Outline the principles involved in the care of the organ donor.
Discuss with transplant coordinator
Establish family rapport early
Diagnose brain death correctly
Establish presence of condition causing brain death. Exclude confounders (sedation, paralysis, endocrine, metabolic, temperature) - use vascular imaging if necessary. Satisfy legal criteria for organ donors relevant to the jurisdiction
Non-coercive sensitive family discussion re opportunity for donation
High availability. Answer questions
Initiate tissue typing, viral screen, further organ function tests
Maintain extra-cerebral physiological stability
Ventilatory - oxygenation, normocapnia, lung protective strategies. Circulatory - monitoring, filling,
noradrenaline, vasopressin. Normothermia. Diagnose and treat diabetes insipidus
(DDAVP/vasopressin, free water). Steroid and T3 replacement
Facilitate family time at bedside
Ensure aftercare of donor family
Transplant co-ordinator. Limited anonymous information available. Further family meeting offered
Few candidates considered that the donor could be either living related, or a non-beating heart donor.
This question closely resembles Question 1 from the second paper of 2012.
Non-clinical issues: (presumably, these have been dealt with now that the patient is "awaiting surgery for organ donation"
Summarized from the ANZIC statement on Brain Death and Organ Donation, Version 3.2
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