Influences of the Donor Type On Organ Energy Status: Living Versus Brain Dead Versus DCD.

Abstract# C2078

Organs from living donors seem to have a better graft function after transplantation compared to organs from brain dead and non-heart beating organ donors. We hypothesized that brain death might impair the energy status of organs and therefore systematically evaluated high energy phosphate content in organs from living, brain dead and from non-heart-beating donors in a pig model

In 6 pigs brain death was induced under general anaesthesia by inflating a balloon in the epidural space. 10 hours after confirmation of brain death organs were retrieved. In 6 animals cardiac arrest was induced using 9 V direct current and mechanical and medical reanimation was performed after 10 min of ventricular fibrillation without cardiac output for 30 min. In 6 pigs organs were explanted without induction of brain death. Tissue was harvested before perfusion, after perfusion and after cold ischemia. Xanthine, hypoxanthine, adenosine-monophosphate, adenosine-diphosphate and adenosine-triphosphate were measured using high-performance liquid chromatographie. Energy charge and ATP/ADP ratio were calculated.

Overall, after ischemia no difference in energy status of organs was observed between the different donor types. In all organs an increase in hypoxanthine levels and a decrease of high energy phosphate content was observed during perfusion and ischemia, irrespective of the donor type.

In conclusion our hypothesis that brain death or cardiac arrest significantly impairs the energy status of donor organs did not hold true. Therefore the negative impact of brain death or cardiac arrest on graft function can not be attributed to changes in energy status.