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[PMID]:28457413
[Au] Autor:Puliti Reigada CH; de Ataide EC; de Almeida Prado Mattosinho T; Boin IFSF
[Ad] Endereço:Unit of Liver Transplantation Unit, State University of Campinas, Campinas, Brazil.
[Ti] Título:Hepatic Artery Thrombosis After Liver Transplantation: Five-Year Experience at the State University of Campinas.
[So] Source:Transplant Proc;49(4):867-870, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hepatic artery thrombosis (HAT) is reported in 4%-15% of orthotopic liver transplants. Risk factors include technical error in the anastomosis, vascular anatomic variation, and high microvascular resistance. The aim of this study was to verify the incidence of HAT, early or late, and possible risk factors. METHODS: This was a retrospective study from January 2007 to December 2012 at the State University of Campinas. Variables analyzed were age, sex, cold and warm ischemia times, underlying disease, presence of hepatocellular carcinoma, Model for End-Stage Liver Disease (MELD) score, arterial anatomic variation in the graft, cytomegalovirus (CMV) infection, rejection, biliary complications, retransplantation rate, and survival. RESULTS: The incidence of HAT was 21/263, or 7.9%. Pure average MELD score was 22 ± 7.4. There was vascular anatomic variation in the graft in 14.2% of cases, in the majority (66.6%) a right hepatic artery from the superior mesenteric artery, and 4.76% of patients had CMV infection and acute cellular rejection (1 case each). There were biliary complications in 38% of patients, 13.3% of cases in patients with early HAT, and 100% of patients with late HAT (P = .002). Body mass index in late HAT was higher (P = .01). CONCLUSIONS: Late HAT was related to a significant increase in biliary complications (stenosis), and the survival rate was similar at 5 years.
[Mh] Termos MeSH primário: Artéria Hepática
Transplante de Fígado/efeitos adversos
Fígado/irrigação sanguínea
Trombose/epidemiologia
Transplantes/irrigação sanguínea
[Mh] Termos MeSH secundário: Carcinoma Hepatocelular/cirurgia
Isquemia Fria/efeitos adversos
Infecções por Citomegalovirus/complicações
Feminino
Rejeição de Enxerto/virologia
Seres Humanos
Incidência
Fígado/virologia
Neoplasias Hepáticas/cirurgia
Masculino
Artéria Mesentérica Superior
Meia-Idade
Reoperação/estatística & dados numéricos
Estudos Retrospectivos
Fatores de Risco
Índice de Gravidade de Doença
Taxa de Sobrevida
Trombose/etiologia
Isquemia Quente/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28457412
[Au] Autor:Bina Possatto M; de Ataíde EC; Fazzio Escanhoela CA; Sevá-Pereira T; de Cassia Martins Alves da Silva R; Felicio H; de Navarro Amado LR; Ferreira da Silva R; Soares Lima A; Boin IFSF
[Ad] Endereço:Unit of Liver Transplantation, Clinical Hospital, State University of Campinas, Campinas, Brazil.
[Ti] Título:Factors Related to Hepatocellular Carcinoma Recurrence After Liver Transplantation-A Brazilian Multicenter Study.
[So] Source:Transplant Proc;49(4):863-866, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Liver transplantation (LT) is a curative treatment option for hepatocellular carcinoma (HCC); recurrent HCC after liver transplantation (HCC-R) is diagnosed in 9%-16%. The objective of this study was to evaluate which factors are associated with R-HCC after liver transplantation. METHODS: This retrospective real-life study analyzed 278 LTs from 3 reference centers (2,093 LTs) in Brazil from 1988 to 2015. HCC-R with histologic confirmation was seen in 40 patients (14.4%). RESULTS: Most of them were male with cirrhosis secondary to viral hepatitis. Only 37.5% underwent chemoembolization, and 50% had cold ischemia time >8 hours. From the explant analysis, most of the patients were outside Milan criteria and 37.5% had microvascular invasion. The donors were mostly male, and the median intensive care unit time was >3 days. The Kaplan-Meier survival was lower according to alpha-fetoprotein (AFP) >200 ng/dL (P = .02), and older donors and more blood transfusions were risk factors for HCC-R death. CONCLUSION: AFP >200 ng/mL was associated with lower survival, and older donors and more blood transfusions were risk factors for death after HCC-R. A trend to lower survival was observed in patients who did not have chemoembolization and had cold ischemia times >8 hours.
