RUBENS MACEDO ARANTES JUNIOR

(Fonte: Lattes)
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Lattes
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: Annals of Transplantation ×

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  • article 3 Citação(ões) na Scopus
    Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review
    (2022) FORTUNATO, Allana C.; PINHEIRO, Rafael S.; MATSUMOTO, Cal S.; ARANTES, Rubens M.; ROCHA-SANTOS, Vinicius; NACIF, Lucas S.; WAISBERG, Daniel R.; DUCATTI, Liliana; MARTINO, Rodrigo B.; CARNEIRO-D'ALBUQUERQUE, Luiz; ANDRAUS, Wellington
    Short bowel syndrome is the most common etiology of intestinal failure, resulting from either resections of different intestinal segments or a congenital condition. Due to the absence or considerable reduction of intes-tinal loops in the abdominal cavity, patients with short bowel syndrome present with atrophy and muscle re-traction of the abdominal wall, which leads to loss of abdominal domain and elasticity. This complication is an aggravating factor of intestinal transplantation since it can prevent the primary closure of the abdominal wall. A vast array of surgical techniques to overcome the challenges of the complexity of the abdominal wall have been described in the literature. The aim of our study was to review the modalities of abdominal wall closure in intestinal/multivisceral transplantation. Our study consisted of a systematic review following the methodological instructions described in the PRISMA guidelines. Duplicate studies and studies that did not meet the criteria for the systematic review were exclud-ed, especially those without relevance and an explicit relationship with the investigated theme. After this step, 63 articles were included in our study. The results obtained with these techniques have been encouraging, but a high incidence of wound complica-tions in some reports has raised concerns. There is no consensus among transplantation centers regarding which technique would be ideal and with high-er success rates and lower rates of complications.
  • article 0 Citação(ões) na Scopus
    Clinical Validation of a Novel Scoring System Based on Donor and Recipient Risk Factors for Predicting Outcomes in Liver Transplantation
    (2022) NACIF, Lucas Souto; WAISBERG, Daniel Reis; ZANINI, Leonardo Yuri; PINHEIRO, Rafael Soares; ROCHA-SANTOS, Vinicius; MACEDO, Rubens Arantes; DUCATTI, Liliana; HADDAD, Luciana; MARTINO, Rodrigo Bronze de; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz
    Background: Adequate donor and recipient matching in liver transplantation is crucial to improve patient survival. Our ob-jective was to propose and validate a new model for predicting outcomes using donor and recipient scoring criteria.Material/Methods: We retrospectively analyzed data of all patients (n=932) who underwent liver transplantation (n=1106) from January 2006 to December 2018. For score standardization, 30% (n=280) of patients were randomly selected for analysis and divided into 3 categories: 4 pound points, 5 to 8 points, and >8 points. Scoring system validation was performed on a dataset with 70% (n=652) of the patients.Results: Survival of the stratified group (30%) was significant (P<0.001). Scores of 4 to 8 points presented lower risk of death (1.74 [CI 0.97-3.13; P=0.062]), while >8 points presented higher risk (2.74 [CI 1.36-5.57; P=0.005]). In the validation score (70%), global survival was significant (P<0.0016); patients with scores of 4 to 8 points had lower risk of death (1.16 [CI 1.16-2.38; P=0.005]); and scores >8 points (2.22 [CI 1.40-3.50; P<0.001]), re-transplant, fulminant hepatitis, previous large abdominal/biliary tree surgery, MELD score, and serum creati-nine before liver transplantation >1.5 mg/dL (P<0.05) presented higher risk. Individual recipient factors with 4 to 8 points had a lower risk of death (2.29 [CI 1.82-2.87; P<0.0001]) than those with scores >8 points (4.02 [CI 2.22-7.26; P<0.0001]). Conclusions: A novel prognostic-based scoring system using donor and recipient characteristics was proposed and clinically validated. Two-factor scoring indicated the superiority of the predictability outcome and improved prediction of higher mortality.