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Id: biblio-959571
Autor: Leiter H, Francisca; Valdés O, Rosario; Siña Z, Eduardo; Orellana A, Yessenia; Glasinovic P, Andrea; Chapochnick F, Javier.
Título: Ensayo pictórico: Imágenes en trasplante de páncreas: ¿qué debemos buscar? / Pictorial essay: Imaging in pancreas transplants: what should we look for?
Fonte: Rev. chil. radiol;24(1):34-39, mar. 2018. tab, ilus.
Idioma: es.
Resumo: El trasplante de páncreas es una alternativa terapéutica para pacientes diabéticos con complicaciones metabólicas severas y/o enfermedad renal crónica terminal. En el 80% de los casos, se realiza trasplante simultáneo de páncreas y riñón. El ultrasonido (US) es la técnica de elección para una primera evaluación del injerto, principalmente el modo Doppler espectral. Este último permite la evaluación de la vasculatura y perfusión de injerto. La tomografía computada (TC) y resonancia magnética (RM) se reservan para la evaluación de complicaciones (Tabla 1). Se realizó una revisión retrospectiva de una serie casos de trasplante páncreas-riñón realizada en nuestra institución entre los años 2014 y 2017, con un total de 12 casos.

Pancreas transplantation is a therapeutic alternative for diabetic patients with severe metabolic complications and/or terminal chronic kidney disease. In 80% of cases, a simultaneous transplant of pancreas and kidney is performed. Ultrasound (US) is the technique of choice for a first evaluation of the implant, mainly the spectral Doppler mode, which allows evaluation of the graft vasculature and perfusion. Computed tomography (CT) and magnetic resonance imaging (MRI) are reserved for the evaluation of complications (Table). A retrospective review of a series of cases of pancreas-kidney transplantation performed at our institution between 2014 and 2017 was carried out, with a total of 12 cases.
Descritores: Complicações Pós-Operatórias/diagnóstico por imagem
Transplante de Rim/métodos
Transplante de Pâncreas/métodos
-Tomografia Computadorizada por Raios X
Estudos Retrospectivos
Transplante de Rim/efeitos adversos
Transplante de Pâncreas/efeitos adversos
Ultrassonografia Doppler
Diabetes Mellitus/cirurgia
Insuficiência Renal Crônica/cirurgia
Limites: Seres Humanos
Masculino
Feminino
Adulto
Meia-Idade
Tipo de Publ: Relatos de Casos
Revisão
Responsável: CL30.1 - Biblioteca


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Id: lil-751436
Autor: Meirelles Júnior, Roberto Ferreira; Salvalaggio, Paolo; Pacheco-Silva, Alvaro.
Título: Pancreas transplantation: review / Transplante de pâncreas: revisão
Fonte: Einstein (Säo Paulo);13(2):305-309, Apr-Jun/2015. graf.
Idioma: en.
Resumo: ABSTRACT Vascularized pancreas transplantation is the only treatment that establishes normal glucose levels and normalizes glycosylated hemoglobin levels in type 1 diabetic patients. The first vascularized pancreas transplant was performed by William Kelly and Richard Lillehei, to treat a type 1 diabetes patient, in December 1966. In Brazil, Edison Teixeira performed the first isolated segmental pancreas transplant in 1968. Until the 1980s, pancreas transplants were restricted to a few centers of the United States and Europe. The introduction of tacrolimus and mycophenolate mofetil in 1994, led to a significant outcome improvement and consequently, an increase in pancreas transplants in several countries. According to the International Pancreas Transplant Registry, until December 31st, 2010, more than 35 thousand pancreas transplants had been performed. The one-year survival of patients and pancreatic grafts exceeds 95 and 83%, respectively. The better survival of pancreatic (86%) and renal (93%) grafts in the first year after transplantation is in the simultaneous pancreas-kidney transplant group of patients. Immunological loss in the first year after transplant for simultaneous pancreas-kidney, pancreas after kidney, and pancreas alone are 1.8, 3.7, and 6%, respectively. Pancreas transplant has 10 to 20% surgical complications requiring laparotomy. Besides enhancing quality of life, pancreatic transplant increases survival of uremic diabetic patient as compared to uremic diabetic patients on dialysis or with kidney transplantation alone.

