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Eur J Emerg Med.2003
Mar,10(1)52-7
The brain-dead
patient or a flower in the vase? The emergency department
approach to the preservation of the organ donor.
Karcoglu,
Ozgur [latin dotless i]; Ayrk, Cuneyt [latin dotless i];
Erbil, Bulent
Abstract:
Transplantation has been incorporated into the treatment of
patients with end-stage diseases of most major organ systems
in recent years. However, organ supply is the greatest
limitation to organ transplantation.
Among the
factors that can enhance organ supply, donor
management has received the least attention. The importance
of establishing an acceptable method of rapidly and
accurately determining brain death in potential donors
cannot be overemphasized. With an increased awareness of
donor management issues and the application of a rational
physiological approach, the supply of functional organs for
transplantation can be increased. Rapid and continuing
resuscitation of clinically brain-dead trauma victims is
mandatory. This review addresses the evaluation and
management of the organ donor within the emergency
department. Common management problems (hypotension,
arrhythmias, diabetes insipidus, oliguria, and coagulopathy)
are discussed in detail. An aggressive, proactive approach
to the medical management of the potential donor is
recommended in order to limit the number of medical failures
and
maximize the
number of organs donated.
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