This protocol describes procurement of the FRS after standard multiorgan procurement. The approach for multi-organ donation was pioneered by transplant surgeon Dr. Thomas Starzl more than three decades ago (Starzl, 2009). To minimize total ischemic time, surgery start time is defined by the organ procurement organization and all other team members, transplant teams, and transport systems. Multiple transplant teams may be responsible for the donor’s different organs. Removal of the organs typically proceeds as follows: heart, lung, liver, pancreas, small bowel, kidneys, and large vessels/tissues used as grafts. This order may be changed according to planned transplantations and center expertise. The FRS is recovered last.A standard or modified xipho-pubic incision may be used (Richards, Flyckt, Tzakis, & Falcone, 2018; Testa et al., 2018). This protocol describes a modified aortic cannulation scheme that ensures organ preservation solution is directed both cephalad to perfuse the abdominal organs and caudad to the pelvis in order to preserve the female reproductive tract. This protocol was developed as part of a uterus transplant clinical trial (ClinicalTrials.gov Identifier: NCT03307356).
Richards, E. G., Flyckt, R., Tzakis, A., & Falcone, T. (2018). Uterus transplantation: Organ procurement in a deceased donor model.Fertility and Sterility,110(1), 183. https://doi.org/10.1016/j.fertnstert.2018.04.014
Starzl, T. E. (2009). AN IMPROVED TECHNIQUE FOR MULTIPLE ORGAN HARVESTING, 12.
Testa, G., Anthony, T., McKenna, G. J., Koon, E. C., Wallis, K., Klintmalm, G. B., … Johannesson, L. (2018). Deceased donor uterus retrieval: A novel technique and workflow.American Journal of Transplantation,18(3), 679–683. https://doi.org/10.1111/ajt.14476