An improved technique for multiple organ harvesting

Abstract

A rapid technique for multiple organ harvesting is described which allows removal of all the major organs within 30 to 60 minutes after beginning the donor operation. No preliminary dissection of the liver or kidneys is required or necessary since these organs are cooled by infusion of cold solutions in situ and with subsequent rapid dissection in a bloodless field. The incidence of well functioning kidneys, livers and hearts has been better than with the previous methods. The acceptance of this procedure by other personnel has been almost universal.

Fig. 1

Incision (inset) and encirclement of aorta at the diaphragm.

Fig. 2

Insertion of catheter into inferior mesenteric vein and cannulation of the distal aorta after ligation of the inferior mesenteric artery.

Fig. 3

Cross clamping of aorta at the time of rapid infusion. I.M.v., Inferior mesenteric vein, and I.M.a., inferior mesenteric artery.

Fig. 4

Dissection in bloodless field of hepatic hilar structures. A rim of diaphragm around the suprahepatic inferior vena cava is excised with the liver (inset) and later dissected off at the back table in the recipient hospital.

Fig. 5

Completion of hilar transaction. After cutting the superior mesenteric vein and splenic vein, the portal vein is folded superiorly with the finger and an anomalous right hepatic artery is looked for posterior to the portal vein. L.G.a., Left gastric artery; S.a., splenic artery; S.v., splenic vein; S.M.v., superior mesenteric vein; R.H.a., right hepatic artery; S.M..a., superior mesenteric artery; C.H.a., common hepatic artery, and C.A., celiac axis.

Fig. 6

Excised liver in ice basin with a cannula secured in the portal vein, which is used to infuse chilled Collin’s solution. S.M.v., Superior mesenteric vein.