proc. 1999;31:2008–9.

    Article  CAS  PubMed  Google Scholar 

  24. Casavilla A, Ramirez C, Shapiro R, et al. Experience with liver and kidney allografts from non-heart-beating donors. Transplantation. 1995;59:197–203.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Sutherland DER, Morel P, Gruessner RW. Transplantation of two diabetic patients with one divided deceased donor pancreas. Transplant Proc. 1990;22:585.

    CAS  PubMed  Google Scholar 

  26. Ausania F, Drage M, Manas D, Callaghan CJ. A registry analysis of damage to the deceased donor pancreas during procurement. Am J Transplant. 2015;15(11):2955–62.

    Article  CAS  PubMed  Google Scholar 

  27. Lam HD, Schaapherder AF, Kopp WH, Putter H, et al. Professionalization of surgical abdominal organ recovery leading to an increase in pancreatic allografts accepted for transplantation in The Netherlands: a serial analysis. Transpl Int. 2017;30(2):117–23.

    Article  PubMed  Google Scholar 

  28. Finger EB, Radosevich DM, Bland BJ, Dunn TB, et al. Comparison of recipient outcomes following transplant from local versus imported pancreas donors. Am J Transplant. 2012;12(2):447–57.

    Article  CAS  PubMed  Google Scholar 

  29. Serrano OK, Vock DM, Snyder JJ, Chinnakotla S, et al. Influence of the procurement surgeon on transplanted abdominal organ outcomes: an SRTR analysis to evaluate regional organ procurement collaboration. Am J Transplant. 2019;19(8):2219–31.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA

    Stephan A. Gruessner

  2. Department of Surgery, State University of New York, Brooklyn, NY, USA

    John F. Renz

Authors
  1. Stephan A. Gruessner
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  2. John F. Renz
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Correspondence to Stephan A. Gruessner .

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Editors and Affiliations

  1. Department of Surgery, State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA

    Rainer W. G. Gruessner

  2. Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA

    Angelika C. Gruessner

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Gruessner, S.A., Renz, J.F. (2023). Donor Procurement After Brain Death. In: Gruessner, R.W.G., Gruessner, A.C. (eds) Transplantation of the Pancreas. Springer, Cham. https://doi.org/10.1007/978-3-031-20999-4_14

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  • DOI: https://doi.org/10.1007/978-3-031-20999-4_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-20998-7

  • Online ISBN: 978-3-031-20999-4

  • eBook Packages: MedicineMedicine (R0)

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