DOI: https://doi.org/10.22263/2312-4156.2024.4.44
A.L. Lipnitski1,2, А.V. Marochkov1,2
The analysis of the C-reactive protein dynamics in donors with brain death
1Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus
2Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2024;23(4):44-50.
Abstract.
A high level of C-reactive protein (CRP) in a potential donor may be a consequence of either the presence of a serious infection or the pathogenesis of an existing underlying disease and brain death (BD).
Objectives. To study the dynamics of C-reactive protein level in potential donors before harvesting the organs and tissues for transplantation.
Material and methods. A prospective pilot study included 219 brain-dead patients. The age of the donors was 54 (41; 61) years, men – 132 (60.3%), women – 87 (39.7%). The diagnoses leading to BD were: intracerebral hemorrhage (n=114 (58%)), cerebral infarction (n=31 (16%)), traumatic brain injury (n=35 (18%)), subarachnoid hemorrhage (n=9 (5%)), posthypoxic encephalopathy (n=6 (3%)). To determine the level of CRP content, a biochemical analyzer AU 680 (Bechman Coulter, USA) and the method of immunoturbidimetric analysis were used. Reference values for serum CRP levels are 0-5 mg/l.
Results. The level of CRP during the first council’s examination for the determination of BD was already significantly higher than the normal values and equal to 180.9 (100.5; 279.8) mg/l (the minimum value – 0 mg/l, the maximum one – 656.2 mg/l). At the same time, only 2 (0.9%) potential donors had normal CRP values. In 20-24 hours after the first examination, a further statistically significant increase in the level of CRP up to 229 (122.4; 316.1) mg/l, p<0.001 was noted. The level of CRP during the second council’s examination for the determination of BD was also statistically significantly higher compared to stages 1 and 2 and made up 274.7 (182.1; 365) mg/l, p <0.001.
Conclusions. The data we obtained demonstrated that already at the beginning of establishing brain death, 99.1% of potential donors had a significantly increased level of CRP – 180.9 (100.5; 279.8) mg/l.
Keywords: С-reactive protein, brain death, potential donor, organ donor, transplantation.
Information about the source of support in the form of grants, equipment, medicinal agents. The research was carried out within the frames of the Republic of Belarus Presidential grant in healthcare “For the development and implementation in clinical practice of new methods of diagnosing and conditioning of functional systems of a deceased donor in order to increase the efficacy of conditioning and subsequent transplantation of organs and tissues” (Order No. 32 rp of the President of the Republic of Belarus dated January 19, 2018).
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Submitted 11.06.2024
Accepted 28.08.2024
Information about authors:
A.L. Lipnitski – Candidate of Medical Sciences, head of the department for coordination of taking organs and tissues for transplantation, Mogilev Regional Clinical Hospital; associate professor of the affiliated branch of the Chairs of Anesthesiology and Resuscitation with the course of the Faculty for Advanced Training & Retraining and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0002-2556-4801,
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Artur L. Lipnitski;
A.V. Marochkov – Doctor of Medical Sciences, professor, anesthesiologist-resuscitator of the anesthesiology and resuscitation department, Mogilev Regional Clinical Hospital; professor of the branch of the Chairs of Anesthesiology & Resuscitation and Hospital Surgery with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University, https://orcid.org/0000-0001-5092-8315
