[Donor heart preservation].
Heart transplantation is a common procedure for patients with severe heart failure and shortage of donor organs is a significant problem even in Europe and USA. We, anesthesiologists, contribute to transplantation by anesthetic management of a donor and it is essential to maintain cardiac function until the organ harvest for successful organ transplantation. Since cardiac dysfunction occurrs following brain death, it is clinically important to find some interventions to maintain the cardiac function or to delay cardiac deterioration following brain death. We investigated the cardiac function following experimental brain death in rats. Experimental brain death was induced by inflating intracranial balloon. Ejection fraction and dP/dt max significantly decreased earlier than significant blood pressure reduction after brain death. In addition, myocardial sensitization to epinephrine was enhanced following brain death. Preconditioning is a unique phenomenon to prevent cardiac function from ischemic insult. Volatile anesthetics, including sevoflurane and isoflurane, have similar effects in preconditioning. We expect volatile anesthetics to improve cardiac function following brain death due to preconditioning effect.
Hayashi
Yukio
Y
Department of Anesthesiology, Osaka University Medical School, Suita.
Iwasaki
Mitsuo
M
D000818:Animals; D001926:Brain Death / Q000503:physiopathology; D016027:Heart Transplantation; D006801:Humans; D009926:Organ Preservation / Q000379:methods*; D051381:Rats; D014019:Tissue Donors; D019172:Transplantation Conditioning