Translocation of Bacteria and Endotoxin in Organ Donors
Harry van Goor, MD;
Camiel Rosman, MD;
Joris Grond, MD;
Kor Kooi, MD;
Gerhard H. Wübbels, MD;
Robert P. Bleichrodt, MD
Arch Surg. 1994;129(10):1063-1066.
Abstract
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Objective
To determine if bacterial translocation and endotoxin absorption occur in organ donors with an anatomically intact gastrointestinal tract.
Design
Case series.
Setting
Intensive care units in general and university hospitals.
Patients
Twenty-one (multiple) organ donors.
Intervention
None.
Main Outcome Measures
Occurrence of factors that may promote bacterial translocation and/or endotoxin absorption. Bacterial concentration in mesenteric lymph nodes, abdominal fluid, blood, liver, lung, and spleen. Endotoxin level in abdominal fluid, peripheral blood, and portal blood. Anatomical integrity of the bowel wall.
Results
Factors that may promote bacterial translocation and/or endotoxin absorption were present in all organ donors. Culture specimens revealed bacteria in 14 organ donors (67%). In 210 (81%) of 260 culture specimens, the bacteria isolated were identical to those isolated from the bowel content, demonstrating bacterial translocation. Endotoxin was found in nine (53%) of 17 abdominal fluid samples, in four (19%) of 21 peripheral blood samples, and in two (10%) of 21 portal blood samples. Light- and electron-microscopic examination of the bowel wall showed no anatomical abnormalities.
Conclusion
Bacterial translocation and endotoxin absorption are frequent among organ donors and may adversely influence organ function in transplant recipients and other critically ill patients.
(Arch Surg. 1994;129:1063-1066)
Author Affiliations
From the Departments of Surgery (Drs van Goor and Rosman) and Public Health (Drs Kooi and Wübbels); University Hospital Groningen; the Department of Public Health, Leeuwarden (Dr Grond), and the Department of Surgery, Twenteborg Hospital Almelo (Dr Bleichrodt), the Netherlands.
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