ArticleScientific reports2026
Increasing viability of pathological liver grafts from brain dead donors via intestinal parasympathetic nerve stimulation, or exogenous serotonin.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Livers from donors after brain death (DBDs) with alcohol-associated liver disease (ALD) or steatosis, which undergo prolonged cold ischemia are often not considered for transplantation. We evaluate whether norepinephrine and acetylcholine (ACh) deficiencies impair intestinal serotonin (5-HT) delivery to the liver in extended-criteria DBDs liver transplantation (LT). A DBD rat model with ALD or severe steatosis was used. Norepinephrine, ACh and 5-HT levels were evaluated in liver and intestine. Pharmacological (ACh or 5-HT administration) and electrical stimulation of intestinal parasympathetic nervous system (IPNS) were applied to evaluate their effects on ACh, 5-HT, liver and intestinal damage. Our results indicate that norepinephrine levels were maintained in DBDs, whereas ACh and 5-HT were depleted in both intestine and liver. IPNS stimulation or ACh infusion via mesenteric artery restored intestinal ACh, generating 5-HT and intestinal protection. Platelets potentially transported this 5-HT, with restoration of hepatic 5-HT and protection. Intravenous 5-HT (not intravenous ACh) produced similar benefits, which persisted after 24 h cold ischemia and reperfusion, improving survival. Thus, IPNS electrical stimulation or ACh administration via mesenteric artery (which reversed 5-HT deficiencies in intestine and liver) or 5-HT administration can make steatotic or ALD grafts from extended-criteria DBDs viable after prolonged ischemia, improving LT outcomes.
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