BACKGROUND AND OBJECTIVES: Organ transplantation has long been considered the treatment of choice for many end-stage organ diseases. As soon as transplantation turned to be a viable therapy, organ shortage became the major limitation for the procedures. Nowadays, there is an increasing imbalance between organ supply and demand. Apparently, the most promising way to increase organ supply is optimizing the care for the brain death organ donor. The objective of this manuscript was to review the pathophysiological aspects and therapeutic strategies for the optimized care of the potential organ donor. CONTENTS: Brain death causes a massive catecholamine release, inducing a variety of deleterious effects that can threat organ perfusion. Studies have documented a sudden decrease in cortisol, insulin, thyroid and pituitary hormones. In this scenario of hemodynamic and metabolic instability, a special attention to the multiple organ donor support is required. CONCLUSIONS: An extensive knowledge of the complex brain death pathophysiology is extremely important for the implementation of rational aggressive management protocols of the potential organ donor, aiming to increase the number of harvested organs and the number of organs harvested per donor.
Brain death; Hormonal therapy; Organ donor; Organ transplantation
