Pharmacists' guide to the management of organ donors after brain death.
OBJECTIVE
This article reviews organ donor pathophysiology as it relates to medication use with the goal of maximizing the successful procurement and transplantation of donor organs.


CONCLUSIONS
The number of patients requiring organ transplantation continues to grow, yet organ donation rates remain flat, making it critical to appropriately manage each organ donor in order to ensure viability of all transplantable organs. The care given to one organ donor is tantamount to the care of several transplant recipients. Aggressive donor management ensures that the largest number of organs can be successfully procured and improves the organs' overall quality. Hospital pharmacists are responsible for processing orders and preparing the medications outlined in donor management algorithms developed by their respective medical systems. It is important that pharmacists understand the details of the medications used in these protocols in order to critically evaluate each medication order and appropriately manage the donor. Typical medications used in organ donors after brain death include medications for blood pressure management and fluid resuscitation, medications necessary for electrolyte management, blood products, vasopressors, hormone replacement therapy, antiinfectives, anticoagulants, paralytics, and organ preservation solutions.


CONCLUSIONS
It is essential to provide optimal pharmacotherapy for each organ donor to ensure organ recovery and donation. Typical medications used in organ donors include agents for blood pressure management and fluid resuscitation, medications necessary for electrolyte management, blood products, vasopressors, hormone replacement therapy, antiinfectives, anticoagulants, paralytics, and organ preservation solutions.
Truman Medical Center, Kansas City, MO.
Catherine
C
Korte
Legacy Good Samaritan Medical Center, Portland, OR.
Jennifer L
JL
Garber
University of Wisconsin Hospital and Clinics, Madison, WI.
Jillian L
JL
Descourouez
Beth Israel Deaconess Medical Center, Boston, MA.
Katelyn R
KR
Richards
Division of Pharmacy Practice and Administration, University of Missouri-Kansas City, Kansas City, MO. hardingerk@umkc.edu.
Karen
K
Hardinger
D000925:Anticoagulants / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001926:Brain Death / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D019188:Organ Preservation Solutions / Q000008:administration & dosage; D010595:Pharmacists / Q000592:standards*; D024382:Professional Role; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods / Q000592:standards*
D000925:Anticoagulants; D000959:Antihypertensive Agents; D019188:Organ Preservation Solutions