Update of recommendations for the treatment of the adult and pediatric cadaveric donor after brain death. A Narrative Review

Abstract

The purpose of this review is to provide a practical and critical overview of the general interventions and specific aspects of the treatment of the potential cadaveric organ donor after brain death (BD), so as to increase the possibilities of a successful transplant. Members of the “Comité de Trasplante y Procuración de Órganos y Tejidos” of the “Sociedad Argentina de Terapia Intensiva”, adress seven areas on the subject, making a narrative review of each section. Most of the stated recommendations are based on the extrapolation of evidence on the general management of patients in intensive care units, or on specific pathophysiological reasoning for BD. This is due to the lack of randomized controlled trials on the subject, which generate solid evidence for their optimal treatment. Therefore, research in this direction should be encouraged, in order to better understand the pathophysiology and the correct treatment measures in potential donors, which allow us to optimize the use of organs for transplantation.