Experimental Assessment of Intestinal Damage in Controlled Donation After Circulatory Death for Visceral Transplantation.
Pablo StringaLeandro Emmanuel Vecchio DezillioPaloma TalayeroJavier SerradillaAgustina ErreaMariana MachucaRodrigo Papa-GobbiOnys Camps OrtegaMelisa Pucci MolinerisNatalia LausadaAne Miren Andres MorenoMartin RumboFrancisco Hernández OliverosPublished in: Transplant international : official journal of the European Society for Organ Transplantation (2023)
There is an urgent need to address the shortage of potential multivisceral grafts in order to reduce the average time in waiting list. Since donation after circulatory death (DCD) has been successfully employed for other solid organs, a thorough evaluation of the use of intestinal grafts from DCD is warranted. Here, we have generated a model of Maastricht III DCD in rodents, focusing on the viability of intestinal and multivisceral grafts at five (DCD5) and twenty (DCD20) minutes of cardiac arrest compared to living and brain death donors. DCD groups exhibited time-dependent damage. DCD20 generated substantial intestinal mucosal injury and decreased number of Goblet cells whereas grafts from DCD5 closely resemble those of brain death and living donors groups in terms intestinal morphology, expression of tight junction proteins and number of Paneth and Globet cells. Upon transplantation, intestines from DCD5 showed increased ischemia/reperfusion damage compared to living donor grafts, however mucosal integrity was recovered 48 h after transplantation. No differences in terms of graft rejection, gene expression and absorptive function between DCD5 and living donor were observed at 7 post-transplant days. Collectively, our results highlight DCD as a possible strategy to increase multivisceral donation and transplantation procedures.
Keyphrases
- gene expression
- cardiac arrest
- induced apoptosis
- oxidative stress
- cell therapy
- cell cycle arrest
- resting state
- stem cells
- bone marrow
- risk assessment
- blood brain barrier
- extracorporeal membrane oxygenation
- multiple sclerosis
- functional connectivity
- cardiopulmonary resuscitation
- adipose tissue
- brain injury
- cell death