Name of the Procedure:

Physiological Support for Harvesting of Organ(s) from Brain-Dead Patient
Common names: Organ retrieval, Organ procurement
Technical/Medical terms: Managed donation process for organ procurement, Physiological support for organ donation

Summary

The procedure involves sustaining a brain-dead patient's physiological functions to preserve the viability of their organs for transplant. This process includes mechanical ventilation, maintaining blood pressure, and ensuring the balance of fluids and electrolytes until the organs are harvested.

Purpose

This procedure addresses the need for healthy, viable organs for transplantation in patients suffering from end-stage organ failure. The primary goal is to maintain the organ donor's body in optimal condition to ensure successful organ retrieval and transplantation into recipients.

Indications

Physiological support for organ harvesting is indicated when a patient is declared brain-dead but has viable organs that can be donated. Suitable candidates are typically identified through rigorous brain-death criteria and must be free from systemic infections or major organ diseases.

Preparation

The patient does not need to make any preparations due to their brain-dead status. However, their next of kin must provide consent for organ donation. Medical staff will perform necessary diagnostic tests, including blood typing, tissue typing, and imaging studies, to determine the viability and compatibility of the organs.

Procedure Description

1. Initial Assessment: Confirm brain death through clinical evaluation and necessary tests.
2. Consent: Obtain consent from the patient's family or legal representative for organ donation.
3. Physiological Support:
   • Mechanical Ventilation: Maintain oxygenation and ventilation.
   • Hemodynamic Support: Utilize medications to maintain blood pressure and cardiac output.
   • Fluid and Electrolyte Management: Ensure appropriate fluid balance and correct any electrolyte imbalances.
   • Temperature Control: Maintain normothermia to preserve organ function.
4. Organ Preservation: Utilize specialized fluids to preserve organs during and after procurement.
5. Surgical Harvesting: A transplant surgeon removes the organs in a sterile surgical environment.

Tools and equipment include ventilators, infusion pumps, temperature control devices, and organ preservation solutions. Patients are typically under continuous sedation and anesthesia to maintain hemodynamic stability during organ retrieval.

Duration

The support phases can last from several hours to a couple of days, while the surgical organ harvesting procedure itself usually takes 4-6 hours.

Setting

The procedure takes place in a hospital setting, specifically in an intensive care unit (ICU) for physiological support, and moves to an operating room for the actual organ harvesting.

Personnel

The multidisciplinary team includes intensive care specialists, transplant surgeons, nurses, anesthesiologists, and organ procurement coordinators.

Risks and Complications

For the donor: The donor, being brain-dead, experiences no risks or complications.
For the recipient: Risks include organ rejection, infection, and complications related to the surgical procedure.

Benefits

The primary benefit is providing lifesaving organ transplants to recipients suffering from end-stage organ failure. Realization of these benefits, for recipients, can be immediate post-transplant, with improved organ function and quality of life.

Recovery

For the donor: No recovery process as the donor is brain-dead.
For the recipient: Post-transplant care includes immunosuppressive therapy to prevent rejection, regular monitoring, and follow-up appointments to ensure organ function and overall health recovery.

Alternatives

• Living Donor Transplants: Involves living persons donating organs such as a kidney or part of their liver. Pros include immediate viability; cons involve surgery-related risks to the donor.
• Artificial Organs and Dialysis: Temporary alternatives; pros are availability, cons include limited long-term effectiveness compared to transplant.

Patient Experience

As the donor is brain-dead, they do not experience any sensations during the procedure. For families, the process may bring emotional challenges but also potential solace from the donation's impact on saving other lives.