Heart transplantation is a common procedure for patients with severe
heart failure and shortage of donor organs is a significant problem even in Europe and USA. We, anesthesiologists, contribute to
transplantation by
anesthetic management of a donor and it is essential to maintain cardiac function until the organ harvest for successful
organ transplantation. Since cardiac dysfunction occurrs following
brain death, it is clinically important to find some interventions to maintain the cardiac function or to delay cardiac deterioration following
brain death. We investigated the cardiac function following experimental
brain death in rats. Experimental
brain death was induced by inflating intracranial balloon. Ejection fraction and dP/dt max significantly decreased earlier than significant blood pressure reduction after
brain death. In addition, myocardial sensitization to
epinephrine was enhanced following
brain death. Preconditioning is a unique phenomenon to prevent cardiac function from ischemic insult. Volatile
anesthetics, including
sevoflurane and
isoflurane, have similar effects in preconditioning. We expect volatile
anesthetics to improve cardiac function following
brain death due to preconditioning effect.