This well-illustrated handbook provides answers to important questions that may arise during the retrieval of multiple organs for transplantation and offers step-by-step descriptions of current surgical techniques for procurement of the various thoracic and abdominal organs, including heart, lung, liver, intestine, pancreas, and kidney. The coverage includes detailed instruction on liver splitting techniques and on living donor liver hepatectomies and laparoscopic and robot-assisted nephrectomy for transplantation. In addition, guidance is provided on preoperative evaluation for multiorgan donation, contraindications, management for organ retrieval in deceased donors, and organ preservation. The advice offered and the questions addressed will be of relevance not only to transplant surgeons, trainees, and fellows but also to all other professionals involved in organ transplantation, including nursing staff in intensive care units and emergency rooms.
PART 1 Expanding the donor pool and evaluation of the possible organ donor.- Ethics of organ donation.- Policies for boosting donor enlistment in the North Italy transplant program macro-area.- Preoperative evaluation and arrangements for multi-organ donation: general principles and contra-indications.- PART 2 Principles of brain death diagnosis and optimal management for organ retrieval.- Brain death diagnosis.- Spinal reflexes and movements in brain death donors.- Management of metabolic and hemodynamic derangements in heart beating donors.- Non-heart-beating donors.- Multiple organ retrieval: general principles, organ preservation, and new strategies.- PART 3 Surgical technique for thoracic organ procurement.- Thoracic and mediastinal inspection and heart procurement.- Lung and heart-lung procurement.- PART 4 Surgical technique for abdominal organ procurement.- Detailed abdominal organ inspection and early surgical steps for abdominal organ procurement.- Whole liver procurement.- Split liver: surgical technique for adult-paediatric and for two adult recipients.- Small bowel and multivisceral procurement.- Pancreas Procurement.- Kidney procurement.- Vascular Homograft Procurement.- Transplantation bench surgery of the abdominal organs.- PART 5 Surgical technique for liver and kidney living donor.- Right liver lobe hemi-hepatecomy for living donor liver transplantation.- Pure laparoscopic left lateral and full-left hepatectomy including the middle hepatic vein in living donors.- Total laparoscopic right hepatecomy for living donors.- Laparoscopic and robot-assisted nephrectomy.