Ventricular Dysfunction Associated With Brain Trauma Is Cause for Exclusion of Young Heart Donors

Godino, M.; Lander, Matthew; Cacciatore, Angela; Perez-Protto, Silvia; Mizraji, R.

doi:10.1016/j.transproceed.2010.04.022

Cited by 9 publications

(8 citation statements)

References 9 publications

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“…Renal transplant outcomes are adversely affected by cerebrovascular causes of BD [54, 55]. Lung transplant is unaffected by donor cause of death [56], while heart transplant outcomes remain controversial [57, 58]. For this reason, it is important to consider the pathophysiologic responses to severe central nervous system injury, and their systemic sequelae, prior to brain death.…”

Section: Stage One Of Potential Organ Injury: Brain Injurymentioning

confidence: 99%

Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury

Watts

Thom

Fraser

2013

Journal of Transplantation

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Brain death is associated with dramatic and serious pathophysiologic changes that adversely affect both the quantity and quality of organs available for transplant. To fully optimise the donor pool necessitates a more complete understanding of the underlying pathophysiology of organ dysfunction associated with transplantation. These injurious processes are initially triggered by catastrophic brain injury and are further enhanced during both brain death and graft transplantation. The activated inflammatory systems then contribute to graft dysfunction in the recipient. Inflammatory mediators drive this process in concert with the innate and adaptive immune systems. Activation of deleterious immunological pathways in organ grafts occurs, priming them for further inflammation after engraftment. Finally, posttransplantation ischaemia reperfusion injury leads to further generation of inflammatory mediators and consequent activation of the recipient's immune system. Ongoing research has identified key mediators that contribute to the inflammatory milieu inherent in brain dead organ donation. This has seen the development of novel therapies that directly target the inflammatory cascade.

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Section: Stage One Of Potential Organ Injury: Brain Injurymentioning

confidence: 99%

Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury

Watts

Thom

Fraser

2013

Journal of Transplantation

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“…Cardiac dysfunction, even in the absence of a prior history of heart disease, is the most common cause for rejecting a heart for transplantation [3,4], and is seen in up to 42 % of patients with brain death [5][6][7]. Different causes of brain death have shown no influence on prevalence and severity of cardiac dysfunction in smaller studies [5,8]. In brain death donors, evidence indicates that donors with cardiac dysfunction can recover to normal function over time leading to successful transplantation outcomes [2,9].…”

Section: Introductionmentioning

confidence: 99%

Temporal Changes in Left Ventricular Systolic Function and Use of Echocardiography in Adult Heart Donors

et al. 2015

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“…While cardiac dysfunction after brain death has been described in a variety of brain injury paradigms,[ 8 ] it has not been well described after TBI in the pediatric population, although the pathophysiology may be similar. As most neurologic causes of brain death in the pediatric population tend to occur after trauma,[ 9 ] patients with severe TBI and brain death make a large proportion of pediatric patients presenting for possible organ donation. [ 10 ] To understand the association between TBI-induced brain death and cardiac function, we examined the incidence of cardiac dysfunction among severe pediatric TBI patients, both with and without a diagnosis of brain death.…”

Section: Introductionmentioning

confidence: 99%

Cardiac dysfunction following brain death after severe pediatric traumatic brain injury: A preliminary study of 32 children

Krishnamoorthy

Prathep

Sharma

et al. 2015

Int J Crit Illn Inj Sci

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Background:Cardiac dysfunction after brain death has been described in a variety of brain injury paradigms but is not well understood after severe pediatric traumatic brain injury (TBI). Cardiac dysfunction may have implications for organ donation in this patient population.Materials and Methods:We conducted a retrospective cohort study of pediatric patients with severe TBI, both with and without a diagnosis of brain death, who underwent echocardiography during the first 2 weeks after TBI, between the period of 2003–2011. We examined cardiac dysfunction in patients with and without a diagnosis of brain death.Results:In all, 32 (2.3%) of 1,413 severe pediatric TBI patients underwent echocardiogram evaluation. Most patients had head abbreviated injury score 5 (range 2–6) and subdural hematoma (34.4%). Ten patients with TBI had brain death compared with 22 severe TBI patients who did not have brain death. Four (40%) of 10 pediatric TBI patients with brain death had a low ejection fraction (EF) compared with 1 (4.5%) of 22 pediatric TBI patients without brain death who had low EF (OR = 14, P = 0.024).Conclusions:The incidence of cardiac dysfunction is higher among pediatric severe TBI patients with a diagnosis of brain death, as compared to patients without brain death. This finding may have implications for cardiac organ donation from this population and deserves further study.

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Ventricular Dysfunction Associated With Brain Trauma Is Cause for Exclusion of Young Heart Donors

Cited by 9 publications

References 9 publications

Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury

Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury

Temporal Changes in Left Ventricular Systolic Function and Use of Echocardiography in Adult Heart Donors

Cardiac dysfunction following brain death after severe pediatric traumatic brain injury: A preliminary study of 32 children

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