Procedure For Controlled Donors
If the liver or lungs are felt to be suitable for transplantation, then the donor is usually taken directly to the operating room after cardiac arrest, and a rapid retrieval operation is performed once a 10 minute stand-off period has elapsed. It seems this stand-off period has been reduced to as short as 75 seconds based on a recent article by the CBC. . This is now causing an ethical debate as to whether physicians will declare death sooner than is currently required. This is similar to a normal multi-organ retrieval, but prioritises rapid cannulation, perfusion and cooling with ice, with dissection following later.
If only the kidneys are suitable for retrieval, either rapid retrieval or cannulation with DBTL catheter can be used. Use of a DBTL catheter allows relatives of the deceased to see them after death, but the donor must be taken to the operating room as soon as possible.
The formalities necessary for donation can usually be carried out prior to treatment withdrawal in controlled donation, so early retrieval should be possible.
Category IV donors (who are already brain-stem dead), should either proceed as for a normal multi-organ retrieval – if this has already started – or should be managed as a category II or III as appropriate to the circumstances of cardiac arrest.
Read more about this topic: Non-heart-beating Donation
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