title: Histopathologic and molecular evaluation of the Organ Procurement and Transplantation Network selection criteria for intestinal graft donation.
abstract: BACKGROUND
  The Organ Procurement and Transplantation Network (OPTN) has formulated criteria for the selection of donors for intestinal transplantation. To date, however, no study has correlated histologic findings of intestinal injury with the OPTN criteria. We aimed to describe histopathologic and molecular features of allograft injury in relation to donor conditions defined by the OPTN criteria.
  
  
  METHODS
  Graft histology (Park Score), Claudin-3 staining, systemic inflammatory markers (C-reactive protein/lipopolysaccharide-binding protein) and expression of heat shock protein 70, heme oxygenase 1, and interleukin 6 were evaluated in multiorgan deceased donors (donation after brain death [DBD] and donation after cardiac death [DCD]).
  
  
  RESULTS
  Ninety-seven samples (52 jejunum/45 ileum) were recovered from 59 donors (46 DBD/13 DCD). The OPTN criterion cold ischemia time correlated with histologic injury (Park score) to which the jejunum appeared more susceptible than the ileum. Claudin-3 staining was higher, and heat shock protein 70 expression lower in donors meeting the OPTN criteria compared with donors not meeting the criteria and in DBD versus DCD. In DBD donors, interleukin 6 expression was higher compared with DCD donors and inversely related to C-reactive protein.
  
  
  CONCLUSIONS
  Our multiparameter analysis suggests that the OPTN criteria can be discriminative concerning intestinal graft quality. Our data suggest that DCD intestinal allografts are qualitatively inferior and that the jejunum is more sensitive to ischemia than the ileum.
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands. Electronic address: a.m.roskott@umcg.nl.
authors.forename: Anne Margot C
authors.initials: AM
authors.lastname: Roskott
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Wouter T
authors.initials: WT
authors.lastname: van Haaften
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Henri G D
authors.initials: HG
authors.lastname: Leuvenink
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Rutger J
authors.initials: RJ
authors.lastname: Ploeg
authors.affiliation: Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Tjasso
authors.initials: T
authors.lastname: Blokzijl
authors.affiliation: Department of Surgery, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Petra J
authors.initials: PJ
authors.lastname: Ottens
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Gerard
authors.initials: G
authors.lastname: Dijkstra
authors.affiliation: Department of Gastroenterology and Hepatology, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Vincent B
authors.initials: VB
authors.lastname: Nieuwenhuijs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000235:genetics / Q000378:metabolism / Q000592:standards; D002648:Child; D002675:Child, Preschool; D062465:Claudin-3 / Q000235:genetics / Q000378:metabolism / Q000592:standards; D019446:Endotoxemia / Q000209:etiology / Q000473:pathology; D006801:Humans; D007082:Ileum / Q000378:metabolism / Q000473:pathology* / Q000637:transplantation*; D007223:Infant; D015850:Interleukin-6 / Q000096:biosynthesis / Q000235:genetics / Q000592:standards; D007583:Jejunum / Q000378:metabolism / Q000473:pathology* / Q000637:transplantation*; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects / Q000592:standards*; D009927:Tissue and Organ Procurement / Q000592:standards*; D055815:Young Adult
chemical_list: C568122:CLDN3 protein, human; D062465:Claudin-3; D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: Donor quality; Graft donation criteria; Intestinal graft; Intestinal graft donation; Intestinal transplantation; Organ viability