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"Brain death"

K Ganapathy
Until six decades ago, death was considered to be a specific point in time, referring to the moment at which life ends. With the availability of ventilators, even determining when death has occurred is becoming difficult, as cessation of life functions is often not simultaneous across organ systems. With increasing accessibility to intensive care units (ICUs) even in Tier II and Tier III cities, and the government making it mandatory to notify brain death to facilitate cadaveric organ transplants, it behooves the neurosurgeon and neurologist to totally understand the minutiae of brain death...
March 2018: Neurology India
A C Van Erp, R A Rebolledo, D Hoeksma, N R Jespersen, P J Ottens, R Nørregaard, M Pedersen, C Laustsen, J G M Burgerhof, J C Wolters, J Ciapaite, H E Bøtker, H G D Leuvenink, B Jespersen
Hepatic and renal energy status prior to transplantation correlates with graft survival. However, effects of brain death (BD) on organ-specific energy status are largely unknown. We studied metabolism, perfusion, oxygen consumption, and mitochondrial function in the liver and kidneys following BD. BD was induced in mechanically-ventilated rats, inflating an epidurally-placed Fogarty-catheter, with sham-operated rats as controls. A 9.4T-preclinical MRI system measured hourly oxygen availability (BOLD-related R2*) and perfusion (T1-weighted)...
March 13, 2018: Scientific Reports
B Palkoci, M Vojtko, J Fialová, D Osinová, M Lajčiaková
Background: Collection of kidneys from extended criteria donors (ECD) with diagnosed brain-death forms a part of the collection program that increases the number of transplantations. Objective: To compare the results of ECD with those of standard criteria donors (SCD). Methods: In a retrospective analysis in a group of 156 kidney donors, we identified ECD donors. We detected the basic parameters of the donors before kidney collection, and then evaluated the function of the graft, the survival of the graft, and the survival of the patients after 1, 3, and 5 years of transplantation...
2018: International Journal of Organ Transplantation Medicine
Pelin Corman Dincer, Deniz Birtan, Mustafa Kemal Arslantas, Gulbin Tore Altun, Hilmi Omer Ayanoglu
OBJECTIVES: Organ donation is the most important stage for organ transplant. Studies reveal that attitudes of families of brain-dead patients toward donation play a significant role in their decision. We hypothesized that supporting family awareness about the meaning of organ donation, including saving lives while losing a loved one, combined with being informed about brain death and the donation process must be maintained by intensive care unit physicians through standardized interviews and questionnaires to increase the donation rate...
March 2018: Experimental and Clinical Transplantation
Erzsebet Polyak, Julian Ostrovsky, Min Peng, Stephen D Dingley, Mai Tsukikawa, Young Joon Kwon, Shana E McCormack, Michael Bennett, Rui Xiao, Christoph Seiler, Zhe Zhang, Marni J Falk
Oxidative stress is a known contributing factor in mitochondrial respiratory chain (RC) disease pathogenesis. Yet, no efficient means exists to objectively evaluate the comparative therapeutic efficacy or toxicity of different antioxidant compounds empirically used in human RC disease. We postulated that pre-clinical comparative analysis of diverse antioxidant drugs having suggested utility in primary RC disease using animal and cellular models of RC dysfunction may improve understanding of their integrated effects and physiologic mechanisms, and enable prioritization of lead antioxidant molecules to pursue in human clinical trials...
February 23, 2018: Molecular Genetics and Metabolism
Mehrzad Kiani, Mahmoud Abbasi, Mehdi Ahmadi, Bahare Salehi
Organ transplantation is a new issue in medical science. It is an important achievement and a sign of the progression and ability of medical centers around the world. Governments, populations, the medical community and people involved in culture, art, and media all have a decisive role in the culture of organ donation, which is the only way to guarantee that the healthy organs of a brain-dead person can continue to work and save the lives of people in need of organ transplantation. The brain death phenomenon and its possible application in organ transplantation, while offering new hope for the salvation of a number of patients, has led to many ethical, cultural, and legal issues...
