Book Volume 3
List of Contributors
Page: ii-iii (2)
Author: Robert S.D. Higgins and Juan A. Sanchez
DOI: 10.2174/9781681087566118030002
Introduction
Page: 1-3 (3)
Author: Juan A. Sanchez and Robert S.D. Higgins
DOI: 10.2174/9781681087566118030003
The Organ Allocation System
Page: 4-23 (20)
Author: Karen Kennedy and Charles Alexander
DOI: 10.2174/9781681087566118030004
PDF Price: $30
Abstract
The following chapters give a succinct reference about how the system is set up, including how organs are listed and allocated and then distributed, for a reader like a resident or fellow trying to understand how organs go from donor to implanted organs, as well as the role of the OPO and what governs your efforts and success.
Identification of the Brain Dead Donor
Page: 24-43 (20)
Author: Justin Zamoyski and Diana Greene-Chandos
DOI: 10.2174/9781681087566118030005
PDF Price: $30
Abstract
The determination of brain death criteria has been the cornerstone of organ donation since 1968 when the Ad Hoc Committee at Harvard established medical definitions. It continues to stand the test of time as a means to establish medical and legal criteria for all transplant professionals in the field to rely upon and maintain the public’s trust in the organ procurement system. This chapter reviews the origins of these criteria as well as the current application of neurologic criteria to determine brain death. It further reviews updated guidelines from the neurological professional community affirming these criteria and conduct of the brain death determination.
Management of Public Health Service (PHS) Increased Risk Donors and Hepatitis C or HIV Infected Donors
Page: 44-52 (9)
Author: Nicole Theodoropoulos, Stephanie Pouch and Dorry Segev
DOI: 10.2174/9781681087566118030006
PDF Price: $30
Abstract
The goal of this chapter is to review the currently Public Health Service defined increased risk donors and discuss management of recipients of these donor organs.
Management of the Multi-Organ Donor and Logistic Considerations
Page: 53-65 (13)
Author: Sharon Weeks, Shane Ottmann and Andrew Cameron
DOI: 10.2174/9781681087566118030007
PDF Price: $30
Abstract
This chapter examines the effect of brain death physiology on potentially recoverable organs and provides specific management recommendations for the care of the multi-organ donor. We also review the logistic considerations important for successful procurement. The goal of these aims is to optimize function and maximize recovery of life-saving organs.
Current State of Organ Preservation
Page: 66-79 (14)
Author: Eliza Beal, Bryan Whitson and Sylvester Black
DOI: 10.2174/9781681087566118030008
PDF Price: $30
Abstract
The objective of this chapter is to review the principles of organ preservation and current preservation solutions employed in multi-organ transplantation with specific reference to unique organ specific preservation.
Organ Specific Considerations: Heart
Page: 80-89 (10)
Author: Vincent Nardy, Ahmet Kilic and Arman Kilic
DOI: 10.2174/9781681087566118030009
PDF Price: $30
Abstract
Cardiac allograft evaluation and procurement are integral parts of the multiorgan donation process as cardiac function prior to brain death determination often has a critical impact on multiorgan function. In this chapter, the authors review the basic principles of cardiac assessment as well as maintaining cardiopulmonary function during the period after brain death determination to enhance overall cardiopulmonary as well as abdominal organ perfusion and function. They also review acceptable donor criteria, expanding the donor criteria to enhance organ availability, preservation solution selection and techniques and donor-recipient selection and matching to improve post transplant success.
Organ Specific Considerations: Lung
Page: 90-101 (12)
Author: Jinny Ha, Stephen Broderick and Errol Bush
DOI: 10.2174/9781681087566118030010
PDF Price: $30
Abstract
Donor lung assessment has evolved significantly as experience grows in the field of cardiopulmonary transplantation and organ donors are more actively managed with consideration of their pulmonary function. This chapter evaluates the current criteria employed in many centers evaluating traditional assessments of oxygenation and ventilation to avoid early graft dysfunction secondary to ischemia-reperfusion injury using modern ventilator and preservation fluids and techniques.
Liver Procurement: The Donor Hepatectomy
Page: 102-115 (14)
Author: Marcos E. Pozo, Russell Wesson, Benjamin Philosophe, Andrew Cameron and Jacqueline Garonzik-Wang
DOI: 10.2174/9781681087566118030011
PDF Price: $30
Abstract
Liver procurement is a complex surgical procedure requiring a detailed knowledge of technique, anatomy as well as anatomical variants. A thorough assessment of both the recipient and donor is necessary to optimize graft procurement, prevent complications and the possible loss of a life-saving organ. Standard liver procurement involves warm dissection of the pertinent structures followed by a rapid cold perfusion phase and subsequent evisceration. The surgical technique, as well as common pitfalls and special scenarios are discussed in this chapter with the aim of providing the reader with a comprehensive understanding of liver procurement.
