Progressive development of renal vascular dysfunction in brain death implicates reversible alterations of nitric oxide metabolism

T. B. Andrási, N. Stumpf, A. Blázovics

Research output: Contribution to journalArticle

Abstract

Background: Vascular endothelial dysfunction occurs in the kidney graft from marginal brain death (BD) donors and may be responsible for a low success rate after transplantation. Methods: BD was induced in 16 dogs for 6 hours. Immediately after the inflation of the intracranial balloon, the treated group (n = 8) received 40 mg/kg bolus followed by 3 mg/kg/min infusion of L-arginine for 30 minutes. Renal vascular function and hemodynamic and biochemical parameters were determined. Results: BD caused vasoconstriction, increase in renal venous nitrite (4.9 ± 0.8 versus 2.6 ± 0.1, P < .05) and myeloperoxidase levels (1.43 ± 0.04 versus 2.43 ± 0.23, P < .001), and reduced vasodilatation of renal artery to acetylcholine. Larginine diminished the renal vasoconstriction induced by 6 hour BD (RVR = 0.92 ± 0.06 versus 1.38 ± 0.003 in controls, P < .05), maintained renal oxygen extraction in physiological range (17.5 ± 4.6% versus 25.4 ± 2.9% in controls, P < .05) and prevented the rise of myeloperoxidase (1.69 ± 0.19, P < .05 versus controls) and nitrite levels (3.3 ± 0.5, P < .05), followed by preservation of endothelium dependent vasodilatation (P < .05 versus controls). Conclusions: The findings suggest that exogenous L-arginine supplementation may preserve endothelial vascular function in the kidney before prelevation from marginal BD donors.

Original languageEnglish
Pages (from-to)1495-1502
Number of pages8
JournalTransplantation proceedings
Volume43
Issue number5
DOIs
Publication statusPublished - Jun 1 2011

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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