Effects of brain death and glucose infusion on hepatic glycogen and blood hormones in the pig

We wished to study the effects of intravenous glucose/ insulin infusion to brain‐dead pigs on the hepatic glycogen content. Four groups of 40‐ kg pigs were studied: brain‐dead and control pigs given isotonic saline or glucose/insulin (7.5 mg glucose/kg/min, 1.25 mU insulin/kg/ min) (n = 5 to 10 in each group). Brain death was induced by inflating a balloon placed in the epidural space. In brain‐dead pigs given saline, liver glycogen decreased from 45 ± 11 mmol/g DNA (mean ± SEM) to 7 ± 3 mmol/ g DNA after 6 hours. Thereafter, it increased to 28 ± 9 mmol/g DNA after 9 hours ( P = .05 compared with the 6‐hour measurement). These changes were accompanied by transient increases in plasma adrenaline, glucose, free fatty acids (FFA), and glucagon. Following glucose/ insulin infusion, hepatic glycogen increased steadily and was approximately double after 12 hours ( P < .01) in both brain‐dead and in non‐brain‐dead pigs. In brain‐dead pigs, the increases in the aforementioned blood measurements were smaller following glucose/insulin infusion than following saline infusion. However, studies of longer duration will be needed to examine these effects on a time scale that is relevant to human organ donors. In conclusion, the decrease in hepatic glycogen content after brain death could be prevented by intravenous glucose/insulin infusion probably because of a reduction of the adrenaline response to the induction of brain death.