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Published on: April 17, 2020
Endocrine changes in brain death and transplantation.
Aaron M Ranasinghe1, Robert S Bonser
1Department of Cardiac Surgery, UHB NHS FT, Edgbaston, Birmingham B15 2TH, UK.
Best Practice & Research. Clinical Endocrinology & Metabolism
|September 20, 2011
Summary
Brain death (BD) causes significant hormonal shifts, impacting organ donor management. Hormone replacement therapy
Area of Science:
- Endocrinology
- Transplantation Medicine
- Critical Care
Background:
- Brain death (BD) triggers complex hormonal dysregulation.
- Hormonal changes include catecholamine fluctuations, reduced antidiuretic hormone and cortisol, and altered thyroid axis function.
- These endocrine alterations are critical in the context of organ donation, especially with increasing donor age.
Purpose of the Study:
- To detail the endocrine changes following brain death.
- To understand the pathophysiological consequences of these hormonal alterations.
- To inform the optimization of brain-stem dead organ donor management.
Main Methods:
- Review of hormonal changes post-brain death.
- Analysis of endocrine axis alterations (catecholamines, ADH, cortisol, thyroid).
- Discussion of implications for organ donor management and transplantation.
Main Results:
- Brain death is associated with increased then decreased catecholamines.
- Reduced levels of antidiuretic hormone and cortisol are observed.
- Hypothalamic-pituitary thyroid axis changes resemble non-thyroidal illness syndrome.
Conclusions:
- Understanding endocrine changes in brain death is crucial for optimizing organ donor management.
- The efficacy of hormone replacement therapy in brain-dead organ donors remains a subject of debate.
- Further research is needed to clarify the benefits of hormone replacement therapy in this context.
