Purpose: The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. Methods: We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria. Results: Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques. Conclusions: Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.

Citerio, G., Cypel, M., Dobb, G., Dominguez Gil, B., Frontera, J., Greer, D., et al. (2016). Organ donation in adults: a critical care perspective. INTENSIVE CARE MEDICINE, 42(3), 305-315 [10.1007/s00134-015-4191-5].

Organ donation in adults: a critical care perspective

CITERIO, GIUSEPPE
Primo
;
2016

Abstract

Purpose: The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. Methods: We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria. Results: Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques. Conclusions: Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.
Articolo in rivista - Review Essay
Brain death; Donation after brain death; Donation after circulatory death; Intensive care; Organ donation;
Brain death; Donation after brain death; Donation after circulatory death; Intensive care; Organ donation
English
2016
42
3
305
315
reserved
Citerio, G., Cypel, M., Dobb, G., Dominguez Gil, B., Frontera, J., Greer, D., et al. (2016). Organ donation in adults: a critical care perspective. INTENSIVE CARE MEDICINE, 42(3), 305-315 [10.1007/s00134-015-4191-5].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/99581
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