*O-36: Intestinal Graft Quality after Norepinephrine and Dopamine Management in an Experimental Brain Dead Model

L, VECCHIO DEZILLIO; D, ROMANIN; I, IVANOFF MARINOFF; J, VERNENGO; J, ABATE ZÁRATE; J, SAVES; M, MACHUCA; N, LAUSADA; P, STRINGA; M, RUMBO

TRANSPLANTATION

LIPPINCOTT WILLIAMS & WILKINS

Lugar: Philadelphia; Año: 2021 vol. 105 p. 19 - 19

0041-1337

Introduction: The hemodynamic instability management of Brain Dead (BD) donors is a critical situation that will influence the quality of the intestine for transplantation. Both norepinephrine and dopamine are used for the correction of mean arterial pressure, however, there are no general protocol for vasopressors use during the organ procurement. Our aim was to compare the effects of each drug in the intestinal graft quality using a rat BD donation model.Methods: Wistar rats (N=21) underwent brain death for 2 hours for norepinephrine group (BDn) (range of dose: 0,2-1µg/kg/min) and for dopamine group (BDD) (range of dose:1,3-3,1 µg/kg/min). Control group (NonBD) was mechanically ventilated for 2 hours without BD. Histological damage was evaluated using Park-Chiu scale. Morphometric variables, such as Villi/Crypt Ratio (VCR), mucosal thickness (MT) and Villi Density (VD) were evaluated using ImageJ® software. Goblet?s cell counting was used as an indicator of epithelial compartment homeostasis and for the assessment of barrier damage, bacterial translocation was evaluated by culture counting on liver samples aseptically taken. Kruskal Wallis, one way anova and Dunn and bonferroni?s post-tests were used as appropriate.Conclusions: Brain death induce changes in epithelial compartment that compromise barrier function, allowing bacterial translocation. In concordance with studies in other solid organs, the intestine does not show a important differences that favors the use of one or another vasopressor. It has been reported that norepinephrine treatment causes an increment in intestinal permeability that may increase inflammatory condition. Considering that dopamine allowed appropriate management of MAP and showed equivalent intestinal parameters, it could be the first choice for hemodynamic management.