title: Endocrine changes in brain death and transplantation.
abstract: Following brain death (BD) many hormonal changes occur. These include an increase and then a fall in the levels of circulating catecholamines, reduced levels of anti-diuretic hormone and cortisol as well as alterations in the hypothalamic-pituitary thyroid axis consistent with the non-thyroidal illness syndrome. In an era when the numbers of potential recipients listed for transplantation are greater than the number of donors, with an increasing donor age, a detailed knowledge of the endocrine changes and pathophysiological consequences of these is essential to optimise the management of the brain-stem dead organ donor. There still remains significant debate as to whether hormone replacement therapy to correct the observed changes is beneficial.
authors.affiliation: Department of Cardiac Surgery, UHB NHS FT, Edgbaston, Birmingham B15 2TH, UK.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Ranasinghe
authors.forename: Robert S
authors.initials: RS
authors.lastname: Bonser
mesh_terms: D000818:Animals; D001926:Brain Death / Q000503:physiopathology*; D004703:Endocrine System / Q000502:physiology* / Q000503:physiopathology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology / Q000503:physiopathology; D016377:Organ Transplantation / Q000639:trends; D010913:Pituitary-Adrenal System / Q000502:physiology / Q000503:physiopathology; D014019:Tissue Donors