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Multiple investigations have documented the health-related quality-of-life (HRQoL) and donation-related experiences of unrelated donors (URDs), but similar investigations of the related donor (RD) experience have been less common. The central goal of this study was to longitudinally examine and compare HRQoL of RD and URD hematopoietic stem cell (HSC) donors from predonation through 1 year postdonation. This prospective investigation included adult HSC donors ages 18 to 60 years who donated bone marrow or peripheral blood stem cells at one of 48 geographically diverse US transplant/donor centers and completed HRQoL interviews at predonation and 4 weeks and 1 year postdonation. At predonation, related donors were less ambivalent about donation (t = –3.30; P = .001), more satisfied with their decision to donate (t = 2.65; P = .009), and more likely to define themselves as donors (t = 2.94; P = .004) than were URDs. However, related donors were more concerned about the use of needles (odds ratio [OR] = 2.19; P = .012), about who would pay for the procedure (OR = 2.80; P = .011), and the possibility that they would feel responsible if the transplant failed (t = 2.31; P = .022). Shortly postdonation, related donors were more likely to report donation-related pain (t = 2.50; P = .013) and lightheadedness (OR = 3.63; P = .028). At 1 year postdonation, related donors were less likely to be fully recovered from donation (OR = 0.10; P = .010) and more likely to report a longer recovery period following donation (t = 2.57; P = .011), although this latter finding was primarily due to the percentage of related versus unrelated donors not fully recovered at 1 year postdonation (10% versus 1%). Taken together, these findings suggest that current related donor management practices may be sufficient in preparing related donors for the psychological aspects of donation but that there may be more to do in terms of calibrating the description of donation-related experiences and recovery time to the related donor group (i.e., descriptions of donation experiences based on unrelated donation may not provide best estimates of experience for this group).

Donation after circulatory death (DCD) provides the option of organ donation for patients who are not brain-dead, but for whom ventilator support will be removed for the purpose of death. With over 112,000 people waiting for a life-saving transplant, it is crucial that organ procurement organizations determine opportunities for the greatest potential for growth. For many, it is DCD donation. It is possible for DCD donors to donate the liver, kidneys, pancreas, lungs, and even the heart, but the most common organs recovered and transplanted from this donor population remain the liver and kidneys.

Due to loss of several regulating entities in case of brain death, the management of optimal organ function in the potential organ donor is challenging. This chapter provides the reader with a systematic walk-through on how to do this.

Abstract: The authors give a short introduction of the Hungarian and the international history of adult heart transplantation, and highlight the similarities in the evolution of the two programs. Their aim was to show how the Hungarian post-transplant survival changed in the last five years. They wanted to investigate how all the changes they had made in the program affected the post-transplant results. They investigated 496 heart transplantation data and compared to international data. Orv Hetil. 2018; 159(46): 1869–1875.

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.

Objectives To describe important considerations during the process of caring for critically ill children who may be potential organ donors and supporting the family during the death of their child. Design Literature review and expert commentary. Measurement and main results Medical literature focusing on pediatric donation, best pediatric donation practices, donor management, and factors influencing donation were reviewed. Additional pediatric data were obtained and reviewed from the U.S. Organ Procurement and Transplantation Network. Achieving successful organ donation requires the coordinated efforts of the critical care team, organ donation organization, and transplant team to effectively manage a potential donor and recover suitable organs for transplantation. Collaboration between these teams is essential to ensure that all potential organs are recovered in optimal condition, to reduce death and morbidity in children on transplantation waiting lists as well as fulfilling the family's wishes for their dying child to become a donor. Conclusions Organ donation is an important component of end-of-life care and can help the healing process for families and medical staff following the death of a child. The process of pediatric organ donation requires healthcare providers to actively work to preserve the option of donation before the death of the child and ensure donation occurs after consent/authorization has been obtained from the family. Medical management of the pediatric organ donor requires the expertise of a multidisciplinary medical team skilled in the unique needs of caring for children after neurologic determination of death and those who become donors following circulatory death after withdrawal of life-sustaining medical therapies.

