Long Term Management of a Deceased Organ Donor-An Organ Donor Coordinator’s Point of View


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Abstract

IntroductionOn average a donation case ranges from 24 to 48 hours from consent to conclusion of retrieval theatre. However there are special circumstance where a donation case may be on hold for a number of days/weeks/months until retrieval can occur. In this case study we will examine the circumstances of a pregnant donor who was supported in the intensive care unit for 8 weeks before retrieval surgery.Case study42 year old female complained of a sudden headache and collapsed at home.Phx: nil significant, currently 26/40 gestation G1P0 On arrival to the local emergency department, Glasgow Coma Scale of 3, intubated at scene for airway protection.CTB: Grade V Subarachnoid Haemorrhage with early hydrocephalus.Theatre: emergency craniotomy with EVD insertion for evacuation of bleed.Day 3: Pupils remain fixed and dilated, nil spontaneous breaths, absent cough and gag reflexes. Absent corneal reflexes. Brain death testing completed via nuclear medicine scan and confirmed by 2 intensive care specialists. Death declared at xx/xx/xx Organ donation was raised with the next of kin (domestic partner) who was very supportive, and signed the formal consent paperwork on the day.Their one request is to deliver the baby when he/she was viable and healthy.Patient was supported for 6 weeks in ICU with multidisciplinary team input- including obstetrics and gynaecology, Infectious diseases, ICU and general medicine. Multiple nursing teams involved in the care of the patient as well as social work involvement.Retrieval theatre 6 weeks post brain death declaration: successful retrieval of heart, lungs, liver, pancreas, kidneys, eyes.Monash Health.

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