title: Logistics and technique for procurement of intestinal, pancreatic, and hepatic grafts from the same donor.
abstract: OBJECTIVE
  To assess a technique for simultaneous recovery of the intestine, pancreas, and liver from the same donor.
  
  
  BACKGROUND
  With the more frequent use of pancreatic and intestinal transplantation, a procurement procedure is needed that permits retrieval of both organs as well as the liver from the same cadaveric donor for transplantation to different recipients. It is believed by many procurement officers and surgeons, however, that this objective is not technically feasible.
  
  
  METHODS
  A technique for simultaneous recovery of the intestine, pancreas, and liver was used in 13 multiorgan cadaver donors during a 26-month period, with transplantation of the organs to 33 recipients. The intestine was removed from 11 donors separately and in continuity with the pancreas in the other 2. Six additional pancreases were excised and transplanted separately. Thirteen livers were retrieved, one of which was discarded because of steatorrhea. Ten of the remaining 12 livers were transplanted intact; the other 2 were split in situ and used as reduced-size hepatic allografts in four recipients.
  
  
  RESULTS
  None of the 11 intestinal, 6 pancreatic, 2 intestinal-pancreatic, or 14 whole or partial liver allografts sustained serious ischemic injury or were lost as a result of technical complications. One liver recipient died 25 months after surgery of recurrent C virus hepatitis. The other 32 recipients had adequate allograft function with a mean follow-up of 8 months.
  
  
  CONCLUSIONS
  It was possible using the described technique to retrieve intestine, pancreas, and liver allografts safely from the same donor and to transplant these organs to different recipients.
authors.affiliation: Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. kae@med.pitt.edu
authors.forename: K
authors.initials: K
authors.lastname: Abu-Elmagd
authors.forename: J
authors.initials: J
authors.lastname: Fung
authors.forename: J
authors.initials: J
authors.lastname: Bueno
authors.forename: D
authors.initials: D
authors.lastname: Martin
authors.forename: J R
authors.initials: JR
authors.lastname: Madariaga
authors.forename: G
authors.initials: G
authors.lastname: Mazariegos
authors.forename: G
authors.initials: G
authors.lastname: Bond
authors.forename: E
authors.initials: E
authors.lastname: Molmenti
authors.forename: R J
authors.initials: RJ
authors.lastname: Corry
authors.forename: T E
authors.initials: TE
authors.lastname: Starzl
authors.forename: J
authors.initials: J
authors.lastname: Reyes
mesh_terms: D000293:Adolescent; D000328:Adult; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D004210:Dissection / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007421:Intestine, Small / Q000637:transplantation*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods; D019188:Organ Preservation Solutions; D016035:Pancreas Transplantation; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D019188:Organ Preservation Solutions; C071285:hydroxyethyl starch-free University of Wisconsin solution