ESTELA AZEKA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
8 resultados
Resultados de Busca
Agora exibindo 1 - 8 de 8
- ISHLT consensus statement on donor organ acceptability and management in pediatric heart transplantation(2020) KIRK, Richard; I, Anne Dipchand; DAVIES, Ryan R.; MIERA, Oliver; CHAPMAN, Gretchen; CONWAY, Jennifer; DENFIELD, Susan; GOSSETT, Jeffrey G.; JOHNSON, Jonathan; MCCULLOCH, Michael; SCHWEIGER, Martin; ZIMPFER, Daniel; ABLONCZY, Laszlo; ADACHI, Iki; ALBERT, Dimpna; ALEXANDER, Peta; AMDANI, Shahnawaz; AMODEO, Antonio; AZEKA, Estela; BALLWEG, Jean; BEASLEY, Gary; BOHMER, Jens; BUTLER, Alison; CAMINO, Manuela; CASTRO, Javier; CHEN, Sharon; CHRISANT, Maryanne; CHRISTEN, Urs; DANZIGER-ISAKOV, Lara; DAS, Bibhuti; EVERITT, Melanie; FEINGOLD, Brian; FENTON, Matthew; GARCIA-GUERETA, Luis; GODOWN, Justin; GUPTA, Dipankar; IRVING, Claire; JOONG, Anna; KEMNA, Mariska; KHULBEY, Sanjeev Kumar; KINDEL, Steven; KNECHT, Kenneth; LAL, Ashwin K.; LIN, Kimberly; LORD, Karen; MOLLER, Thomas; NANDI, Deipanjan; NIESSE, Oliver; PENG, David M.; PEREZ-BLANCO, Alicia; PUNNOOSE, Ann; REINHARDT, Zdenka; ROSENTHAL, David; SCALES, Angie; SCHEEL, Janet; SHIH, Renata; SMITH, Jonathan; SMITS, Jacqueline; THUL, Josef; WEINTRAUB, Robert; ZANGWILL, Steve; ZUCKERMAN, Warren A.The number of potential pediatric heart transplant recipients continues to exceed the number of donors, and consequently the waitlist mortality remains significant. Despite this, around 40% of all donated organs are not used and are discarded. This document (62 authors from 53 institutions in 17 countries) evaluates factors responsible for discarding donor hearts and makes recommendations regarding donor heart acceptance. The aim of this statement is to ensure that no usable donor heart is discarded, waitlist mortality is reduced, and post-transplant survival is not adversely impacted.
- Clinical approach to antibody-mediated rejection from the pediatric heart transplant society(2022) AMDANI, Shahnawaz; HENDERSON, Heather; EVERITT, Melanie D.; BEASLEY, Gary; SHIH, Renata; EXIL, Vernat; ALEJOS, Juan; WALLIS, Gonzalo; AZEKA, Estela; NANDI, Deipanjan; PROFITA, Elizabeth; SPINNER, Joseph; MAGNETTA, Defne; MARTINEZ, Hugo; FENTON, Matthew; CONWAY, Jennifer; URSCHEL, SimonObjective This document is designed to outline the definition, pathogenesis, diagnostic modalities and therapeutic measures to treat antibody-mediated rejection in children postheart transplant Methods Literature review was conducted by a Pediatric Heart Transplant Society (PHTS) working group to identify existing pediatric and adult studies on antibody-mediated rejection (AMR). In addition, the centers participating in PHTS were asked to submit their approach to diagnosis and management of pediatric AMR. This document synthesizes information gathered from both these sources to highlight a practical approach to diagnosing and managing a child with AMR postheart transplant. This document may not represent the practice at all centers in the PHTS and serves as a starting point to understand an approach to this clinical scenario.