[Mh] Termos MeSH primário: Carcinoma Hepatocelular/patologia
Isquemia Fria/efeitos adversos
Neoplasias Hepáticas/patologia
Transplante de Fígado/efeitos adversos
Recidiva Local de Neoplasia/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Transfusão de Sangue/estatística & dados numéricos
Brasil
Carcinoma Hepatocelular/cirurgia
Embolização Terapêutica
Feminino
Seres Humanos
Estimativa de Kaplan-Meier
Cirrose Hepática/cirurgia
Cirrose Hepática/virologia
Neoplasias Hepáticas/cirurgia
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Doadores de Tecidos
alfa-Fetoproteínas/análise
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (alpha-Fetoproteins)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28457402
[Au] Autor:de Freitas RAP; de Lima ML; Mazzali M
[Ad] Endereço:Renal Transplant Unit, Clinics Hospital, State University of Campinas, Campinas, São Paulo, Brazil; Division of Urology, Department of Surgery, State University of Campinas, Campinas, São Paulo, Brazil.
[Ti] Título:Early Vascular Thrombosis After Kidney Transplantation: Can We Predict Patients at Risk?
[So] Source:Transplant Proc;49(4):817-820, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Renal transplant is the therapy of choice for patients with chronic renal disease. In recent years, improvement in immunosuppressive drugs reduced early graft loss associated with acute rejection. However, vascular thrombosis, accounting for 5% of early graft loss, can sensitize the recipient for human leukocyte antibodies, reducing the chance for a second transplant. The aim of this study was to identify risk factors for vascular thrombosis in a single transplant center, to design specific prevention protocol. METHODS: This was a retrospective, case-control study. From the Renal Transplant Unit database, we identified 21 cases of vascular thrombosis in recipients of kidneys from deceased donors. Recipients from the contralateral kidney from the same donor, without vascular complications, were assigned to the control group. Data analyzed included donor, recipient, transplant surgery, and post-operative follow-up. The local ethics committee approved the protocol. RESULTS: Thrombosis and control groups were comparable for recipient characteristics, cold ischemia time, organ side (right or left), and site of arterial anastomosis. We observed an increased risk for vascular thrombosis in kidneys with multiple veins (odds ratio, 11.32; P = .03). Organ retrieval surgery complications, such as vascular lesions or heterogeneous perfusion, despite normal pre-implantation biopsy, were considered risk factors for vascular thrombosis within the first post-operative day (odds ratio, 7.1; P = .03). CONCLUSIONS: In this series, multiple renal vein and organ retrieval surgery complications were risk factors for early vascular thrombosis.
[Mh] Termos MeSH primário: Transplante de Rim/efeitos adversos
Trombose/epidemiologia
Trombose/etiologia
Coleta de Tecidos e Órgãos/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Estudos de Casos e Controles
Isquemia Fria/efeitos adversos
Feminino
Seres Humanos
Falência Renal Crônica/cirurgia
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Doadores de Tecidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:28457390
[Au] Autor:Reigada CHP; de Ataide EC; Mattosinho TDAP; Costa LBE; Escanhoela CA; Boin IFSF
[Ad] Endereço:Unit of Liver Transplantation, State University of Campinas, Brazil.
[Ti] Título:Association Safety of Liver Preservation Solutions at the State University of Campinas From 2010 to 2014.
