TY - JOUR
T1 - Activation of the Innate Immune System in Brain-Dead Donors Can Be Reduced by Luminal Intestinal Preservation During Organ Procurement Surgery
T2 - A Porcine Model
AU - Weiss, Marc Gjern
AU - de Jong, Anne Marye
AU - Seegert, Helene
AU - Moeslund, Niels
AU - Maassen, Hanno
AU - Schjalm, Camilla
AU - de Boer, Eline
AU - Leuvenink, Henri
AU - Mollnes, Tom Eirik
AU - Eijken, Marco
AU - Keller, Anna Krarup
AU - Dijkstra, Gerard
AU - Jespersen, Bente
AU - Pischke, Søren Erik
N1 - Publisher Copyright:
Copyright © 2024 Weiss, de Jong, Seegert, Moeslund, Maassen, Schjalm, de Boer, Leuvenink, Mollnes, Eijken, Keller, Dijkstra, Jespersen and Pischke.
PY - 2024/10/31
Y1 - 2024/10/31
N2 - Organs obtained from brain dead donors can have suboptimal outcomes. Activation of the innate immune system and translocation of intestinal bacteria could be causative. Thirty two pigs were assigned to control, brain death (BD), BD + luminal intestinal polyethylene glycol (PEG), and BD + luminal intestinal University of Wisconsin solution (UW) groups. Animals were observed for 360 min after BD before organ retrieval. 2,000 mL luminal intestinal preservation solution was instilled into the duodenum at the start of organ procurement. Repeated measurements of plasma C3a, Terminal Complement Complex (TCC), IL-8, TNF, and lipopolysaccharide binding protein were analysed by immunoassays. C3a was significantly higher in the BD groups compared to controls at 480 min after brain death. TCC was significantly higher in BD and BD + UW, but not BD + PEG, compared to controls at 480 min. TNF was significantly higher in the BD group compared to all other groups at 480 min. LPS binding protein increased following BD in all groups except BD + PEG, which at 480 min was significantly lower compared with all other groups. Brain death induced innate immune system activation was decreased by luminal preservation using PEG during organ procurement, possibly due to reduced bacterial translocation.
AB - Organs obtained from brain dead donors can have suboptimal outcomes. Activation of the innate immune system and translocation of intestinal bacteria could be causative. Thirty two pigs were assigned to control, brain death (BD), BD + luminal intestinal polyethylene glycol (PEG), and BD + luminal intestinal University of Wisconsin solution (UW) groups. Animals were observed for 360 min after BD before organ retrieval. 2,000 mL luminal intestinal preservation solution was instilled into the duodenum at the start of organ procurement. Repeated measurements of plasma C3a, Terminal Complement Complex (TCC), IL-8, TNF, and lipopolysaccharide binding protein were analysed by immunoassays. C3a was significantly higher in the BD groups compared to controls at 480 min after brain death. TCC was significantly higher in BD and BD + UW, but not BD + PEG, compared to controls at 480 min. TNF was significantly higher in the BD group compared to all other groups at 480 min. LPS binding protein increased following BD in all groups except BD + PEG, which at 480 min was significantly lower compared with all other groups. Brain death induced innate immune system activation was decreased by luminal preservation using PEG during organ procurement, possibly due to reduced bacterial translocation.
KW - brain dead donor
KW - C3a
KW - innate immune system
KW - lipopolysaccharide binding protein
KW - luminal intestinal preservation
KW - organ procurement and porcine model
KW - terminal complement complex
UR - http://www.scopus.com/inward/record.url?scp=85209406089&partnerID=8YFLogxK
U2 - 10.3389/ti.2024.13569
DO - 10.3389/ti.2024.13569
M3 - Article
C2 - 39544322
AN - SCOPUS:85209406089
SN - 0934-0874
VL - 37
JO - Transplant International
JF - Transplant International
M1 - 13569
ER -