False positive (FP) viral marker results in blood donors continue to pose many challenges. Informing donors of FP results and subsequent deferral can result in stress and anxiety for donors and additional complexity and workload for blood services. Donor management strategies need to balance the requirement to minimise donor anxiety and inconvenience while maintaining sufficiency of supply. Decisions about how and when to inform donors of FP results and determine deferral periods can be difficult as FP results, while often transitory, can take up to several years to resolve. Additional complexities include the interpretation of indeterminate serological confirmatory testing without detectable viral RNA or non-discriminated NAT results with concomitant anti-HBc reactivity - both may be due to FP results, but the former may also represent past infection and the later may represent occult hepatitis B infection. In this review we discuss strategies to minimise indeterminate serological confirmatory results, possible donor deferral policies and the impact on donors when notified of FP results. We also provide some new data from Australia that address the challenge of interpreting non-discriminated NAT results with concomitant anti-HBc reactivity. Ultimately, the challenge is for each blood service to develop appropriate strategies for donor management, taking into account local information and requirements.

Changes in the causes of brain death may influence the numbers of hearts that can be procured and transplanted. We retrospectively investigated whether the distribution of causes responsible for brain death have changed over a 15-year period in a cohort of 1286 potential heart donor (aged ≤ 60), and whether it influenced heart procurement. Between 2001 and 2016, the age of potential donors significantly increased (p

Assessment of potential donors is an essential part of heart transplantation. Despite the shortage of donor hearts, donor heart procurement from brain-dead organ donors remains low in France, which may be explained by the increasing proportion of high-risk donors, as well as the mismatch between donor assessment and the transplant team's expectations. Improving donor and donor heart assessment is essential to improve the low utilization rate of available donor hearts without increasing post-transplant recipient mortality. This document provides information to practitioners involved in brain-dead donor management, evaluation and selection, concerning the place of medical history, electrocardiography, cardiac imaging, biomarkers and haemodynamic and arrhythmia assessment in the characterization of potential heart donors.

Background Deferral for low hemoglobin (Hb) increases the likelihood that donors do not return for future donations. Zinc protoporphyrin (ZPP) has been described as a sensitive marker of iron-deficient erythropoiesis, before Hb decreases. It is a relatively cheap, rapid, and easy-to-perform measurement in a drop of whole blood. To assess the utility of ZPP measurement in donor management we examined whether ZPP and Hb levels among first-time donors differ from repeat donors. We further explored whether ZPP increases over subsequent donations at a donor population level and whether increasing ZPP levels coincide with decreasing Hb levels and donor deferral. Study design and methods We included first-time (n = 4983) and repeat (n = 3533) whole blood donors from the ZPP and Iron in the Netherlands Cohort (ZINC) study. ZPP and Hb were measured at each subsequent donation during a 4-year period after inclusion in the study. Results Median ZPP levels were higher in repeat than in first-time donors. In first-time donors, especially women, ZPP levels were increased with a corresponding decline in Hb levels over subsequent donations. ZPP levels were increased among first-time donors deferred for low Hb. Conclusion Our results suggest that adding ZPP to Hb measurements in the daily blood collection setting, especially for first-time donors and first-time female donors may add to the identification of a donor subpopulation with low functional iron stores.

Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis. Aspects such as catecholamine storm management, use of vasoactive drugs, hemodynamic objectives and monitoring, assessment of the heart for donation, and general care of the donor in BD are reviewed.

The shortage of suitable organs is the biggest obstacle for transplants. At present, most organs for transplant in the United States are from donation after neurologic determination of death (brain death). Potential organs for transplant need to maintain their viability during a series of insults, including the original disease, physiologic derangements during the dying process, ischemia, and reperfusion. Proper donor management before, during, and after procurement has potential to increase the number and quality of organs from donors. Anesthesiologists need to understand the physiologic derangements associated with brain death and the updated donor management during the periprocurement period.

