Organ donation: when should we consider intestinal donation
Carl-Ludwig Fischer-Fröhlich
Region Baden-Württemberg, Deutsche Stiftung Organtransplantation, Stuttgart, Germany
Search for more papers by this authorAlfred Königsrainer
Klinik für Allgemein, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Tübingen, Germany
Search for more papers by this authorRandolph Schaffer
Scripps Center for Organ and Cell Transplantation, Scripps Clinic Medical Group, La Jolla, CA, USA
Search for more papers by this authorFranz Schaub
Deutsche Stiftung Organtransplantation, Frankfurt, Germany
Search for more papers by this authorJohann Pratschke
Universitätsklinik für Visceral-, Transplantation- und Thoraxchirurgie, Innsbruck, Austria
Search for more papers by this authorAndreas Pascher
Charité, Campus Virchow-Klinikum, Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Berlin, Germany
Search for more papers by this authorWolfgang Steurer
Abteilung für Allgemein- und Viszeralchirurgie Robert-Bosch-Krankenhaus, Auerbachstraße Stuttgart, Germany
Search for more papers by this authorSilvio Nadalin
Klinik für Allgemein, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Tübingen, Germany
Search for more papers by this authorCarl-Ludwig Fischer-Fröhlich
Region Baden-Württemberg, Deutsche Stiftung Organtransplantation, Stuttgart, Germany
Search for more papers by this authorAlfred Königsrainer
Klinik für Allgemein, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Tübingen, Germany
Search for more papers by this authorRandolph Schaffer
Scripps Center for Organ and Cell Transplantation, Scripps Clinic Medical Group, La Jolla, CA, USA
Search for more papers by this authorFranz Schaub
Deutsche Stiftung Organtransplantation, Frankfurt, Germany
Search for more papers by this authorJohann Pratschke
Universitätsklinik für Visceral-, Transplantation- und Thoraxchirurgie, Innsbruck, Austria
Search for more papers by this authorAndreas Pascher
Charité, Campus Virchow-Klinikum, Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Berlin, Germany
Search for more papers by this authorWolfgang Steurer
Abteilung für Allgemein- und Viszeralchirurgie Robert-Bosch-Krankenhaus, Auerbachstraße Stuttgart, Germany
Search for more papers by this authorSilvio Nadalin
Klinik für Allgemein, Viszeral- und Transplantationschirurgie, Universitätsklinikum Tübingen, Tübingen, Germany
Search for more papers by this authorConflicts of Interest: The authors disclose no commercial association that may pose a conflict of interest in connection with the submitted manuscript.
Summary
Although more than 2300 intestinal transplantations (IT) have been performed worldwide, a description of intestinal donor criteria is still missing. This causes confusion among transplant coordinators, OPOs, physicians at intensive care unit and transplant surgeons. A Med-line search looking for publications about donor criteria or donor selection in human IT was performed in December 2011. Retrospective analysis of 39 deceased donors from whom, in the period January 2006–December 2011, 20 isolated intestinal grafts and 19 multivisceral grafts were recovered and successfully transplanted. Review of the Literature: Among 3504 publications about IT, no study reported specifically about intestinal donor profile. The most commonly cited donor criterion was age, while all other criteria were inconsistently discussed. Based on the collected data, we suggest following inclusion criteria for donation of IT grafts: age 0–50 years, ICU-stay <1 week, no blunt abdominal trauma, most recent Sodium <155 mmol/l, no severe ongoing transfusion requirements, standard donor therapy including early enteral nutrition and a compatible donor–recipient size match. By providing simple criteria for intestinal donation from deceased donor, we may help to properly utilize the limited donor pool.
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