Changes in hepatic microcirculation and histomorphology in brain-dead organ donors: an experimental study in rats.
OBJECTIVE
To assess the effect of brain death on hormonal homeostasis, hepatic microcirculation, and histomorphology in organ donors.


METHODS
Prospective randomised experimental study.


METHODS
Institute for Surgical Research, Germany.


METHODS
12 male Sprague-Dawley rats


METHODS
6 rats acted as controls, and 6 had brain death induced by inflation of an intracranial balloon.


METHODS
Mean arterial pressure, serum concentration of antidiuretic hormone (ADH), thyroxine (T4), free-T4, triiodothyronine (T3) and free-T3, bile production, intravital fluorescence microscopy and electron microscopic appearances.


RESULTS
After induction of brain death mean arterial pressure rose within 5 minutes followed by significant hypotension (p < 0.01). ADH concentration was reduced (p < 0.01), as was bile production (p < 0.05). There was impaired sinusoidal perfusion and increased interaction between leucocytes and endothelium in the hepatic microvasculature. The electron microscopic analysis showed vacuolisation of hepatocytes.


CONCLUSIONS
Macrohaemodynamics, ADH homeostasis, and the hepatic microcirculation deteriorate after brain death, which leads to histomorphological damage of hepatocytes and compromised liver function.
Okamoto
S
S
Institute for Surgical Research, University of Munich, Germany.
Corso
C O
CO
Kondo
T
T
Leiderer
R
R
Rascher
W
W
Yamamoto
Y
Y
Yamaoka
Y
Y
Messmer
K
K
D000818:Animals; D001926:Brain Death / Q000473:pathology* / Q000503:physiopathology; D004569:Electroencephalography; D005434:Flow Cytometry / Q000379:methods; D008099:Liver / Q000098:blood supply / Q000473:pathology*; D008102:Liver Circulation; D008297:Male; D008833:Microcirculation / Q000473:pathology; D008854:Microscopy, Electron / Q000379:methods; D008856:Microscopy, Fluorescence / Q000379:methods; D051381:Rats; D017207:Rats, Sprague-Dawley; D014019:Tissue Donors