Objective: To assess the effect of brain death on hormonal homeostasis, hepatic microcirculation, and histomorphology in organ donors.
Design: Prospective randomised experimental study.
Setting: Institute for Surgical Research, Germany.
Subjects: 12 male Sprague-Dawley rats
Interventions: 6 rats acted as controls, and 6 had brain death induced by inflation of an intracranial balloon.
Main Outcome Measures: 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.
Conclusion: Macrohaemodynamics, ADH homeostasis, and the hepatic microcirculation deteriorate after brain death, which leads to histomorphological damage of hepatocytes and compromised liver function.
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| http://dx.doi.org/10.1080/11024159950189546 | DOI Listing |
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