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Management of the potential organ donor 

Management of the potential organ donor
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date: 01 December 2020

Transplantation is the optimal treatment of end-stage dysfunction of many organs and can be life-saving. Despite increases in live donation and donation after circulatory death, donation after brain death remains the most important source of donor organs, and is currently the only source of thoracic organs in most countries. Brain death is associated with profound physiological changes including cardiovascular and respiratory changes, and severe metabolic and endocrine dysfunction that can jeopardize transplantable organ function. Although adequate time must be allowed for the proper confirmation of brain death, unnecessary delays should be avoided because the incidence of systemic complications that jeopardize transplantable organ function increases progressively with time. Aggressive donor management increases the number of potential donors who actually become donors, increases the total number of organs transplanted per donor, and improves transplantation outcomes. Various donor management strategies have been described and these are reviewed in this chapter.

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