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The county coroner in your area (or medical examiner in some instances) is responsible for overseeing all deceased human bodies. If foul play is suspected as to the etiology of death or if the patient is a minor ( http://www.selleckchem.com/products/erastin.html Otherwise, an accelerated process is undertaken and the body is placed into the custody of either the funeral home and/or the hospital morgue. In our experience, multiple meetings at the coroner's office were necessary for the establishment of a protocol for interhospital brain-dead donor transport. Each protocol will differ if perhaps donor transport is within the county or if donor consent is obtained at a community hospital within the same health system. Finally, different approvals are required when donor http://www.selleckchem.com/products/3-deazaneplanocin-a-dznep.html transport crosses a state border, which entails the local coroner office having to contact the coroner's office of the state where donor consent was originally signed. Full logistical understanding beforehand will expedite this complicated process. Exact details should also be preestablished for medical transportation (i.e. ground vs. airplane). An ICU physician should be preselected to serve as the accepting staff for the transfer of the beating-heart, brain-dead facial organ donor (preferably admitted to a neurosurgical ICU). We recommend using a different primary attending and separate http://www.selleck.cn/products/pf-06463922.html surgical ICU for the recipient's direct admission, so that the two families (donor and recipient) are not coinciding prematurely. By having both patients in the same locale, concomitant recovery of the donor's facial organ along with the recipient's preparation for transplantation can be done efficiently in neighboring operating rooms. Obviously, this is of tremendous value, since many times preparation of the recipient's craniofacial defect overlaps with the time needed to recover the donor alloflap. This particular process can be quite intricate in detail and adjustments to your original surgical plan may be required (24,25). Therefore, having the option of various surgeons walking between the two operating rooms for the purpose of observing each other's simultaneous progress is invaluable. Face transplantation has progressed tremendously since the first partial allotransplant was performed by Dubernard et al. in 2005 (2). A total of nine patients have since followed and the results have been relatively successful. Early postoperative reports regarding aesthetic and functional outcomes are promising (3). However, two recent face transplant-related deaths highlight the importance of patient selection and compliance with regards to immunosuppression, extreme psychological stability/social support, aggressive rehabilitation therapy and constant patient motivation to succeed (8,9,32).