- The International Society for Heart and Lung Transplantation (ISHLT) guidelines for the care of heart transplant recipients(2023) VELLECA, Angela; SHULLO, Michael A.; DHITAL, Kumud; AZEKA, Estela; COLVIN, Monica; DEPASQUALE, Eugene; FARRERO, Marta; GARCIA-GUERETA, Luis; JAMERO, Gina; KHUSH, Kiran; LAVEE, Jacob; POUCH, Stephanie; PATEL, Jignesh; MICHAUD, C. J.; SCHUBERT, Stephan; ANGELINI, Annalisa; CARLOS, Lilibeth; MIRABET, Sonia; PHAM, Michael; URSCHEL, Simon; KIM, Kyung-Hee; MIYAMOTO, Shelly; CHIH, Sharon; DALY, Kevin; GROSSI, Paolo; JENNINGS, Douglas L.; KIM, In-cheol; LIM, Hoong Sern; MILLER, Tara; POTENA, Luciano; EISEN, Howard; BELLUMKONDA, Lavanya; DANZIGER-ISAKOV, Lara; DOBBELS, Fabienne; HARKESS, Michelle; KIM, Daniel; LYSTER, Haifa; PELED, Yael; REINHARDT, Zdenka
- Heart Retransplantation for Coronary Allograft Vasculopathy in Children: 25 Years of Single -Center Experience(2020) AZEKA, Estela; WALKER, Thomas; SIQUEIRA, Adailson Wagner da Silva; PENHA, Juliano; MIANA, Leonardo; CANEO, Luiz Fernando; MASSOTI, Maria Raquel; TANAMATI, Carla; MIURA, Nana; JATENE, Marcelo Biscegli
- 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).
- Pediatric cardiac waitlist mortality-Still too high(2020) DENFIELD, Susan W.; AZEKA, Estela; DAS, Bibhuti; GARCIA-GUERETA, Luis; IRVING, Claire; KEMNA, Mariska; REINHARDT, Zdenka; THUL, Josef; DIPCHAND, Anne I.; KIRK, Richard; DAVIES, Ryan R.; MIERA, OliverCardiac transplantation for children with end-stage cardiac disease with no other medical or surgical options is now standard. The number of children in need of cardiac transplant continues to exceed the number of donors considered ""acceptable."" Therefore, there is an urgent need to understand which recipients are in greatest need of transplant before becoming ""too ill"" and which ""marginal"" donors are acceptable in order to reduce waitlist mortality. This article reviewed primarily pediatric studies reported over the last 15 years on waitlist mortality around the world for the various subgroups of children awaiting heart transplant and discusses strategies to try to reduce the cardiac waitlist mortality.
- Brain tuberculoma in pediatric heart transplant recipient(2023) OLIVEIRA, Pedro Carpini de; CORBI, Maria Julia de Aro Braz; SIQUEIRA, Adailson Wagner da Silva; NAVAJASEGARAN, Joshua; MESQUITA, Ana Sofia Silva; FRASSETTO, Fernando Pereira; JATENE, Marcelo Bisceglli; IKARI, Nana Miura; AZEKA, EstelaIntroductionHeart transplantation is the standard treatment for end-stage heart disease. Despite advances in the field, patients remain under risk of developing complications, including opportunistic infections, such as tuberculosis. We present the unprecedented case of cerebral tuberculoma in a 9-year-old heart transplant recipient. Case ScenarioA 9-year-old female child, who underwent heart transplantation in December 2020, was admitted to the emergency department in September 2021 due to headache and vomiting. She had normal vital signs and a mild left hemiparesis. Laboratory findings included lymphopenia and a low C Reactive Protein and brain images showed expansive lesions. A biopsy of the intracranial lesion was performed and anatomopathological analysis was compatible with tuberculoma. After the diagnosis was established, treatment protocol for neurotuberculosis was initiated, the patient had a satisfactory clinical evolution and was discharged 22 days after admission. DiscussionClinical manifestation of tuberculosis usually occurs up to 6 months after transplantation, the findings are commonly atypical and symptoms may be mild. We could not find in medical literature any description of the disease in a heart transplant recipient as young as the one presented in this case report. We documented great response to treatment, even though conventional antituberculosis therapy may interfere with immunosuppression. ConclusionPatients in the postoperative period following heart transplantation are at high risk for developing opportunistic infections such as tuberculosis, which may present with atypical symptoms. Therefore the clinician must have a high index of suspicion in order to make the correct diagnosis and promptly start treatment.
- Editorial: Heart Failure in Pediatrics and Congenital Heart Disease(2022) AZEKA, Estela; NAVARAJASEGARAN, Joshua; GRUTTER, Giorgia; ALBERT-BROTONS, Dimpna Calila