ESTELA AZEKA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
- PEDIATRIC HEART TRANSPLANTATION PROGRAM: SINGLE CENTER EXPERIENCE OF 20 YEARS(2013) AZEKA, Estela; GALAS, Filomena; TANAMATI, Carla; PENHA, Juliano; FERNANDES, Marcos; SENAHA, Luciano; XAVIER, Johnny; DELGADO, Ana Beatriz Romani; KAJITA, Luiz; AIELLO, Vera; BENVENUTI, Luiz; MIURA, Nana; AULER JUNIOR, Jose Otavio Costa; JATENE, MarceloOBJECTIVE: Heart transplantation has been the treatment of choice for children with refractory to conventional therapy. To report the experience with heart transplantation in a single center. MATERIAL AND METHODS: To report the single center experience of hearttransplantation. Data analysis was demographic characteristics, clinical outcome and survival Kaplan Meier curve. RESULTS: From October 30, 1992 to October 2nd, 2012, 120 transplants were performed and 115 patients were submitted to heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil. The causes of indication for transplantation were: cardiomyopathies (76%) and congenital heart disease (24%). Five patients were submitted to re-transplantation. Three of them were re-transplanted on the early postoperative period with high mortality (66.6%). One patient was submitted to simultaneous re-transplantation and kidney transplantation after 13.9 yrs of follow-up and one of patient was successful re-transplanted after 10 yr of follow-up. The post-operative immunosuppression regimen was double immunosuppression and polyclonal anti-thymocyte serum induction therapy. The actuarial survival was 80%, 71%, and 61% at 1, 5, and 10 yr, respectively. CONCLUSION: Heart transplantation has been a promising option for children. The use of double immunosuppression with polyclonal anti-thymocyte serum induction therapy combined with surveillance of acute rejection with non-invasive tests may provide favorable clinical outcome.
bookPart Insuficiência cardíaca congestiva e transplante cardíaco na criança(2016) AZEKA, Estela; RIBEIRO, Anna Christina; THOMAZ, Ana Maria; GUIMARãES, Vanessa; GALAS, Filomena Regina; HOROWITZ, Estela; SIQUEIRA, Adailson; BENVENUTI, Luiz; ZORZANELLI, Leina; JATENE, Marcelo- Heart Transplantation in Pediatric Population and in Adults With Congenital Heart Disease: Long-term Follow-up, Critical Clinical Analysis, and Perspective for the Future(2014) AZEKA, E.; JATENE, M.; GALAS, F. R. B.; TANAMATI, C.; PENHA, J.; BENVENUTI, L.; MIURA, N.; JUNIOR, J. O. C.Background. Heart transplantation is a treatment option for children as well as for adults with congenital heart disease. Objective. To report the experience of a tertiary center with heart transplant program in pediatric population and in adults with congenital heart disease. Patients and Methods. The study consisted of the evaluation of pediatric as well as adult patients undergoing heart transplantation for congenital heart disease. We evaluated the following indication and complications such as renal dialysis, graft vascular disease, tumors and survival. Results. From October 1992 to November 2013, 134 patients had transplantation, and there were 139 transplantations and 5 retransplantations. The immunosuppression regimen is based on calcineurin inhibitors and cytostatic drugs. The type of heart disease indicated for transplantation was cardiomyopathies in 70% and congenital heart disease in 30%. Of these 134 patients, 85 patients were alive. Actuarial survival is 77.4%, 69.6%, 59.3% at 1, 5, and 10 years after transplantation. Three patients underwent renal transplantation, 1 patient is in renal dialysis, and 8.2% of patients had post-transplant lymphoproliferative disease. Two patients had retransplantation for graft vascular disease; 1 of them required a simultaneous kidney transplant and died 30 days after the procedure and 1 patient is clinically well 2 years after retransplantation. Conclusion. Heart transplantation in children and in adults with congenital heart disease is a promising therapeutic option and enables long-term survival for these patients.
