Management of the potential organ donor

There is a critical shortage of organs for transplantation. Aggressive management of the potential organ donor in intensive care units will increase the availability of these organs. The physiological changes following brain death impose major problems for the intensivist. The cardiovascular instability that ensues has to be managed judiciously to ensure donor organs are in optimal condition for transplantation. The management includes optimizing fluid status and the use of inotropes using invasive monitoring. Arrhythmias should be prevented and electrolytes status should be carefully monitored. In the immediate period after brain death endocrinopathy may follow and hormonal replacement may be necessary. With growing needs for organs non-heart-beating patients are now considered for organ donation.