Histopathologic and molecular evaluation of the Organ Procurement and Transplantation Network selection criteria for intestinal graft donation

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• 作者：Anne Margot C. Roskott ; MD^a ; ¹ ; ^{a.m.roskott@umcg.nl" class="auth_mail} ; Wouter T. van Haaften ; BSc^a ; ¹ ; Henri G.D. Leuvenink ; PhD^a ; Rutger J. Ploeg ; MD ; PhD^a ; Harry van Goor ; PhD^b ; Tjasso Blokzijl ; BSc^c ; Petra J. Ottens ; BSc^a ; Gerard Dijkstra ; MD ; PhD^c ; ¹ ; Vincent B. Nieuwenhuijs ; MD ; PhD^c ; ¹
• 关键词：Graft donation criteria ; Donor quality ; Intestinal graft ; Intestinal graft donation ; Intestinal transplantation ; Organ viability
• 刊名：Journal of Surgical Research
• 出版年：1 June, 2014
• 年：2014
• 卷：189
• 期：1
• 页码：143-151
• 全文大小：1294 K

文摘

Background

The Organ Procurement and Transplantation Network (OPTN) has formulated criteria for the selection of donors for intestinal transplantation. To date, however, no study has correlated histologic findings of intestinal injury with the OPTN criteria. We aimed to describe histopathologic and molecular features of allograft injury in relation to donor conditions defined by the OPTN criteria.

Materials and methods

Graft histology (Park Score), Claudin-3 staining, systemic inflammatory markers (C-reactive protein/lipopolysaccharide-binding protein) and expression of heat shock protein 70, heme oxygenase 1, and interleukin 6 were evaluated in multiorgan deceased donors (donation after brain death [DBD] and donation after cardiac death [DCD]).

Results

Ninety-seven samples (52 jejunum/45 ileum) were recovered from 59 donors (46 DBD/13 DCD). The OPTN criterion cold ischemia time correlated with histologic injury (Park score) to which the jejunum appeared more susceptible than the ileum. Claudin-3 staining was higher, and heat shock protein 70 expression lower in donors meeting the OPTN criteria compared with donors not meeting the criteria and in DBD versus DCD. In DBD donors, interleukin 6 expression was higher compared with DCD donors and inversely related to C-reactive protein.

Conclusions

Our multiparameter analysis suggests that the OPTN criteria can be discriminative concerning intestinal graft quality. Our data suggest that DCD intestinal allografts are qualitatively inferior and that the jejunum is more sensitive to ischemia than the ileum.