Sequence of retreival

1. Veintilated donor is transferred to theatre
2. Identification of donor and checking of consent
3. NG irrigation with amphoteracin (if pancreas to be taken)
4. Incision from suprasternal notch to pubic symphysis
5. Sternum divided with Gigli saw
6. Division of falciform ligament
7. Inspection of abdomen for tumors, etc
8. Inspection of the organs for donation
9. Ureters are isolated and kidneys mobilised
10. Aorta isolated and the coeliac axis and superior mesenteric artery disseted free
11. The venous systems are isolated
12. The great vessels in the chest are isolated
13. William Harvey cannula placed in aorta, above the bifurcation
14. Cannula placed into the superior mesenteric vein or inferior mesenteric vein, if the liver team wish this
15. Site for venting of IVC chosen, either cut IVC in chest or place vent tube in abdominal IVC
16. Clamp placed across aorta in the chest and /or clamp placed across aorta at the level of the diaphragm
17. Aortic perfusion commenced to cool liver and kidneys with UW solution (University of Wisconsin)
18. Heart is perfused with cardiopleg solution
19. Ventilation is ceased
20. Heart/Heart lungs retrieved
21. Liver retrieval
22. Pancreas retrieval
23. Kidney retreival en bloc
24. Arterial and venous conduits
25. Lymphocyte sources for tissue typing, spleen and lymph nodes