University Hospital's Guidelines for Donor Management

Despite the urgent need to secure transplantable organs, there continues to be a significant gap between the number of potential organ donors and those that actually donate organs.

The most immediate and practical solution to the current crisis in organ donation is the maximal utilization and the optimal management of the existing donor pool in intensive care units. This is a process that begins with surveillance of patients likely to eventuate in brain death, followed by a standardized methodology for declaration of brain death, a uniform request for donation and medical management of the potential donor to ensure the best care for the organs to be donated.

In essence, the management of the potential organ donor is simultaneous to the medical management of the recipient into whom these organs will be transplanted. With the potential procurement of eight transplantable organs, this effectively is the critical care management of eight other individual lives.

It is essential that organ donation is incorporated into end-of-life care in the Intensive Care Unit and that families are presented with the option for donation after the death of their loved one.

Medical management of the potential organ donor begins after brain death and consent has been obtained from the family. Similar to other aspects of medicine, a collaborative and multidisciplinary approach utilizing the skills of intensivists, critical care nurses and respiratory therapists in conjunction with the organ procurement organization (OPO) in a standardized format provides the greatest opportunity to ensure optimal care of the potential organ donor.

Utilizing a standardized approach, the critical care team and UW Organ and Tissue Donation at University Hospital medically manages potential organ donors in the crucial period between brain death and procurement. During this time period, potential organ donors are frequently unstable and require an intense effort by the critical care team and OPO to ensure that procurement can be undertaken.

With this coordinated and integrative multidisciplinary approach, University Hospital has become one of the national leaders in organ donor management.