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Repletion of S-nitrosohemoglobin improves organ function and physiological status in swine after brain death.

Publication ,  Journal Article
Yurcisin, BM; Davison, TE; Bibbs, SM; Collins, BH; Stamler, JS; Reynolds, JD
Published in: Ann Surg
May 2013

OBJECTIVE: To determine if reduction in nitric oxide bioactivity contributes to the physiological instability that occurs after brain death and, if so, to also determine in this setting whether administration of a renitrosylating agent could improve systemic physiological status. BACKGROUND: Organ function after brain death is negatively impacted by reduced perfusion and increased inflammation; the magnitude of these responses can impact post-graft function. Perfusion and inflammation are normally regulated by protein S-nitrosylation but systemic assessments of nitric oxide bioactivity after brain death have not been performed. METHODS: Brain death was induced in instrumented swine by inflation of a balloon catheter placed under the cranium. The subjects were then serially assigned to receive either standard supportive care or care augmented by 20 ppm of the nitrosylating agent, ethyl nitrite, blended into the ventilation circuit. RESULTS: Circulating nitric oxide bioactivity (in the form of S-nitrosohemoglobin) was markedly diminished 10 hours after induction of brain death-a decline that was obviated by administration of ethyl nitrite. Maintenance of S-nitrosohemoglobin was associated with improvements in tissue blood flow and oxygenation, reductions in markers of immune activation and cellular injury, and preservation of organ function. CONCLUSIONS: In humans, the parameters monitored in this study are predictive of post-graft function. As such, maintenance of endocrine nitric oxide bioactivity after brain death may provide a novel means to improve the quality of organs available for donation.

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Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

May 2013

Volume

257

Issue

5

Start / End Page

971 / 977

Location

United States

Related Subject Headings

  • Tissue and Organ Harvesting
  • Swine
  • Surgery
  • Regional Blood Flow
  • Nitrites
  • Nitric Oxide
  • Linear Models
  • Kidney Function Tests
  • Hemoglobins
  • Brain Death
 

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Yurcisin, B. M., Davison, T. E., Bibbs, S. M., Collins, B. H., Stamler, J. S., & Reynolds, J. D. (2013). Repletion of S-nitrosohemoglobin improves organ function and physiological status in swine after brain death. Ann Surg, 257(5), 971–977. https://doi.org/10.1097/SLA.0b013e3182822c52
Yurcisin, Basil M., Tara E. Davison, Syreena M. Bibbs, Bradley H. Collins, Jonathan S. Stamler, and James D. Reynolds. “Repletion of S-nitrosohemoglobin improves organ function and physiological status in swine after brain death.Ann Surg 257, no. 5 (May 2013): 971–77. https://doi.org/10.1097/SLA.0b013e3182822c52.
Yurcisin BM, Davison TE, Bibbs SM, Collins BH, Stamler JS, Reynolds JD. Repletion of S-nitrosohemoglobin improves organ function and physiological status in swine after brain death. Ann Surg. 2013 May;257(5):971–7.
Yurcisin, Basil M., et al. “Repletion of S-nitrosohemoglobin improves organ function and physiological status in swine after brain death.Ann Surg, vol. 257, no. 5, May 2013, pp. 971–77. Pubmed, doi:10.1097/SLA.0b013e3182822c52.
Yurcisin BM, Davison TE, Bibbs SM, Collins BH, Stamler JS, Reynolds JD. Repletion of S-nitrosohemoglobin improves organ function and physiological status in swine after brain death. Ann Surg. 2013 May;257(5):971–977.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

May 2013

Volume

257

Issue

5

Start / End Page

971 / 977

Location

United States

Related Subject Headings

  • Tissue and Organ Harvesting
  • Swine
  • Surgery
  • Regional Blood Flow
  • Nitrites
  • Nitric Oxide
  • Linear Models
  • Kidney Function Tests
  • Hemoglobins
  • Brain Death