Donor Selection and Management of the High-Risk Donor

In light of increasing organ demand in a stable supply setting, prompt and efficacious potential cardiac donor management is of paramount importance. Since the early description of the “ideal” donor by Griepp and associates in 1971 (1), the criteria by which donors are accepted— and the characteristics that determine a “high-risk” donor—have changed substantially (see Tables 1 and 2). Indeed, the growing acceptance of donor organs that meet so-called “extended” criteria for transplantation has further emphasized the importance of aggressive donor management by experienced individuals whose interventions can transform otherwise unusable donors into ones of low or intermediate risk.