Standardized experimental brain death model for studies of intracranial dynamics, organ preservation, and organ transplantation in the pig.

摘要: Organs from deceased donors after brain death (BD) remain the major source of organs for transplantation. The catastrophic event BD and inevitable consequences ischemia reperfusion injury (IRI) are linked to impaired graft quality transplantation outcome. aim this thesis was create a model in pigs assess early effects on IRI kidneys preserved with an oxygenated solution evaluate protective coating renal vessel walls heparin conjugate during hypothermic machine perfusion (HMP).Brain achieved by raising intracranial pressure (ICP) through stepwise increasing volume epidurally placed balloon point exceeding mean arterial (MAP) creating negative cerebral (CPP). This reproducible, clinically relevant experimental makes evaluation potential targeted methods protect possible. Kidneys retrieved brain-dead were either emulsion composed 75% histidine-tryptophan-ketoglutarate (HTK) 25% perfluorohexyloctane F6H8 or HTK alone. After 18h cold storage transplanted into allogeneic pigs. associated replenishment adenosine triphosphate lower gene expression hypoxia inducible factor (HIF)-1a, vascular endothelial growth (VEGF), interleukin (IL)-1α tumour necrosis (TNF)-α. reduced at both cellular molecular level.Kidneys evaluated feasibility CHC (Corline Systems AB, Uppsala, Sweden) restore glycocalyx. Porcine HMP 20h 50 mg biotinylated added solution. detected inner surface kidney vessels immunofluorescence, its uptake confirmed content perfusate. An ex vivo normothermic circuit developed function. Perfusion creatinine levels, increased urine tubular injury. Modifying using improved Preservation could be used improve ameliorate donors.