[So] Source:Transplant Proc;49(4):761-764, 2017 May.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The probable reason for mixing solutions during the harvesting procedure is due to the presence of multiple transplant teams that have their own solution usage tradition. Despite numerous studies comparing the efficacy of different preservation solutions, there is no study addressing the associating solution and if there is any impact on liver graft and patient survival. The aim was to evaluate the effect of the association of preservation solutions during the harvesting procedure on liver transplantation outcomes, especially in relation to the degree of preservation injury in the postreperfusion period and patient survival. We analyzed 206 transplants that were distributed as follows: when there was association (89/206 = 43.2%) and when there was no association (117/206 = 56.8%). There was a statistically significant difference in relation to the degree of preservation injury correlated to cold ischemia time (P = .009, odds ratio 1.992; 95% confidence interval 1.185-3.347). Severe harvesting (grades III and IV) was 71.8% when the solution was not associated (P = .008). There was no difference regarding patient survival either. We found that the association of liver preservation solutions has no impact on patient survival, so it can be done safely. The best survival rate was associated with minimal harvesting.
[Mh] Termos MeSH primário: Sobrevivência de Enxerto/efeitos dos fármacos
Transplante de Fígado/mortalidade
Soluções para Preservação de Órgãos/efeitos adversos
Preservação de Órgãos/métodos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Isquemia Fria
Feminino
Seres Humanos
Fígado/efeitos dos fármacos
Estudos Longitudinais
Masculino
Meia-Idade
Estudos Retrospectivos
Taxa de Sobrevida
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Organ Preservation Solutions)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171218
[Lr] Data última revisão:
171218
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:29054234
[Au] Autor:Sponga S; Napgal D; Beltrami AP; Ferrara V; Nalon S; Finato N; Livi U
[Ad] Endereço:Cardiothoracic Department, University Hospital of Udine, Udine, Italy. Electronic address: sandro_sponga@yahoo.com.
[Ti] Título:Coronary Dissection Discovered During Ex Vivo Organ Preservation: Avoiding a Fatal Complication.
[So] Source:Ann Thorac Surg;104(5):e383-e384, 2017 Nov.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:This report describes the case of undiagnosed posttraumatic coronary artery dissection in a young multiorgan donor. Ex vivo preservation with the Organ Care System (TransMedics, Inc, Andover, MA) revealed the presence of coronary disease and avoided transplantation of an organ at high risk for failure.
[Mh] Termos MeSH primário: Aneurisma Dissecante/diagnóstico
Aneurisma Coronário/diagnóstico
Rejeição de Enxerto/prevenção & controle
Preservação de Órgãos/métodos
Doadores de Tecidos
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Adolescente
Aneurisma Dissecante/patologia
Isquemia Fria/métodos
Aneurisma Coronário/patologia
Erros de Diagnóstico
Feminino
Transplante de Coração
Seres Humanos
Técnicas In Vitro
Traumatismo Múltiplo/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171022
[St] Status:MEDLINE


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[PMID]:28658200
[Au] Autor:Messner F; Hautz T; Blumer MJF; Bitsche M; Pechriggl EJ; Hermann M; Zelger B; Zelger B; Öfner D; Schneeberger S
[Ad] Endereço:1 Center for Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Medical University Innsbruck, Innsbruck, Austria. 2 Department of Anatomy, Histology and Embryology, Division of Clinical and Functional Anatomy, Medical University Innsbruck, Innsbruck, Austria. 3 Department of Anesthesiology and Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria. 4 Department of Pathology, Medical University Innsbruck, Innsbruck, Austria. 5 Department of Dermatology, Medical University Innsbruck, Innsbruck, Austria.
[Ti] Título:Critical Ischemia Times and the Effect of Novel Preservation Solutions HTK-N and TiProtec on Tissues of a Vascularized Tissue Isograft.
[So] Source:Transplantation;101(9):e301-e310, 2017 Sep.
