Indian Journal of Neurotrauma 2014; 11(02): 122-125
DOI: 10.1016/j.ijnt.2014.05.004
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Diagnosis of brain death and management of brain dead organ donor

Sanjith Saseedharan
a   Head, Department Intensive Care Unit, S.L. Raheja Hospital (A Fortis Associate), Mahim West, Mumbai, Maharashtra 400 016, India
,
Vaibhav Kubal
b   Senior Registrar, Department Intensive Care Unit, S.L. Raheja Hospital (A Fortis Associate), Mahim West, Mumbai, Maharashtra 400 016, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

12 March 2014

12 May 2014

Publication Date:
06 April 2017 (online)

Abstract

Care of a severe brain injury is one of the most daunting tasks in critical care and the importance of golden hour and quick treatment cannot be overemphasized while dealing with such patients.

On many occasions the severity of injury or the unfortunate incident of not getting timely help may see many a patient evolve to the condition of brain death. It is important to understand that brain death for all practical reasons is death and there is futility of medical science in the treatment of this condition which is a prerequisite for organ donation and transplantation.

Certification of brain death and thus facilitation of organ donation results in many patients getting a new lease of life. This article provides a concise but complete review of the diagnosis of brain death and the management of a brain death organ donor.

 
  • References

  • 1 A definition of irreversible coma. Report of the Ad Hoc Committee of the Harvard Medical School to examine the definition of brain death. JAMA 1968; Aug 5 205 (06) 337-340
  • 2 Gelb A.W., Robertson K.M.. Anaesthetic management of the brain dead for organ donation. Can J Anaesth 1990; Oct 37 (07) 806-812
  • 3 Schnuelle P., Gottmann U., Hoeger S.. et al Effects of donor pretreatment with dopamine on graft function after kidney transplantation: a randomized controlled trial. JAMA 2009; Sep 9 302 (10) 1067-1075
  • 4 Schnuelle P., Yard B.A., Braun C.. et al Impact of donor dopamine on immediate graft function after kidney transplantation. Am J Transplant 2004; Mar 04 (03) 419-426
  • 5 Schnuelle P., Berger S., de Boer J., Persijn G., van der Woude F.J.. Effects of catecholamine application to brain-dead donors on graft survival in solid organ transplantation. Transplantation 2001; Aug 15 72 (03) 455-463
  • 6 Stoica S.C., Satchithananda D.K., White P.A.. et al Noradrenaline use in the human donor and relationship with load-independent right ventricular contractility. Transplantation 2004; Oct 27 78 (08) 1193-1197
  • 7 Shemie S.D., Ross H., Pagliarello J.. et al Organ donor management in Canada: recommendations of the forum on Medical Management to Optimize Donor Organ Potential. CMAJ 2006; Mar 14 174 (06) S13-S32
  • 8 Rosengard B.R., Feng S., Alfrey E.J.. et al Report of the Crystal City meeting to maximize the use of organs recovered from the cadaver donor. Am J Transplant 2002; Sep 02 (08) 701-711
  • 9 Mascia L., Mastromauro I., Viberti S., Vincenzi M., Zanello M.. Management to optimize organ procurement in brain dead donors. Minerva Anestesiol 2009; Mar 75 (03) 125-133
  • 10 Totsuka E., Dodson F., Urakami A., Moras N., Ishii T.. et al Influence of high donor serum sodium levels on early postoperative graft function in human liver transplantation: effect of correction of donor hypernatremia. Liver Transpl Surg 1999; Sep 05 (05) 421-428
  • 11 Novitzky D., Cooper D.K., Rosendale J.D., Kauffman H.M.. Hormonal therapy of the brain-dead organ donor: experimental and clinical studies. Transplantation 2006; Dec 15 82 (11) 1396-1401
  • 12 Venkateswaran R.V., Patchell V.B., Wilson I.C., Mascaro J.G., Thompson R.D.. Early donor management increases the retrieval rate of lungs for transplantation. Ann Thorac Surg 2008; Jan 85 (01) 278-286 discussion 286
  • 13 Kotsch K., Ulrich F., Reutzel-Selke A., Pascher A., Faber W.. et al Methylprednisolone therapy in deceased donors reduces inflammation in the donor liver and improves outcome after liver transplantation: a prospective randomized controlled trial. Ann Surg 2008; Dec 248 (06) 1042-1050
  • 14 McLean K.M., Duffy J.Y., Pandalai P.K.. et al Glucocorticoids alter the balance between pro- and anti-inflammatory mediators in the myocardium in a porcine model of brain death. J Heart Lung Transplant 2007; Jan 26 (01) 78-84
  • 15 Kainz A., Wilflingseder J., Mitterbauer C.. et al Steroid pretreatment of organ donors to prevent postischemic renal allograft failure: a randomized, controlled trial. Ann Intern Med 2010; Aug 17 153 (04) 222-230