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

1. Compare DBD vs DCD donor workflow and define total vs functional warm ischemia.
   

2. Identify key OR roles and the ethical/legal separation of death declaration from procurement teams.

3. Outline the core steps of abdominal procurement, including exposure, cannulation, cross-clamp, and organ removal sequence.
   
4. Apply a practical troubleshooting approach when flush flow is inadequate

1. Englesbe MJ, Mulholland MW. Operative Techniques in Transplantation Surgery. Philadelphia, PA: Wolters Kluwer; 2018.
2. 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/
3. 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/