RESUMO O transplante vascularizado de pâncreas é o único tratamento que estabelece normoglicemia e normaliza os níveis séricos de hemoglobina glicosilada em pacientes diabéticos tipo 1. O primeiro transplante de pâncreas vascularizado foi realizado para tratar um paciente diabético tipo 1 em dezembro de 1966, por William Kelly e Richard Lillehei. No Brasil, Edison Teixeira realizou o primeiro transplante de pâncreas segmentar isolado em 1968. Até a década de 1980, os transplantes de pâncreas ficaram restritos a poucos centros dos Estados Unidos e da Europa. A introdução dos imunossupressores tacrolimo e micofenolato mofetila, a partir de 1994, propiciou a melhora significativa dos resultados e a consequente realização de transplantes em escala crescente em vários países. Segundo o Registro Internacional de Transplante de Pâncreas, foram realizados, até 31 de dezembro de 2010, mais de 35 mil transplantes de pâncreas. Sobrevida no primeiro ano dos pacientes e dos enxertos pancreáticos excede, respectivamente, 95 e 83%. A melhor sobrevida dos enxertos pancreático (86%) e renal (93%), no primeiro ano pós-transplante, está na categoria de transplante simultâneo de pâncreas e rim. As perdas imunológicas no primeiro ano pós-transplante para transplante simultâneo de pâncreas e rim, transplante de pâncreas após rim e transplante de pâncreas isolado foram, respectivamente, 1,8, 3,7, e 6%. O transplante de pâncreas apresenta de 10 a 20% de complicações cirúrgicas, necessitando laparotomia. O transplante de pâncreas, além de melhorar a qualidade de vida, proporciona o aumento da sobrevida em diabéticos urêmicos, comparados aos diabéticos em diálise ou transplantados renais.
Descritores: Complicações Pós-Operatórias
Transplante de Pâncreas/métodos
Diabetes Mellitus Tipo 1/cirurgia
Rejeição de Enxerto/complicações
Infecção/complicações
-Estados Unidos
Brasil
Taxa de Sobrevida
Imunossupressão/métodos
Transplante de Pâncreas/mortalidade
Seleção do Doador/normas
Diabetes Mellitus Tipo 1/mortalidade
Transplantados
Limites: Seres Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-1005985
Autor: Fortunato, Rita Marcela; Arias, Héctor Emmanuel; Gutiérrez, Luis María; Mos, Fernando Amador; Raffaele, Pablo Miguel.
Título: Calcifilaxis luego del trasplante renal. Reporte de 3 casos clínicos / Calciphylaxis after renal transplant. Three clinical cases report
Fonte: Rev. nefrol. diál. traspl;36(1):12-20, ene. 2016. ilus.
Idioma: es.
Conferência: Apresentado em: XXIII Congreso Latinoamericano y del Caribe de Trasplante, STALYC 2015, Ciudad de Cancún, 14-17 oct. 2015.
Resumo: INTRODUCCIÓN: La calcifilaxis (CFX) es un síndrome caracterizado por depósito de calcio en la capa íntima y media de los vasos, proliferación, fibrosis y trombosis luminal, isquemia y necrosis tisular. Su reporte inicial y descripciones posteriores estuvieron asociados a la insuficiencia renal crónica terminal (IRCT). Hay poca información sobre el efecto que la recuperación de la función renal secundaria al trasplante renal produce en la incidencia de esta patología. MATERIAL Y MÉTODOS: Estudio retrospectivo unicéntrico. Se realizó un análisis retrospectivo de la cohorte de los 448 pacientes trasplantados de riñón y riñón y páncreas entre el 1 de enero de 2001 y el 1 de enero de 2014 en nuestro Servicio. RESULTADOS: Tres pacientes presentaron CFX confirmada por biopsia. En los 3 pacientes la CFX se asoció a hipercalcemia (calcemia promedio 11.5 mg/dl), en 2 de ellos al momento del diagnóstico. La Paratohormona intacta (PTHi) al momento del diagnóstico fue 2pg/ml, 62,3pg/ml y 3561pg/ml respectivamente. Dos pacientes eran diabéticos. Se halló hipoalbuminemia en los 3 pacientes. Sólo un paciente presentó obesidad, hiperfosfatemia y anticoagulación como factores de riesgo agregados. En todos los casos la biopsia proporcionó el diagnóstico de certeza para CFX. La mediana de la creatininemia en el momento del diagnóstico de CFX fue de 1,5 mg/dl (1,2mg/dl; 1,2mg/dl y 2mg/dl respectivamente) y el promedio de tiempo entre el trasplante y el desarrollo de CFX fue de 32 meses. En todos los casos se realizó un estricto control del fósforo, la hipercalcemia, las lesiones dérmicas y se administró tiosulfato de sodio IV durante 7 meses promedio. Se observó hipercalcemia al año post trasplante en el 19,59 % de los 448 pacientes estudiados, la evolución fue favorable dos pacientes, con control de la calcemia y mejoría de las manifestaciones cutáneas, y conservación de la función renal. CONCLUSIONES: La prevalencia de CFX luego de un TxR sobre un total de 448 pacientes trasplantados de riñón y de riñón y páncreas para el periodo 2001/2014 fue del 0,66%, inferior a los reportes de incidencia de CFX en diálisis. Los factores asociados a CFX en nuestros pacientes fueron la hipercalcemia al año post trasplante y al momento del evento, la hipoalbuminemia, la diabetes y los desórdenes de la glándula paratiroidea. La persistencia de la hipercalcemia al año post-trasplante renal debe ser un elemento de alta sospecha clínica de esta complicación

