The influence of donor brain death on long-term function of renal allotransplants in rats

Pratschke, Johann; Wilhelm, Markus J.; Laskowski, Igor; Kusaka, Mamoru; Paz, Dustin; Tullius, Stefan G.; Hancock, Wayne W.; Tilney, Nicholas L.

doi:10.1016/s0041-1345(00)02207-7

Cited by 37 publications

(37 citation statements)

References 9 publications

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“…Organs can be also harvested from non-heart beating donors (NHBD). According to Summers et al the results of kidney transplantation of that kind of organs can be compared to the results of brain death donors' organ transplantation results [3][4][5][6]. In our study we proved that patients, who received a kidney from a donor with intracranial bleeding, had had worse kidney graft function in comparison with recipients who received a kidney from a donor with cranial injury.…”

Section: Discussionsupporting

confidence: 54%

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Kieszek¹,

Jędrzejko²

2015

J Transplant Technol Res

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Section: Discussionsupporting

confidence: 54%

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Kieszek¹,

Jędrzejko²

2015

J Transplant Technol Res

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“…It is recognized that brain death has defined effects on hemodynamic stability, hormone regulation, and inflammatory reactivity that predispose for additional organ injury during hypothermic preservation and reperfusion after transplantation (7). In this regard, brain death is associated with structural myocardial damage (31), intense nonimmune inflammation in kidney isografts (8), and higher incidence of acute and chronic allograft rejection (12,(32)(33)(34). This study represents the first examination of brain death's impact on islet recovery and functionality in vitro and in vivo after transplantation.…”

Section: Discussionmentioning

confidence: 99%

Brain Death Significantly Reduces Isolated Pancreatic Islet Yields and Functionality In Vitro and In Vivo After Transplantation in Rats

et al. 2003

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Although ϳ1 million islets exist in the adult human pancreas, current pancreas preservation and islet isolation techniques recover <50%. Presently, cadaveric donors remain the sole source of pancreatic tissue for transplantation. Brain death is characterized by activation of proinflammatory cytokines and organ injury during preservation and reperfusion. In this study, we assessed the effects of brain death on islet isolation yields and functionality. Brain death was induced in male 250-to 350-g Lewis rats by inflation of a Fogarty catheter placed intracranially. The rats were mechanically ventilated for 2, 4, and 6 h before removal of the pancreas (n ‫؍‬ 6). In controls, the catheter was not inflated (n ‫؍‬ 6). Shortly after brain death induction, a significant increase in serum tumor necrosis factor-␣ (TNF-␣), interleukin (IL)-1␤, and IL-6 was demonstrated in a time-dependent manner. Upregulation of TNF-␣, IL-1␤, and IL-6 mRNA was noted in the pancreas. Brain death donors presented lower insulin release after glucose stimulation assessed by in situ perfusion of the pancreas. Islet recovery was reduced in brain death donors compared with controls (at 6 h 602.3 ؎ 233.4 vs. 1,792.5 ؎ 325.4 islet equivalents, respectively; P < 0.05). Islet viability assessed in dissociated islet cells and in intact cultured islets was reduced in islets recovered from brain death donors, an effect associated with higher nuclear activities of NF-B p50, c-Jun, and ATF-2. Islet functionality evaluated in vitro by static incubation and in vivo after intraportal transplantation in syngeneic streptozotocin-induced diabetic rats was significantly reduced in preparations obtained from brain death donors. In conclusion, brain death significantly reduced islet yields and functionality. These observations may lead to strategies to reduce the effects of brain death on pancreatic islets and improve the results in clinical transplantation.

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“…63 In summary, brain death is associated with the release of proinflammatory substances and inflammatory responses are detected in all organs suitable for transplantation leading to immunologically activated organs before engraftment, resulting in histological damage, decreased function, and lower graft survival compared with organs from living donors. 58,[64][65][66][67][68] …”

Section: Inflammatory and Immunological Aspects Of Brain Deathmentioning

confidence: 99%

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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The influence of donor brain death on long-term function of renal allotransplants in rats

Cited by 37 publications

References 9 publications

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Analysis of Factors Influencing on Living Kidney Donors and Deceased Kidney Donors Transplantation Results

Brain Death Significantly Reduces Isolated Pancreatic Islet Yields and Functionality In Vitro and In Vivo After Transplantation in Rats

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

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