Background Left ventricular systolic dysfunction (LVSD) accounts for almost 25% of nonacceptance of potential donor hearts. Previous smaller, single-center studies showed that LVSD following brain death may be transient, and such hearts can be successfully resuscitated with resolution of LVSD, then transplanted. Objectives This study evaluated outcomes of donor hearts with LVSD on initial transthoracic echocardiogram (TTE) that resolved during donor management. Methods We reviewed echocardiograms of all cardiac donors in the United Network of Organ Sharing database that were transplanted from January 1, 2007, to September 30, 2015, and identified 472 donor hearts with LVSD (left ventricular ejection fraction [LVEF] ≤40%) on initial TTE that resolved (LVEF ≥50%) during donor management on a subsequent TTE. These patients comprised the improved donor LVEF group. These were compared with donor hearts with normal LVEF (LVEF ≥55%) on the initial TTE for recipient mortality, cardiac allograft vasculopathy (CAV), and primary graft failure (PGF). Results There was no significant difference in recipient mortality at 30 days, 1 year, 3 years, and 5 years of follow-up, nor any difference in rates of PGF at 90 days and CAV at 5 years between recipients of donor hearts with improved LVEF and recipients of donor hearts with initially normal LVEF. Post-transplant length of stay was also similar between the 2 groups. Using propensity scores, 461 transplants in the improved-donor LVEF group were matched to 461 transplants in the normal-donor LVEF group. There was no significant difference in PGF at 90 days or recipient mortality after up to 5 years of follow-up. Conclusions In the largest analysis of donor hearts with transient LVSD, we found that such hearts can be successfully resuscitated and transplanted without increasing recipient mortality, CAV, or PGF. These results underscore the importance of appropriate donor management and should help to increase utilization of donor hearts with transient LVSD.

Background The Alliance of Blood Operators initiated a project labelled ‘Donor of the Future’. This study gives an overview of the project results, in particular with regard to country differences. Study Design and Methods A large survey (N = 7663) among blood donors in six countries was conducted to analyse the effects of five global areas of change: (1) demographic change; (2) technological developments; (3) health innovations; (4) public, behavioural and attitudinal aspects; and (5) political, economic and environmental issues. Results The main results exhibited similarities and differences between blood donors of the participating countries. Greater differences were found, for example, regarding technological developments. Whereas only blood donors from the UK and Australia would like to be informed via SMS, blood donors from all countries would like to be informed via email. Conclusion Different priorities of donors have been uncovered. These differences give suggestions to improve the country-specific donor management. Furthermore, the key findings provide a comprehensive overview of major future research domains.

Despite important advances in the care of postcardiac arrest patients, severe brain injury remains one of the major causes of death in the cardiac intensive care unit. Neurological prognostication after cardiac arrest has evolved significantly since the introduction of therapeutic hypothermia. It now relies on a multimodal approach and a minimal observation period of 72 hours is usually advocated. However, when brain injury is severe and the prognosis considered dismal, patients become eligible for organ donation. Patients with severe anoxic encephalopathy might evolve toward brain death and be candidates for donation after brain death. In the presence of severe brain injury without brain death criteria, when withdrawal of life-sustaining therapy is considered, patients might be eligible for donation after cardiocirculatory death. The diagnosis of brain death, the differences between donation after brain death and donation after cardiocirculatory death, family approach, and donor management in the intensive care unit are discussed. Because these are increasingly encountered situations in the cardiac intensive care unit, it is essential that physicians involved in cardiac critical care be familiar with these concepts.

Background No standard exists for the use of deceased donor liver biopsy during procurement. We sought to evaluate liver biopsy and the impact of findings on outcomes and graft utilization. Methods A prospective observational study of donors after neurologic determination of death was conducted from 02/2012-08/2017 (16 OPOs). Donor data were collected through the UNOS Donor Management Goals Registry Web Portal and linked to the Scientific Registry of Transplant Recipients (SRTR) for recipient outcomes. Recipients of biopsied donor livers (BxDL) were studied and a Cox proportional hazard analysis was used to identify independent predictors of 1-year graft survival. Results Data from 5449 liver transplant recipients were analyzed, of which 1791(33%) received a BxDL. There was no difference in graft or patient survival between the non-BxDL and BxDL recipient groups. On adjusted analysis of BxDL recipients, macrosteatosis (21%-30%[n = 148] and >30%[n = 92]) was not found to predict 1-year graft survival, whereas increasing donor age (HR1.02), donor Hispanic ethnicity (HR1.62), donor INR (HR1.18), and recipient life support (HR2.29) were. Conclusions Excellent graft and patient survival can be achieved in recipients of BxDL grafts. Notably, as demonstrated by the lack of effect of macrosteatosis on survival, donor to recipient matching may contribute to these outcomes.

