Procedure For Uncontrolled Donors
Following declaration of death, cardiopulmonary resusciation (CPR) is continued until the transplant team arrive. A stand-off period is observed after cessation of CPR to ensure that death has occurred; this is usually from 5 to 10 minutes in length and varies according to local protocols.
Once the stand-off period has elapsed, a cut down is performed over the femoral artery, and a double-balloon triple-lumen (DBTL) catheter is inserted into the femoral artery and passed into the aorta. The balloons are inflated to occlude the aorta above and below the renal arteries (any donor blood specimens required can be taken before the top balloon is inflated). A pre-flush with streptokinase or another thrombolytic is given through the catheter, followed by 20 litres of cold kidney perfusion fluid; the opening of the lumen is between the balloons so that most of the flush and perfusion fluid goes into the kidneys. Another catheter is inserted into the femoral vein to allow venting of the fluid.
Once full formal consent for organ donation has been obtained from relatives, and other necessary formalities such as identification of the deceased by the police and informing the Coroner (in the UK), the donor is taken to the operating room, and the kidneys and heart valves retrieved.
Read more about this topic: Non-heart-beating Donation