Browsing by Author "Rebolledo Acevedo, Rolando Arturo"

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    Chilean experience in liver transplantation for acute liver failure in children
    (2010) Uribe, M.; Alba, A.; Hunter, B.; Valverde, C.; Godoy, J.; Ferrario, M.; Buckel, E.; Cavallieri, S.; Rebolledo Acevedo, Rolando Arturo; Herzog, C.; Calabrán, L.; Flores, L.; Soto, P.
    Background: Acute liver failure (ALF) in children is a life-threatening condition, associated with high mortality, and in almost one third of the cases, with no other therapeutic option than orthotopic liver transplant (OLT). The aim of this study was to present our experience with OLT for ALF in pediatric patients in Chile. Patients fulfilling the criteria for ALF who were transplanted in our centers were prospectively included in an excel Microsoft database. We analyzed demographics, etiology, surgical techniques, complications, and long-term results. Patients and Methods: Between 1994 and 2009, we transplanted 52 pediatric patients with ALF. The most frequent known etiology was acute hepatitis A in 9 cases (18%), but in 26 cases (50%) it was impossible to determine the etiology. Thirty- one patients were males (63%). The overall mean age was 7.5 years and the mean weight, 28.1 kg. Thirty-five (67%) received a cadaveric graft. Among them in 18 cases (34%) the liver had to be reduced but 17 (33%) received whole livers. There were 17 (33%) recipients of living-related livers. Twenty-two patients needed reoperation, including 13 due to surgical complications (59%) and 9 (41%) as planned interventions. Ten patients were retransplanted. Results: Actuarial survival of patients at 1 year was 80% and at 5 and 10 years, 72%. Graft survival at 1 year was 79%, at 5 years 69%, and at 10 years 50%. Conclusion: We have reported a series of pediatric liver transplant patients due to ALF whose results were comparable to other reported series. Living donor transplantation for ALF should be considered and offers a low morbidity rate without mortality.
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    Prednisolone has a positive effect on the kidney but not on the liver of brain dead rats: a potencial role in complement activation
    (2014) Rebolledo Acevedo, Rolando Arturo; Liu, Bo; Akhtar, Mohammed Z.; Ottens, Petra J.; Zhang, Jian-Ning; Ploeg, Rutger J.; Leuvenink, Henri G. D.
    Background: Contradictory evidence has been published on the effects of steroid treatments on the outcomes of kidney and liver transplantation from brain dead (BD) donors. Our study aimed to evaluate this disparity by investigating the effect of prednisolone administration on BD rats. Methods: BD induction was performed in ventilated rats by inflating a Fogarty catheter placed in the epidural space. Prednisolone (22.5 mg/kg) was administered 30 min prior to BD induction. After four hours of determination of BD: serum, kidney and liver tissues samples were collected and stored. RT-qPCR, routine biochemistry and immunohistochemistry were performed. Results: Prednisolone treatment reduced circulating IL-6 and creatinine plasma levels but not serum AST, ALT or LDH. Polymorphonuclear influx assessed by histology, and inflammatory gene expression were reduced in the kidney and liver. However, complement component 3 (C3) expression was decreased in kidney but not in liver. Gene expression of HSP-70, a cytoprotective protein, was down-regulated in the liver after treatment. Conclusions: This study shows that prednisolone decreases inflammation and improves renal function, whilst not reducing liver injury. The persistence of complement activation and the negative effect on protective cellular mechanisms in the liver may explain the disparity between the effects of prednisolone on the kidney and liver of BD rats. The difference in the molecular and cellular responses to prednisolone administration may explain the contradictory evidence of the effects of prednisolone on different organ types from brain dead organ donors.
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    The Crosstalk between ROS and Autophagy in the Field of Transplantation Medicine
    (2017) Van Erp, Anne C.; Hoeksma, Dane; Rebolledo Acevedo, Rolando Arturo; Ottens, Petra J.; Jochmans, Ina; Monbaliu, Diethard; Pirenne, Jacques; Leuvenink, Henri G. D.; Decuypere, Jean Paul