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2 results

  • 8.5 - Physiological Support of the Organ Donor

  • from Section 8 - End-of-Life Care
  • Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
  • Book:
    Intensive Care Medicine
    Published online:
    27 July 2023
    Print publication:
    01 December 2021, pp 683-685

  • Summary

    Key Learning Points

    1. 1. Any patient likely to progress to brain death is a potential organ donor.

    2. 2. Severe raised intracranial pressure and brain death are associated with various organ system consequences.

    3. 3. Optimising the physiological status of a potential donor is an active process and may require escalation of monitoring and therapies.

    4. 4. Donor management improves the quality of donated organs.

    5. 5. Care bundles for the management of brain-dead organ donors are available.

  • A porcine model to study the effect of brain death on kidney genomic responses

  • Mitchell B. Sally, Darren J. Malinoski, Frank P. Zaldivar, Tony Le, Matin Khoshnevis, William A. Pinette, Michael Hutchens, Shlomit Radom-Aizik
  • Journal:
    Journal of Clinical and Translational Science / Volume 2 / Issue 4 / August 2018
    Published online by Cambridge University Press:
    30 October 2018, pp. 208-216
    • Article
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  • Introduction

    A majority of transplanted organs come from donors after brain death (BD). Renal grafts from these donors have higher delayed graft function and lower long-term survival rates compared to living donors. We designed a novel porcine BD model to better delineate the incompletely understood inflammatory response to BD, hypothesizing that adhesion molecule pathways would be upregulated in BD.

    Methods

    Animals were anesthetized and instrumented with monitors and a balloon catheter, then randomized to control and BD groups. BD was induced by inflating the balloon catheter and animals were maintained for 6 hours. RNA was extracted from kidneys, and gene expression pattern was determined.

    Results

    In total, 902 gene pairs were differently expressed between groups. Eleven selected pathways were upregulated after BD, including cell adhesion molecules.

    Conclusions

    These results should be confirmed in human organ donors. Treatment strategies should target involved pathways and lessen the negative effects of BD on transplantable organs.