Cadaveric kidney donor management

Hippokratia 1997, 1(4):177-188

G Vergoulas


In recent years, renal transplantation has assumed an important role in the treatment of patients with end stage renal failure due to various diseases. However, even today, the greatest limitation in kidney transplantation is the shortage of renal grafts. It is well known that cadaveric donors consist the main source of renal grafts all over the world, as well as that correct management of these donors can augment the number and the quality of cadaveric grafts. Unfortunately, till now in Greece, has not been paid proper attention to this matter which results in graft losses. This review addresses management of cadaver heart beating, non-heart beating or anencephalic kidney donors. The knowledge of all the aspects related with the correct management of cadaveric donors and the alertness of I.C.U. teams to apply a scheduled reasonable approach to them (early declaration of coming brain death, quick assessment of candidate for kidney donation, diagnosis of brain death, management of disturbances that appear during the event of brain death, resuscitation measures for cadaveric donors with reversible cardiac arrest, and in situ preservation of renal grafts with triple lumen double balloon catheter placed in abdominal aorta, management of anencephalic donors etc) has been shown to result in higher numbers and improved quality of cadaveric kidneys.