Appendix B — Appendix B. Organ Procurement Equipment Checklist

Version: Draft v0.1 | 📋 Requires review and supplementation by the TSGH transplant team

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B.1 B.1 Pre-Departure Checklist

B.1.1 Documents and Communication

Item	✓
Donor information (ID, blood type, height/weight, CMV status)	□
Matching confirmation documents	□
Copy of consent form	□
Team contact phone list	□
Surgical scheduling confirmation (recipient side)	□
Transportation arrangement confirmation (flight/high-speed rail/ambulance)	□

B.1.2 Preservation Solution and Perfusion

Item	Quantity	✓
Perfadex (low-potassium dextran solution)	4-6 L	□
Prostaglandin E1 (Alprostadil)	500 μg (added to perfusion solution)	□
Ice (crushed ice)	Sufficient	□
Sterile ice water	Sufficient	□
Organ preservation bags (triple bag)	2 sets	□
Cooler	1-2	□
Temperature monitor	1	□

B.1.3 Surgical Instruments

Item	Quantity	✓
Thoracotomy instrument set	1 set	□
Sternal saw / Sternotomy set	1 set	□
Long vascular clamps (large)	2-4	□
Scissors (Metzenbaum, Mayo)	2 each	□
Scalpel blades (#10, #15)	5 each	□
Electrocautery (monopolar)	1	□
Satinsky clamp	1-2	□
TA stapler (for bronchus)	1	□
Suction cannula	2	□

B.1.4 Sutures and Supplies

Item	Quantity	✓
Prolene 4-0 (pulmonary artery/vein)	4	□
Gauze (4x4)	1 pack	□
Surgical drapes	Sufficient	□
Sterile gloves (assorted sizes)	Sufficient	□
Sterile surgical gowns	Sufficient	□
Drain tubes (chest tubes)	On standby	□

B.1.5 Perfusion Equipment

Item	Quantity	✓
Perfusion cannula (pulmonary artery)	1	□
Retrograde flush cannula (pulmonary vein)	1	□
Y-connector	1	□
IV tubing / perfusion tubing	2 sets	□
Three-way stopcock	2-3	□

B.1.6 Miscellaneous

Item	Quantity	✓
Flashlight / headlamp	1	□
Specimen bags (tissue/culture)	Several	□
Culture tubes (aerobic/anaerobic)	2 each	□
Labels (left lung/right lung)	2	□
Camera / mobile phone (for documentation)	1	□

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B.2 B.2 Back Table Preparation

Step	Description	✓
Confirm left/right lung labeling	Prevent misidentification	□
Inspect lung parenchyma	Appearance, contusions, nodules	□
Retrograde flush	Perfadex via pulmonary vein retrograde perfusion	□
Trimming	PA, PV, bronchus cuff	□
Culture	Bronchial secretion for culture	□
Documentation	Record cold ischemia time onset	□

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B.3 B.3 Cold Ischemia Time Management

Phase	Record
Cross-clamp time	:
Perfusion start time	:
Perfusion end time	:
Departure from donor hospital	:
Arrival at TSGH	:
First lung reperfusion	:
Second lung reperfusion	:
Total cold ischemia time	_h _min

⚠️ Target cold ischemia time < 6 hours; PGD risk increases significantly when > 8 hours

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B.4 B.4 Emergency Contacts

📋 TSGH team contact information to be filled in:

Role	Name	Phone
Lead surgeon	__________	__________
Procurement surgeon	__________	__________
Transplant coordinator	__________	__________
Anesthesiology	__________	__________
ICU on-call	__________	__________
Organ procurement center	__________	__________

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📋 This checklist requires review and revision by the TSGH transplant team based on actual equipment and procedures.