Brain death

• Regulated cell death and DAMPs as biomarkers and therapeutic targets in normothermic perfusion of transplant organs. Part 1: their emergence from injuries to the donor organ
• Brain-Death in Rats Increases Neutrophil Extracellular Trap Formation in Donor Organs
• Impact of portal vein thrombosis grade and donor characteristics on biliary complications after liver transplantation: A risk stratification framework
• Normothermic regional perfusion in donation after circulatory death compared with brain dead donors: Single-center cardiac allograft outcomes
• From Referral to Consent: Unveiling Racial Disparities at Critical Stages of Pediatric Organ Donation
• Large-for-Size Graft in Cadaveric Liver Transplantation: Application of BSA (Body Surface Area) for Prompt Evaluation
• New methods for improving pancreas preservation
• Attitudes toward organ donation among university students in the United Arab Emirates: a cross-sectional survey

https://n.neurology.org/content/74/23/1911

The cause of the cessation of brain activity (CBA) can usually be determined by a combination of medical history, physical examination, laboratory tests and imaging studies.

The declaration of “death by neurological criteria” (DNC) also referred to as brain death (BD), understood in the sense of whole BD, and not in the sense of brain stem death or higher BD—is an established medicolegal practice throughout the United States and in many countries worldwide

Brain death determination.

The World Brain Death Project

see Computed tomography angiography for brain death.

Changes in S100B protein, especially the levels of this dimer 48 hours after trauma can be used as marker to predict brain death. Alongside other known prognostic factors such as age, GCS and diameters of the pupils, however, this factor individually can not conclusive predict the patient's clinical course and incidence of brain death. However, it is suitable to use GCS, CT scan, clinical symptoms and biomarkers together for a perfect prediction of brain death ¹⁾.

Near-Infrared Spectroscopy for Brain death

The practicability of Gadolinium-enhanced magnetic resonance angiography to confirm cerebral circulatory arrest was assessed after the diagnosis of brain death in 15 patients using a 1.5 Tesla MRI scanner. In all 15 patients extracranial blood flow distal to the external carotid arteries was undisturbed. In 14 patients no contrast medium was noted within intracerebral vessels above the proximal level of the intracerebral arteries. In one patient more distal segments of the anterior and middle cerebral arteries (A3 and M3) were filled with contrast medium. Gadolinium-enhanced MRA may be considered conclusive evidence of cerebral circulatory arrest, when major intracranial vessels fail to fill with contrast medium while extracranial vessels show normal blood flow ²⁾.

The level of knowledge of medical students at Centro Universitário Lusíada - UNILUS- Santos (SP), Brazil, regarding brain death and transplantation is limited, which could be the result of inadequate education during medical school ³⁾.

Brain death criteria.

A 41-year-old man was admitted to hospital due to sudden loss of consciousness. A regional brain perfusion SPECT/low-dose CT showed abnormal 99mTc-HMPAO uptake in the right hemisphere frontotemporally without any other supratentorial or infratentorial radiotracer uptake. A neuropathological examination disclosed a middle cerebral artery aneurysm. Presumably, vessel wall fibrosis prevented collapse. Multiple transmural dissections of the fibrotic aneurysmal wall were the source of the subarachnoid hemorrhage. This interesting image shows that radiotracer accumulation in cerebral artery aneurysms can be a diagnostic pitfall in brain death scintigraphy assessment ⁴⁾

Decompressive craniectomy as a potentially reversible condition in brain death-brain stunning or skin and pericranium stretching? ⁵⁾.

In a editorial, Hibi et al., aimed to provide an outline of the world history of liver transplantation (LT), with a special focus on the innovation, development, and current controversies of living donor (LD) LT from East Asian and Western perspectives. In 1963, Starzl et al. (University of Colorado, U.S.) performed the world's first human LT for a 3-year-old child with biliary atresia. The donor was a 3-year-old patient who had suffered from brain death following neurosurgery. ⁶⁾.