Desmopressin impairs microcirculation in donor pancreas and early graft function after experimental pancreas transplantation

Citation
T. Keck et al., Desmopressin impairs microcirculation in donor pancreas and early graft function after experimental pancreas transplantation, TRANSPLANT, 72(2), 2001, pp. 202-209
Citations number
35
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Medical Research Diagnosis & Treatment
Journal title
TRANSPLANTATION
ISSN journal
0041-1337 → ACNP
Volume
72
Issue
2
Year of publication
2001
Pages
202 - 209
Database
ISI
SICI code
0041-1337(20010727)72:2<202:DIMIDP>2.0.ZU;2-N
Abstract
Background. Protective effects of desmopressin in brain dead organ donors o ppose reports on a hypercoagulatory potential and an increased leukocyte-en dothelial. interaction (LEI) after application of the drug. The aim was to evaluate the effect of desmopressin on organ donor's pancreas and early gra ft function. Methods. Donor microcirculation was evaluated via intra-vital microscopy (I VM) in 24 BR (di/di) rats with central diabetes insipidus, randomly assigne d to groups I (control without desmopressin application), II (single i.v. a pplication, no pretreatment) or group III (single i.v. desmopressin applica tion, s.c. pretreatment for 3 days). Microcirculation in recipients was eva luated I hr and 6 hr after syngenic pancreas transplantation. Groups III an d I served as organ donors. After IVM specimens were taken for histology an d immunohistochemistry. Results. Desmopressin in II vs. I led to temporarily (30 ') increased LEI ( Sticker 274.3 +/- 87.7 vs. 76.5 +/- 31.1/mm(2) endothelial surface; P <0.01 ) and impaired microcirculation (MCEV 0.43 +/-0.07 vs. 0.99 +/-0.06 mm/s; P <0.01). Repeated application reduced MCEV and increased LEI for up to 12 h r. Histology in I vs. III showed increased inflammation (n.s.), necrosis (P <0.05) and vacuolization (P <0.01). Immunohistochemistry revealed increase d endothelial P-selectin 20 ' after application. 6 hr after reperfusion org ans from III showed reduced MCEV and increased LEI (P <0.01). Conclusion. Repeated application of desmopressin impairs graft microcircula tion. Perfusion of the pancreas is significantly reduced at the beginning o f or-gan tissue conservation as well as after reperfusion. These disturbanc es might partly be due to observed endothelial P-selectin expression. Appli cation of desmopressin up to 12 hr prior to organ explantation may impact g raft quality.