Loss of his organs due to the initial insult or due to shock lasting for more than 30 minutes, except for corneal transplantation (look for special criteria for corneal transplantation).

Malignancy, confirmed or suspected (except primary brain tumor proved by brain biopsy and basal cell carcinoma of skin).

Unexplained or unknown disease.

Active generalized viral or bacterial infection.

HIV positive patients.

Hepatitis B and HTLV positive patients. **

Neurologic diseases: e.g., Reye's syndrome, slow virus diseases. e.g., Creutzfeldt-Jakob disease or subacute sclerosing panencephalitis, rabies or Kawasaki disease.

Narcotic addiction.

Donor has one of the problems mentioned under general criteria.

Creatinine is more than 2.5 mg/dl despite adequate fluid replacement. (consult Saudi Center for Organ Transplantation before deciding his "un-fitness" for donation).

Donor has chronic renal disease and/or uncontrolled chronic hypertension. Mild diabetic patients or patients with inactive SLE may be suitable for donation. Consult Saudi Center for Organ Transplantation in order to take suitable decision.

Presence of viral infections like hepatitis B or HIV.

If age of the donor is < 2 years or > 65 years, he is not fit to donate. If the donor age is unknown, decision is taken depending on his physiologic age, his past medical history and serum creatinine level. In all such cases the Saudi Center for Organ Transplantation should be consulted.

If the donor has one of the problems mentioned under general criteria.

Male donors should be less than 40 years of age and females less than 50 years. The Saudi Center for Organ Transplantation should be consulted in all cases. *

The heart should be normal on physical examination, ECG, chest X-ray and two dimensional echo assessment and cardiac enzymes should be within normal limits.

If the cadaveric donor is suffering from severe chest trauma injuring the heart.

If cold ischemia time exceeds 5 hours.

If donor has one of the problems mentioned under general criteria.

If the donor age exceeds 50 years for males and 55 years for females. The Saudi Center for Organ Transplantation should be consulted in all cases.

If the past medical history of the donor reveals evidence of chronic respiratory disease, or he was a smoker, or if he has had thoracic surgery knowing that a unilateral thoracic surgery does not affect the stability of the other lung, or if he has had bronchial disease or recurrent respiratory infections.

If the donor has had trauma that has caused injury to the lungs, exposure to toxic gases or fumes or aspiration of gastric contents.

If the lungs were abnormal by clinical evaluation. X-ray chest and blood gases examination performed after putting the patient on Fi02 of 100% with PEEP of 5 cm water for 5 minutes.

If the donor has purulent tracheobronchial secretions and Gr's stain and possibly culture reveals pathologic organisms.

If there is size incompatibility between donor and recipient.

If donor has one of the problems mentioned under general criteria.

If the donor has one of the problems mentioned under general criteria.

If there is any disease of his eye like a tumor, active conjunctivitis, any disease involving the cornea or iris, or if a previous surgical procedure has been performed on the eye, which has damaged the cornea.

If he has congenital rubeola.

If the time between donor cardiac arrest and corneal harvesting exceeds 12 hours.

Keep systolic blood pressure > 100 mm Hg in adults by giving appropriate fluids to keep CVP around 12 cm water and the use of vasopressors as needed. Dopamine singly or in combination with other vasopressors is considered to be the best choice.

Keep urine Output between 80 to 100 ml per hour and maintain balance between fluid intake and urine output.

Keep blood gases in the normal level (paO2 = 100 mm Hg, PaC02 =35mm Hg).

Keep acid-base status normal and maintain blood electrolytes in the normal range.

Diabetes insipidus is a common complication in these patients in which case vasopressin may be used if required, to keep urine output between 1.5 to 3 ml/kg/hr.

Prevent infection.

Maintain core temperature within the normal limits using either cooling or warming blankets.

The eyes of the organ donor should be kept closed and appropriate eye drops are used systematically.