Nonheartbeating Donor Procurement

In instances in which the donor has irreversible neurologic injury but does not fulfill the criteria of brain death, the organs can be procured after pronouncement of cardiac death. Procurement from nonheart-beating donors entails withdrawing life support from the potential donor in a controlled setting. Such setting is usually the operating room or a nearby adjacent site. At the time of withdrawal of life support, heparin (30,000 Units, or 3,000 Units/kg) is administered. After the donor has been pronounced dead according to accepted medical criteria, a period of time following asystole (5 to 10 minutes) is allowed as a safeguard prior to performing the procurement.

The aorta is rapidly clamped at its bifurcation into iliac arteries, and preservation fluid instilled in order to perfuse the abdominal organs. The chest is opened, and the descending aorta clamped to prevent unnecessary perfusion of the supradiaphragmatic region of the body. Ice is placed within the abdominal cavity. The organs are then procured following the routine steps of cadaver donors.

Posttransplantation function of a hepatic allograft procured from a nonheart-beating donor is dependent upon factors associated with both donor and recipient. Potential donor variables include hemodynamic status prior to withdrawal of life support, time from withdrawal of life support until pronouncement, timely access to the aorta and initiation of cold perfusion, donor comorbidities, and condition of the donor liver, among others.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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