Abdominal Organ Retrieval and Transplantation Bench Surgery by Gabriel Oniscu, John Forsythe, John Fung

By Gabriel Oniscu, John Forsythe, John Fung

Offers transplant pros with a step-wise method of stomach organ retrieval and bench surgical procedure, illustrating advanced anatomical occasions and offering perform issues and determination algorithms. A go-to reference for transplant surgeons, trainees and fellows, in addition to for different pros thinking about stomach organ transplantation.

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Extra resources for Abdominal Organ Retrieval and Transplantation Bench Surgery

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The uncontrolled vasodilation accelerates heat loss and hypothermia. Brainstem death is also associated with an active inflammatory response, with elevated levels of proinflammatory cytokines and upregulation of receptors in target organs. Although this may be due to ­associated trauma or critical illness, brainstem death itself may trigger this response. The inflammatory response is maintained or amplified by the physiological changes related to brainstem death [16,17,18]. This affects all organs and is associated with measurable organ damage in the donor, and subsequent poor function and increased risk of graft loss in recipients.

Collaboration of all professionals in the field of ­donation and transplantation is a must, in order to advance our knowledge and make high quality ­transplantation sustainable in the future. Summary box Preservation strategies should maintain viability and allow rapid restoration of function: • Hypothermia, prevention of acidosis and oedema and neutralization of ROS are the main principles of organ preservation • Ten percent of the normal metabolic rate is maintained at 10°C • To provide an effective preservation, the solution has to contain macromolecular agents or impermeants, an adequate pH-buffer, a balanced electrolyte composition of Na and K and antioxidants • University of Wisconsin (UW) solution is the most commonly used preservation solution • Less than 10 L of HTK compromises the clinical outcome • Machine perfusion provides a better outcome than static cold perfusion in kidney transplantation • In situ normothermic regional perfusion is showing promising results for organ reconditioning in liver transplantation • Ex situ warm perfusion liver machines are undergoing clinical trials • Organs should be packed in three adequately sized bags 21 Abdominal Organ Retrieval and Transplantation Bench Surgery References 1 Moers C, Leuvenink HG, Ploeg RJ.

17 Barklin A. Systemic inflammation in the brain-dead organ donor. Acta Anaesthesiol Scand 2009; 53(4):425–35. 18 Murugan R, Venkataraman R, Wahed AS, et al. Increased plasma interleukin-6 in donors is associated with lower recipient hospital-free survival after cadaveric organ transplantation. Crit Care Med 2008; 36(6):1810–16. 19 Cantin B, Kwok BWK, Chan MCY, et al. The impact of brain death on survival after heart transplantation: time is of the essence. Transplantation 2003; 76(9):1275–9. 20 Nijboer WN, Moers C, Leuvenink H, et al.

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