Barklin A
Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Noerrebrogade 44, Aarhus C, Denmark.
Acta Anaesthesiol Scand. 2009 Apr;53(4):425-35. doi: 10.1111/j.1399-6576.2008.01879.x. Epub 2009 Feb 18.
Brain death itself impairs organ function in the potential donor, thereby limiting the number of suitable organs for transplantation. In addition, graft survival of kidneys obtained from brain-dead (BD) donors is inferior to that of kidneys obtained from living donors. Experimental studies confirm an inferior graft survival for the heart, liver and lungs from BD compared with living donors. The mechanism underlying the deteriorating effect of brain death on the organs has not yet been fully established. We know that brain death triggers massive circulatory, hormonal and metabolic changes. Moreover, the past 10 years have produced evidence that brain death is associated with a systemic inflammatory response. However, it remains uncertain whether the inflammation is induced by brain death itself or by events before and after becoming BD. The purpose of this study is to discuss the risk factors associated with brain death in general and the inflammatory response in the organs in particular. Special attention will be paid to the heart, lung, liver and kidney and evidence will be presented from clinical and experimental studies.
脑死亡本身会损害潜在供体的器官功能，从而限制了适合移植的器官数量。此外，从脑死亡（BD）供体获取的肾脏移植存活率低于从活体供体获取的肾脏。实验研究证实，与活体供体相比，BD供体的心脏、肝脏和肺的移植存活率较低。脑死亡对器官产生恶化作用的潜在机制尚未完全明确。我们知道，脑死亡会引发大规模的循环、激素和代谢变化。此外，过去十年已有证据表明，脑死亡与全身炎症反应有关。然而，炎症是由脑死亡本身引起，还是由成为BD之前和之后的事件引起，仍不确定。本研究的目的是探讨一般与脑死亡相关的危险因素，尤其是器官中的炎症反应。将特别关注心脏、肺、肝脏和肾脏，并将展示来自临床和实验研究的证据。
