Our experience with deceased organ donor maintenance

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.