Behind The Knife: The Surgery Podcast9 Feb

Clinical Challenges in Transplant Surgery: Deceased Donor Abdominal Recovery - A Step-by-Step Guide

Abdominal organ procurement is a high-stakes operation that blends anatomy, speed, and coordinated teamwork. In this Behind the Knife episode, the UNMC transplant team walks through the practical “how-to” of deceased donor abdominal recovery—covering OR roles and logistics, key anatomic maneuvers, cannulation/flush troubleshooting, and the workflow differences that matter most between donation after brain death (DBD) and donation after circulatory death (DCD).

Hosts
Madeline Cloonan, MD PhD – General Surgery Resident, University of Nebraska Medical Center (@maddie_cloonan)

Evelyn Waugh, MD – Transplant Surgery Fellow, University of Nebraska Medical Center

Jacqueline Dauch, MD – Abdominal Transplant Surgeon, University of Nebraska Medical Center

Alex Maskin, MD – Kidney & Pancreas Transplant Surgeon, University of Nebraska Medical Center

Learning Objectives

Compare DBD vs DCD donor workflow and define total vs functional warm ischemia.
Identify key OR roles and the ethical/legal separation of death declaration from procurement teams.
Outline the core steps of abdominal procurement, including exposure, cannulation, cross-clamp, and organ removal sequence.
Apply a practical troubleshooting approach when flush flow is inadequate

References

Englesbe MJ, Mulholland MW. Operative Techniques in Transplantation Surgery. Philadelphia, PA: Wolters Kluwer; 2018.
Tullius SG, Rabb H. Improving the supply and quality of deceased-donor organs for transplantation. N Engl J Med. 2018;378(20):1924–1933. doi:10.1056/NEJMra1708700. https://pubmed.ncbi.nlm.nih.gov/29768153/
Croome KP, Barbas AS, Whitson B, et al. American Society of Transplant Surgeons recommendations on best practices in donation after circulatory death organ procurement. Am J Transplant. 2023;23(2):171–179. doi:10.1016/j.ajt.2022.10.009. https://pubmed.ncbi.nlm.nih.gov/36695685/

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