INTRODUCTION: Calciphylaxis (CFX) is a syndrome characterized by deposition of calcium in the intima and media of vessels, intimal proliferation, fibrosis, luminal thrombosis, tissue ischemia and necrosis. Its initial report and subsequent descriptions were associated with chronic renal failure. There is little information regarding the possible effect of the recovery of renal function secondary to kidney transplantation in the incidence of this disease. METHODS: Center retrospective study. We analyze in this report the three cases of patients who developed CFX after a renal transplant within a cohort of 448 kidney and kidney-pancreas transplant patients from January 1th 2001 to January 1th 2014 in our Hospital. RESULTS: Three patients were found to have CFX. All of them had hypercalcemia (serum calcium average 11.5 mg/dl) at first year post transplant and 2 patients at diagnosis of CFX. PTHi in the three CFX patients was 2 pg/ml, 62,3pg/ml and 3561pg/ml respectively. Hypoalbuminemia was found in all patients. Two patients were diabetic. Only one patient was obese and under anticoagulation treatment. In all cases a biopsy provided the diagnosis of certainty for calciphylaxis. Median serum creatinine at diagnosis was 1.5 mg/dl (1.2 mg/dl 1.2 mg/dl and 2 mg/dl, respectively) and the average time between transplantation and calciphylaxis diagnosis was 32 months. In all cases, strict control of phosphorus and hypercalcemia and sodium IV thiosulfate treatment was performed. The evolution was successful in two patients, controlling blood calcium and improving cutaneous manifestations with preservation of renal function. CONCLUSIONS: CFX prevalence in a cohort of 448 kidney and kidney-pancreas transplant patients from 2001 to 2014 was 0.66%, less than reported in dialysis patients. Factors associated with CFX in our patients were hypercalcemia in the first year after renal transplant and at the time of the event, hypoalbuminemia, diabetes and disorders of the parathyroid gland. The persistence of hypercalcemia in the first year after renal transplant should be an element of high clinical suspicion of this complication in the kidney transplant recipients
Descritores: Calciofilaxia
Transplante de Rim
Transplante de Pâncreas
Hipercalcemia
Limites: Seres Humanos
Responsável: AR444.1 - BAN - Biblioteca Argentina de Nefrología Dr. Víctor R. Miatello


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Id: biblio-869464
Autor: Ferrario B., Mario; Alba G., Andrea; Fierro C., Alberto; Buckel G., Erwin.
Título: Trasplante páncreas y riñón en Clínica Las Condes / Simultaneous kidney pancreas transplant, Clínica Las Condes experience
Fonte: Rev. Méd. Clín. Condes;21(2):273-277, mar. 2010. tab.
Idioma: es.
Resumo: El trasplante combinado páncreas-riñón (TPR) para pacientes portadores de Diabetes Mellitus 1 con insuficiencia renal crónica terminal, ha demostrado ser la única terapia que permite alcanzar el estado de normoglicemia de manera estable, situación que lleva a una disminución de las complicaciones crónicas de la DM y mejora la expectativa y calidad de vida. En nuestro país la tasa de realización de este trasplante es aún muy baja, lo que se debe a factores asociados a la donación y a una insuficiente divulgación de los resultados nacionales. Objetivo: Describir los resultados obtenidos por el equipo de trasplante de Clínica Las Condes en TPR desde el inicio del programa, en marzo 1994 a marzo 2009. Método: Se recopiló la información de los 12 pacientes sometidos a TPR en nuestro centro entre 1994 y marzo 2009, analizando las variables con estadística descriptiva y la sobrevida con curvas de Kaplan-Meier. Resultados: La sobrevida actuarial de pacientes a 5 y 10 años fue de 75 por ciento. La sobrevida actuarial de páncreas fue 83 por ciento a los 5 y 10 años, y la de riñón 74 por ciento en los mismos periodos. Nueve pacientes presentan injertos funcionantes a marzo 2009, todos los cuales realizan una vida normal. Discusión: Estos resultados son comparables a los presentados por centros extranjeros de prestigio internacional y se deben principalmente a avances en las técnicas quirúrgicas y de inmunosupresión. La baja tasa de complicaciones y alta sobrevida presentada refuerzan la necesidad de potenciar esta terapia en nuestro país.

