Retrieval of Donor Livers SYLVESTER STERIOFF, M.D., Section of Transplantation Surgery; ROBERT H. SAUNDERS, A.A.S., Methodist Hospital Organ Procurement; MICHAEL P. MULLEN, B.S., Saint Marys Hospital Organ Procurement; TERRY D. HORNSETH, B.S., MARY BETH CONWAY, B.S., Methodist Hospital Organ Procurement; AHMED EID, M.D., Section of Transplantation Surgery At the inception of a liver transplantation program at our institution, an organ pro- curement service was established. Specially trained personnel, availability of a trans- portation system, and development of communication between distant retrieval sites and the operating room were important elements of this service. For the first 100 liver allografts in our transplantation program, 118 retrievals were necessary. The central location of the Mayo Clinic allowed retrieval from anywhere within continental North America. In this initial phase of the liver transplantation program, the concern that organ availability would be the rate-limiting factor was unfounded. For establishment of a liver transplantation pro- gram, we recognized the need for a different mag- nitude of organization for organ donation than had existed previously. Organ procurement had been established at the Mayo Clinic for the kid- ney transplantation program, which involved oc- casional distant retrieval from community hos- pitals in southern Minnesota and North and South Dakota. In addition, multiorgan (heart, liver, and pancreas) retrieval had been arranged for other transplantation teams coming to Rochester, Min- nesota. For liver transplantation, the following three factors were needed: (1) organ procurement coordinators, dedicated solely to organ retrieval, with additional educational, administrative, tech- nical, and logistic skills; (2) a transportation sys- tem that would ensure rapid and safe delivery of the organs and personnel within the time con- straints of liver preservation (8 hours); and (3) a reliable communication system between distant retrieval sites and the operating room. After review of past experience, it became apparent that the Mayo-affiliated hospitals in Rochester would be unable to provide the total number of donor livers necessary to support an active liver transplantation program. The mean number of kidney donors during the previous 5 years had been approximately 15 annually, and not all kidney donors qualify for liver donation as well. An initial concern was that the avail- ability of donor organs would be the limiting factor in the growth of the liver transplantation program. In 1985, livers for transplantation could be obtained through the North American Trans- plant Coordinators Organization (NATCO), which provided a telephone contact between donor teams offering organs and the recipient hospital. A second resource was a regional organ procure- ment agency under the supervision of the St. Paul (Minnesota) Red Cross in cooperation with the University of Minnesota Hospitals and Hennepin County Medical Center. Individual reprints of this article are not available. The entire Symposium on Liver Transplantation will be available for purchase as a bound booklet from the Proceedings Circulation Office in June. ASSESSMENT AND SELECTION OF DONORS Beginning in March 1985, the organ procurement coordinator at Mayo could receive potential donor information as a result of our providing the fol- Mayo Clin Proc 64:112-115,1989 112