[Is] ISSN:1534-6080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: We herein investigate critical ischemia times and the effect of novel preservation solutions such as new histidine-tryptophan-ketoglutarate (HTK-N) and TiProtec on the individual tissues of a rat limb isograft. METHODS: Orthotopic hind-limb transplantations were performed in male Lewis rats after 2 hours, 6 hours, or 10 hours of cold ischemia (CI). Limbs were flushed and stored in HTK-N, TiProtec, HTK, or saline solution. Muscle, nerve, vessel, skin, and bone samples were procured on day 10 for histology, immunohistochemistry, confocal and electron microscopy, and quantitative real-time polymerase chain reaction analysis. RESULTS: Histomorphology of the muscle showed a mainly perivascular inflammatory infiltrate, fibrotic degeneration, and neovascularization after 6 hours and 10 hours of CI. However, centrally aligned nuclei observed in muscle fibers suggest for muscle regeneration in these samples. In addition to Wallerian degeneration, nerve injury was significantly aggravated (P = 0.032) after prolonged CI. Proinflammatory and regulatory cytokines were most significantly upregulated after 2-hour CI. Our data suggest no superiority of novel perfusates HTK-N and TiProtec in terms of tissue preservation, compared with HTK and saline. CONCLUSIONS: Limiting CI time for less than 6 hours is the most significant factor to reduce tissue damage in vascularized tissue transplantation. Signs of muscle regeneration give rise that ischemic muscle damage in limb transplantation might be reversible to a certain extent.
[Mh] Termos MeSH primário: Transplante Ósseo/efeitos adversos
Isquemia Fria/efeitos adversos
Membro Posterior/irrigação sanguínea
Membro Posterior/transplante
Soluções para Preservação de Órgãos/farmacologia
Preservação de Órgãos/métodos
Transplante de Pele/efeitos adversos
[Mh] Termos MeSH secundário: Animais
Transplante Ósseo/métodos
Citoproteção
Regulação da Expressão Gênica
Glucose/farmacologia
Membro Posterior/metabolismo
Membro Posterior/ultraestrutura
Isoenxertos
Masculino
Manitol/farmacologia
Microscopia Confocal
Microscopia Eletrônica de Transmissão
Modelos Animais
Desenvolvimento Muscular/efeitos dos fármacos
Cloreto de Potássio/farmacologia
Procaína/farmacologia
Ratos Endogâmicos Lew
Reação em Cadeia da Polimerase em Tempo Real
Regeneração/efeitos dos fármacos
Transplante de Pele/métodos
Fatores de Tempo
Sobrevivência de Tecidos/efeitos dos fármacos
Degeneração Walleriana
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bretschneider cardioplegic solution); 0 (HTK-N solution); 0 (Organ Preservation Solutions); 0 (TiProtec solution); 3OWL53L36A (Mannitol); 4Z8Y51M438 (Procaine); 660YQ98I10 (Potassium Chloride); IY9XDZ35W2 (Glucose)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.1097/TP.0000000000001845


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[PMID]:28437389
[Au] Autor:Watson CJE; Kosmoliaptsis V; Randle LV; Gimson AE; Brais R; Klinck JR; Hamed M; Tsyben A; Butler AJ
[Ad] Endereço:1 Department of Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom. 2 The NIHR Cambridge Biomedical Research Centre and the NIHR Blood and Transplant Research Unit in Organ Donation and Transplantation at the University of Cambridge, Cambridge, United Kingdom. 3 Department of Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom. 4 Department of Pathology, Addenbrooke's Hospital, Cambridge, United Kingdom. 5 Division of Perioperative Care, Addenbrooke's Hospital, Cambridge, United Kingdom. 6 University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, United Kingdom.
[Ti] Título:Normothermic Perfusion in the Assessment and Preservation of Declined Livers Before Transplantation: Hyperoxia and Vasoplegia-Important Lessons From the First 12 Cases.
[So] Source:Transplantation;101(5):1084-1098, 2017 May.
