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G J Brandon Bravo Bruinsma, J J Bredee, T J C Ruigrok, C J A Van Echteld
Ann Transplant 2000; 5(4): 36-40
Many heart transplant clinicians are inclined to reject the heart of a hemodynamically unstable brain dead donor for heart transplantation because graft survivalis reduced [1-3].The precise mechanisms of brain deathrelated hemodynamic instability remain unknown. Beside the disturbance of the endocrine homeostasis and vascular resistance, it has been reported to originate from myocardial injury resulting from the release of endogenous catecholamines during the onset of brain death [4,5]. Myocardial injury has been supposed to change aerobic to anaerobic energy metabolism causing depletion of myocardial high-energy phosphates and contractile dysfunction...