BRAIN DEATH From Inflammation to Metabolic Changes

BRAIN DEATH
From Inflammation to Metabolic Changes
Rolando Rebolledo Acevedo
ISBN: 978-94-6182-647-3
Copyright 2016 © Rolando Rebolledo
All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system or transmitted in any form or by any means without permission of the author.
Layout and printing: Off Page, Amsterdam
BRAIN Death:
DEATH: FROM
INFLAMMATION
Brain
From
Inflammation
TO METABOLIC CHANGES
to Metabolic Changes
PhD thesis
PhD thesis
to obtain the degree of PhD at the
University of Groningen
on the the
authority
to obtain
degreeofofthe
PhD at the
Rector Magnificus
E. Sterken
University Prof.
of Groningen
authoritywith
of the
andoninthe
accordance
Rector
Magnificus
Prof.
Sterken
the decision by the College ofE.Deans.
and in accordance with
the decision by the College of Deans.
This thesis will be defended in public on
This thesis will be defended in public on
Wednesday 6 January 2016 at 12.45 hours
Wednesday 6 January 2016 at 12.45 hours
by
by
Rolando Rebolledo Acevedo
born on 17 April 1982
Rolando
Rebolledo
Acevedo
in Santiago,
Chili
born on 17 April 1982
in Santiago, Chili
SUPERVISORS
Prof. H.G.D. Leuvenink
Prof. P. Romanque
Prof. B. Jespersen
ASSESSMENT COMMITTEE
Prof. A.J. Moshage
Prof. G. van Dijk
Prof. M. Arrese
TABLE OF CONTENTS
Chapter 1
Introduction9
Chapter 2
Prednisolone has a positive effect on the kidney but not on the liver
of brain dead rats: a potential role in complement activation
25
Chapter 3
Steroid anti-inflammatory effects did not improve organ quality
in Brain-dead Rats
45
Chapter 4
Anti-apoptotic effects of 3,3’, 5-triiodo-l-thyronine
in the liver of brain dead rats
65
Chapter 5
Slow induction of brain death leads to decreased renal function
and increased hepatic apoptosis in rats
85
Chapter 6
Metabolic Changes in Brain Dead Rats
109
Chapter 7
Non invasive assessment of tissue oxygenation and
organ perfusion in Brain Dead Rats.
127
Chapter 8
Mitochondrial function in Brain Dead Rats
143
Chapter 9
Summary, conclusion and future perspectives
169
Nederlandse samenvatting 175
Resumen en Español 181
Acknowledgements187
To my life partners Ximena and Simón
To Roberto Bolaños, chilean writer, who died waiting for a liver transplantation.
...los viajes, el sexo y los libros son caminos que no llevan a ninguna parte, y que sin
embargo son caminos por los que hay que internarse y perderse para volverse a encontrar
o para encontrar algo, lo que sea, un libro, un gesto, un objeto perdido, para encontrar
cualquier cosa, tal vez un método, con suerte: lo nuevo, lo que siempre ha estado allí.