manuseio do potencial doador de múltiplos órgãos care of the potential organ donor
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ID: 195090
2007
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Abstract
JUSTIFICATIVA E OBJETIVOS: O transplante de órgãos sólidos vem sendo considerado o tratamento de eleição para várias doenças terminais que afetam rim, pâncreas, fígado, coração e pulmão. Atualmente, o maior limitante às cirurgias dos transplantes é a escassez de órgãos. O objetivo deste estudo foi revisar aspectos fisiopatológicos da morte encefálica e resumir estratégias terapêuticas atuais, para o cuidado otimizado do doador, do que depende o sucesso dos transplantes. CONTEÚDO: A morte encefálica é uma síndrome inflamatória que pode rapidamente produzir alterações deletérias nos órgãos dos potenciais doadores. Esse contexto de instabilidade hemodinâmica, metabólica e eletrolítica, exige do intensivista cuidados especiais com o doador de múltiplos órgãos. CONCLUSÔES: O adequado conhecimento da complexa fisiopatologia envolvendo a morte encefálica é de fundamental importância para que se implemente de forma racional um protocolo de manuseio agressivo do potencial doador, o que certamente resultará num aumento de órgãos captados e do número de órgãos captados por doador, além da redução das taxas de disfunção primária dos enxertos transplantados.
BACKGROUND AND OBJECTIVES: Organ transplantation has long been considered the treatment of choice for many end-stage organ diseases. As soon as transplantation turned to be a viable therapy, organ shortage became the major limitation for the procedures. Nowadays, there is an increasing imbalance between organ supply and demand. Apparently, the most promising way to increase organ supply is optimizing the care for the brain death organ donor. The objective of this manuscript was to review the pathophysiological aspects and therapeutic strategies for the optimized care of the potential organ donor. CONTENTS: Brain death causes a massive catecholamine release, inducing a variety of deleterious effects that can threat organ perfusion. Studies have documented a sudden decrease in cortisol, insulin, thyroid and pituitary hormones. In this scenario of hemodynamic and metabolic instability, a special attention to the multiple organ donor support is required. CONCLUSIONS: An extensive knowledge of the complex brain death pathophysiology is extremely important for the implementation of rational aggressive management protocols of the potential organ donor, aiming to increase the number of harvested organs and the number of organs harvested per donor.
BACKGROUND AND OBJECTIVES: Organ transplantation has long been considered the treatment of choice for many end-stage organ diseases. As soon as transplantation turned to be a viable therapy, organ shortage became the major limitation for the procedures. Nowadays, there is an increasing imbalance between organ supply and demand. Apparently, the most promising way to increase organ supply is optimizing the care for the brain death organ donor. The objective of this manuscript was to review the pathophysiological aspects and therapeutic strategies for the optimized care of the potential organ donor. CONTENTS: Brain death causes a massive catecholamine release, inducing a variety of deleterious effects that can threat organ perfusion. Studies have documented a sudden decrease in cortisol, insulin, thyroid and pituitary hormones. In this scenario of hemodynamic and metabolic instability, a special attention to the multiple organ donor support is required. CONCLUSIONS: An extensive knowledge of the complex brain death pathophysiology is extremely important for the implementation of rational aggressive management protocols of the potential organ donor, aiming to increase the number of harvested organs and the number of organs harvested per donor.
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rech2007revistamanuseio
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| Authors | ;Tatiana H. Rech;Édison Moraes Rodrigues Filho |
| Journal | Database : the journal of biological databases and curation |
| Year | 2007 |
| DOI |
10.1590/S0103-507X2007000200010
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