Our experience with deceased organ donor maintenance|
Kumar, Meena; Shendge, Prakash; Kumar, Vineet; Trivedi, Vatsala; Waghela, Jagruti & Rajpal, Dilip
Deceased organ donors in an intensive care unit (ICU) are the richest source of organs for transplantation. Careful donor maintenance plays a vital role in the successful functioning of the organ in the recipient.
Aims : Early identification of brain stem death (BSD) in the ICU, problems and management in donor maintenance till retrieval are the main objectives.
Materials and Methods : BSD was identified in a level I trauma center over a period of eight years (1996-2004) using UK code. After screening for fitness, they were maintained to achieve normothermia, systolic BP > 90 mm Hg, CVP 8-10 cm water, urine output > 80 ml/hour and normal acid base balance.
Results: 168 cases of BSD were maintained, 30 with identity unknown. Common transient complications noted were hypotension (68%), hypokalemia (62%), hypothermia (12%), diabetes insipidus (70%). Brain stem death was identified early and resuscitated to maintain normal tissue perfusion. 17 (12.3%) consent for organ donation was obtained. Organs (24 kidneys and one liver) were retrieved from 12 donors. Four donors sustained cardiac arrest before retrieval.
Conclusion: Early recognition of brain stem death and prompty correction of hemodyanamic instability is the key to deceased donor maintenance. Optimal care of potential donor translates to care of multiple recipients.
Brain Stem Death (BSD), deceased organ donor, maintenance