Significant reduction of proinflammatory cytokines by treatment of the brain-dead donor

Kuecuek, O; Mantouvalou, L; Klemz, Roman; Kotsch, Katja; Volk, Hans‐Dieter; Jonas, Sven; Wesslau, C; Tullius, Stefan G.; Neuhaus, P.; Pratschke, Johann

doi:10.1016/j.transproceed.2004.12.165

Cited by 69 publications

(51 citation statements)

References 4 publications

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“…time points in two groups. Previous studies have shown that the majority of the investigated cytokines were obviously up-regulated after laparotomy of the BD donor (28)(29)(30). These observations are consistent with the results of this study indicating that gene expression and serum levels of IL1B and IL10 cytokines were more up-regulated in the peripheral blood of the two groups immediately after laparotomy.…”

supporting

confidence: 92%

“…Olinga et al and Kuecuek et al reported that through the real-time reverse transcriptase-polymerase chain reaction (QRT-PCR) analysis of the liver tissues from BD donors, the expression levels of IL1B and IL10 mRNA before the incision were significantly higher than those of living donors (27,28). Our results revealed that mRNA expression levels of the studied cytokines were up-regulated at all the …”

Section: Discussionmentioning

confidence: 44%

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Evaluation of Gene Expression Pattern of IL1B and IL10 Cytokines Following Vitamin C Administration among Brain-Dead Liver Donors

Sisakht

Khosravi

Milani

et al. 2016

Iran Red Crescent Med J

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Background: Inflammatory events following brain death (BD) decrease the quality of donor organs which can affect the outcome of the transplantation. It experimentally and clinically is verified that the level of inflammatory cytokines is increased in the BD of the donor results. In experiments, the in vitro use of vitamin C can successfully decrease the levels of inflammatory cytokines. Objectives: The aim of this study was to investigate the influence of vitamin C administration on the inflammatory status of the graft in BD liver donors. Methods: This study was conducted at Nemazee Hospital's transplant center (Shiraz, Iran). In this interventional study, the BD liver donors (n = 40) were randomly divided into two groups. The control group received only the routine intensive care unit (ICU) considerations, and the intervention group was treated with Vitamin C before harvesting organ (100 mg/kg, initially followed by 100 mg/kg/6h until organ removal). Blood samples were taken from BD patients in the intervention and control groups 3 times: 6 hours before operation, immediately after laparotomy, and immediately prior to clamping the aorta to assess the gene expression ratio of Interleukin 1 beta (IL1B) and Interleukin 10 (IL10) cytokines using real time polymerase chain reaction (PCR) (n = 40). Soluble serum cytokines were measured by enzyme-linked immunosorbent assay (ELISA) (n = 24). Results: No significant differences were observed in mRNA expression ratio of IL1B and IL10 between two groups. Despite an acceptable decrease in serum concentration of the inflammatory markers IL1B and IL10 at time point 2 minus time point 1 (T2-1), no significant differences were observed in vitamin C-treated BD donors compared with the control donors. There was a significant difference among aspartate aminotransferase (AST) and alanine aminotransferase (ALT) changes on the 3rd to 1st days after operation between the control and intervention recipients (P < 0.05). Conclusions:The present study suggests a beneficial effect of vitamin C adsministration on post-transplant function of the liver from BD liver donors.

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supporting

confidence: 92%

Section: Discussionmentioning

confidence: 44%

Evaluation of Gene Expression Pattern of IL1B and IL10 Cytokines Following Vitamin C Administration among Brain-Dead Liver Donors

Sisakht

Khosravi

Milani

et al. 2016

Iran Red Crescent Med J

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“…128 The I/R injury was ameliorated, and reduced rates of acute rejections were observed during follow-up. Methylprednisolone administration to brain-dead donors can reduce cytokine activation to levels almost comparable to the levels seen in living donor transplantation, 127 and should as a consequence, be given to all donors immediately after brain death. The dose often recommended is a single bolus of 15 mg/kg bwt, 83,98 whereas Pratschke and colleagues 127,128 used 250 mg as a bolus, followed by an infusion of 100 mg/h.…”

Section: Hemodynamic Managementmentioning

confidence: 98%

“…Administration of methylprednisolone to brain dead donors is associated with improved short-and long-term outcome for most transplanted organs. [124][125][126][127][128][129] It reduces the increase in EVLW ob-served during donor management, 21 and it was the most significant independent predictor of successful lung donation in a multivariate analysis on lung donor variables. 129 It is also associated with significant reductions in the incidence of early graft dysfunction in heart transplantation.…”

Section: Hemodynamic Managementmentioning

confidence: 99%

“…129 It is also associated with significant reductions in the incidence of early graft dysfunction in heart transplantation. 124 In both experimental and clinical investigations, Pratschke and colleagues 127,128 have demonstrated that methylprednisolone reduces the immunological activation observed after brain death. In a prospective randomized study, they found that methylprednisolone reduced both serum and intragraft cytokine expression and improved graft function in human liver transplantation.…”

Section: Hemodynamic Managementmentioning

confidence: 99%

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Brain death and its implications for management of the potential organ donor

Bugge

2009

Acta Anaesthesiol Scand

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The systemic physiologic changes that occur during and after brain death affect all organs suitable for transplantation. Major changes occur in the cardiovascular, pulmonary, endocrine, and immunological systems, and, if untreated may soon result in cardiovascular collapse and somatic death. Understanding these complex physiologic changes is mandatory for developing effective strategies for donor resuscitation and management in such a way that the functional integrity of potentially transplantable organs is maintained. This review elucidates these physiological changes and their consequences, and based on these consequences the rationale behind current medical management of brain-dead organ donors is discussed.

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Innovations in Organ Donation

Goldstein¹,

Lubezky²,

Yushkov³

et al. 2012

Mount Sinai J Medicine

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The growing disparity between organ availability for transplantation and the number of patients in need has challenged the donation and transplantation community of practice to develop innovative processes, ideas, and techniques to bridge the gaps. Advances in the sharing of best practices in the donation community have contributed greatly over the last 8 years. Broader sharing of updated guidelines for declaration of brain death in conjunction with improvements in deceased donor management have increased opportunities for organ donation. New techniques for organ preservation and organ resuscitation have allowed for better utilization of the potential donor pool. This review will highlight processes, ideas, and techniques in organ donation.

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Significant reduction of proinflammatory cytokines by treatment of the brain-dead donor

Cited by 69 publications

References 4 publications

Evaluation of Gene Expression Pattern of IL1B and IL10 Cytokines Following Vitamin C Administration among Brain-Dead Liver Donors

Evaluation of Gene Expression Pattern of IL1B and IL10 Cytokines Following Vitamin C Administration among Brain-Dead Liver Donors

Brain death and its implications for management of the potential organ donor

Innovations in Organ Donation

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