Changes in Hemodynamic and Metabolic Parameters Following Induced Brain Death in the Pig

Pm, Mertès; K, el Abassi; Jaboin, Y.; Burtin, P.; Pinelli, G; Jp, Carteaux; Burlet, C.; Boulangé, M; Jp, Villemot

doi:10.1097/00007890-199408270-00004

Cited by 109 publications

(57 citation statements)

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“…As mentioned before small differences between groups may not be adequately expressed. The effect of DGF on graft survival of HBD kidneys and NHBD kidneys may be completely different (33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

Outcome of Nonheart‐Beating Donor Kidneys with Prolonged Delayed Graft Function after Transplantation

Renkens¹,

Rouflart²,

Christiaans³

et al. 2005

American Journal of Transplantation

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Nonheart-beating donor (NHBD) kidneys are frequently associated with delayed graft function (DGF), with a deleterious effect on kidney function and allograft survival. The influence and the duration of DGF on the outcome of NHBD kidneys are assessed. All recipients of an NHBD kidney in the period 1993-2003 were reviewed. Excluded from analysis were patients with primary nonfunction (PNF).One hundred and five patients with a functioning NHBD graft were reviewed: 23 (22%) had immediate function (group 1), 40 (38%) had DGF ≤ 2 weeks (group 2), 31 (30%) had DGF 15 days to 4 weeks (group 3) and 11 (10%) had DGF for >4 weeks (group 4). Creatinine clearance at 3 months was higher in groups 1 and 2 versus group 4 (p = 0.015 and p = 0.006, respectively) and was higher in group 2 versus group 4, at 1 year (p = 0.01). Graft survival was 95%, 98%, 97% and 89%, respectively, at 1 year and 95%, 85%, 77% and 89%, respectively, at 5 years, which was not significantly different.The duration of DGF in NHB kidneys has a negative effect on creatinine clearance, but no effect on graft survival.

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Section: Discussionmentioning

confidence: 99%

Outcome of Nonheart‐Beating Donor Kidneys with Prolonged Delayed Graft Function after Transplantation

Renkens¹,

Rouflart²,

Christiaans³

et al. 2005

American Journal of Transplantation

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“…Severe alterations have been described in several organs after BD. This has been associated with marked macrocirculatory changes (6,16,17) caused by progressive deterioration in brain function, with loss of central neurohormonal regulatory control of vital functions (18). Macrocirculation can decisively influence microcirculation, which itself is a determining factor in organ quality and graft viability.…”

Section: Discussionmentioning

confidence: 99%

Brain Death Impairs Pancreatic Microcirculation

Obermaier

Dobschuetz

Keck

et al. 2004

American Journal of Transplantation

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Brain death (BD) influences the quality of donor grafts in transplantation. To evaluate the impact of BD on pancreas grafts, we investigated the influence of BD on the microcirculation and histology of the pancreas in a rat model of explosive BD. A group of Wistar rats (n = = 7), rendered brain dead by inflating an intracranially inserted Fogarty catheter was compared with controls (CO) using intravital epifluorescence-microscopy over 4 h after BD induction; functional capillary density (FCD), leukocyte adherence (AL) in post-capillary venules, histology and pancreatic enzymes were investigated. Four hours after BD, FCD decreased (333 ± 11 vs. baseline 444 cm/cm 2 ± 5 SEM; p < 0.01) and showed lower values than CO (388 ± 9 p < 0.01). In BD, AL was increased (628 cells/mm 2 ± 110 SEM vs. baseline 123 ± 32, and vs. CO 180 ± 33; p < 0.001). BD caused increased histological damage (CO 1.6 scorepoints ± 0.7 SD vs. BD 8.3 ± 7.1; p < 0.05). Amylase was higher in BD (p < 0.05) but did not reach pathological values. We show for the first time that BD causes relevant changes in pancreatic microcirculation, histology and leukocyte endothelial interaction which might have a serious impact on the function of grafts. New strategies for preventing this damage are therefore highly desirable in order to improve the outcome of pancreas transplantation.

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“…However, hypervolemia may aggravate right ventricular dysfunction 80 and cause rapid deterioration of lung function. 81,82 The goal should therefore be to achieve normovolemia if thoracic organs are to be harvested. On the other hand, kidney function seems to benefit from a more aggressive fluid regimen, 83 making it necessary to balance the antagonistic interests of organs related to fluid resuscitation.…”

Section: Hemodynamic Managementmentioning

confidence: 99%

Brain death and its implications for management of the potential organ donor

Bugge

2009

Acta Anaesthesiol Scand

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The systemic physiologic changes that occur during and after brain death affect all organs suitable for transplantation. Major changes occur in the cardiovascular, pulmonary, endocrine, and immunological systems, and, if untreated may soon result in cardiovascular collapse and somatic death. Understanding these complex physiologic changes is mandatory for developing effective strategies for donor resuscitation and management in such a way that the functional integrity of potentially transplantable organs is maintained. This review elucidates these physiological changes and their consequences, and based on these consequences the rationale behind current medical management of brain-dead organ donors is discussed.

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Changes in Hemodynamic and Metabolic Parameters Following Induced Brain Death in the Pig

Cited by 109 publications

References 0 publications

Outcome of Nonheart‐Beating Donor Kidneys with Prolonged Delayed Graft Function after Transplantation

Outcome of Nonheart‐Beating Donor Kidneys with Prolonged Delayed Graft Function after Transplantation

Brain Death Impairs Pancreatic Microcirculation

Brain death and its implications for management of the potential organ donor

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