Elsevier

Transplantation Proceedings

Volume 44, Issue 7, September 2012, Pages 2185-2189
Transplantation Proceedings

Donor management
Establishing a Brain-Death Donor Model in Pigs

https://doi.org/10.1016/j.transproceed.2012.07.105Get rights and content

Abstract

Introduction

An animal model that imitates human conditions might be useful not only to monitor pathomechanisms of brain death and biochemical cascades but also to investigate novel strategies to ameliorate organ quality and functionality after multiorgan donation.

Methods

Brain death was induced in 15 pigs by inserting a catheter into the intracranial space after trephination of the skull and augmenting intracranial pressure until brain stem herniation. Intracranial pressure was monitored continuously; after 60 minutes, brain death diagnostics were performed by a neurologist including electroencephalogram (EEG) and clinical examinations. Clinical examinations included testing of brain stem reflexes as well as apnoe testing; then intensive donor care was performed according to standard guidelines until 24 hours after confirmation of brain death. Intensive donor care was performed according to standard guidelines for 24 hours after brain death.

Results

Sixty minutes after brain-death induction, neurological examination and EEG examination confirmed brain death. Intracranial pressure increased continuously, remaining stable after the occurrence of brain death. All 15 animals showed typical signs of brain death such as diabetes insipidus, hypertensive and hypotensive periods, as well as tachycardia. All symptoms were treated with standard medications. After 24 hours of brain death we performed successful multiorgan retrieval.

Discussion

Brain death can be induced in a pig model by inserting a catheter after trephination of the skull. According to standard guidelines the brain-death diagnosis was established by a flat-line EEG, which occurred in all animals at 60 minutes after induction.

Section snippets

Materials and Methods

All animal experiments were performed after approval by the local ethical committee according to Austrian animal law.

Results

The inflated balloon catheter caused brain damage and consecutively BD in all 15 animals (Fig 2) at 60 minutes after BD induction, neurological and EEG examinations confirmed BD (Fig 3A, 3B). Intracranial pressure increased continuously, remaining stable after the occurrence of BD. All 15 animals showed typical signs of BD, such as diabetes insipidus, hypertensive and hypotensive periods, and tachycardia. All symptoms were treated with standard medication. Baseline levels and values during 24

Discussion

Several BD models have already been described mostly using animal rats, dogs, and pigs.23, 31, 32 These studies investigated hemodynamic, metabolic, and endocrine changes during and after BD as well as the effects of hormone replacement therapy.9, 12, 16, 19, 21, 23, 33, 34 However, BD and donor care never exceeded 12 hours.

In many animal studies of BD, domestic pigs have been used because of their availability and resemblance to the human cardiovascular system. Two methods have been used to

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  • M.S. and P.S. contributed equally to this work.

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