Tag Archives: brain-dead patients

Hypothalamic-pituitary axis disorder – “the puppet master” of multiple organ dysfunction in brain-dead patients

DOI: 10.2478/jccm-2021-0029

One of the most revolutionary discoveries of modern medicine was organ transplantation, as it brought hope and healing in cases that seemed incurable. Best outcomes in organ transplantation are related to a rigorous tissue typing and an appropriate immunosuppressant therapy that allowed a longer survival rate for recipients [1]. The management of the potential brain-dead donor is a complex one that involves several well-defined stages: early identification of potential donors, brain death determination, maintaining vital functions, and graft transplantation.
Brain death determination is synonymous with irreversible anatomical and functional injury to the entire brain and brainstem. This process involves a major alteration of the hemodynamic and hormonal homeostasis. Hypothalamic irreversible injury is followed by a profound normothermia dysregulation. The aggressive inflammatory response after brain death occurrence is responsible for capillary leakage and refractory hypotension [2]. Clinical diagnostic tests that assess brain death include brain stem areflexia, apnea, and cerebral unresponsiveness, linked with a known, irreversible cause of coma [3].[More]

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