title: Changes in hepatic microcirculation and histomorphology in brain-dead organ donors: an experimental study in rats.
abstract: 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.
authors.affiliation: Institute for Surgical Research, University of Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Okamoto
authors.forename: C O
authors.initials: CO
authors.lastname: Corso
authors.forename: T
authors.initials: T
authors.lastname: Kondo
authors.forename: R
authors.initials: R
authors.lastname: Leiderer
authors.forename: W
authors.initials: W
authors.lastname: Rascher
authors.forename: Y
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Yamaoka
authors.forename: K
authors.initials: K
authors.lastname: Messmer
mesh_terms: 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