March 5, 2018: Journal of Clinical Medicine
Jessica Lindemann, Leigh Anne Dageforde, Neeta Vachharajani, Emily Stahlschmidt, Diane Brockmeier, Jason R Wellen, Adeel Khan, William C Chapman, Majella Doyle
BACKGROUND: Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. DCD program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported. STUDY DESIGN: Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected...
March 2, 2018: Journal of the American College of Surgeons
Qi Cheng, Kunal Patel, Biao Lei, Lindsay Rucker, D Patterson Allen, Peng Zhu, Chentha Vasu, Paulo N Martins, Martin Goddard, Satish N Nadig, Carl Atkinson
Donor brain death (BD) is an inherent part of lung transplantation (LTx) and a key contributor to ischemia-reperfusion injury (IRI). Complement activation occurs as a consequence of BD in other solid organ Tx and exacerbates IRI, but the role of complement in LTx has not been investigated. Here, we investigate the utility of delivering nebulized C3a receptor antagonist (C3aRA) pre-Transplant to BD donor lungs in order to reduce post-LTx IRI. BD was induced in Balb/c donors, and lungs nebulized with C3aRA or vehicle 30 minutes prior to lung procurement...
March 5, 2018: American Journal of Transplantation
Geisiane Custódio, Patrícia Schwarz, Daisy Crispim, Rafael B Moraes, Mauro Czepielewski, Cristiane B Leitão, Tatiana H Rech
BACKGROUND: Vitamin D insufficiency is linked to several common inflammatory disorders. Brain death (BD) causes a massive catecholamine release, leading to intense inflammatory activity. We aimed to evaluate vitamin D serum levels in brain-dead individuals in comparison to critically ill patients without BD to assess the correlation between vitamin D and cytokine levels. METHODS: Sixteen brain-dead patients and 32 critically ill controls were prospectively enrolled...
February 28, 2018: Transplant Immunology
Gonzalo Sirgo, Federico Esteban, Josep Gómez, Gerard Moreno, Alejandro Rodríguez, Lluis Blanch, Juan José Guardiola, Rafael Gracia, Lluis De Haro, María Bodí
BACKGROUND: Big data analytics promise insights into healthcare processes and management, improving outcomes while reducing costs. However, data quality is a major challenge for reliable results. Business process discovery techniques and an associated data model were used to develop data management tool, ICU-DaMa, for extracting variables essential for overseeing the quality of care in the intensive care unit (ICU). OBJECTIVE: To determine the feasibility of using ICU-DaMa to automatically extract variables for the minimum dataset and ICU quality indicators from the clinical information system (CIS)...
April 2018: International Journal of Medical Informatics
Aravinda Page, Simon Messer, Stephen R Large
Fifty years since the first successful human heart transplant from a non-heart beating donor, this concept of heart transplantation from donation after circulatory determined death (DCD) promises to be one of the most exciting developments in heart transplantation. Heart transplantation has established itself as the best therapeutic option for patients with end-stage heart failure, with the opportunity to provide these patients with a near-normal quality of life. However, this treatment is severely limited by the availability of suitable donor hearts...
January 2018: Annals of Cardiothoracic Surgery
Rongtao Zhu, Weizhi Guo, Hongbo Fang, Shengli Cao, Bing Yan, Sanyang Chen, Kaiming Zhang, Shuijun Zhang
Brain death (BD) impairs liver function in potential donors, and is associated with hormonal and metabolic changes or molecular effects with pro‑inflammatory activation. Resident macrophages in the liver named Kupffer cells (KCs) undergo pro‑ or anti‑inflammatory pathway activation, which affects liver function. However, the role of the KCs in liver dysfunction following BD has not been fully elucidated. The aim of the present study was to investigate the role of KCs in liver dysfunction in the context of BD and the effects of their inhibition by gadolinium chloride (GdCl3)...
February 27, 2018: Molecular Medicine Reports
Ariane Lewis, Jonathan Howard, Amanda Watsula-Morley, Colleen Gillespie
OBJECTIVE: Medical student knowledge about brain death determination is limited. We describe an educational initiative to improve medical student awareness about brain death and assess the impact of this initiative. SUBJECTS AND METHODS: Beginning in July 2016, students at our medical school were required to attend a 90-min brain death didactic and simulation session during their neurology clerkship. Students completed a test immediately before and after participating in the initiative...