conferenceObject HEART TRANSPLANTATION IN PEDIATRIC AND ADULT WITH CONGENITAL HEART DISEASE: CURRENT STATUS.(2017) COUTINHO, K.; SIQUEIRA, A.; BENVENUTI, L.; MIURA, N.; JATENE, M.; AZEKA, E.conferenceObject RESTRICTIVE AND HYPERTROPHIC CARDIOMYOPATHIES AS INDICATION FOR HEART TRANSPLANTATION: CLINICAL OUTCOME IN A SINGLE CENTER(2013) TANAKA, Ana Cristina; MIURA, Nana; THOMAZ, Ana Maria; AIELLO, Vera Demarchi; BENEVENUTI, Luiz; TAVARES, Glaucia; NOMURA, Cesar; JATENE, Marcelo Biscegli; AZEKA, EstelaPURPOSE: The purpose of this study was evaluate the prevalence and outcome of restrictive and hypertrophic cardiomyopathies in a cohort of pediatric heart transplantation. METHOD: To evaluate the prevalence and clinical outcome of children with restrictive and hypertrophic cardiomyopathies submitted heart transplantation. RESULTS: From october 1992 to 2012, 115 patients were submitted heart transplantation. 120 transplants were performed at Heart Institute (InCor) University São Paulo Medical School. Seventeen (14,7%) of these patients hat restrictive cardiomyopathy/hypertrophic cardiomyopathy and have undergone to heart transplantation. The mean age was 10,4 years. Survival was 76,4%. Follow-up period ranged from 26 days to 6,6 years. CONCLUSION: Restrictive and hypertrophic cardiomyopathies can be an indication for heart transplantation a favorable outcome.- POSTTRANSPLANT LYMPHOPROLIFERATIVE DISEASE IN CHILDREN AFTER HEART TRANSPLANTATION(2013) MARCONDES, Rafael; JATENE, Marcelo; CRISTOFANI, Lilian; TANAMATI, Carla; FERNANDES, Marcos; BENVENUTI, Luiz; ODONI, Vicente; MIURA, Nana; AZEKA, EstelaOBJECTIVE: The purpose of this study was to evaluate the prevalence of PTLD after pediatric heart transplantation in a single center. PATIENTS AND METHODS: From 1992 to 2012, 115 patients were submitted to heart transplantation. One hundred and twenty transplants were performed. The clinical findings and outcome were evaluated. RESULTS: Nine (7.8%) of 115 patients developed PTLD. The presentation of PTLD was cervical tumor in three patients, abdominal tumor in three patients and pulmonary nodules in three patients. Five (55.5%) patients are alive. All had positive serology for EBV. CONCLUSION: PTLD is a severe complication after heart transplantation. Therapeutic strategies need to be developed to improve the survival in this
conferenceObject CLINICAL CHALLENGES AFTER PEDIATRIC HEART TRANSPLANTATION: 20 YEARS OF EXPERIENCE(2013) AZEKA, Estela; AULER, Jose Otavio; GALAS, Filomena; TANAMATI, Carla; PENHA, Juliano; KAJITA, Luiz; AIELLO, Vera; BENVENUTI, Luiz; JATENE, MarceloPURPOSE: Heart transplantation has been the treatment of choice for children with refractory to conventional therapy. Objective: to report the clinical experience with heart transplantation in a single center. METHOD: To report the single center experience of heart transplantation. Data analysis was demographic characteristics, clinical outcome and survival Kaplan Meier curve. RESULTS: From October 30, 1992 to October 2nd, 2012, 120 transplants were performed and 115 patients were submitted to heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School, Sao Paulo, Brazil. The causes of indication for transplantation were: cardiomyopathies (76%) and congenital heart disease (24%). Five patients were submitted to re-transplantation. Three of them were re-transplanted on the early postoperative period with high mortality (66.6%). One patient was submitted to simultaneous re-transplantation and kidney transplantation after 13.9 years of follow-up and one of patient was successful re-transplanted after 10 year of follow-up. The post-operative immunosuppression regimen was double immunosuppression and polyclonal anti-thymocyte serum induction therapy. The actuarial survival was 80%, 71%, and 61% at 1, 5, and 10 yr, respectively. CONCLUSION: Heart transplantation has been a promising option for children. The use of double immunosuppression with polyclonal anti-thymocyte serum induction therapy combined with surveillance of acute rejection with non-invasive tests may provide favorable clinical outcome.- Case Report: The Challenge for Diagnosis of Myocarditis and Transplant Rejection After COVID Infection in a Heart-Transplanted Adolescent(2023) PEGADO, Helio Milani; SIQUEIRA, Adailson; NAVARAJASEGARAN, Joshua; BENVENUTI, Luiz Alberto; CASTRO, Claudia Regina Pinheiro; ARRIETA, Santiago Raul; GUTIERREZ, Paulo Sampaio; DOLHNIKOFF, Marisa; AIELLO, Vera Demarchi; JATENE, Marcelo Biscegli; AZEKA, EstelaPatients who have undergone organ transplantation are immunosuppressed hosts, leaving them at a higher risk of infections. SARS-COV-2 has been shown to affect heart-transplanted patients. In this case report, we present the case of a 14-year-old heart transplant recipient who developed signs and symptoms of heart failure, along with fatigue, after a COVID-19 infection. An endomyocardial biopsy was performed to diagnose rejection and to evaluate whether this was myocarditis due to SARS-COV-2. The biopsy showed intense acute cellular rejection (3R) and antibody rejection PAMR1 H+ but was negative for the SARS-CoV-2 virus. The patient received organ rejection therapy with high-dose methylprednisolone and human immunoglobulin. After treatment, her heart function recovered, with biopsy investigations showing a lower level of cellular rejection (1R).
