Donor management seems to be the most underestimated field in transplantology. Goals and principles of care of the organ donors remain unclear for the large population of intensive care unit employees. In Poland less than 50 anesthetists manages donors more than once a year. Principle of care is quite simple and easy to remember, maintain all vital parameters within physiological range. It needs attention and care, starting with the proper nursing care ending with advanced hemodynamic management and hormonal substitution. Proper donor management and compilation of good blood pressure and cardiac output, provides good organ condition and maximize organ availability. Aggressive management of organ donors is an early approach to prevention of hypotension using proper inotropic support and good fluid balance under surveillance of pulmonary artery catheter, hormonal substitution for maintaining electrolyte and metabolic balance, but first of all aggressive management is a complete change in mental approach to the donor management. There is not enough donors for the passive "old" standards of care, active and aggressive standard of care is the one among all, which can maximize the chance for recipient for being transplanted in present donor shortage situation.

Keywords: Organ donors