Energy status of pig donor organs after ischemia is independent of donor type.
BACKGROUND
Literature is controversial whether organs from living donors have a better graft function than brain dead (BD) and non-heart-beating donor organs. Success of transplantation has been correlated with high-energy phosphate (HEP) contents of the graft.


METHODS
HEP contents in heart, liver, kidney, and pancreas from living, BD, and donation after cardiac death in a pig model (n=6 per donor type) were evaluated systematically. BD was induced under general anesthesia by inflating a balloon in the epidural space. Ten hours after confirmation, organs were retrieved. Cardiac arrest was induced by 9V direct current. After 10min of ventricular fibrillation without cardiac output, mechanical and medical reanimation was performed for 30min before organ retrieval. In living donors, organs were explanted immediately. Freeze-clamped biopsies were taken before perfusion with Celsior solution (heart) or University of Wisconsin solution (abdominal organs) in BD and living donors or with Histidine-Tryptophan-Ketoglutaric solution (all organs) in non-heart-beating donors, after perfusion, and after cold ischemia (4h for heart, 6h for liver and pancreas, and 12h for kidney). HEPs (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate, and phosphocreatine), xanthine, and hypoxanthine were measured by high-performance liquid chromatography. Energy charge and adenosine triphosphate-to-adenosine diphosphate ratio were calculated.


RESULTS
After ischemia, organs from different donor types showed no difference in energy status. In all organs, a decrease of HEP and an increase in hypoxanthine contents were observed during perfusion and ischemia, irrespective of the donor type.


CONCLUSIONS
Organs from BD or non-heart-beating donors do not differ from living donor organs in their energy status after average tolerable ischemia.
Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Vanessa
V
Stadlbauer
Philipp
P
Stiegler
Philipp
P
Taeubl
Michael
M
Sereinigg
Andreas
A
Puntschart
Andrea
A
Bradatsch
Pero
P
Curcic
Thomas
T
Seifert-Held
Gerda
G
Zmugg
Tatjana
T
Stojakovic
Barbara
B
Leopold
Daniela
D
Blattl
Vera
V
Horki
Ursula
U
Mayrhauser
Iris
I
Wiederstein-Grasser
Bettina
B
Leber
Günther
G
Jürgens
Karlheinz
K
Tscheliessnigg
Seth
S
Hallström
D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D001926:Brain Death; D004734:Energy Metabolism; D007511:Ischemia / Q000378:metabolism*; D007668:Kidney / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D019520:Living Donors; D009206:Myocardium / Q000378:metabolism; D016377:Organ Transplantation; D010179:Pancreas / Q000378:metabolism; D013552:Swine; D014019:Tissue Donors
D000255:Adenosine Triphosphate