**2. Brief history of multiorgan donation**

The era of organ transplantation was started successful kidney transplantation in the early 1950s. First organ donation from non-heart-beating donors was associated with successful liver transplantation by Thomas Starzl in 1963 [1]. First rare heart-beating donors without any hope of survival (not living donors) were those who underwent cardiac bypass but not able to detach from the heart-lung machine whose kidneys were used for transplantation before death in 1962 [2]. Next successful transplantation from heart-beating donors were done in 1964 in Sweden and in 1966 in United States from patients with irreversible brain damage under mechanical ventilation [2]. The term "cerebral death" was supposed by Swedish neurosurgeons in 1965 [3]. First series of successful liver transplantations from such "brain death" donors was done by Thomas Starzl in 1967–1968 and Professor Barnard do the first successful heart transplant in the same year from another brain-dead person [2]. At that time Barnard waited for cardiac asystole to prevent any negative debate for "brain death concept" in the community [4]. In the next decade many authorities in all the pioneer countries in transplantation made every effort to legally confirm the brain death patients as a potential donor and at last in 1971 the "Uniform Anatomical Gift Act" in Kansas was approved by the governor as a basis for globalization of legally "brain death concept" [5]. Development of multiple transplant teams in next decade resulted in first multiorgan retrieval procedures from the same donor in the 1980s [6, 7]. First heart-lung transplant was done in 1982 and first long term survived lung transplant alone was done in 1987 [8]. In the same era till the 1990s, successful combined transplantation such as liver combined with small bowel and other more complex multivisceral transplantation was developed by Thomas Starzl and his former fellow Andreas Tzakis [9]. Thanks to all the pioneers' efforts, now we have a near standard technique for multiorgan procurement from all stable brain-dead donors. Only the availability of all the team members and also the suitability of all the organs and suitable recipients are among the remaining obstacle such a complex procedure and multiorgan donation at the same time is a rule in most experienced transplant centers.