Combined kidney-pancreas transplant (KPT) for patients with type 1 Diabetes Mellitus complicated with end stage renal disease has shown to be the best treatment to achieve a stable metabolic condition, which may lead to a decrease in chronic diabetes complications and improves quality of life and patient survival. In our country, the rate of this transplant is still very low, associated with donation issues and little knowledge of the results achieved by Chilean experience. Objective: describe the results obtained by Clínica Las Condes transplant team in KPT, from the beginning of the program in March 1994 to March 2009. Methods: Information of 12 patients undergoing KPT in our center from 1994 to march 2009, was collected and analyzed through descriptive statistics. Actuarial survival was calculated with Kaplan Meier formula. Results: Patient survival was 75 percent at 5 and 10 years. Kidney transplant survival was 74 percent and pancreas survival was 83 percent in the same periods. Nine patients have functioning grafts, all of them living a normal life. Discussion: These results are similar to those reported by foreign centers of international status and are due to advances in surgical techniques and immunosuppressive treatment. The low rate of complications and excellent survival presented in this article enforces the need to potentates this therapy in our country.
Descritores: Insuficiência Renal Crônica/cirurgia
Transplante de Pâncreas/estatística & dados numéricos
Transplante de Rim/estatística & dados numéricos
-Chile
Diabetes Mellitus Tipo 1/complicações
Diabetes Mellitus Tipo 1/epidemiologia
Seguimentos
Insuficiência Renal Crônica/epidemiologia
Rejeição de Enxerto/epidemiologia
Análise de Sobrevida
Transplante de Pâncreas/efeitos adversos
Transplante de Rim/efeitos adversos
Limites: Seres Humanos
Masculino
Adulto
Feminino
Meia-Idade
Responsável: CL37.1 - Biblioteca


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Id: biblio-869457
Autor: Zehnder B., Carlos.
Título: Trasplante de páncreas tipos, selección de receptores y donantes / Pancreas trasplantion: the different modalities, donor and recipient selection
Fonte: Rev. Méd. Clín. Condes;21(2):214-217, mar. 2010. tab.
Idioma: es.
Resumo: En este artículo se describe el estado actual del trasplante de páncreas, los tipos de trasplante más frecuentes -trasplante de páncreas aislado, trasplante de páncreas riñón- sus indicaciones, resultados y las características de receptores y donantes.

This article describes pancreas transplantation, the more frequent modalities such as pancreas transplantation alone and simultaneous pancreas kidney transplantation, their indications and outcomes, as well as the characteristics of suitable recipients and donors.
Descritores: Seleção do Doador
Doadores de Tecidos
Transplantados
Transplante de Pâncreas/métodos
-Diabetes Mellitus Tipo 1/cirurgia
Seleção de Pacientes
Transplante de Rim/métodos
Limites: Seres Humanos
Adulto
Responsável: CL37.1 - Biblioteca


