title: Pharmacological strategy designed to limit ischemia-reperfusion injury in brain dead donor kidneys.
abstract: Ischemia-reperfusion injury is a complex physiological process responsible for delayed renal function or primary graft non-function, explicitly when kidney allograft are issued from expanded criteria donor. The purpose of this review is to detail the detrimental phenomenons altering kidney allograft's integrity in brain dead donor, therefore suggesting pharmacological interventions aiming to reduce ischemia-reperfusion injuries and improving transplantation outcome. This ischemia-reperfusion phenomenon must therefore be anticipated through the whole procedure starting at the stage of conditioning of the potential donor. Hormonal and haemodynamic consequences of brain death modify perfusion and oxygenation conditions of the organs Thus, after describing the autonomic, metabolic, endocrine and chemokine storm occurring during brain death, the authors focus on strategies to prevent hemodynamic instability in the donor and to limit the consequences of hormonal and immunological changes on organs that will eventually be transplanted.
authors.affiliation: Service d'Urologie, CHU de Nantes - Hôtel-Dieu, 1 place Alexis Ricordeau, 44093 Nantes Cedex 1, France. Electronic address: julienbranchereau@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Branchereau
authors.affiliation: INSERM, U1087, Ischémie-reperfusion en transplantation d'organe : mécanismes et innovations thérapeutiques, Poitiers ; université de Poitiers, faculté de Médecine et de Pharmacie, 86021 Poitiers, France.
authors.forename: B
authors.initials: B
authors.lastname: Barrou
mesh_terms: D001926:Brain Death; D018890:Chemoprevention; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D016030:Kidney Transplantation; D015427:Reperfusion Injury / Q000517:prevention & control*; D014019:Tissue Donors
keywords: Actions Pharmacologic; Actions pharmacologiques; Brain Death; Hemodynamics; Hémodynamique; Ischemia-Reperfusion Injury; Ischémie-reperfusion; Kidney transplantation; Mort Cérébrale; Transplantation rénale