[Endocrinological management in patients with irreversible loss of brain function prior to organ donation].

Organ donation is often the only treatment option for patients with severe, life-threatening organ insufficiencies. The precondition for organ donation in Germany is the irreversible loss of brain function (ILB). When ILB occure, multiple changes in the organism take place, including the endocrinological system. Organ-protective therapy includes all essential organ systems and, in addition to differentiated volume and catecholamine therapy, lung-protective ventilation and the maintenance of homeostasis with regard to the acid-base balance, electrolytes and also the endocrinological system. Endocrinological management is of equal importance to hemodynamic management in the context of organ-protective therapy. In some cases, endocrinological changes in severe brain damage also determine the hemodynamic situation. This means that endocrinological dysfunctions must be treated even before an ILB is diagnosed. In the most severe cerebral pathologies and then also with the onset of ILB, multiple pathophysiological changes in the endocrinological system usually take place. These changes then also require specific therapy. The changes are complex and include the dysfunction of the hypothalamic-pituitary axis and the destruction of the vagus nuclei. This results in significant endocrinological changes. This article is intended to provide a brief overview of the post-mortem changes and the possibilities of therapy in the context of organ-protective treatment of endocrinological changes prior to organ donation.