CARLA TANAMATI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
- 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.
- 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.
- 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
conferenceObject Waiting List Risk Factors in Pediatric Heart Transplant Center in the Developing Country(2012) CAUDURO, A. S.; MOREIRA, L. F. P.; TANAMATI, C.; CANEO, L. F.; PENHA, J.; JATENE, M. B.Purpose: Most of data upon waiting list risk factors are based in studies done in developed countries. In this study we aimed to identify what are these risk factors in a health system enviroment of a developing country like Brazil. Methods and Materials: Time on the waiting list was defined as the time of initial listing to the time of removal due a transplant, death, recovery or removed. Survival time in the waiting list was estimated using the Kaplan-Meier method. Univariate and multivariate relationships were evaluated with the Cox proportional hazards model. Results: Of 222 patients the median age was 3.9 yrs, median weight 13Kg; female 52%. Dilated cardiomyopathy 62%, congenital heart disease 25%, restrictive cardiomyopathy10%, chronic graft failure 3%. We had 45%listed as priority. 41% transplant, 40% died, 14% were removed, 5% are still waiting. Survival were 73% in 30 days, 60% in 90, 51% in 6m. Diagnosis, age, weight, urea, level and priorit status were considered predictors in the univariate analysis. Diagnosis of CHD and, priority status, were found as independent risk factors. Conclusions: Less has been known about the mortality risk factors in the waiting list in our enviroment. Actually these data are very similar to those ones retrieved in the early 1990 when the young and very ill children were destined to died. These results support the urgency of adoption of new technologies and new strategies addressed to child in the waiting list.- NEUROLOGICAL COMPLICATIONS AFTER PEDIATRIC HEART TRANSPLANTATION(2013) FERNANDES, Marcos; AZEKA, Estela; SENAHA, Luciano; DELGADO, Ana Beatriz Romani; GALAS, Filomena; GUIMARAES, Vanessa; HAJJAR, Ludmilha; TANAMATI, Carla; PENHA, Juliano; AULER JUNIOR, Jose Otavio Costa; JATENE, MarceloOBJECTIVES: Neurological complications can occur after pediatric heart transplantation and its outcome may cause disabilities and limit the prognosis of children who have undergone this procedure. The aim of the study is to evaluate the neurological complications during the first 30 days after the heart transplantation. MATERIAL AND METHODS: A survey was made at based on the InCor records to find the data. RESULTS: From September 2011 to September 2012, 15 heart transplants were performed at the Heart Institute (InCor) University of Sao Paulo Medical School. The mean age was 11.1± yr5.34 yrs, median 9.63 yrs. There were 8 (53.3%) males. The diagnosis for heart transplantation was 80% cardiomiopathies. Two of them wereë. re-transplantation. One patient was with ECMO before transplantation and one was with assist device. Seven of them were priority when listed for the heart transplantation. The immunosuppression therapy was calcineurin inhibitor and cytostatic drug. Induction therapy was performed with antithymocyte globulin. Eight (53%) of 15 patients developed neurological complications. The main cause were strokes in 37.5%. The other causes were anisocoria in 1 (12%) patient, ischemic vascular accident 1 (12%) patient, hemorrhagic vascular accident 1 (12%). Three (20%) of them died due to multiple organ failure and infection, two of them were in priority before transplant (one with assist device) and were intubated with renal failure and sedated. These two patients were the ones that showed the worse neurological complications after the transplant. CONCLUSION: Neurological complications were common after heart transplantation, patient can have favorable clinical outcome after treatment.
- 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.conferenceObject CARDIAC RE-TRANSPLANTATION IN PATIENTS WITH VASCULAR GRAFT DISEASE.(2017) BORGES, V. G.; MACIEL, R. P.; SOMOZA, C. L.; SIQUEIRA, A.; TANAMATI, C.; GALAS, F.; JATENE, M. B.; AZEKA, E.- Heart Transplantation in Children and Adults With Congenital Heart Disease: 3 Decades of Evolution(2023) AZEKA, Estela; SIQUEIRA, Adailson Wagner Da Silva; TANAKA, Ana Cristina; MASSOTI, Maria Raquel Brigoni; MIANA, Leonardo; ZORZANELLI, Leina; GUIMARAES, Vanessa; PENHA, Juliano; CANEO, Luiz Fernando; TANAMATI, Carla; MIURA, Nana; JATENE, Marcelo BiscegliHeart transplantation is the treatment of choice for children and adults with congenital heart disease. We report the heart transplant single-center experience. The number of transplantations has increased over the last 3 decades. The Kaplan-Meier survival curves in the first, second, and third decades at 5 and 10 years were 69% and 59%, 62% and 52%, and 66% and 60%, respectively.
- 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.