Current opinion in anaesthesiology · 2025
Critical care for deceased liver donors.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Arrigo Gabriele, Barberis Luigi, Garrino Paola Maria, Zanza Christian, Racca Fabrizio
Аннотация
PURPOSE OF REVIEW: In this article, we review the ICU management of donors after brain death, with a particular focus on liver donors.
RECENT FINDINGS: The demand for transplantable organs far exceeds the available supply, making it crucial to optimize both the quantity and quality of organ procurement. Following brain death, the focus of critical care shifts from patient survival to organ preservation for transplantation. Hemodynamic instability and elevated serum sodium levels have been linked to poorer liver transplant outcomes.
SUMMARY: Organs are primarily obtained from donors declared dead based on neurological or circulatory criteria. In this article, we focus on brain-dead donors. The physiological changes that occur after brain death can compromise organ function. Intensivists must recognize these alterations, as some may require targeted treatment. In particular, the primary objective of intensive care management in these patients is to mitigate these changes through supportive measures, including hemodynamic stabilization, endocrine therapy, respiratory and temperature management. These interventions are essential for preserving the function of transplanted organs and optimizing transplantation outcomes. Liver donors should be treated similarly to other organ donors, with particular regard to serum sodium level and adequate volume replacement.
RECENT FINDINGS: The demand for transplantable organs far exceeds the available supply, making it crucial to optimize both the quantity and quality of organ procurement. Following brain death, the focus of critical care shifts from patient survival to organ preservation for transplantation. Hemodynamic instability and elevated serum sodium levels have been linked to poorer liver transplant outcomes.
SUMMARY: Organs are primarily obtained from donors declared dead based on neurological or circulatory criteria. In this article, we focus on brain-dead donors. The physiological changes that occur after brain death can compromise organ function. Intensivists must recognize these alterations, as some may require targeted treatment. In particular, the primary objective of intensive care management in these patients is to mitigate these changes through supportive measures, including hemodynamic stabilization, endocrine therapy, respiratory and temperature management. These interventions are essential for preserving the function of transplanted organs and optimizing transplantation outcomes. Liver donors should be treated similarly to other organ donors, with particular regard to serum sodium level and adequate volume replacement.