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Id: biblio-830321
Autor: Caicedo, Luis Armando; Gómez-Vega, Juan Carlos; Serrano, Óscar Javier; Manzi, Eliana; Posada, Juan Guillermo; Mesa, Liliana; Schweineberg, Johanna; Durán, Carlos Eduardo; Arrunátegui, Ana María; Dávalos, Diana; Villegas, Jorge Iván; Echeverri, Gabriel Jaime.
Título: Derivación exocrina al duodeno en trasplante simultáneo de riñón y páncreas, experiencia en la Fundación Valle de Lili, Cali, Colombia / Exocrine bypass to the duodenum in simultaneous kidney and pancreas transplant, experience at Fundación Valle de Lili, Cali, Colombia
Fonte: Rev. colomb. cir;31(3):178-184, jul.-set. 2016. ilus, tab.
Idioma: es.
Resumo: Introducción: El trasplante simultáneo de riñón y páncreas es reconocido como un tratamiento eficaz para el manejo de pacientes con diabetes mellitus, principalmente de tipo I, e insuficiencia renal crónica. Sin embargo, hoy en día aún existe dificultad para el seguimiento del injerto pancreático, ya que no existe un marcador serológico definitivo que lo permita y persiste la dificultad para la toma de biopsias. Se ha descrito una modificación en la técnica quirúrgica que permitiría el acceso endoscópico mediante una duodeno-duodenostomía. Material y métodos. Se seleccionaron los pacientes que recibieron un trasplante simultáneo de riñón y páncreas con derivación exocrina al duodeno, evaluando la seguridad del procedimiento, la evolución y las complicaciones médico-quirúrgicas. Resultados. Nueve pacientes fueron sometidos a trasplante simultáneo de riñón y páncreas con derivación exocrina al duodeno. La mediana de la edad fue de 36 años y la mayoría era del sexo masculino. El tiempo de isquemia en frío fue de 10 horas para el injerto pancreático y de 11 horas para el renal. El tiempo total de hospitalización fue de 21 días. Se presentó una pérdida del injerto pancreático y una pérdida del injerto renal. Hubo una sola muerte, causada por aspergilosis pulmonar. Conclusiones. La derivación exocrina duodenal permite y facilita la evaluación y el seguimiento endoscópico del injerto pancreático. No supone una mayor exigencia técnica en el trasplante simultáneo de riñón y páncreas, ni un incremento en el número de complicaciones en relación directa con la modificación del procedimiento quirúrgico.

Introduction: Despite its recognition as an effective therapy for the management of patients with Type I diabetes mellitus and chronic renal failure, simultaneous kidney and pancreas transplant encounters difficulties in monitoring the pancreatic graft, and there is no strong serologic marker coupled with the difficulties in taking biopsies. We describe a modification of a surgical technique that allows endoscopic access through a duodenostomy. Material and methods. Patients who received simultaneous kidney-pancreas transplantation with exocrine bypass to the duodenum were selected to evaluate the safety of the procedure, the clinical postoperative course, and the medical and surgical complications. Results: Nine patients were submitted to simultaneous kidney-pancreas transplantation with exocrine bypass to the duodenum. Median age was 36, most patients where male. Cold ischemia time was 10 hours for the pancreatic graft and 11 hours for the kidney graft. Total hospital stay was 21 days. There was one death caused by pulmonary aspergillosis. Conclusion: The duodenal exocrine derivation permits and facilitates the evaluation and endoscopy follow-up of the pancreatic graft. It neither imposes greater technical demands in simultaneous kidney-pancreas transplantation, nor an increase in the number of complications directly related to the modification of the surgical procedure.
Descritores: Pâncreas Exócrino
-Complicações do Diabetes
Diabetes Mellitus
Transplante de Rim
Transplante de Pâncreas
Insuficiência Renal Crônica
Limites: Seres Humanos
Tipo de Publ: Artigo Clássico
Responsável: CO332 - Facultad de Medicina


