[Cadaver donor nephrectomy. Surgical technique in the context of multi-organ donation].
95% of renal transplantations performed in France use cadaver donor kidneys. Two donor nephrectomy techniques are proposed: a beating heart technique and an arrested heart technique. In the very great majority of cases (80%), donor nephrectomy can be performed during multi-organ removal, performed according to bioethical regulations: unrelated, anonymity between donor and recipient, security, traceability and evaluation. The urologist has a role to play at each step of organ donation, in which he is the main protagonist. The first steps are performed in close collaboration with the intensive care unit which established the diagnosis of brain death of the potential donor. The following steps, guided by the French transplant establishment, are the urologist's responsibility: He is responsible for abdominal exploration looking for a tumour or any other abnormality. A strictly aseptic technique is essential to prevent contamination of the organ. He is responsible for removing kidneys in such a way as to ensure the shortest possible warm ischaemia time, the best storage solution, and the best preservation of their anatomical structure. He must be familiar with the outcome of transplants in order to adapt his technique to the results of transplants.
Benoit
G
G
Service d'Urologie, CHU de Bicêtre, Le Kremlin Bicêtre.
Eschwege
P
P
Decaux
A
A
Alexandre
L
L
D001926:Brain Death / Q000175:diagnosis; D002102:Cadaver; D003422:Critical Care; D004992:Ethics, Medical; D006324:Heart Arrest, Induced; D006801:Humans; D016030:Kidney Transplantation; D009392:Nephrectomy / Q000379:methods*; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome; D014572:Urology