Maintenance of physical infrastructure transitioned from donor management to national ownership has been a challenge in the health sector leading to a considerable number of physical infrastructure dilapidating to a deplorable state. This study investigated the causes of deterioration for Health Physical Infrastructure Transitioned from Donor to National Management in Zambia. A mixed method approach was adopted for the study. Qualitative and quantitative data was collected through interviews and questionnaires respectively. The findings revealed that there was lack of onsite maintenance technicians in the health centres. Further, that though maintenance plans were in place in most urban facilities as compared to rural health facilities adherence to such plans was hindered due to lack of funding. The study therefore, recommends improved budget allocation for maintenance activities to the Ministry of Health, assigning of qualified maintenance technicians in health centres. Further, that Government should consider having a maintenance policy to achieve sustainability for built assets transferred from donor to national management.

Background: There is no specific guidelines concerning intraoperative management of brain-dead donors (BDD) during organ procurement (OP). This study aimed at describing usual anesthetic practices for BDD during an OP procedure and to assess the knowledge and self-confidence of French anesthesiologists with this practice. Methods: An electronic, national and anonymous survey with closed-questions about anesthetic management of BDD was distributed to French anesthesiologists via the mailing list of the French Society of Anesthesiology and Intensive Care. The questionnaire included questions concerning monitoring, intraoperative resuscitation, anesthetic drugs use and confidence of the respondents. Results: 458 responses were analyzed. Respondents were mainly attending physicians with more than 10 years of professional experience, equally distributed between university and non-university centers. Seventy-eight percent of them declared knowledge about guidelines regarding ICU management of BDD. Advanced hemodynamic monitoring and endocrine substitution were poorly considered by respondents (31% and 35% of respondents, respectively). 98% of the respondents used crystalloids for fluid resuscitation. During the procedure, use of neuromuscular blockers, opioids and sedative agents were considered by respectively 84%, 61% and 27% of the respondents. A very high level of agreement (10 [8-10], on a ten-points Likert-style scale) was reported concerning the expected impact of intraoperative anesthetic management on the primary function of grafts. Conclusions: Declared anesthetic practice appeared in accordance with guidelines concerning ICU management of organ donors. Further studies are needed to evaluate the specific impact of intraoperative management during this procedure and thus the need for specific anesthetic guidelines.

OBJECTIVES To evaluate the improvement in lung donation and immediate lung function after the implementation of a 360° rotational positioning protocol within an organ procurement organization in the Midwest. DESIGN Retrospective observational study. SETTING The Midwest Transplant Network from 2005 to 2017. Rotational positioning of donors began in 2008. SUBJECTS Potential deceased lung donors. INTERVENTIONS A 360° rotational protocol. Presence of immediate lung function in recipients, change in PaO2:FIO2 ratio during donor management, initial and final PaO2:FIO2 ratio, and proportion of lungs donated were measured. Outcomes were compared between rotated and nonrotated donors. MEASUREMENTS AND MAIN RESULTS A total of 693 donors were analyzed. The proportion of lung donations increased by 10%. The difference between initial PaO2:FIO2 ratio and final PaO2:FIO2 ratio was significantly different between rotated and nonrotated donors (36 ± 116 vs 104 ± 148; p < 0.001). Lungs transplanted from rotated donors had better immediate function than those from nonrotated donors (99.5% vs 68%; p < 0.001). CONCLUSIONS There was a statistically significant increase in lung donations after implementing rotational positioning of deceased donors. Rotational positioning significantly increased the average difference in PaO2:FIO2 ratios. There was also superior lung function in the rotated group. The authors recommend that organ procurement organizations consider adopting a rotational positioning protocol for donors to increase the lungs available for transplantation.

