The cardiac transplant donor: identification, assessment, and management.
In the previous 2 decades, there have been many advances in the treatment of coronary and valvular heart disease. However, these treatments remain imperfect, and more patients are surviving only to have congestive heart failure develop later in life. During the same 2 decades, advances in surgical techniques and immunosuppression made cardiac transplantation the treatment of choice for severe, end-stage heart failure. Despite concomitant legislation designed to promote organ donation, there remains a severe shortfall in the number of organ donors compared with the number of potential recipients. This article discusses identification of the potential organ donor, assessment of the heart for donation, medical management of the brain-dead organ donor from pronouncement to procurement, and finally, some of the ethical issues raised in the wake of further efforts to increase the potential donor pool.
Van Bakel
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Department of Medicine, Medical University of South Carolina, Charleston 29425-2221, USA.
D001778:Blood Coagulation Disorders; D001921:Brain / Q000098:blood supply; D001926:Brain Death; D003919:Diabetes Insipidus; D004493:Education; D004992:Ethics, Medical; D006333:Heart Failure / Q000601:surgery; D006334:Heart Function Tests; D016027:Heart Transplantation; D006439:Hemodynamics; D006801:Humans; D007035:Hypothermia; D011180:Postmortem Changes; D012119:Respiration; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014850:Waiting Lists; D014882:Water-Electrolyte Balance