Korean J Crit Care Med.  2012 Nov;27(4):286-289. 10.4266/kjccm.2012.27.4.286.

Successful Brain Dead Donor Management with CRRT: A Case Report

• Lim SH
• Lee YJ
• Joe HB
• Lee JM
• Lee IK

• KMID: 2227960
• DOI: http://doi.org/10.4266/kjccm.2012.27.4.286

Abstract

Brain death results in adverse pathophysiologic effects in many brain-dead donors with cardiovascular instability. We experienced a brain-dead donor with continuous renal replacement therapy (CRRT) who was in a severe metabolic, electrolyte derangement and poor pulmonary function. The thirty-nine-year-old male patient with subarachnoid hemorrhage and intraventricular hemorrhage was admitted into the intensive care unit (ICU). After sudden cardiac arrest, he went into a coma state and was referred to as a potential organ donor. When he was transferred, his vital sign was unstable even under the high dose of inotropics and vasopressors. Even with aggressive treatment, the level of blood sugar was 454 mg/dl, serum K+ 7.1 mEq/L, lactate 5.33 mmol/L and PaO2/FiO2 60.3. We decided to start CRRT with the mode of continuous venovenous hemodiafiltration (CVVHDF). After 12 hours of CRRT, vital sign was maintained well without vasopressors, and blood sugar, serum potassium and lactate levels returned to 195 of PaO2/FiO2. Therefore, he was able to donate his two kidneys and his liver.

Keyword

brain-dead donor; continuous renal replacement therapy; potential organ donor

MeSH Terms

Blood Glucose
Brain
Brain Death
Coma
Death, Sudden, Cardiac
Hemodiafiltration
Hemorrhage
Humans
Intensive Care Units
Kidney
Lactic Acid
Liver
Male
Potassium
Renal Replacement Therapy
Subarachnoid Hemorrhage
Tissue Donors
Vital Signs
Blood Glucose
Lactic Acid
Potassium