By Gabriel Oniscu, John Forsythe, John Fung
Offers transplant pros with a step-wise method of belly organ retrieval and bench surgical procedure, illustrating advanced anatomical occasions and offering perform issues and selection algorithms. A go-to reference for transplant surgeons, trainees and fellows, in addition to for different execs inquisitive about stomach organ transplantation.
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Extra info for Abdominal Organ Retrieval and Transplantation Bench Surgery
Fluid balance can be challenging and may be best guided by cardiac output monitoring. • Hormonal resuscitation as per local protocols. • Good perioperative communication during retrieval procedures is vital. • Active organ donor management to achieve physiological goals consistently produces more transplantable organs of a higher quality and standard. References 1 Mackersie R, Bronsther O, Shackford S. Organ procurement in patients with fatal head injuries. The fate of the potential donor. Ann Surg 1991; 213(2):143–50.
Recruitment manoeuvres are particularly important following apnoea testing, endotracheal suction or disconnection from the ventilator [4,5,30]. • Nurse patient 30 degrees head up • Limit tidal volume to 6–8 mL/kg predicted body weight. • Limit ventilatory plateau pressure to < 30 cm H2O • Avoid hyperoxia • Conservative fluid strategy Cardiovascular management Treatment of the rapid and dramatic changes around the time of brainstem death is challenging, and if attempted only short-acting drugs should be used due to the dynamic nature of the circulatory changes.
Nephrol Dial Transplant 2012. Epub. 40 Jochmans I, Moers C, Smits JM, et al. The prognostic value of renal resistance during hypothermic machine perfusion of deceased donor kidneys. Am J Transplant 2011; 11(10):2214–20. 41 Moers C, Varnav OC, van Heurn E, et al. The value of machine perfusion perfusate biomarkers for predicting kidney transplant outcome. Transplantation 2010; 90(9):966–73. 42 Groen H, Moers C, Smits JM, et al. Cost-effectiveness of hypothermic machine preservation versus static cold storage in renal transplantation.