Slow induction of brain death leads to decreased renal function and increased hepatic apoptosis in rats

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dc.contributor.authorRebolledo, Rolando
dc.contributor.authorHoeksma, Dane.
dc.contributor.authorHottenrott, Christina M. V.
dc.contributor.authorBodar, Yves J. L.
dc.contributor.authorOttens, Petra J.
dc.contributor.authorWiersema Buist, Janneka.
dc.contributor.authorLeuvenink, Henri G. D.
dc.date.accessioned2019-10-17T18:21:54Z
dc.date.available2019-10-17T18:21:54Z
dc.date.issued2016
dc.date.updated2019-10-14T18:49:13Z
dc.description.abstractAbstract Background Donor brain death (BD) is an independent risk factor for graft survival in recipients. While in some patients BD results from a fast increase in intracranial pressure, usually associated with trauma, in others, intracranial pressure increases more slowly. The speed of intracranial pressure increase may be a possible risk factor for renal and hepatic graft dysfunction. This study aims to assess the effect of speed of BD induction on renal and hepatic injury markers. Methods BD induction was performed in 64 mechanically ventilated male Fisher rats by inflating a 4.0F Fogarty catheter in the epidural space. Rats were observed for 0.5, 1, 2 or 4 h following BD induction. Slow induction was achieved by inflating the balloon-catheter at a speed of 0.015 ml/min until confirmation of BD. Fast induction was achieved by inflating the balloon at 0.45 ml/min for 1 min. Plasma, kidney and liver tissue were collected for analysis. Results Slow BD induction led to higher plasma creatinine at all time points compared to fast induction. Furthermore, slow induction led to increased renal mRNA expression of IL-6, and renal MDA values after 4 h of BD compared to fast induction. Hepatic mRNA expression of TNF-α, Bax/Bcl-2, and protein expression of caspase-3 was significantly higher due to slow induction after 4 h of BD compared to fast induction. PMN infiltration was not different between fast and slow induction in both renal and hepatic tissue. Conclusion Slow induction of BD leads to poorer renal function compared to fast induction. Renal inflammatory and oxidative stress markers were increased. Liver function was not affected by speed of BD induction but hepatic inflammatory and apoptosis markers increased significantly due to slow induction compared to fast induction. These results provide initial proof that speed of BD induction influences detrimental renal and hepatic processes which could signify different donor management strategies for patients progressing to BD at different speeds.Abstract Background Donor brain death (BD) is an independent risk factor for graft survival in recipients. While in some patients BD results from a fast increase in intracranial pressure, usually associated with trauma, in others, intracranial pressure increases more slowly. The speed of intracranial pressure increase may be a possible risk factor for renal and hepatic graft dysfunction. This study aims to assess the effect of speed of BD induction on renal and hepatic injury markers. Methods BD induction was performed in 64 mechanically ventilated male Fisher rats by inflating a 4.0F Fogarty catheter in the epidural space. Rats were observed for 0.5, 1, 2 or 4 h following BD induction. Slow induction was achieved by inflating the balloon-catheter at a speed of 0.015 ml/min until confirmation of BD. Fast induction was achieved by inflating the balloon at 0.45 ml/min for 1 min. Plasma, kidney and liver tissue were collected for analysis. Results Slow BD induction led to higher plasma creatinine at all time points compared to fast induction. Furthermore, slow induction led to increased renal mRNA expression of IL-6, and renal MDA values after 4 h of BD compared to fast induction. Hepatic mRNA expression of TNF-α, Bax/Bcl-2, and protein expression of caspase-3 was significantly higher due to slow induction after 4 h of BD compared to fast induction. PMN infiltration was not different between fast and slow induction in both renal and hepatic tissue. Conclusion Slow induction of BD leads to poorer renal function compared to fast induction. Renal inflammatory and oxidative stress markers were increased. Liver function was not affected by speed of BD induction but hepatic inflammatory and apoptosis markers increased significantly due to slow induction compared to fast induction. These results provide initial proof that speed of BD induction influences detrimental renal and hepatic processes which could signify different donor management strategies for patients progressing to BD at different speeds.
dc.fuente.origenBiomed Central
dc.identifier.citationJournal of Translational Medicine. 2016 May 19;14(1):141
dc.identifier.doi10.1186/s12967-016-0890-0
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/26828
dc.issue.numeroNo. 141
dc.language.isoen
dc.nota.accesoContenido completo
dc.pagina.final12
dc.pagina.inicio1
dc.revistaJournal of Translational MedicineJournal of Translational Medicinees_ES
dc.rightsacceso abierto
dc.rights.holderThe Author(s).
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.otherMuerte cerebrales_ES
dc.subject.otherDonaciones de órganos, tejidos, etces_ES
dc.subject.otherRiñones - Trasplantees_ES
dc.subject.otherHigado -Trasplantees_ES
dc.titleSlow induction of brain death leads to decreased renal function and increased hepatic apoptosis in ratses_ES
dc.typeartículo
dc.volumenVol.14
sipa.codpersvinculados127520
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