DONOR CRITERIA AND EVALUATION
Section snippets
DECLARATION OF BRAIN DEATH
Brain death is defined as the complete and irreversible loss of all brain and brainstem function. Lack of cerebral responses and brainstem—mediated reflexes, as well as absolute apnea, occur with brain death. The standard definition of brain death is derived from many sources, including the report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death,3 the National Institutes of Health Collaborative Study (1977), and The President's Commission for the
GENERAL ISSUES OF DONOR ACCEPTANCE
Numerous issues determine the general acceptability of a donor for solid organ transplantation. Many of them have been regulated by UNOS and some are left to the discretion of the individual transplant center.
A social and medical history and physical examination are obtained on each donor. All potential donors, regardless of history, are tested for hepatitis B surface antigen, the antibody to human immunodeficiency virus (HIV)-1 (in many centers the more sensitive polymerase chain reaction
LUNG DONOR-SPECIFIC ISSUES FOR ACCEPTANCE
Historically, lung transplantation carried sufficiently high risks that it was limited to ideal recipients and perfect donors. As lung transplantation has improved and the waiting list of potential lung transplant recipients has expanded, the definition of the acceptable donor has been liberalized.
Current generally accepted donor criteria for lung transplantation are listed in Table 4. Although appearing eminently reasonable, it is important to recognize that the listed standard criteria
DONOR–RECIPIENT MATCHING ISSUES
ABO compatibility is considered necessary for successful thoracic organ transplantation, although data exist in liver transplantation demonstrating good results from the use of ABO-incompatible donors. In cardiac transplantation, transgression of blood-group compatibility has resulted in hyperacute rejection, primary graft nonfunction, and an increased incidence of delayed graft failure. A comparison in heart transplant recipients of histologic features of acute rejection in ABO-identical
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Cited by (0)
Address reprint requests to Adaani E. Frost, MD, Baylor College of Medicine, Sm 1237, 6550 Fannin, The Methodist Hospital, Houston, TX 77030
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From the Department of Medicine, Baylor College of Medicine, The Methodist Hospital, Houston, Texas