Hemodynamic monitoring of organ donors: A novel use of the esophageal echo-Doppler probe

Abstract

The esophageal Doppler monitoring (EDM) technology is well described in the literature. As it evolved over the last several years, the use of EDM has found expanded indications in various clinical settings. One of the areas where EDM has not been studied extensively is its use during optimization of organ donors before organ procurement. Close hemodynamic monitoring has become essential in the era of increasing use of extended organ donors. We present six cases of successful EDM use during preorgan procurement resuscitation of organ donors. Despite labile hemodynamics in the majority of these cases, EDM-guided optimization of resuscitative end-points allowed successful organ procurements and transplants, including 12 kidneys, 6 livers, 3 hearts, 2 pancreases, and 2 lungs. The EDM technology is noninvasive, technically easy, and less expensive than the traditional pulmonary artery catheter. Other potential benefits of the EDM include its portability and possibility of deployment in any setting by trained organ procurement personnel or critical care nursing staff. In conclusion, successful organ procurement can be facilitated by the use of EDM technology in hemodynamically labile organ donor patients.