Brain death and its influence on the lungs of the donor: how is it prevented?
The need for lung grafts is currently greater than ever. Unfortunately, the availability of grafts is insufficient for this demand. So we are forced to request organs for transplantation in the "waste bin." One possible solution to this problem may be the use of grafts from brain-dead patients. Sadly brain death is followed by devastating hemodynamic, inflammatory, and neurohumoral reactions in the potential donor which not only inflict direct damage, but also induce activation of the immune system which can cause rejection or even graft failure. Therefore, various groups have examined measures to prevent this outcome. In this review, we attempt to reconstruct the events that follow brain death, suggesting an algorithm to prevent a brain-dead patient's lungs from further damage. Finally, we are proposing potential measures of graft's protection of further investigation.
Faropoulos
K
K
Neurosurgery Department, University Hospital of Patras, University Campus, Rio, Patras Achaia 26504, Greece. stratisapostolakis@yahoo.gr
Apostolakis
E
E
D000818:Animals; D001921:Brain / Q000473:pathology; D001926:Brain Death / Q000473:pathology*; D002319:Cardiovascular System / Q000473:pathology / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D006728:Hormones / Q000097:blood / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007378:Interleukins / Q000378:metabolism; D007427:Intracranial Pressure; D008168:Lung / Q000473:pathology*; D016040:Lung Transplantation / Q000473:pathology* / Q000706:statistics & numerical data; D023421:Models, Animal; D009336:Necrosis; D014019:Tissue Donors / Q000706:statistics & numerical data*; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D006728:Hormones; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha