Brain death and organ damage: The modulating effects of nutrition

Severe brain injury that progresses to brain death may result in a series of insults, including hemodynamic instability, endocrine disturbances, and the release of chemokines and cytokines, which may have a deleterious effect on the quality of donor organs so that many are lost for transplantation. In addition, during the harvesting, preservation, and reperfusion stages, organs are subject to ischemia-reperfusion injury, which may impair the functioning of harvested organs. These processes also result in marked alterations in the nutritional status of the brain-dead organ donor. Because organ energy and redox status are closely related to nutritional status, organ dysfunction may be further compromised. Appropriate nutritional support can prevent depletion of micro- and macronutrients. In addition, experimental evidence suggests that the use of antioxidants may decrease the oxidative stress as well as the effects of ischemia reperfusion injury. We review the effects of nutritional depletion and discuss the potential modulating role of nutritional support using nutraceuticals, in particular polyphenols, fish oil, and glutamine, in preventing organ dysfunction.