Brain death causes structural and inflammatory changes in donor intestine.

L G Koudstaal; N A 't Hart; A van den Berg; P Olinga; H van Goor; R J Ploeg; H G D Leuvenink

doi:10.1016/j.transproceed.2004.12.258

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Brain death causes structural and inflammatory changes in donor intestine.

L G Koudstaal·N A 't Hart·A van den Berg·P Olinga·H van Goor·R J Ploeg·H G D Leuvenink

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Abstract

UNLABELLED: Brain death donors are frequently used for transplantation. Previous studies showed that brain death (BD) negatively affects the immunological and inflammatory status of both liver and kidney. OBJECTIVE: Therefore we studied the inflammatory and morphological changes in donor small intestine after brain death induction. METHODS: BD was induced in rats by slow inflation of an epidural balloon catheter. Three groups (n = 6) were compared, 1 hour, 4 hours BD and sham operated controls. The liver was used as a reference to confirm our previous findings. Intestinal injury was determined using the Park score. Polymorphonuclear cells (PMNs) were counted in intestine and liver as a marker for inflammatory response. Real time PCR was used to demonstrate the effects of BD on ICAM-1 expression in the jejunum. RESULTS: The morphology of the intestine was compromised after 1 and 4 hours BD. In brain dead rats, apical lifting of epithelial cells was clearly present, which resulted in higher Park scores compared to controls (P < .05). Liver morphology remained intact. In small intestine and liver an increased PMN influx in the 1 hour BD group was observed in comparison to controls. Hepatic PMN influx increased further in the 4 hours BD group (P < .05). ICAM-1 was upregulated in jejunum in both the 1 hour BD and 4 hours BD groups compared to controls (P < .05). In conclusion, the early occurrence of intestinal damage after BD induction may negatively influence transplant outcome.

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Animals Base Sequence Brain Death Brain Stem DNA Primers Disease Models, Animal Gene Expression Regulation Inflammation Intercellular Adhesion Molecule-1 Intestine, Small Liver Male Rats Rats, Inbred F344 Reflex Journal Article

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L G Koudstaal, N A 't Hart, A van den Berg, P Olinga, H van Goor, R J Ploeg, H G D Leuvenink. Brain death causes structural and inflammatory changes in donor intestine.. https://doi.org/10.1016/j.transproceed.2004.12.258

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