Brain death hormone therapy and Graft survival: a systematic review of the literature

 Marzieh Latifi, Farzaneh Bagherpour, Habib Rahban, Elahe Pourhossein, Sanaz Dehghani^*

Abstract

Introduction: During brain death a number of Events occur including hormonal, metabolic and systemic changes. The aim of this systematic review is to find the role of hormone therapy in the cadaver donors and its impact on graft function and/or survival following solid organ transplantation.

Method and materials: Randomized clinical trials were reviewed to investigate the effects of hormone therapy on graft survival amongst brain death cases. studies from Medline, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were identified and reviewed for this current work. In total, 18 studies met inclusion criteria and were rated. Two reviewers rated the respective study quality independently.

Results: Over 2235 titles were retrieved from various search sources and 16 full papers were identified for possible inclusion. Trial sample sizes varied widely from 25 to 12333 patients. Multiple therapy schemes were developed and applied for brain death donors. The first scheme simply involved applying Triiodothyronine, Dopamine, immunosuppressive, Vasopressin and Desmopressin separately. The second scheme consisted of applying double hormone therapy using Methylprednisolone and vasopressin simultaneously. Finally, triple hormone therapy was applied which included methylprednisolone, triiodothyronine and arginine vasopressin.

Conclusions: All in all, results from the present systematic reviews showed that the brain death hormone therapy use does not have a detrimental effect on overall survival organ recipients. It therefore is logical to attempt to further investigate more the positive effects of hormone therapy in brain death scenarios

Keywords: Brain death, Hormone therapy, Graft survival

https://doi.org/10.1016/j.tpr.2022.100098