Anesthesia for Transplant Surgery - Anesthesia for Organ Procurement

Types of donors

Types of donors^a

1. Donation after brain death (DBD) donors are patients who have had a terminal neurologic insult and have been declared brain dead in accordance with the American Academy of Neurology guidelines and any institutional policies.
2. Donation after cardiac death donors are patients who have had a terminal neurologic insult but do not meet criteria for brain death. Death is declared based on cardiopulmonary criteria after life support is withdrawn. A period of 5 minutes is allowed to elapse prior to procurement to ensure no autoresuscitation.
3. Living donors are patients who willingly donate an organ, most often a kidney. Living liver donation can occur with left lateral segment or lobe donation to a pediatric recipient or a right lobe in adult-to-adult transplants.
   1. Living organ donation boasts improved survival rates, reduced waiting times, and opportunity to electively schedule surgery. However, it presents a significant ethical challenge as it is the only surgery from which a patient derives no benefit for the risk they take.
   2. Living liver donations should involve a liver transplant anesthesiologist who is familiar with the anesthetic considerations for dissection and mobilization of the hepatic segment, which can present significant risk to the donor.