[Is] ISSN:1534-6080
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A program of normothermic ex situ liver perfusion (NESLiP) was developed to facilitate better assessment and use of marginal livers, while minimizing cold ischemia. METHODS: Declined marginal livers and those offered for research were evaluated. Normothermic ex situ liver perfusion was performed using an erythrocyte-based perfusate. Viability was assessed with reference to biochemical changes in the perfusate. RESULTS: Twelve livers (9 donation after circulatory death [DCD] and 3 from brain-dead donors), median Donor Risk Index 2.15, were subjected to NESLiP for a median 284 minutes (range, 122-530 minutes) after an initial cold storage period of 427 minutes (range, 222-877 minutes). The first 6 livers were perfused at high perfusate oxygen tensions, and the subsequent 6 at near-physiologic oxygen tensions. After transplantation, 5 of the first 6 recipients developed postreperfusion syndrome and 4 had sustained vasoplegia; 1 recipient experienced primary nonfunction in conjunction with a difficult explant. The subsequent 6 liver transplants, with livers perfused at lower oxygen tensions, reperfused uneventfully. Three DCD liver recipients developed cholangiopathy, and this was associated with an inability to produce an alkali bile during NESLiP. CONCLUSIONS: Normothermic ex situ liver perfusion enabled assessment and transplantation of 12 livers that may otherwise not have been used. Avoidance of hyperoxia during perfusion may prevent postreperfusion syndrome and vasoplegia, and monitoring biliary pH, rather than absolute bile production, may be important in determining the likelihood of posttransplant cholangiopathy. Normothermic ex situ liver perfusion has the potential to increase liver utilization, but more work is required to define factors predicting good outcomes.
[Mh] Termos MeSH primário: Seleção do Doador
Hiperóxia/etiologia
Transplante de Fígado/métodos
Perfusão/métodos
Complicações Pós-Operatórias/etiologia
Vasoplegia/etiologia
Isquemia Quente/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Isquemia Fria
Seguimentos
Seres Humanos
Hiperóxia/prevenção & controle
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Perfusão/efeitos adversos
Complicações Pós-Operatórias/prevenção & controle
Vasoplegia/prevenção & controle
Isquemia Quente/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170425
[St] Status:MEDLINE
[do] DOI:10.1097/TP.0000000000001661


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[PMID]:28411916
[Au] Autor:Zabell JR; Wu J; Suk-Ouichai C; Campbell SC
[Ad] Endereço:Glickman Urological and Kidney Institute, Department of Urology, Cleveland Clinic, 9500 Euclid Avenue, Mail Code Q10-1, Cleveland, OH 44195, USA.
[Ti] Título:Renal Ischemia and Functional Outcomes Following Partial Nephrectomy.
[So] Source:Urol Clin North Am;44(2):243-255, 2017 May.
[Is] ISSN:1558-318X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Renal function after renal cancer surgery is a critical component of survivorship. Quantity and quality of preserved parenchyma are the most important determinants of functional recovery; type and duration of ischemia play secondary roles. Several studies evaluated surgical techniques to minimize ischemia; however, long-term outcomes and potential benefits over clamped partial nephrectomy (PN) have not been consistently demonstrated. Analysis of acute kidney injury (AKI) after PN suggest that most kidneys recover strongly even if AKI is experienced after surgery. Ongoing study is required to evaluate long-term implications of AKI after PN and further assess impact of ischemia on functional outcomes.
[Mh] Termos MeSH primário: Lesão Renal Aguda/epidemiologia
Isquemia Fria
Neoplasias Renais/cirurgia
Nefrectomia/métodos
Complicações Pós-Operatórias/epidemiologia
Isquemia Quente
[Mh] Termos MeSH secundário: Lesão Renal Aguda/etiologia
Seres Humanos
Complicações Pós-Operatórias/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170427
[Lr] Data última revisão:
170427
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170417
[St] Status:MEDLINE


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[PMID]:28366459
[Au] Autor:Crawford TC; Magruder JT; Grimm JC; Kemp CD; Suarez-Pierre A; Zehr KJ; Mandal K; Whitman GJ; Conte JV; Higgins RS; Cameron DE; Sciortino CM
[Ad] Endereço:Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
[Ti] Título:The Paradoxical Relationship Between Donor Distance and Survival After Heart Transplantation.