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Id: lil-750508
Autor: Carena, Alberto A; Boughen, Santiago; Gagliardi, María Inés; Galante, Mariana.
Título: Diarrea aguda en trasplantes renales y reno-pancreáticos
Fonte: Medicina (B.Aires);75(1):29-36, Feb. 2015. graf, tab.
Idioma: es.
Projeto: Nación. Comisión Nacional Salud Investiga, Ministerio de Salud. Programa de Becas \"Carrillo-Oñativia.
Resumo: La diarrea es una complicación frecuente y potencialmente grave del trasplante renal. Se describen aquí, en un estudio de corte transversal, las características epidemiológicas y microbiológicas de la diarrea aguda y persistente en pacientes internados con trasplante renal o reno-páncreas. Se incluyeron 52 pacientes internados en un hospital de la Ciudad de Buenos Aires, 42 (80.8%) habían recibido un trasplante renal y 10 (19.2%) reno-páncreas. La diarrea fue el motivo de ingreso en 34 casos (65.4%). La etiología de la diarrea pudo estudiarse en 50 pacientes: en 25 (50%) no se arribó a un diagnóstico etiológico y en 18 (36%) se constató diarrea con causa microbiológica específica: 3 (6%) enfermedad por citomegalovirus, 6 (12%) diarrea atribuida a citomegalovirus, 5 (10%) a rotavirus y 4 (8%) a Clostridium difficile. En 7 (14%) la diarrea fue atribuida a fármacos (mofetil micofenolato y sirolimus). Aquellos con diarrea con causa microbiológica habían recibido recientemente inmunosupresores a altas dosis con mayor frecuencia que el resto (p = 0.048). Los pacientes con diarrea atribuida a fármacos recibían más frecuentemente mofetil micofenolato (p = 0.039). En 16 (30.8%) se realizaron modificaciones de los inmunosupresores como medida terapéutica, y a 47 (90.4%) se les indicó antibioticoterapia empírica. La mediana de duración de internación fue de 6 días y 7 pacientes (14.6%) persistieron con diarrea al quinto día. Todos tuvieron resolución de la diarrea al alta y un tercio persistió con insuficiencia renal. La información de este estudio puede servir para mejorar las medidas preventivas, diagnósticas y terapéuticas en estos pacientes.

Diarrhea is a frequent and potentially severe complication of kidney transplantation. We describe here, in a cross-sectional study, the epidemiological and microbiological characteristics of acute and persistent diarrhea in 52 inpatients with kidney and kidney-pancreas transplant in a hospital in Buenos Aires, 42 (80.8%) of whom had received a kidney and 10 (19.2%) a kidney-pancreas transplant. Diarrhea was the reason of admission of 34 cases (65.4%). The etiology could be studied in 50 patients: 25 (50%) had no etiological diagnosis of diarrhea and 18 (36%) had a specific infectious etiology: 3 (6%) cytomegalovirus disease, 6 (12%) diarrhea attributed to cytomegalovirus, 5 (10%) to rotavirus and 4 (8%) to Clostridium difficile. In 7 (14%) diarrhea was attributed to drugs (mycophenolate mofetil and sirolimus). Patients with infectious diarrhea had recently received high doses of immunosuppressive therapy more frequently than the rest (p = 0.048). Those with diarrhea attributed to drugs were more frequently on mycophenolate mofetil than the rest (p = 0.039). Empirical modification of the immunosuppressive treatment was done in 16 (30.8%) and empirical antibiotic therapy was given to 47 patients (90.4%). Median length of hospital stay was 6 days. Seven patients (14.6%) persisted with diarrhea at the fifth day of admission. At hospital discharge all cases had complete resolution of symptoms and one third persisted with kidney failure. Information provided in this study can be useful as a starting point for improving preventive, diagnostic and therapeutic measures in these patients.
Descritores: Infecções por Clostridium/complicações
Infecções por Citomegalovirus/complicações
Diarreia/etiologia
Transplante de Rim/efeitos adversos
Transplante de Pâncreas/efeitos adversos
Infecções por Rotavirus/complicações
-Estudos Transversais
Clostridium difficile/isolamento & purificação
Imunossupressores/efeitos adversos
Tempo de Internação/estatística & dados numéricos
Limites: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: AR1.2 - Instituto de Investigaciónes Epidemiológicas


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Id: lil-749990
Autor: Bernasconi, Amelia R; Voto, Liliana S; Waisman, Rosa; Heguilen, Ricardo M; Casadei, Domingo H.
Título: Trasplante renopáncreas: una nueva realidad en la nefro-obstetricia / Kidney and pancreas transplant: a new reality in nephroobstetrics
Fonte: Rev. nefrol. diál. traspl;34(2):87-94, 2014. tab.
Idioma: es.
Descritores: Transplante de Rim
Transplante de Pâncreas
Gravidez
Limites: Feminino
Gravidez
Tipo de Publ: Relatos de Casos
Responsável: AR444.1 - BAN - Biblioteca Argentina de Nefrología Dr. Víctor R. Miatello


