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Introduction The organ shortage for transplantation, the principal factor that increases waiting lists, has become a serious public health problem. In this scenario, the intensivist occupies a prominent position as one of the professionals that first has a chance to identify brain death and to be responsible for the maintenance of the potential deceased donor. Objective This report attempts to establish guidelines for care and maintenance of adult deceased donor organs guiding and standardizing care provided to patients with brain death. Method These guidelines were composed by intensivists, transplant coordinators, professionals from various transplant teams, and used transplant center. The formulated questions were forwarded to all members and recommendations were constructed after an extensive literature review selecting articles with the highest degree of evidence. Results Guidelines were developed in the form of questions reflecting frequent experiences in clinical intensive care practices. The main questions were: Is there an optimal interval for keeping organs of deceased donors viable? What actions are considered essential for maintaining deceased donors in this period? What are the limits of body temperature? How should the patient be warmed? Which laboratory tests should be performed? What is the collection interval? What are the limits in the laboratory and the capture scenario? What are the limits of blood pressure? When and how should one use catecholamines? Conclusions This pioneer project involved a multidisciplinary team working in organ transplantation seeking to provide treatment guidance to increase the number of viable organs from deceased adult donors.

A atuacao do intensivista durante a manutencao do potencial doador falecido na busca da reducao de perdas de doadores e do aumento da efetivacao de transplantes nao se restringe aos aspectos hemodinâmicos. O adequado controle endocrino-metabolico e essencial para a manutencao do aporte energetico aos tecidos e do controle hidro-eletrolitico, favorecendo inclusive a estabilidade hemodinâmica. A abordagem das alteracoes hematologicas e igualmente importante considerando as implicacoes da pratica transfusional inapropriada. Ressalta-se ainda o papel da ventilacao protetora na modulacao inflamatoria e consequente aumento do aproveitamento de pulmoes para transplante. Por fim, assinala-se a relevância da avaliacao criteriosa das evidencias de atividade infecciosa e da antibioticoterapia na busca do maior utilizacao de orgaos de potenciais doadores falecidos

A desproporção entre a grande demanda por transplantes de órgãos e a baixa realização de transplantes é um grave problema de saúde pública. O reconhecimento da morte encefálica, a adequada abordagem da família e a manutenção clínica do doador falecido são fundamentais para a diminuição desta desproporção. Neste cenário, o intensivista tem importância central e a aplicação do conjunto de informações disponíveis para manutenção do potencial doador falecido está claramente associada à redução de perdas de doadores e ao aumento da qualidade e da efetivação de transplantes There is a relative shortage of appropriate organs available for transplantation. The appropriate diagnosis of brain death, a suitable family approach and the maintenance of the deceased donor are fundamental in addressing this issue. The intensive care physician plays a key role in the maintenance of the deceased donor, thereby reducing losses and increasing the number of successful transplants

There is a relative shortage of appropriate organs available for transplantation. The appropriate diagnosis of brain death, a suitable family approach and the maintenance of the deceased donor are fundamental in addressing this issue. The intensive care physician plays a key role in the maintenance of the deceased donor, thereby reducing losses and increasing the number of successful transplants.