Organ Harvesting Anesthesia

[naturalgas]

I find it interesting that anesthesia is required for the donor body, already pronounced clinically dead, during the harvesting of organs for donation. Yes, anesthesia is not just for the living. Does the CRNA role involve actively trying to keep all of the hemodynamic parameters stable to maintain the viability of the organs prior to surgical removal? If so, I would assume that this is very challenging. Are there any CRNA's out there in "CRNA land" that would be able to provide more insight into this very fascinating topic? Thanks in advance, I would be very interested in hearing about your experiences.

[foraneman]

AH...I see how the term is being used now....had never heard it called 'non brain dead' before. Controlled donaition after Cardiac Death (DCD) is the common slang. However, a patient removed from life support and in cardiac arrest is brain dead no matter how you slice it. It is the a cadavar procurement, albeit a fresh cadaver so the kidneys can be taken. I was not aware this was controversial any longer.

There IS a controversial form of donation we will hear more about: uncontrolled Donation after Cardiac Death (uDCD). The controversies surrounding it are discipating however. Basically, all patients whose unexpected cardiac arrest (from any cause) resucitation efforts fail are immediately processed as if they will be donating their organs, by am inhouse team of individuals assigned just for that purpose. All preparations are made regardless of the unkown donation status of the deceased. The family is contacted and approached regarding donation as a matter of course should there be no donor card, but meanwhile ALL preparations proceed as if consent has been given....short of yanking the organs out. Preparation includes the immediate administration of ice cold IV fluids via special IV catheters which are inserted post mortum, to preserve the organs in situ, in under 45 minutes. Peritoneal lavage with iced fluids has also been shown to improve organ viability. The kidneys of course are the target organs and institution of this program can increase kidney donation 40% or more. If the family ends up not consenting and the decedant was not listed as a donor, then off to the funeral home....slightly chilled.