title: [Brain death, physiopathology, optimal care and hormonal therapy for cardiac donation].
abstract: Heart transplantation goes on leading the standard therapy for the terminal heart failure. The success of this procedure and the post-transplantation survival, meaning during the perioperative time, is variable because of the good performance of the donor graft, due to this situation, the pre-harvesting evaluation is very important. The brain death brought many changes: 1) first of all the "adrenergic storm" with its hemodynamic and cardiac dangerous events; 2) Thyroidal hormones, cortisol, vasopressin, and seric insulin depletion with its metabolic consequences respectively. Since 2002 during the Crystal Consensus started the using of the hormonal therapeutic with triyodothironine, vasopressin and metilprednisolone for improving, meaning those limitrophes ones, the performance donor hearts with brain death, and the goal has been to harvest more donated organs en quality and numbers. This hormonal therapeutic has had great acceptation and is successful; having more harvesting of solids organs: hearts, lungs and kidneys; with more performance and surviving at 1 year post-transplantation and less mortality. Our Hospital began the hormonal therapeutic since January 2011with excellent results. On this basis we can concluded that, hormonal rescue therapy, improves the availability and performance of organs for transplantation.
authors: Departamento de Cirugía Cardiotorácica y Soporte Cardiopulmonar de la UMAE, Hospital General Dr. Gaudencio González Garza, Centro Médico Nacional La Raza, IMSS D.F. México, México.
authors: Hugo
authors: H
authors: Zetina-Tun
authors: Carlos
authors: C
authors: Lezama-Urtecho
authors: Rafael
authors: R
authors: Urías-Báez
authors: Guillermo
authors: G
authors: Careaga-Reyna
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000465:Algorithms; D001919:Bradycardia / Q000209:etiology; D001926:Brain Death / Q000503:physiopathology; D004703:Endocrine System / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology; D006333:Heart Failure / Q000601:surgery; D016027:Heart Transplantation; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007328:Insulin / Q000627:therapeutic use*; D019586:Intracranial Hypertension / Q000209:etiology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D020858:Tissue and Organ Harvesting / Q000379:methods* / Q000592:standards; D014284:Triiodothyronine / Q000627:therapeutic use*; D014667:Vasopressins / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000517:prevention & control
chemical_list: D000305:Adrenal Cortex Hormones; D007328:Insulin; D014284:Triiodothyronine; D014667:Vasopressins