Rat donor lung quality deteriorates more after fast than slow brain death induction

Judith E van Zanden*, Rolando A Rebolledo, Dane Hoeksma, Jeske M Bubberman, Johannes G Burgerhof, Annette Breedijk, Benito A Yard, Michiel E Erasmus, Henri G D Leuvenink, Maximilia C Hottenrott

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Donor brain death (BD) is initiated by an increase in intracranial pressure (ICP), which subsequently damages the donor lung. In this study, we investigated whether the speed of ICP increase affects quality of donor lungs, in a rat model for fast versus slow BD induction. Rats were assigned to 3 groups: 1) control, 2) fast BD induction (ICP increase over 1 min) or 3) slow BD induction (ICP increase over 30 min). BD was induced by epidural inflation of a balloon catheter. Brain-dead rats were sacrificed after 0.5 hours, 1 hour, 2 hours and 4 hours to study time-dependent changes. Hemodynamic stability, histological lung injury and inflammatory status were investigated. We found that fast BD induction compromised hemodynamic stability of rats more than slow BD induction, reflected by higher mean arterial pressures during the BD induction period and an increased need for hemodynamic support during the BD stabilization phase. Furthermore, fast BD induction increased histological lung injury scores and gene expression levels of TNF-α and MCP-1 at 0.5 hours after induction. Yet after donor stabilization, inflammatory status was comparable between the two BD models. This study demonstrates fast BD induction deteriorates quality of donor lungs more on a histological level than slow BD induction.

Original languageEnglish
Article numbere0242827
Number of pages15
JournalPLoS ONE
Volume15
Issue number11
DOIs
Publication statusPublished - 30-Nov-2020

Keywords

  • Animals
  • Brain/physiopathology
  • Brain Death/physiopathology
  • Hemodynamics
  • Lung/physiopathology
  • Lung Transplantation
  • Male
  • Rats
  • Tissue Donors

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