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 RESEARCH ARTICLE
Year : 2007  |  Volume : 11  |  Issue : 2  |  Page : 49--53

Our experience with deceased organ donor maintenance


1 Department of Surgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, India
2 Sir H N Hospital, Mumbai, India

Correspondence Address:
Meena Kumar
Department of Surgery, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai
India
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DOI: 10.4103/0972-5229.33385

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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.






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