Background Obstacles encountered during the organ donation process may result in the loss of organs. A centralized medical advisory service (MAS), providing a 24/7/365 service, was established in 2007 to respond to queries from healthcare professionals regarding organ safety, brain death (BD) determination, and donor management. Methods Data collected from 2007 to 2017 included the number and context of the queries and the mean number of organs transplanted/donor. Since 2012, the number of six donor management goals (DMGs) met at the time of consent has been monitored. Results The number of queries relative to the number of potential donors increased from 12.4% (n = 78 queries) in 2007 to 48.2% (304 queries) in 2009 and has remained widely utilized, with most queries consistently related to organ safety. The context of the queries informed the formulation of protocols relating to donor infections and malignancy and identified difficulties regarding BD determination and subsequent implementation of solutions. A mean of 5.0 ± 0.7 DMGs was achieved, while the number of organs transplanted/donor increased from 3.4 in 2007 to 4.0 in 2017. Conclusion We suggest that this model may provide a valuable resource to improve the safety, standardization, and quality of the donation process.

Delayed graft function (DGF) in kidney transplant significantly increases inpatient and outpatient cost. Targeted, mild hypothermia in organ donors after neurologic determination of death significantly reduced the rate of DGF in a recent randomized controlled clinical trial. To assess the potential economic benefit of national implementation of donor hypothermia, rates of reduction DGF were combined with estimates of the impact of DGF on hospital cost and total health expenditure for standard and extended criteria donor organs (SCD and ECD). DGF increases the cost of the transplant episode by $9487 for ECD transplant and $10 342 for SCD transplant. Medicare recipients with DGF incur an additional $18 513 spending for ECD and $14 948 in SCD transplants over the first year. An absolute reduction in DGF rate after kidney transplantation consistent with trial results (ECD 25%, SCD 7%) has the potential to lower annual hospital cost for kidney transplant by $13 178 746 and annual Medicare spending by $20 970 706 compared to standard donor management practice using static cold storage. Targeted mild hypothermia improves care of renal transplant patients by safely reducing DGF rates in both ECD and SCD transplant. Broader application of this safe, effective, and low-cost intervention could reduce healthcare expenditures for providers and insurers.

Over the last decade, striking progress has been made in the field of organ transplantation, such as better surgical expertise and preservation techniques. Therefore, organ transplantation is nowadays considered a successful treatment in end-stage diseases of various organs, e.g. the kidney, liver, intestine, heart, and lungs. However, there are still barriers which prevent a lifelong survival of the donor graft in the recipient. Activation of the immune system is an important limiting factor in the transplantation process. As part of this pro-inflammatory environment, the complement system is triggered. Complement activation plays a key role in the transplantation process, as highlighted by the amount of studies in ischemia-reperfusion injury (IRI) and rejection. However, new insight have shown that complement is not only activated in the later stages of transplantation, but already commences in the donor. In deceased donors, complement activation is associated with deteriorated quality of deceased donor organs. Of importance, since most donor organs are derived from either brain-dead donors or deceased after circulatory death donors. The exact mechanisms and the role of the complement system in the pathophysiology of the deceased donor have been underexposed. This review provides an overview of the current knowledge on complement activation in the (multi-)organ donor. Targeting the complement system might be a promising therapeutic strategy to improve the quality of various donor organs. Therefore, we will discuss the complement therapeutics that already have been tested in the donor. Finally, we question whether complement therapeutics should be translated to the clinics and if all organs share the same potential complement targets, considering the physiological differences of each organ.

BACKGROUND Continuous effort around the globe is exerted into donor management, with the overall aim of keeping a constant flow of new donations. To achieve this goal, blood banks and blood donor associations are taking initiatives to get the same donor to make repeated donations. In general, such initiatives are implemented without proper evaluation. This study circumvents this trend and evaluates the effect on donations from sending blood donors a text message when their donation has helped a patient. METHODS AND MATERIALS In a large-scale field experiment (n = 20,365), we randomized donors such that half are sent a text message when their donation was used. Among those who were randomized to the text message, we also randomized the time of day the text message was sent. RESULTS The messages increased subsequent donations by 3.6% (p = 0.023), compared with donors who did not get the message. It was also shown that optimizing the time of day when the text messages were sent increased the effect substantially. Text messages sent in the evening increased donations by 6.5% (p = 0.011). Finally, it was found that, among whole blood donors, the text messages did not have a significant effect (p = 0.554), whereas it did among the plasma donors (p = 0.003). CONCLUSION Several blood banks have adopted the strategy of sending blood donors a text message that acknowledges that donors' contributions helped a patient. This study is the first to formally test the effects of such a message with a control group.

