Trascrizione in lingua in Inglese

INSPECTION BEFORE EXPLANTATION

The problem is one of fully informed consent

or refusal by each individual:

a personal choice, yes or no, to an eventual

organ harvesting after death (ndr. so called “brain stem death”),

and, most important, sharing the decision,

once it has been made, with family and

friends.

The administration of the accredited hospital

has to make sure

that every formality has been dealt with,

that no opposition remains,

and signed the final authorization for organ

removal.

Now the surgical team has to get ready.

And now there you are.

We have come to the end of the road.

The operation of organ harvesting is about

to start.

It will be carried out by a team of

experienced and specially trained surgeons

following a highly rigorous technique.

Cardiac surgeons, hepatic surgeons,

urologists, will act together, or in rapid

succession, to retrieve heart, lungs, liver

and both kidneys.

Throughout the operation a constant watch is

maintained by the I.U. staff over the

artificial ventilation and on the

appropriate perfusion indispensable to

maintain until the end the steady heart beat

and normal arterial and venous pressure.

Scrub nurses will now move ahead and the operation

will get under way, and in two or three

hours should be completed.

The surgical team is now at work, and it is

performing one of the most important steps:

the direct appraisal, through the mid-line

incision, of organs in the chest and in the

abdomen.

The heart beats regularly,

coronary arteries are patent

and muscle, the myocardium, shows a good

tonicity;

at inspection and palpation the liver

appears to be of excellent quality.

Now the right kidney appears to the

urologist as having a good color, a good

tension, as being normal.

All these organs are perfectly sounds,

and may be transplanted in other people

in all safety.

Having been freed, the organs will now be

cooled,

by direct in situ perfusion,

using appropriate solutions,

cooled down to a temperature of four degrees

centigrade,

ant then kept in ice boxes

until the best recipient has been selected

and transportation insured in the best of

time

to the hospital where the implantation will take place.