Ann Thorac Surg 1995;60:54
© 1995 The Society of Thoracic Surgeons
Discussion
 |
Introduction
|
|---|
 Top
 Introduction
|
|---|
See also page 47.
DR DAVIS C. DRINKWATER, JR (Los Angeles, CA): I am at a little bit of a loss to see the real importance of this enormous study, as similar information has been obtained in animals that are closer to the human. Extensive work with the Chacma baboon demonstrated severely depressed myocardial function associated with brain death. All of our donors are brain dead, and some have myocardial effects. We and others have developed protocols, such as triiodothyronine, to treat them. It seems to me that resuscitation during the critical hours of dysfunction is the key intervention and may determine whether or not to use that particular donor. Have you thought about a preoperative intervention or resuscitation in your model?
DR BITTNER: Thanks for these very important remarks. In the past, extensive studies have been performed to investigate the effects of brain death on donor organ function. However, in none of these studies was brain death validated; brain death was only assumed or diagnosed by electroencephalographic tracings or by nonoccurrence or disappearance of brain stem reflexes, which is questionable in experimental studies, as all the animals required anesthesia.
In previous studies, right ventricular function has never been scrutinized. To our knowledge, this is the first attempt to evaluate the important function of the right ventricle for posttransplantation performance or failure. As we all know, in the transplant business, the right ventricle is the prominent ventricle in terms of function for the first 6 to 7 days.
The next step is to evaluate possible interventions. We would like to replicate previous results obtained from pharmacologic interventions such as the administration of thyroid and pituitary hormones in these animal models.