KEY IDEAS Donation willingness is generally high but registering with donor centers lags behind.We need to understand why and when during the life course which groups of individuals are motivated to donate.With this knowledge, we can design targeted recruitment and retention strategies and improve evidence‐based donor management.

[Resumen] Introducción: La donación de órganos es un proceso complejo que nos permite sustituir un órgano enfermo por otro que desempeña sus funciones fisiológicas. España es actualmente el país con mayor número de donaciones de órganos y trasplantes anuales, gracias al “Modelo Español”. Los órganos pueden proceder de 3 fuentes principales, aunque la mayoría se obtienen de donantes en muerte encefálica. Para asegurar un manejo adecuado del donante potencial, es imprescindible que el equipo multidisciplinar conozca las alteraciones fisiopatológicas desencadenadas de la muerte encefálica, con el fin de optimizar la función de los órganos que se trasplantarán, intentando utilizar las menores medidas de soporte necesarias. • Objetivos: Conocer las alteraciones fisiopatológicas derivadas de la ME, así como agrupar las recomendaciones y la evidencia disponible necesaria para estandarizar los cuidados de los donantes. • Metodología: Se realiza una búsqueda bibliográfica en distintas bases de datos, fijándose unos criterios de selección y de exclusión que nos permitan limitar los resultados. • Discusión: No existe suficiente evidencia que respalde los cuidados llevados a cabo hoy en día. Las guías y artículos se basan principalmente en modelos animales y en opiniones de expertos, lo que supone una variabilidad interpersonal en el manejo del donante potencial. [Resumo] Introdución: A doazón de órganos é un proceso complexo que nos permite substituír un órgano enfermo por outro que desempeña as súas función fisiolóxicas. España é actualmente o país con maior número de doazóns de órganos e transplantes anuais, grazas ao “Modelo Español”. Os órganos poden proceder de 3 fontes principais, aínda que a maioría obtéñense de doantes con morte encefálica. Para asegurar un manexo adecuado do doante potencial, é imprescindible que o equipo multidisciplinario coñeza as alteracións fisiopatolóxicas desencadeadas da morte encefálica, co fin de optimizar a función dos órganos que se van a transplantar, intentando utilizar as menores medidas de soporte necesarias. • Obxectivos: Coñecer as alteracións fisiolóxicas derivadas da ME, así como agrupar as recomendación e a evidencia necesaria para estandarizar os coidados dos doantes. • Metodoloxía: Realízase una busca bibliográfica en distintas bases de datos, fixándose criterios de selección e de exclusión que nos permitan limitar os resultados. • Discusión: Non existe suficiente evidencia que respalde os coidados levados a cabo hoxe en día. As guías e artigos baséanse principalmente en modelos animais e opinións de expertos, o que supón una variabilidade interpersoal no manexo do potencial doante. [Abstract] Introduction: Organ donation is a complex process that allow us to replace an ill organ for another that performs his physiological functions. Actually, Spain is the country with de highest number of organ donors and transplants, due to “Spanish Model”. Organs can proceed from three main sources but most of them proceed of brain death donors. To assure a proper handling of potential organ donor, multidisciplinary team must know physiopathology alterations triggered from the brain death in order to optimize the function of the organs that are going to be transplanted, trying to use the least necessary support measures • Objectives: Know about the physiopathology alterations triggered from the brain death as well as join the recommendations and the evidence needed to standardize management of the donors. • Methodology: We search in different databases, establishing selection criteria and exclusion criteria to limit the results. • Discussion: There isn’t enough evidence to support management of potential donor that we are carrying out today. Guidelines and articles are based on animal models and expert opinions. That supposes an interpersonal variability in management of organ donor. Traballo fin de grao (UDC.ENFC). Enfermaría. Curso 2018/2019