Surgical Techniques of Multiorgan Procurement from a Deceased Donor

Abstract

Solid organ transplantation is now the standard treatment for many types of diseases and using a standard surgical technique for organ procurement from the deceased donors is an important step in preventing complications after such complicated procedures. In most centers, retrieval of heart, lungs, liver, kidneys, small bowel, pancreas and other organs is done at the same time by different surgeons under supervision by a team leader who is most familiar with at least basic steps of surgical technique of procurement of all the solid organs. Each transplant surgeon, regardless of his or her sub-specialty, has to know how to prepare and dissect the delicate anatomical structures which are in common between the two adjacent organs for example portal vein (liver-pancreas), superior mesenteric vein (pancreas-small bowel), abdominal inferior vena cava (liver-kidneys), supra-diaphragmatic inferior vena cava (liver-heart) and pulmonary artery-veins (heart-lungs). This needs a multidisciplinary approach by the most experienced members of the transplant team to decrease the warm ischemic time of the organs without any harm to them by better coordination between all the surgeons. In this, chapter we briefly describe the multiorgan retrieval procedure in a deceased donor, and we hope that following these instructions results in better quality of the procured organs without jeopardizing their vital anatomical structures.