By Edwards N.M., Chen J.M., Mazzeo P.A.
Univ. of Wisconsin, Madison. Summarizes the daily administration of transplant donors and recipients, masking a variety of surgical innovations, pathology, and immunosuppression. additionally discusses posttransplant administration, pediatric middle transplantation, surgical possible choices, and mechanical circulatory assistance. For physicians.
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Extra info for Cardiac Transplantation
Multiple studies have demonstrated that the consent rate for organ donation at the request of an organ procurement organization (OPO) member is favored over a physician’s request (2). Therefore, we strongly encourage the early involvement of such OPO-designated individuals in the transplant process. Appropriate multiorgan donor assessment and management requires a careful balance of the solid organ transplant teams’ competing clinical agendas. For example, whereas aggressive fluid infusion may favor the cardiac or renal procurement teams, it may be detrimental to those procuring lungs.
Because the history and impact of significant substance abuse or poisoning is incomplete, we have tended, in these circumstances, to rely heavily on the echocardiogram and the donor team’s opinion at visualization to assess global myocardial function. Infection Pyrexia is a common finding of the brain-dead state, and finding positive cultures is extremely common in organ donation, owing largely to prolonged ICU support prior to the donation consent acquisition. Thankfully, in the current broad-spectrum antibiotic era, the rate of bacterial infection transferred from cardiac donor to recipient is exceed- Chen and Edwards 31 ingly low.
Chen and Edwards 29 The suggestion to add a low-dose vasopressin infusion often meets with resistance, particularly from the renal procurement teams. , lactic acidosis, end-organ hypoperfusion, etc). ABO Compatibility/Positive Cross-Match Although there appear to be no appreciable sequelae to transplanting across Rhesus blood groups, transplantation within ABO blood groups remains axiomatic. On occasion, we have transplanted across ABOcompatible blood groups with poor results, even with adjunctive plasmapheresis and additional immunosuppression.