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[Hormone modulation of organ donor. Utility of the steroids]. / Modulación hormonal del donante de órganos. Utilidad de los esteroides.
Michelena, Juna C; Chamorro, Carlos; Falcón, Juan A; Garcés, Sandra.
Afiliação
  • Michelena JC; Coordinación Nacional de Trasplantes de la República de Cuba, Cuba.
Med Intensiva ; 33(5): 251-5, 2009.
Article em Es | MEDLINE | ID: mdl-19625000
Recently, the work group made up of the National Transplant Organization (Organización Nacional de Trasplantes, ONT), Spanish Society of Intensive, Critical Medicine and Coronary Units (Sociedad Española de Medicina Intensiva, Crítica y de Unidades Coronarias, SEMICYUC) and other Scientific Societies have recommended using 15 mg/kg of methyl prednisolone during the management of lung donors after brain death. This recommendation is based on descriptive and retrospective studies. However, the review of different experimental and clinical studies also suggests a potential benefit of using steroids in either thoracic or abdominal organ donors during management strategies. In brain death management, early steroid administration may decrease cytokine production and also may prevent alterations induced by proinflammatoy mediators, stabilize cell membranes, reduce expression of cell surface adhesion molecules and avoid lipid peroxidation after the ischemic period. This could be beneficial in increasing number and quality of organs harvested and in decreasing rejection episodes after transplant. It would be very recommendable to carry out prospective and comparative studies to demonstrate these potential utilities. Meanwhile and knowing the deleterious effects of inflammatory activity arising during and after brain death, we recommend using 15 mg/kg of methyl prednisolone in the organ donor management, as soon as possible. The potential benefit of its immunomodulation effects, its low cost and the absence of major side effects can justify this recommendation.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doadores de Tecidos / Glucocorticoides Tipo de estudo: Guideline / Observational_studies Limite: Humans Idioma: Es Revista: Med Intensiva Ano de publicação: 2009 Tipo de documento: Article País de afiliação: Cuba País de publicação: Espanha
Buscar no Google
Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doadores de Tecidos / Glucocorticoides Tipo de estudo: Guideline / Observational_studies Limite: Humans Idioma: Es Revista: Med Intensiva Ano de publicação: 2009 Tipo de documento: Article País de afiliação: Cuba País de publicação: Espanha