TRANSLOCATION OF BACTERIA AND ENDOTOXIN IN ORGAN DONORS

Objective: To determine if bacterial translocation and endotoxin absor ption occur in organ donors with an anatomically intact gastrointestin al tract. Design: Case series. Setting: Intensive care units in genera l and university hospitals. Patients: Twenty-one (multiple) organ dono rs. Intervention: None. Main Outcome Measures: Occurrence of factors t hat may promote bacterial translocation and/or endotoxin absorption. B acterial concentration in mesenteric lymph nodes, abdominal fluid, blo od, liver, lung, and spleen. Endotoxin level in abdominal fluid, perip heral blood, and portal blood. Anatomical integrity of the bowel wall. Results: Factors that may promote bacterial translocation and/or endo toxin absorption were present in all organ donors. Culture specimens r evealed bacteria in 14 Organ donors (67%). In 210 (81%) of 260 culture specimens, the bacteria isolated were identical to those isolated fro m the bowel content, demonstrating bacterial translocation. Endotoxin was found in nine (53%) of 17 abdominal fluid samples, in four (19%) o f 21 peripheral blood samples, and in two (10%) of 21 portal blood sam ples. Light- and electron-microscopic examination of the bowel wall sh owed no anatomical abnormalities. Conclusion: Bacterial translocation and endotoxin absorption are frequent among organ donors and may adver sely influence organ function in transplant recipients and other criti cally ill patients.