Energy status of pig donor organs after ischemia is independent of donor type

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• 作者：Vanessa Stadlbauer ; MD^a ; ¹ ; Philipp Stiegler ; MD^b ; ¹ ; Philipp Taeubl ; MD^a ; Michael Sereinigg ; MD^b ; Andreas Puntschart ; MD^b ; Andrea Bradatsch ; MD^b ; Pero Curcic ; MD^c ; Thomas Seifert-Held ; MD^d ; Gerda Zmugg^d ; Tatjana Stojakovic ; MD^e ; Barbara Leopold^b ; Daniela Blattl^b ; Vera Horki ; MD^b ; Ursula Mayrhauser ; PhD^b ; Iris Wiederstein-Grasser ; DVM^f ; Bettina Leber ; PhD^b ; Gü ; nther Jü ; rgens^g (Prof) ; Karlheinz Tscheliessnigg^b (Prof) ; Seth Hallströ ; m^g ; ^{seth.hallstroem@meduni-graz.at} (Prof)
• 关键词：Living donor ; Brain dead donor ; Non&ndash ; heart-beating donor ; High-energy phosphates ; Heart ; Liver ; Kidney ; Pancreas
• 刊名：Journal of Surgical Research
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：180
• 期：2
• 页码：356-367
• 全文大小：517 K

文摘

Background

Literature is controversial whether organs from living donors have a better graft function than brain dead (BD) and non-heart-beating donor organs. Success of transplantation has been correlated with high-energy phosphate (HEP) contents of the graft.

Methods

HEP contents in heart, liver, kidney, and pancreas from living, BD, and donation after cardiac death in a pig model (n = 6 per donor type) were evaluated systematically. BD was induced under general anesthesia by inflating a balloon in the epidural space. Ten hours after confirmation, organs were retrieved. Cardiac arrest was induced by 9 V direct current. After 10 min of ventricular fibrillation without cardiac output, mechanical and medical reanimation was performed for 30 min before organ retrieval. In living donors, organs were explanted immediately. Freeze-clamped biopsies were taken before perfusion with Celsior solution (heart) or University of Wisconsin solution (abdominal organs) in BD and living donors or with Histidine-Tryptophan-Ketoglutaric solution (all?organs) in non-heart-beating donors, after perfusion, and after cold ischemia (4 h?for?heart, 6 h for liver and pancreas, and 12 h for kidney). HEPs (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate, and phosphocreatine), xanthine, and hypoxanthine were measured by high-performance liquid chromatography. Energy charge and adenosine triphosphate-to-adenosine diphosphate ratio were calculated.

Results

After ischemia, organs from different donor types showed no difference in energy status. In all organs, a decrease of HEP and an increase in hypoxanthine contents were observed during perfusion and ischemia, irrespective of the donor type.

Conclusion

Organs from BD or non-heart-beating donors do not differ from living donor organs in their energy status after average tolerable ischemia.