Liver Donation by a Trauma Patient: A Case Study in Placement

Journal of Transplant Coordination, Vol. 9, Number 3, September 1999 injuries, the patient was transported by medevac helicopter to the nearest trauma center. On arrival, C.C.’s physical examination showed significant bleeding from multiple facial lacerations and nares. Scattered abrasions of the chest and back were noted. Auscultation revealed clear, equal breath sounds bilaterally, with symmetrical chest wall expansion. The abdomen was soft and nondistended, with scattered abrasions and hypoactive bowel sounds. The extremities were unremarkable, with the exception of multiple abrasions. Neurologically, the pupils were pinpoint, corneal reflexes were absent, and painful stimuli elicited decerebrate posturing. The admission CT scan of the head showed transverse bitemporal skull fractures, with pneumocephalus and a subarachnoid hemorrhage. Admission CT scan of the abdomen and pelvis, according to the radiologist, showed a questionable liver laceration with no free air or fluid. No other intra-abdominal findings were noted. The results of this CT scan played a significant role in later attempts to place the liver. C.C.’s admission laboratory values are noted in Table 1. In the emergency department, a ventriculostomy was inserted, but over the course of the next 8 hours C.C.’s neurologic status deteriorated. During the night, he became hypertensive, with a peak blood pressure of 264/170 mm Hg and an intracranial pressure of 170 mm Hg. Shortly after, there was absence of neurologic function accompanied by hypotension, Liver donation by a trauma patient: a case study in placement