[So] Source:Ann Thorac Surg;103(5):1384-1391, 2017 May.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Concerns over prolonged allograft ischemia have limited the widespread adoption of long-distance organ procurement in heart transplantation (HT). We sought to assess whether donor distance from the center of transplantation independently affects mortality. METHODS: We queried the United Network for Organ Sharing (UNOS) database for adults undergoing isolated HT from 2005 to 2012. Risk-adjusted Cox proportional hazards models were constructed for the primary outcomes of 30-day and 1-year mortality, and the independent impact of donor distance from transplantation center at the time of procurement was assessed. RESULTS: We included 14,588 heart transplant recipients. The mean distance from location of the donor heart to transplantation center was 184.4 ± 214.6 miles; 1,214 HTs (8.3%) occurred at the same location as the donor heart. Ischemic times were inversely related to the distance from the site of donor procurement to recipient transplantation. After risk adjustment, longer donor distances (in miles) were associated with a significantly lower risk of mortality at both 30 days (hazard ratio [HR] 0.9993, 95% confidence interval [CI]: 0.9988 to 0.9998, p < 0.01) and 1 year (HR 0.9994, 95% CI: 0.9989 to 0.9999, p = 0.015). Risk-adjusted hazards for mortality were significantly reduced in recipients receiving hearts from more than 25 miles away. The hazard reduction was greatest in recipients receiving donor hearts from more than 500 miles away (1-year HR 0.64, p < 0.01; 30-day HR 0.47, p < 0.01). CONCLUSIONS: Longer distances between donor location and center of heart transplantation are associated with a reduced hazard for survival at 30 days and 1 year, despite greater ischemic times. Future studies are necessary to elucidate the protective factors surrounding long-distance heart donation.
[Mh] Termos MeSH primário: Sobrevivência de Enxerto
Acesso aos Serviços de Saúde/estatística & dados numéricos
Transplante de Coração/mortalidade
Complicações Pós-Operatórias/mortalidade
Coleta de Tecidos e Órgãos/estatística & dados numéricos
Obtenção de Tecidos e Órgãos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Idoso
Isquemia Fria/estatística & dados numéricos
Bases de Dados Factuais
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Modelos de Riscos Proporcionais
Isquemia Quente/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE


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[PMID]:28340802
[Au] Autor:Karayagiz AH; Erturk T; Cakir U; Berber I
[Ad] Endereço:Transplant Center, Acibadem International Hospital, Acibadem University, Istanbul, Turkey.
[Ti] Título:Comparison of Two Different Laparoscopic Donor Nephrectomy With Vaginal Extraction Techniques-A Single-Center Experience.
[So] Source:Transplant Proc;49(3):411-414, 2017 Apr.
[Is] ISSN:1873-2623
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to compare the results of standard laparoscopic donor nephrectomy with vaginal extraction (SLDN-VE) and laparoendoscopic single-site donor nephrectomy with vaginal extraction (LESSDN-VE). METHODS: We analyzed the data of 95 female donors who underwent SLDN-VE (group I; n = 87) and LESSDN-VE (group II; n = 8) in our center. Parameters regarding donor age, body mass index (BMI), length of hospitalization, duration of surgical procedure, amount of blood loss, warm and cold ischemia times, side of graft nephrectomy, number of renal arteries and veins, postoperative visual analog pain scores at 6th and 12th hours (VAS6, VAS12), peri-and postoperative complications of donors and recipients, and graft function at discharge and follow-up were compared between the 2 groups. RESULTS: No significant difference regarding donor age, mean operative time, amount of blood loss, or warm ischemia time was observed between the 2 groups. However, BMI (P = .018) and pain scores (VAS6: P = .047; VAS12: P = .009) were lower and length of hospitalization (P = .005) shorter in group II. On the other hand, cold ischemia time (P = .047) was lower in group I. No peri- or postoperative complications occurred for donors and recipients in both groups. Graft function at discharge and during follow-up were similar in both groups. CONCLUSIONS: Because our first priority is to minimize the morbidity of donors, LESSDN-VE can be chosen in selected female donors for not only decreased pain and hospital stay, but also for better cosmetic outcomes.
[Mh] Termos MeSH primário: Doadores Vivos
Nefrectomia/métodos
Coleta de Tecidos e Órgãos/métodos
[Mh] Termos MeSH secundário: Adulto
Isquemia Fria
Feminino
Seres Humanos
Transplante de Rim/métodos
Laparoscopia/métodos
Tempo de Internação
Meia-Idade
Duração da Cirurgia
Complicações Pós-Operatórias
Artéria Renal
Vagina
Isquemia Quente
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170529
[Lr] Data última revisão:
170529
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170326
[St] Status:MEDLINE



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