February 2, 2018: Clinical Neurology and Neurosurgery
Shaifali Sandal, Xun Luo, Allan B Massie, Steven Paraskevas, Marcelo Cantarovich, Dorry L Segev
Background: The use of machine perfusion (MP) in kidney transplantation lowers delayed graft function (DGF) and improves 1-year graft survival in some, but not all, grafts. These associations have not been explored in grafts stratified by the Kidney Donor Profile index (KDPI). Methods: We analyzed 78 207 deceased-donor recipients using the Scientific Registry of Transplant Recipients data from 2006 to 2013. The cohort was stratified using the standard criteria donor/expanded criteria donor (ECD)/donation after cardiac death (DCD)/donation after brain death (DBD) classification and the KDPI scores...
February 20, 2018: Nephrology, Dialysis, Transplantation
Thaddeus Mason Pope
No abstract text is available yet for this article.
July 2017: Journal of Legal Medicine
Vaishaly K Bharambe, Vasanti U Arole, Vatsalaswamy Puranam, Preeti P Kulkarni, Prashant B Kulkarni
Organ shortage is the greatest challenge facing the field of organ transplantation today. We aimed to study the attitude and knowledge toward body and organ donation among people in rural India. The present study was conducted in a rural town called Lanja, in the Konkan region of Maharashtra in India. A questionnaire covering demographic data, knowledge, and attitude of the participants was distributed to 400 students, middle-aged and senior citizens; 91.5% of the respondents were aware about organ donation...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Won Joo Jeong, Jae Seung Bang, Kyu Sun Yum, Sangkil Lee, Inyoung Chung, O-Ki Kwon, Chang Wan Oh, Beom Joon Kim, Hee-Joon Bae, Moon-Ku Han
Brain herniation is most often the result of severe brain swelling and can rapidly lead to death or brain death. We retrospectively identified radiologic indicators to evaluate the effects of targeted temperature management (TTM) on the extent of cerebral edema and determine the cutoff values that best predict TTM outcomes in patients with large hemispheric infarction. We retrospectively reviewed brain computed tomography (CT) scans of 21 patients with large hemispheric infarctions, who were treated with TTM...
February 15, 2018: Therapeutic Hypothermia and Temperature Management
Paweł Chudoba, Wojciech Krajewski, Joanna Wojciechowska, Dorota Kamińska
BACKGROUND: 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. METHODS: 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"...
December 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Pei-Hsun Sung, Fan-Yen Lee, Ling-Chun Lin, Kuan-Hung Chen, Hung-Sheng Lin, Pei-Lin Shao, Yi-Chen Li, Yi-Ling Chen, Kun-Chen Lin, Chun-Man Yuen, Hsueh-Wen Chang, Mel S Lee, Hon-Kan Yip
We tested the hypothesis that melatonin prevents brain death (BD) tissue extract (BDEX)-induced cardiac damage by suppressing inflammatory damage-associated molecular pattern (DAMP) signaling in rats. Six hours after BD induction, levels of a DAMP component (HMGB1) and inflammatory markers (TLR-2, TLR-4, MYD88, IκB, NF-κB, IL-1β, IFN-γ, TNF-α and IL-6) were higher in brain tissue from BD animals than controls. Levels of HMGB1 and inflammatory markers were higher in BDEX-treated H9C2 cardiac myoblasts than in cells treated with healthy brain tissue extract...
January 9, 2018: Oncotarget
Mahmoud Abbasi, Mehrzad Kiani, Mehdi Ahmadi, Bahare Salehi
Organ transplantation is an effective process that prolongs the lives of individuals suffering from incapacitating conditions. The aim of this study was to evaluate the view point of medical students in Iran regarding ethical aspects and knowledge on organ transplantation and donation. The participants included 165 medical students from different faculties of Shahid Beheshti University of Medical Sciences, Tehran, Iran. They were assessed using a reliable questionnaire that examined their ethical aspects and knowledge regarding organ transplantation and donation...
January 31, 2018: Cellular and Molecular Biology
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