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Id: lil-728646
Autor: Salzedas-Netto, Alcides Augusto; Gonzalez, Adriano Miziara; Fagundes, Ulysses; Linhares, Marcelo Moura; Vicentine, Fernando Pompeu Piza; Romero, Luis Ramiro Núñez; Martins, José Luis; Pestana, José Osmar Medina; Oliva, Carlos Alberto Garcia.
Título: Financial cost of the admissions for simultaneous pancreas-kidney transplant in a Brazilian Hospital
Fonte: Acta cir. bras;29(11):748-751, 11/2014. tab, graf.
Idioma: en.
Resumo: PURPOSE: To perform a cost analysis of simultaneous pancreas-kidney transplantation (SPKT) in a Brazilian hospital. METHODS: Between January 2008 and December 2011, 105 consecutive SPKTs at the Hospital of Kidney and Hypertension in Sao Paulo were evaluated. We evaluated the patient demographics, payment source (public health system or supplementary system), and the impact of each hospital cost component. The evaluated costs were corrected to December 2011 values and converted to US dollars. RESULTS: Of the 105 SPKT patients, 61.9% were men, and 38.1% were women. Eight patients died, and 97 were discharged (92.4%). Eighty-nine procedures were funded by the public health system. The cost for the patients who were discharged was $18.352.27; the cost for the deceased patients was $18.449.96 (p = 0.79). The FOR for SPKT during this period was positive at $5,620.65. The costs were distributed as follows: supplies, 36%; administrative costs, 20%; physician fees, 15%; intensive care unit, 10%; surgical center, 10%; ward, 9%. CONCLUSION: Mortality did not affect costs, and supplies were the largest cost component. .
Descritores: Custos e Análise de Custo
Transplante de Rim/economia
Transplante de Pâncreas/economia
-Brasil
Hospitalização/economia
Unidades de Terapia Intensiva/economia
Transplante de Rim/mortalidade
Transplante de Pâncreas/mortalidade
Estatísticas não Paramétricas
Fatores de Tempo
Limites: Feminino
Seres Humanos
Masculino
Responsável: BR1.1 - BIREME


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Id: lil-668800
Autor: Oliveira, Vanessa M. de; Brauner, Janete S.; Rodrigues Filho, Edison; Susin, Ruth G. A.; Draghetti, Viviane; Bolzan, Simone T.; Vieira, Silvia R. R..
Título: Is SAPS 3 better than APACHE II at predicting mortality in critically ill transplant patients?
Fonte: Clinics;68(2):153-158, 2013. ilus, tab.
Idioma: en.
Resumo: OBJECTIVES: This study compared the accuracy of the Simplified Acute Physiology Score 3 with that of Acute Physiology and Chronic Health Evaluation II at predicting hospital mortality in patients from a transplant intensive care unit. METHOD: A total of 501 patients were enrolled in the study (152 liver transplants, 271 kidney transplants, 54 lung transplants, 24 kidney-pancreas transplants) between May 2006 and January 2007. The Simplified Acute Physiology Score 3 was calculated using the global equation (customized for South America) and the Acute Physiology and Chronic Health Evaluation II score; the scores were calculated within 24 hours of admission. A receiver-operating characteristic curve was generated, and the area under the receiver-operating characteristic curve was calculated to identify the patients at the greatest risk of death according to Simplified Acute Physiology Score 3 and Acute Physiology and Chronic Health Evaluation II scores. The Hosmer-Lemeshow goodness-of-fit test was used for statistically significant results and indicated a difference in performance over deciles. The standardized mortality ratio was used to estimate the overall model performance. RESULTS: The ability of both scores to predict hospital mortality was poor in the liver and renal transplant groups and average in the lung transplant group (area under the receiver-operating characteristic curve = 0.696 for Simplified Acute Physiology Score 3 and 0.670 for Acute Physiology and Chronic Health Evaluation II). The calibration of both scores was poor, even after customizing the Simplified Acute Physiology Score 3 score for South America. CONCLUSIONS: The low predictive accuracy of the Simplified Acute Physiology Score 3 and Acute Physiology and Chronic Health Evaluation II scores does not warrant the use of these scores in critically ill transplant patients.
Descritores: Indicadores Básicos de Saúde
Mortalidade Hospitalar
Transplante de Rim/mortalidade
Transplante de Fígado/mortalidade
Transplante de Pulmão/mortalidade
Transplante de Pâncreas/mortalidade
-APACHE
Brasil
Estado Terminal/mortalidade
Unidades de Terapia Intensiva
Prognóstico
Medição de Risco
Curva ROC
Índice de Gravidade de Doença
Limites: Seres Humanos
Tipo de Publ: Estudo Comparativo
Estudos de Validação
Responsável: BR1.1 - BIREME



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