Organ Specific Considerations: Pancreas and Kidney
Page: 116-124 (9)
Author: Iyore James, Ashraf El-Hinnawi and Amer Rajab
DOI: 10.2174/9781681087566118030012
PDF Price: $30
Abstract
Pancreas transplantation is experiencing a resurgence in interest as one of the last frontiers in multiorgan transplantation. Most commonly performed in combination with kidney transplantation, this chapter reviews key aspects of donor assessment as well as preservation and anatomic recovery to enhance success of these procedures. Pancreas transplantation in Donation after cardiac death is also reviewed as an evolving potential source of organs in this field.
Living Donation
Page: 125-146 (22)
Author: Benjamin Philosophe, Jaime Glorioso, Shane Ottmann, Iyore James and Amer Rajab
DOI: 10.2174/9781681087566118030013
PDF Price: $30
Abstract
Living Donation of kidneys and liver has been an important component of organ donation since the field’s inception. Living donation requires meticulous examination of potential donors, both to ensure the safety of the donor and assure that the organ is well suited to the recipient. These procedures must be done in a safe and highly reliable way to avoid short and long term complications for the donor. In this chapter, we review specific nuances and recovery techniques in living liver and living kidney donation procedures.
Pediatric Issues: Split Liver/Living Liver Donation
Page: 147-159 (13)
Author: Kyle Jackson, Benjamin Philosophe and Andrew Cameron
DOI: 10.2174/9781681087566118030014
PDF Price: $30
Abstract
In this chapter, we review the technical nuances and donor-recipient matching principles of the adult-pediatric split liver donation and living donor transplant process. Specific attention is paid to the safe conduct of the procedures, which in the case of living donation, have high stakes consequences for both the recipient and the donor.
Islet Cell Donation
Page: 160-167 (8)
Author: Jill Buss and Amer Rajab
DOI: 10.2174/9781681087566118030015
PDF Price: $30
Abstract
Islet cell transplantation has evolved as a viable alternative to solid organ pancreas transplantation. In this chapter, we review the important donor characteristics and techniques for successful islet cell procurement and transplantation.
The Future of Organ Donation: Ex Vivo Preservation
Page: 168-188 (21)
Author: Eliza Beal, Sylvester Black and Bryan Whitson
DOI: 10.2174/9781681087566118030016
PDF Price: $30
Abstract
Extending the donor organ pool has been a long-standing goal of the transplant community given the inadequate supply of donor organs in comparison to the number of patients on the transplant waiting list. ex vivo preservation techniques are now evolving as a viable means to accomplish these goals. In this chapter, we review and explore the currently available techniques and potential for ex vivo preservation of solid organs.
The Future of Organ Donation and Transplantation: 2018 and Beyond
Page: 189-191 (3)
Author: Robert S.D. Higgins
DOI: 10.2174/9781681087566118030017
PDF Price: $30
Subject Index
Page: 192-201 (10)
Author: Robert S.D. Higgins and Juan A. Sanchez
DOI: 10.2174/9781681087566118030018
Introduction
Advances in the science of immunology have improved the success rate of organ transplantations since the mid twentieth century. Organ transplantation is now a lifesaving medical procedure for thousands of patients around the world with end-organ diseases. The lifesaving potential of transplantation has been limited by the number and quality of appropriate organ donors. The evolution of brain death criteria by the Harvard Ad-Hoc Committee Report has opened the door to understanding the importance of medical, legal and ethical challenges of organ donation in support of the growth of the transplant science. The possibility of organ donation from living donors has enhanced organ availability for patients with kidney failure. Modern inotropes and immunosuppression regimens have been critical to the success of other organ transplant procedures. However, the cornerstone of successful transplantation continues to be the appropriate selection, evaluation, preservation of organ tissues and the successful surgical procurement process to mitigate the impact of tissue ischemia and reperfusion. In this textbook, the art and science of organ donation and tissue preservation is examined. Through this authoritative text by leaders in the field, the editors provide a state of the art review of modern preservation techniques, patient selection and screening criteria, as well as best practices for multi-organ procurement. Information presented in the book will familiarize readers with the initial steps of determining organ availability which ultimately enables health care professionals to realize the extraordinary potential of successful multi-organ transplant procedures. This guide is intended to be a fundamental resource for students, residents, faculty and staff for all disciplines allied to health care delivery and organ donation.