Our Summary

Mechanical circulatory support (MCS) is a set of tools used to aid blood circulation in people with heart failure. This research paper reviews how livers taken from brain-dead donors that were on MCS are used in transplants. The study evaluated 22 previous research papers, most of which were case reports. The researchers found that 156 liver transplants have been reported where the donor was on MCS. In most cases, the new liver functioned effectively almost 100% of the time. Only a 1% failure rate was reported. There have only been three successful liver transplants reported from donors who had a specific type of MCS called a ventricular assist device. The researchers suggest that more attention should be given to factors such as the donor’s heart health history, biochemical tests, and imaging, as well as the parameters of the MCS, to determine if the liver is suitable for transplant. They conclude that brain-dead patients on MCS should be more systematically considered as potential liver donors.

FAQs

  1. What is Mechanical Circulatory Support (MCS) and how is it used in organ transplantation?
  2. What was the success rate of liver transplants from brain-dead donors on MCS according to the study?
  3. What factors do the researchers suggest should be considered to determine the suitability of a liver for transplant?

Doctor’s Tip

A doctor might tell a patient undergoing brain surgery to follow all pre-operative instructions carefully, stay well-rested, and ask any questions or express any concerns they may have before the surgery. It’s also important to follow all post-operative care instructions, attend follow-up appointments, and communicate any changes or complications to their healthcare provider promptly. Additionally, it’s important to have a strong support system in place during the recovery process.

Suitable For

Patients who are typically recommended for brain surgery include those with:

  1. Brain tumors: Surgery may be recommended to remove tumors that are causing symptoms or are located in critical areas of the brain.

  2. Aneurysms: Surgery may be recommended to repair aneurysms that are at risk of rupturing and causing a potentially life-threatening bleed.

  3. Epilepsy: Surgery may be recommended for patients with epilepsy that cannot be controlled with medication, in order to remove the area of the brain that is causing seizures.

  4. Traumatic brain injury: Surgery may be recommended to remove blood clots or repair damage to the brain caused by a traumatic injury.

  5. Hydrocephalus: Surgery may be recommended to place a shunt to drain excess cerebrospinal fluid from the brain.

  6. Parkinson’s disease: Deep brain stimulation surgery may be recommended for patients with Parkinson’s disease who are not responding well to medication.

  7. Brain abscess: Surgery may be recommended to drain an abscess in the brain caused by infection.

  8. Cerebral hemorrhage: Surgery may be recommended to remove a blood clot or repair damaged blood vessels in the brain.

Overall, brain surgery is typically recommended for patients with conditions that cannot be effectively treated with medication or other non-invasive treatments. The decision to undergo brain surgery is made on a case-by-case basis, taking into consideration the specific condition, the patient’s overall health, and the potential risks and benefits of the procedure.

Timeline

  • Before brain surgery:
  1. Patient experiences symptoms that require medical attention, such as seizures, headaches, or changes in mental status.
  2. Patient undergoes diagnostic tests, such as MRI or CT scans, to determine the cause of their symptoms.
  3. Patient consults with a neurosurgeon to discuss the possibility of brain surgery and the risks and benefits involved.
  4. Patient undergoes pre-operative preparations, such as blood tests, imaging studies, and medication adjustments.
  • After brain surgery:
  1. Patient is monitored closely in the intensive care unit immediately following surgery.
  2. Patient may experience side effects such as pain, swelling, or changes in cognitive function.
  3. Patient undergoes physical therapy and rehabilitation to regain strength and function.
  4. Patient receives follow-up care and monitoring to ensure proper healing and recovery.
  5. Patient may need ongoing therapy or medication to manage any long-term effects of the surgery.

What to Ask Your Doctor

  1. What specific type of brain surgery will I be undergoing?
  2. What are the potential risks and complications associated with this surgery?
  3. How long will the recovery process be, and what can I expect in terms of pain management?
  4. Are there any alternative treatments or options available besides surgery?
  5. What is the success rate for this type of brain surgery?
  6. Will I need any additional treatments or therapies after the surgery?
  7. How will this surgery impact my overall quality of life and daily functioning?
  8. What can I do to help prepare for the surgery and optimize my chances for a successful outcome?
  9. Are there any long-term effects or considerations I should be aware of after the surgery?
  10. Are there any specific lifestyle changes or precautions I should take post-surgery to support my recovery?

Reference

Authors: De Carlis R, Buscemi V, Checchini G, Frassoni S, Bagnardi V, Pagnanelli M, Lauterio A, De Carlis L. Journal: Transpl Int. 2021 Jan;34(1):5-15. doi: 10.1111/tri.13766. Epub 2020 Oct 28. PMID: 33037727