P Singer1, J Cohen, L Cynober. 1. Department of General Intensive Care, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel. pierres@post.tau.ac.il
Abstract
OBJECTIVE: We describe the effect of the metabolic and nutritional modifications caused by severe illness or injury in brain-dead organ donors on transplant organ function. Malnutrition is frequently found in brain-dead organ donors and nutrients may interfere with different organ functions. METHODS: Literature was obtained from MEDLINE using the key words organ donation, brain death, transplantation, nutrition, fish oil, amino acids. RESULTS: In the liver, infusion of large quantities of dextrose can restore glycogen reserves but may induce hyperglycemia and a hyperosmolar hepatic state. Feeding improves protein synthesis in hepatocytes, and fat (fish oil) administration in particular increases the hepatic energy and adenosine triphosphate content. Amino acids have a significant effect on regenerating hepatic tissue when given with fat and glucose. In the heart, free fatty acids administered during reperfusion improve cardiac functional recovery, and administration of propofol, a general anesthetic agent enriched with fatty acids, have protective effects on ischemia-and-reperfusion injury. Glutamine also can induce graft protection during ischemia-and-reperfusion injury. Renal function is improved by fish oil supplementation. In addition, effective renal plasma flow, glomerular filtration rate, and renal blood flow are increased, apparently by a reduction in thromboxane B2 production. Glycine or alanine can protect renal tubules from stress injury. CONCLUSION: Nutrition plays an important role in the modulation of organ function after transplantation.
OBJECTIVE: We describe the effect of the metabolic and nutritional modifications caused by severe illness or injury in brain-dead organ donors on transplant organ function. Malnutrition is frequently found in brain-dead organ donors and nutrients may interfere with different organ functions. METHODS: Literature was obtained from MEDLINE using the key words organ donation, brain death, transplantation, nutrition, fish oil, amino acids. RESULTS: In the liver, infusion of large quantities of dextrose can restore glycogen reserves but may induce hyperglycemia and a hyperosmolar hepatic state. Feeding improves protein synthesis in hepatocytes, and fat (fish oil) administration in particular increases the hepatic energy and adenosine triphosphate content. Amino acids have a significant effect on regenerating hepatic tissue when given with fat and glucose. In the heart, free fatty acids administered during reperfusion improve cardiac functional recovery, and administration of propofol, a general anesthetic agent enriched with fatty acids, have protective effects on ischemia-and-reperfusion injury. Glutamine also can induce graft protection during ischemia-and-reperfusion injury. Renal function is improved by fish oil supplementation. In addition, effective renal plasma flow, glomerular filtration rate, and renal blood flow are increased, apparently by a reduction in thromboxane B2 production. Glycine or alanine can protect renal tubules from stress injury. CONCLUSION: Nutrition plays an important role in the modulation of organ function after transplantation.
Authors: Mathias Plauth; William Bernal; Srinivasan Dasarathy; Manuela Merli; Lindsay D Plank; Tatjana Schütz; Stephan C Bischoff Journal: Clin Nutr Date: 2019-01-16 Impact factor: 7.324
Authors: Georgene W Hergenroeder; Norman H Ward; Xiaoying Yu; Antone Opekun; Anthony N Moore; Claudia A Kozinetz; David J Powner Journal: Prog Transplant Date: 2013-12 Impact factor: 1.187