Clinical Challenges in Transplant Surgery: Deceased Donor Abdominal Recovery - A Step-by-Step Guide

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

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

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

• Outline the core steps of abdominal procurement, including exposure, cannulation, cross-clamp, and organ removal sequence.

• Apply a practical troubleshooting approach when flush flow is inadequate

References

• Englesbe MJ, Mulholland MW. Operative Techniques in Transplantation Surgery. Philadelphia, PA: Wolters Kluwer; 2018.

• 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. pubmed.ncbi.nlm.nih.gov/29768153

• 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. pubmed.ncbi.nlm.nih.gov/36695685

Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
If you liked this episode, check out our recent episodes here: behindtheknife.org/listen
Behind the Knife Premium:
General Surgery Oral Board Review Course: behindtheknife.org/premium/general-surgery-ora…
Trauma Surgery Video Atlas: behindtheknife.org/premium/trauma-surgery-vide…
Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: behindtheknife.org/premium/dominate-surgery-a-…
Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: behindtheknife.org/premium/dominate-surgery-fo…
Vascular Surgery Oral Board Review Course: behindtheknife.org/premium/vascular-surgery-or…
Colorectal Surgery Oral Board Review Course: behindtheknife.org/premium/colorectal-surgery-…
Surgical Oncology Oral Board Review Course: behindtheknife.org/premium/surgical-oncology-o…
Cardiothoracic Oral Board Review Course: behindtheknife.org/premium/cardiothoracic-surg…
Download our App:
Apple App Store: apps.apple.com/us/app/behind-the-knife/id16724…
Android/Google Play: play.google.com/store/apps/details?id=com.btk.…