Chudoba Paweł, Krajewski Wojciech, Wojciechowska Joanna, Kamińska Dorota
Department of Vascular, General and Transplant Surgery, Wroclaw Medical University, Poland.
Department of Urology and Oncological Urology, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2017 Dec;26(9):1457-1464. doi: 10.17219/acem/65068.
At present, organ transplantation is the most efficient treatment of end-stage failure of various organs, including the heart, lungs, pancreas, intestines, kidney, and liver. Despite the efforts to use organs from living donors or from donors after circulatory death, most of the organs are recovered from brain dead (BD) donors.
The Medline and Web of Science databases were searched without time limit on November 2015 using the terms "brain dead donor" and "deceased donor" in conjunction with "transplantation", "graft", "organ", "hemodynamic", "hormonal", or "management". The search was limited to the English, Polish and Spanish literature. Articles that did not address the topics were excluded and the full text of the remaining articles was reviewed.
It is well established that brain death is associated with a cascade of hemodynamic, inflammatory, and immunologic events that affect the outcome of transplanted organs. Proper management of the potential organ donor may help increase the supply of organs for transplantation. However, because there is a lack of good quality evidence, it is difficult to establish specific BD donor management guidelines.
In this paper we present a review of studies and literature concerning the detrimental impact of donor brain death on graft function. We present pathologic changes that take place after brain death, their influence on graft quality and therapeutic solutions to enhance transplanted organ function.
目前，器官移植是治疗包括心脏、肺、胰腺、肠道、肾脏和肝脏在内的各种器官终末期衰竭最有效的方法。尽管人们努力使用活体供体或循环死亡后供体的器官，但大多数器官还是从脑死亡（BD）供体获取的。
2015年11月，在Medline和科学网数据库中进行检索，不限时间，使用“脑死亡供体”和“已故供体”与“移植”“移植物”“器官”“血流动力学”“激素”或“管理”等词结合进行检索。检索限于英文、波兰文和西班牙文文献。未涉及这些主题的文章被排除，其余文章的全文进行了回顾。
众所周知，脑死亡与一系列影响移植器官结局的血流动力学、炎症和免疫事件相关。对潜在器官供体进行恰当管理可能有助于增加移植器官的供应。然而，由于缺乏高质量证据，很难制定具体的脑死亡供体管理指南。
在本文中，我们对有关供体脑死亡对移植物功能的有害影响的研究和文献进行了综述。我们介绍了脑死亡后发生的病理变化、它们对移植物质量的影响以及增强移植器官功能的治疗方案。
