Considérations anesthésiques pour la chirurgie de prélèvement d’organes: une étude narrative

Translated title of the contribution: Anesthetic considerations in organ procurement surgery: a narrative review

T. Anthony Anderson, Peter Bekker, Parsia A. Vagefi

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Purpose: While a few publications specify the anesthetic implications of either brain or cardiac death, they lack detail on how to provide anesthesia during organ donation surgery. We provide a thorough description of important anesthetic considerations during organ donation surgery in patients with either brain or cardiac death. Source: A thorough literature review was undertaken to locate all relevant articles that describe systemic effects of brain and cardiac death and their anesthetic implications. We searched PubMed, Pubget, and EMBASE™ for relevant articles using the following search terms: anesthesia, management, donation cardiac death, donation brain death. In addition, we reviewed the relevant protocols at our own institution. Principal findings: Highly specific intraoperative management by an anesthesiologist is required during organ procurement after brain death. To manage the heart-beating brain-dead donor, the anesthesiologist must incorporate knowledge of the effects of brain death on each organ system as well as the effects of the preoperative measures that the donor required in the intensive care unit. It is also important to know which organs are going to be procured in order to establish specific goals and implement strategies (e.g., lung-protective ventilation or intraoperative glycemic control) to optimize donor outcome. During organ procurement after cardiac death, an anesthesiologist’s direct involvement is particularly important for lung donors. Conclusion: Anesthesiologist-guided physiological optimization of the brain-dead donor may be a factor in determining the outcome of the organ recipient. Additionally, anesthesiologists have an important role in helping to ensure that the highest quality and most appropriate care are rendered to non-heart-beating donors. This is achieved through establishing protocols in their hospitals for donation after cardiac death that maximize the number of available organs with the best chance for long-term graft viability.

Original languageFrench
Pages (from-to)529-539
Number of pages11
JournalCanadian Journal of Anesthesia
Volume62
Issue number5
DOIs
StatePublished - Apr 8 2015
Externally publishedYes

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ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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