A SIMPLIFIED TECHNIQUE FOR EN BLOC PROCUREMENT OF ABDOMINAL ORGANS SUITABLE FOR PANCREAS AND SMALL BOWEL TRANSPLANTATION

Background. Graft shortage makes multiorgan procurement mandatory. We describe the results Of a simplified method for the en bloc procurement of multiple organs, which permits isolated transplantation of all abdominal grafts, including the pancreas and the small bowel, to different recipients. Methods. Three hundred forty-three multiorgan procurements were done with a simplified en bloc technique. Results. None of the 1374 grafts that were procured sustained injuries that potentially precluded transplantation. Seventy-two grafts that were Procured from 18 donors (5 %) who were diagnosed with a neoplasm were discarded. Overall, 339 grafts that were procured from 325 donors were discarded because of specific contraindications, and 963 grafts (74 %) were transplanted. Ninety-seven pancreata were transplanted. In 3 instances the pancreas and the small bowel were procured simultaneously and transplanted to different recipients. A total of 287 liver grafts were also transplanted at 13 different institutions. In 42 instances, the liver was not allocated to our center. Forty liver teams (95 %) from I I different institutions agreed to procure their grafts according to the simplified en bloc technique. Our team performed 18 procurements, and a surgeon from the liver transplantation team, who was assisted by one of the members of our team, performed 22 procurements. In all, 576 kidneys were transplanted, either alone or simultaneously, with other abdominal grafts at 15 different institutions. Conclusions. This procurement method has high yields, allows pancreas and small-bowel procurement, and can be learned readily.