title: Brain death causes structural and inflammatory changes in donor intestine.
abstract: Brain death donors are frequently used for transplantation. Previous studies showed that brain death (BD) negatively affects the immunological and inflammatory status of both liver and kidney.
  
  
  OBJECTIVE
  Therefore we studied the inflammatory and morphological changes in donor small intestine after brain death induction.
  
  
  METHODS
  BD was induced in rats by slow inflation of an epidural balloon catheter. Three groups (n = 6) were compared, 1 hour, 4 hours BD and sham operated controls. The liver was used as a reference to confirm our previous findings. Intestinal injury was determined using the Park score. Polymorphonuclear cells (PMNs) were counted in intestine and liver as a marker for inflammatory response. Real time PCR was used to demonstrate the effects of BD on ICAM-1 expression in the jejunum.
  
  
  RESULTS
  The morphology of the intestine was compromised after 1 and 4 hours BD. In brain dead rats, apical lifting of epithelial cells was clearly present, which resulted in higher Park scores compared to controls (P < .05). Liver morphology remained intact. In small intestine and liver an increased PMN influx in the 1 hour BD group was observed in comparison to controls. Hepatic PMN influx increased further in the 4 hours BD group (P < .05). ICAM-1 was upregulated in jejunum in both the 1 hour BD and 4 hours BD groups compared to controls (P < .05). In conclusion, the early occurrence of intestinal damage after BD induction may negatively influence transplant outcome.
authors.affiliation: Groningen University Medical Center, Groningen, Netherlands.
authors.forename: L G
authors.initials: LG
authors.lastname: Koudstaal
authors.forename: N A
authors.initials: NA
authors.lastname: 't Hart
authors.forename: A
authors.initials: A
authors.lastname: van den Berg
authors.forename: P
authors.initials: P
authors.lastname: Olinga
authors.forename: H
authors.initials: H
authors.lastname: van Goor
authors.forename: R J
authors.initials: RJ
authors.lastname: Ploeg
authors.forename: H G D
authors.initials: HG
authors.lastname: Leuvenink
mesh_terms: D000818:Animals; D001483:Base Sequence; D001926:Brain Death / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology; D017931:DNA Primers; D004195:Disease Models, Animal; D005786:Gene Expression Regulation; D007249:Inflammation; D018799:Intercellular Adhesion Molecule-1 / Q000235:genetics; D007421:Intestine, Small / Q000503:physiopathology*; D008099:Liver / Q000503:physiopathology; D008297:Male; D051381:Rats; D011916:Rats, Inbred F344; D012018:Reflex
chemical_list: D017931:DNA Primers; D018799:Intercellular Adhesion Molecule-1