Contents

1. Principles of Brain Death Diagnosis 1

Marwan S. Abouljoud, Marlon F. Levy

Introduction 1

Historical Background 1

Clinical Diagnosis of Brain Death 4

Confirmatory Tests for Brain Death 8

Conclusion 12

2. Approaching the Family 14

Jerome Menendez, Tammie S. Peterson, Alison B. Smith

Approaching the Family 14

Phase 1-Identification and Referral of the Potential Donor 15

Phase 2-Predonation Family Evaluation 16

Phase 3-Understanding Brain Death 18

Phase 4-The Grieving Process 20

Phase 5-Presenting The Option 23

Phase 6-Aftercare of the Family 27

3. Physiologic Consequences of Brain Death 31

Dimitri Novitzky

Introduction 31

Histological Changes 35

Endocrine Changes 38

The Impact of Brain Death on the Hemodynamic and Metabolic Functions, the Role of Hormonal Replacement 39

Hormonal Therapy in the Brain Dead Organ Donors 43

Discussion 43

4. Assessing Suitability of the Cadaver Donor 47

Giuliano Testa, Goran B. Klintmalm

Introduction 47

Defining the Donor 48

Living Donors 48

The Cadaveric Donor 50

The Marginal Donor 58

Non-Heart-Beating Donors 59

5. Organ Preservation 63

James H. Southard

Introduction 63

Brief Historical Perspective on Organ Preservation 63

Principles of Organ Preservation 66

Delayed Graft Function and Chronic Rejection 73

Future of Organ Preservation 74

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