State of the Science in Deceased Organ Donor Management

Abstract

Research in deceased organ donor management offers an opportunity to increase the quantity and quality of organs available for transplantation. This article aims to appraise the current literature with a focus on reviewing deceased donor intervention trials. Aggressive critical care management after determination of brain death resulting in meeting of a donor management goal bundle has consistently demonstrated an association with significantly more organs transplanted per donor as well as improved graft outcomes. Although there is a dearth of experience with randomized donor intervention studies, dopamine and targeted mild therapeutic hypothermia have been found to significantly reduce delayed graft function in kidney recipients. Progress in understanding the ethical, legal, regulatory, policy, and organizational elements of organ donor research has provided a mechanism that allows for the endorsement of potentially impactful donor management studies. Ongoing trials should incorporate methods to ensure safety to all organs donated from donors enrolled in interventional trials.