Assessment of systemic inflammation in potential brain-dead donors

The dynamics of the systemic inflammatory response in potential donors with irreversible brain injury and death have not yet been reliably established. Various laboratory markers can be used to assess the level of systemic inflammation in brain-dead donors. The aim of this study was to evaluate the dynamics of systemic inflammation based on C-reactive protein (CRP) and serum iron levels in potential organ and tissue donors during protective intensive care. This prospective, non-randomized study included 404 potential brain-dead organ and tissue donors, who underwent protective intensive care and functional systems conditioning. The main diagnoses leading to brain death were as follows: non-traumatic intracranial hemorrhage ( n = 259 (64 %)); ischemic brain injury – cerebral infarction ( n = 63 (16 %)); posthypoxic encephalopathy ( n = 16 (4 %)); traumatic brain injury ( n = 66 (16 %)). Potential donors with traumatic brain injury had higher CRP levels and lower iron levels, which may be due to factors such as surgical interventions, blood loss, delayed brain death, and a longer duration of intensive care. A positive correlation was found between the level of systemic inflammation, assessed by CRP and serum iron, as well as the presence of obesity (BMI – 30 kg/m 2  or greater) in the donor: R = 0.24, p = 0.0009 and R = 0.17, p = 0.02, respectively. Correlation analysis revealed a statistically significant correlation between CRP and serum iron levels and the duration of intensive care in the ICU before brain death was determined: R = 0.42, p < 0.00001 and R = –0.23, p = 0.0002, respectively. Serum iron and CRP levels serve as independent markers of the systemic inflammatory response in potential donors with irreversible brain injury.