Evaluating the translational value of postmortem brain reperfusion technology

A novel pulsatile-perfusion technology, dubbed BrainEx, has been shown to restore microcirculation and cellular functions in the pig brain, 4 h postmortem. This technology has generated enthusiasm for its translational value for human neuroresuscitation. I offer a critical analysis of the study and its methodology, providing several reasons for skepticism. This includes: all phenomena were observed at different degrees of hypothermia; the physiological and biochemical milieu of the experimental preparation is radically different than the clinical setting of hypoxic-ischemic brain injury; and the study is confounded by uncontrolled traumatic brain injury and lifelong stress in all the animals.