Brain death and donor heart dysfunction: implications in cardiac transplantation
| Autor: | Haralambos Parissis, Efstratios Apostolakis, Dimitrios Dougenis |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Pulmonary and Respiratory Medicine
Cardiac function curve Pathology medicine.medical_specialty Brain Death Necrosis Heart Diseases medicine.medical_treatment Hemodynamics Catecholamines Receptors Adrenergic beta Medicine Myocyte Humans Heart transplantation business.industry Myocardium Organ Preservation Pathophysiology Tissue Donors Transplantation Cytokine Heart Transplantation Surgery medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Journal of cardiac surgery. 25(1) |
| ISSN: | 1540-8191 |
| Popis: | Aim: In this article, the hemodynamic, humoral, and immunological perturbations following brain death (BD) are going to be discussed in a stepwise manner. Materials and Methods: BD produces derangements in cardiac function, through a not-yet-well-explained mechanism. Using literature review, we attempted to delineate the “pathophysiology” involved. Results: A severe a-adrenergic stimulation following catecholamine storm results in conditions such that the pulmonary capillary pressure is massively increased. Furthermore, cytokine up-regulation, endothelial expression molecules, and neutrophil infiltration produce tissue damage. The end result reflects myocardial necrosis due to reduction of the calcium ATPase activity that leads to myocyte calcium overload and cell death. Conclusions: Delineation of the mechanisms responsible for donor heart dysfunction (DHD) would be presented. Furthermore, an attempt would be made to apply this knowledge into the clinical practice in order to increase the suitability of donor hearts for transplantation.(J Card Surg 2010;25:98-106) |
| Databáze: | OpenAIRE |
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