Intestinal Graft Quality after Norepinephrine and Dopamine Management in an Experimental Brain Dead Model

VECCHIO DEZILLIO LEANDRO; ROMANIN DAVID; IVANOFF MARINOFF IVANA; VERNENGO JULIETA; ABATE ZÁRATE JUAN CRUZ; SAVES JOSEFINA; MACHUCA MARIANA; LAUSADA NATALIA; STRINGA PABLO; RUMBO MARTÍN

Auckland

Congreso; 17th Congress of Intestinal Rehabilitation and Transplant Association; 2021

CIRTA - TTS

Introduction: The hemodynamic instability management of Brain Dead (BD)donors is a critical situation that will influence the quality of the intestine fortransplantation. Both norepinephrine and dopamine are used for the correctionof mean arterial pressure, however, there are no general protocol for vasopressors use during the organ procurement. Our aim was to compare the effects ofeach 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 dopaminegroup (BDD) (range of dose:1,3-3,1 µg/kg/min). Control group (NonBD) wasmechanically ventilated for 2 hours without BD. Histological damage wasevaluated using Park-Chiu scale. Morphometric variables, such as Villi/CryptRatio (VCR), mucosal thickness (MT) and Villi Density (VD) were evaluatedusing ImageJ® software. Goblet’s cell counting was used as an indicatorof epithelial compartment homeostasis and for the assessment of barrierdamage, bacterial translocation was evaluated by culture counting on liversamples 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 compartmentthat compromise barrier function, allowing bacterial translocation. In concordance with studies in other solid organs, the intestine does not showa important differences that favors the use of one or another vasopressor.It has been reported that norepinephrine treatment causes an increment inintestinal permeability that may increase inflammatory condition. Consideringthat dopamine allowed appropriate management of MAP and showedequivalent intestinal parameters, it could be the first choice for hemodynamicmanagement.