- I DIRETRIZ DE INSUFICIÊNCIA CARDÍACA (IC) E TRANSPLANTE CARDÍACO, NO FETO, NA CRIANÇA E EM ADULTOS COM CARDIOPATIA CONGÊNITA, DA SOCIEDADE BRASILEIRA DE CARDIOLOGIA(2014) AZEKA, E.; JATENE, M. B.; JATENE, I. B.; HOROWITZ, E. S. K.; BRANCO, K. C.; SOUZA NETO, J. D.; MIURA, N.; MATTOS, S.; AFIUNE, J. Y.; TANAKA, A. C.; SANTOS, C. C. L.; GUIMARAES, I. C. B.; MANSO, P. H.; PELLIZARI, R. C. R. S.; SANTOS, M. V. C.; THOMAZ, A. M.; CRISTOFANI, L. M.; RIBEIRO, A. C. L.; KULIKOWSKI, L. D.; SAMPAIO, M. C.; PEREIRA, A. C.; SOARES, A. M.; SOARES JUNIOR, J.; OH, G. H. Y.; MOREIRA, V; MOTA, C. C. C.; AFIUNE, C. M. C.; PEDRA, C.; PEDRA, S.; PEDROSA, A.; GUIMARAES, V; CANEO, L. F.; FERREIRO, C. R.; CAVALHEIRO FILHO, C.; STEFANELLO, B.; NEGRAO, C. E.; TURQUETTO, A. L. R.; MESQUITA, S. M. F.; MAEDA, W. T.; ZORZANELLI, L.; PANAJOTOPOLOS, N.; SIQUEIRA, A. W. S.; GALAS, F. R. B.; HAJJAR, L. A.; BENVENUTI, L. A.; VINCENZI, P.; ODONE, V; LOPES, M. H.; V, T. M. Strabelli; FRANCHI, S. M.; TAKEUTI, A. D.; DUARTE, M. F.; LEON, R. G. P.; HERMIDA, R. P. M.; SORPRESO, I. C. E.; SOARES JUNIOR, J. M.; MELO, N. R.; BARACAT, E. C.; BORTOLOTTO, M. R. F. L.; SCANAVACCA, M.; SHIMODA, M. S.; FORONDA, G.; ROMANO, B. W.; SILVA, D. B.; OMURA, M. M.; BARBEIRO, C. P. M.; VINHOLE, A. R. G.; PALOMO, J. S. H.; GONCALVES, M. A. B.; REIS, I. C. F.; OLIVEIRA, L. G.; RIBEIRO, C. C.; ISOSAKI, M.; VIEIRA, L. P.; FELTRIM, M. I. Z.; MANOEL, L. A.; ABUD, K. C. O.; PASCHOTTO, D. R.; NEVES, I. L. I.; SENAHA, L. E.; GARCIA, A. C. C. N.; CIPRIANO, S. L.; SANTOS, V. C.; FERRAZ, A. S.; MOREIRA, A. E. L. C.; PAULO, A. R. S. A. De; DUQUE, A. M. P. C.; TRINDADE, E.; BACAL, F.; AULER JUNIOR, J. O. C.; ALMEIDA, D. R.
- CONGENITAL HEART DISEASE IN ADOLESCENT AND ADULTS: INDICATION FOR HEART TRANSPLANTATION AND CLINICAL OUTCOME(2013) FARHAT, Juliana; JATENE, Marcelo; FERNANDES, Marcos; SENAHA, Luciano; DELGADO, Ana Beatriz Romani; TANAMATI, Carla; AIELLO, Vera; BENVENUTI, Luiz; PENHA, Juliano; VALDO, Melinade Oliveira; BRITO, Pedro Thiago; AZEKA, EstelaOBJECTIVE: The aim of the study was to evaluate the patients who were submitted to heart transplantation due to congenital heart disease. MATERIAL AND METHODS: It was considered a retrospective analysis of the medical records of the patients who were submitted to heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School from 2002 through 2012. RESULTS: From 2002 through 2012, 115 patients have undergone heart transplantation at Heart Institute (InCor) University of Sao Paulo Medical School. Of those, 29 (25.2%) had congenital heart diseases, having one of them submitted to re-transplantation 9 yrs after transplantation. The mean age was 8.56 yrs old (range of 0.11–26.06). The assessed congenital heart diseases were: double outlet (three patients), hypoplastic heart syndrome (two patients), pulmonary atresia (two patients), ventricular septal defect (one patient), Ebstein anomaly (two patients),Uhl anomaly (one patient), congenital heart block (three patients), tetralogy of Fallot (one patient), av canal (one patient), complex congenital heart disease (12 patients). Twenty patients had submitted to cardiac surgery before transplantation. The mean ischemia time was 170.8 min. Thirteen patients (44.8%) died (due to surgical complications, heart failure due to acute rejection and multiple organ insufficiency). Mean follow-up period of 4.7 yrs. CONCLUSION: Heart transplantation is an indication for patients with congenital heart disease and allowed long term survival for this population.