Brain death is associated with complex hemodynamic, endocrine, and metabolic dysfunction that can lead to major complications with the potential donor. Untreated, this can progress to cardiovascular collapse with loss of valuable organs for transplantation. We hypothesized that brain
death-related complications would have no effect on the number of organs donated if an aggressive donor management protocol was in place. We identified all successful organ donations between January 2000 and December 2003 and evaluated them for brain death-associated complications (defined
as vasopressor requirement, coagulopathy, diabetes insipidus, cardiac ischemia, lactic acidosis, renal failure, and acute respiratory distress syndrome) and donated organs per donor . Sixty-nine organ donors were identified. Complications identified were as follows: intravenous vasopressor
requirement in 97.1 per cent, coagulopathy in 55.1 per cent, thrombocytopenia in 53.6 per cent, diabetes insipidus in 46.4 per cent, cardiac ischemia in 30.4 per cent, lactic acidosis in 24.6 per cent, renal failure in 20.3 per cent, and acute respiratory distress syndrome in 13 per cent.
There was no significant effect of complications on the average number of organs harvested, with the exception of an increase in organs harvested in the presence of diabetes insipidus. With the implementation of an aggressive organ donor management protocol, these complications can be effectively
managed with no impact on the number of organs harvested for transplant.
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Document Type: Research Article
From the Department of Surgery, Division of Trauma and Critical Care, University of Southern California Keck School of Medicine and the Los Angeles County and University of Southern California Medical Center, Los Angeles, California
From the Department of Surgery, Division of Trauma and Critical Care, University of Southern California Keck School of Medicine and the Los Angeles County and University of Southern California Medical Center, Los Angeles,
Publication date: May 1, 2006
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