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The Influence of Brain Death and Intensive Care Management on Donor Organs: Assessment of Inflammatory Markers

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The Brain-Dead Organ Donor

Abstract

The observation that kidney transplants from living donors have superior short- and long-term outcome compared to kidneys donated after brain death prompted research into the events surrounding brain death. Experiments in animals have clearly demonstrated that brain death is associated with a systemic inflammatory response that affects the peripheral organs. A number of studies have demonstrated that brain death results in the release of cytokines and chemokines leading to activation of endothelium and leukocyte recruitment into various organs. These changes have important consequences, such as increasing the immunogenicity of the organ, amplifying reperfusion injury and increasing the incidence of acute rejection following transplantation. Importantly, other experiments and recent clinical evidence shows that strategies designed to reduce the inflammatory response result in improved graft outcome following transplantation. In an era of organ shortage, more organs from marginal donors are used for transplantation; minimizing additional injury related to brain death may potentially increase the number and quality of organs for transplantation.

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Authors and Affiliations

  1. Institute of Liver Studies, King’s College Hospital, King’s College London, London, UK

    Wayel Jassem M.D., Ph.D.

  2. Nuffield Department of Surgical Sciences, Oxford Transplant Centre, University of Oxford, Oxford, UK

    Susan V. Fuggle M.Sc., D.Phil., F.R.C.Path.

Authors
  1. Wayel Jassem M.D., Ph.D.
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  2. Susan V. Fuggle M.Sc., D.Phil., F.R.C.Path.
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Correspondence to Susan V. Fuggle M.Sc., D.Phil., F.R.C.Path. .

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Editors and Affiliations

  1. Tampa VA Medical Center, Surgery, University of South Florida, Bruce B. Downs Blvd 12901, Tampa, 33612, Florida, USA

    Dimitri Novitzky

  2. Thomas E. Starzl Transplantation Institu, Department of Surgery, University of Pittsburgh Medical Center, Lothrop Street 200, Pittsburgh, 15213, Pennsylvania, USA

    David K C Cooper

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Jassem, W., Fuggle, S.V. (2013). The Influence of Brain Death and Intensive Care Management on Donor Organs: Assessment of Inflammatory Markers. In: Novitzky, D., Cooper, D. (eds) The Brain-Dead Organ Donor. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4304-9_10

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  • DOI: https://doi.org/10.1007/978-1-4614-4304-9_10

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