[Brain death: repercussion on the organs and tissues].
Brain death is accompanied by a series of hemodynamic, hormonal and inflammatory systemic effects that have an important repercussion on the economy of the organs and tissues. There is increasing evidence that the organs from brain death donors have an inflammatory response grade secondary to brain death and sometimes proportional to the intensity and rate of its progression. Both clinical and experimental studies have shown that the result of organs from heart arrest deceased donors or live donors have the same or better clinical results than those obtained in brain death donors and who have suffered the inflammatory process secondary to it. There is proof that this inflammatory response occurs in the lung, heart, kidneys, liver, intestine. Furthermore, the evidence also shows that the grade of inflammatory response observed in the organs has an important influence on the final outcome of the transplant. Consequently, the development of the knowledge regarding the pathways that interrelate brain death with the inflammatory organ response provides us with an important area of knowledge, which allow for future therapeutic strategies aimed at modulating the systemic response to brain death to improve the quality of the organs obtained for transplant and also to increase graft survival of the solid organ transplant recipients.
Domínguez-Roldán
J M
JM
Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España. jmdominguez@telefonica.net
García-Alfaro
C
C
Jimenéz-González
P I
PI
Hernández-Hazañas
F
F
Gascón Castillo
M L
ML
Egea Guerrero
J J
JJ
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D001926:Brain Death / Q000097:blood / Q000503:physiopathology*; D002102:Cadaver; D016207:Cytokines / Q000097:blood; D004298:Dopamine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D006085:Graft Survival; D006321:Heart / Q000503:physiopathology; D006323:Heart Arrest; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control; D007422:Intestines / Q000503:physiopathology; D007668:Kidney / Q000503:physiopathology; D008099:Liver / Q000503:physiopathology; D019520:Living Donors; D008168:Lung / Q000503:physiopathology; D009928:Organ Specificity; D011180:Postmortem Changes; D051381:Rats; D009927:Tissue and Organ Procurement
D000305:Adrenal Cortex Hormones; D016207:Cytokines; D004298:Dopamine