Brain death: Challenges and management

Brain death is associated with complex hemodynamic, endocrine, and metabolicdysfunction that can lead to major complications in potential donors. Cardiovascularcollapse resulting from arrhythmias and hypotension, pulmonary edema, acidemia, anddisseminated intravascular coagulopathy are well known complications of brain death.Studies have demonstrated a significant increase in the number of organs procured perdonor with a rapid brain-death determination protocol and aggressive resuscitation guidedby intensive monitoring.Brain death is an irreversible end of all brain activity associated with profoundphysiological disturbances resulting in diffuse vascular and cellular injury. A protocoldrivenapproach by a dedicated organ donor management team is the key component tomanage these complex physiological changes for successful organ procurement.This chapter discusses the complications associated with brain death, andmanagement options for successful organ procurement.