Extreme marginal donor: severe XXXX as a rare preservation condition for explantable organs--a case report.

@entity1 @entity1560 @entity1620 @entity1576 @entity3851 @entity1167 @entity2300 @entity3489 @entity2332
The progressive increase in @entity1 with @entity3851 has lengthend the waiting- list for liver transplantation. Unfortunately this has not been followed by a suitable increase in the number of donors. The expanding "donor pool" has required use of "marginal" donors (ICU stay > 10 days, sepsi; @entity1560 > 30-40%, @entity3489 > 155 mmol/L, inotropic drugs). We report the case of a skier who remained for more than 1 hour in @entity1576 under the snow; the 49-year-old @entity1 was extracted from the snow after 1 hour and 12 minutes and found to be @entity1167 , fixed @entity2300 and deep @entity2332 (27.2 degrees C). After cardiopulmonary resuscitation, partial cardio-respiratory activity was re-established. In the ICU severe @entity2332 (26.7 degrees C) was treated with extracorporeal circulation until a re-establishment of satisfactory cardio-circulatory conditions was obtained. Unfortunately cerebral @entity1620 was established and multiorgan procurement performed 3 days later. After liver transplantation into a 59 year-old @entity1 with PNC-C was performed. The course was uneventful and the @entity1 was discharged on the 19th postoperative day. CONCLUSIONS: Organ procurement from donors involved in accidental traumatic events with @entity1576 and @entity2332 , is similar to the non-heart-beating donor (NHBD) condition. Correct cardiopulmonary resuscitation and the use of extracorporeal circulation for gradual restoration of body temperature are necessary for optimal organ perfusion. In the present case the anoxic insult induced by the cessation of the cardio-respiratory function, was probably mitigated (if not even annulled) by the @entity2332 .
