Activation of the Innate Immune System in Brain-Dead Donors Can Be Reduced by Luminal Intestinal Preservation During Organ Procurement Surgery - A Porcine Model

TY - JOUR

T1 - Activation of the Innate Immune System in Brain-Dead Donors Can Be Reduced by Luminal Intestinal Preservation During Organ Procurement Surgery - 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

Y1 - 2024

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 - Journal article

C2 - 39544322

AN - SCOPUS:85209406089

SN - 0934-0874

VL - 37

JO - Transplant International

JF - Transplant International

M1 - 13569

ER -