УРОВЕНЬ КОРТИЗОЛА У ПОТЕНЦИАЛЬНЫХ ДОНОРОВ ОРГАНОВ

Abstract

Currently, the need for the administration of corticosteroids to restore the normal adrenal function in patients with brain death (BD) in order to condition the functional systems before organ harvesting remains unclear. Objectives. To analyze the level of cortisol in potential donors with brain death before harvesting their organs and tissues for transplantation. Material and methods. A prospective pilot study included 60 patients with brain death. The average age of a patient with brain death was 53.5 (48.5; 58.5) years, males - 32 (53.3%) years, females - 28 (46.7%) years. The causes of brain death were: intracerebral hemorrhage - in 30 (50%) patients, traumatic brain injury - in 10 (16.7%) patients, subarachnoid hemorrhage - in 7 (11.7%) patients, cerebral infarction - in 13 (21.6%) patients. The level of cortisol in the blood was determined by the method of radioimmune assay using a set of reagents UP «PP IBC NAS of Belarus» ( Minsk, Republic of Belarus). Results. The cortisol level in patients with BD was 422.8 (216.7; 687.1) nmol/L. The level of cortisol was lower than the reference values in 11 (18.3%) patients with BD, and higher - in 12 (20%) patients. There were no differences between the groups in terms of cortisol level in the following parameters: arterial blood pressure, heart rate, frequency of vasopressors use, dose of vasopressors, time from the patient’s admission to the moment of BD diagnosis, time of observation of a potential donor between two examinations of the council, the number of organs being harvested for transplantation. Conclusions. In potential donors with brain death with low cortisol level, the indices of arterial blood pressure and the doses of injected vasopressors did not statistically significantly differ from those in donors with normal and elevated cortisol level.