Translocation of bacteria and endotoxin in organ donors
H. van Goor, C. Rosman, J. Grond, K. Kooi, G. H. Wubbels and R. P. Bleichrodt
Department of Surgery, University Hospital Groningen, The Netherlands.
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.
