An improved technique for multiple organ harvesting

A rapid technique for multiple organ harvesting is described which allows removal of all the major organs within 30 to 60 minutes after beginning the donor operation. No preliminary dissection of the liver or kidneys is required or necessary since these organs are cooled by infusion of cold solutions in situ and with subsequent rapid dissection in a bloodless field. The incidence of well functioning kidneys, livers and hearts has been better than with the previous methods. The acceptance of this procedure by other personnel has been almost universal

Equitable allocation of extrarenal organs: With special reference to the liver

A national plan is proposed for the equitable allocation of extrarenal organs, with particular reference to the liver. The principles of the plan include preferential use of the organs in the local and regional area of procurement, with national listing of the organs left over after the original cut. At each of the local, regional, and national levels, the allocation is based on total points awarded for medical urgency, time waiting, blood group conformity, and physical location of both donor and recipient. The plan, which should be applicable as well for allocation of hearts, is compatible with international sharing with nearby countries such as Canada

Combination donor hepatectomy and nephrectomy and early functional results of allografts

In an approach to combined donor hepatectomy and nephrectomy, which is adaptable to any cadaveric kidney procurement method now in use, the importance of precooling with portal venous infusion is stressed. The over-all effectiveness of the technique in providing equal protection for the quality of all three organs is supported by the data presented. Encouragement should be given to the type of interinstitutional collaborations that are necessary for the continued progression of extrarenal organ transplantation

Effect of cold ischemia time on the early outcome of human hepatic allografts preserved with uw solution

Five hundred ninety-three cadaveric livers were used for primary liver transplantation between October 24, 1987, and May 19, 1989. The grafts were procured with a combined method, using in situ cooling with cold electrolyte solution and backtable flushing with UW solution. The mean cold-ischemia time was 12.8 (range 2.4- 34.7) hr. The cases were divided into 5 groups according to the cold-ischemia time: Group 1: 25 hr (n=29). There was no difference between the 5 groups in 1-year patient survival, highest SGOT in first week after operation, and SGOT and total bilirubin during the first month after operation. However, with a logistic regression model, the retransplantation rate (P=0.001) and primary nonfunction rate (P=0.006) significantly rose as cold-ischemia time increased, meaning that the equivalency of patient survival was increasingly dependent on aggressive retransplantation. © 1991 by Williams & Wilkins