• Efstratios Apostolakis, Haralambos Parissis, and Dimitrios Dougenis.
• University of Patras Medical School, Patras, Greece.
• J Card Surg. 2010 Jan 1; 25 (1): 98-106.

AimIn this article, the hemodynamic, humoral, and immunological perturbations following brain death (BD) are going to be discussed in a stepwise manner.Materials And MethodsBD produces derangements in cardiac function, through a not-yet-well-explained mechanism. Using literature review, we attempted to delineate the "pathophysiology" involved.ResultsA severe a-adrenergic stimulation following catecholamine storm results in conditions such that the pulmonary capillary pressure is massively increased. Furthermore, cytokine up-regulation, endothelial expression molecules, and neutrophil infiltration produce tissue damage. The end result reflects myocardial necrosis due to reduction of the calcium ATPase activity that leads to myocyte calcium overload and cell death.ConclusionsDelineation of the mechanisms responsible for donor heart dysfunction (DHD) would be presented. Furthermore, an attempt would be made to apply this knowledge into the clinical practice in order to increase the suitability of donor hearts for transplantation.

17 keywords...

hide…