EDSON ABDALA

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Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina - Docente
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/47 - Laboratório de Hepatologia por Vírus, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: Liver Transplantation ×

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Agora exibindo 1 - 4 de 4
  • article 9 Citação(ões) na Scopus
    Coronavirus Disease 2019 in the Early Postoperative Period of Liver Transplantation: Is the Outcome Really So Positive?
    (2021) WAISBERG, Daniel Reis; ABDALA, Edson; NACIF, Lucas Souto; DUCATTI, Liliana; HADDAD, Luciana Bertocco; MARTINO, Rodrigo Bronze; PINHEIRO, Rafael Soares; ARANTES, Rubens Macedo; GALVAO, Flavio Henrique; GOUVEIA, Larissa Nunes; TERRABUIO, Debora Raquel; DARCE, George Felipe; ROCHA-SANTOS, Vinicius; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto
  • article 52 Citação(ões) na Scopus
    Surgical site infections in liver transplant recipients in the model for end-stage liver disease era: An analysis of the epidemiology, risk factors, and outcomes
    (2013) FREIRE, Maristela Pinheiro; OSHIRO, Isabel C. V. Soares; BONAZZI, Patricia Rodrigues; GUIMARAES, Thais; FIGUEIRA, Estela Regina Ramos; BACCHELLA, Telesforo; COSTA, Silvia Figueiredo; D'ALBUQUERQUE, Luiz Augusto Carneiro; ABDALA, Edson
    In recipients of liver transplantation (LT), surgical site infection (SSIs) are among the most common types of infection occurring in the first 60 days after LT. In 2007, the Model for End-Stage Liver Disease (MELD) scoring system was adopted as the basis for prioritizing organ allocation. Patients with higher MELD scores are at higher risk for developing SSIs as well as other health care-associated infections. However, there have been no studies comparing the incidence of SSIs in the pre-MELD era with the incidence in the period since its adoption. Therefore, the objectives of this study were to evaluate the incidence, etiology, epidemiology, and outcomes of post-LT SSIs in those 2 periods and to identify risk factors for SSIs. We evaluated all patients who underwent LT over a 10-year period (2002-2011). SSI cases were identified through active surveillance. The primary outcome measure was an SSI during the first 60 days after LT. Risk factors were analyzed via logistic regression, and 60-day survival rates were evaluated via Cox regression. We evaluated 543 patients who underwent LT 597 times. The SSI rates in the 2002-2006 and 2007-2011 periods were 30% and 24%, respectively (P=0.21). We identified the following risk factors for SSIs: retransplantation, the transfusion of more than 2 U of blood during LT, dialysis, cold ischemia for >400 minutes, and a cytomegalovirus infection. The overall 60-day survival rate was 79%. Risk factors for 60-day mortality were retransplantation, dialysis, and a longer surgical time. The use of the MELD score modified the incidence and epidemiology of SSIs only during the first year after its adoption. Risks for SSIs were related more to intraoperative conditions and intercurrences after LT than to a patient's status before LT. Liver Transpl 19:1011-1019, 2013. (c) 2013 AASLD.
  • conferenceObject
    Predictive Factors of Survival and Prognostic Score Validation in Liver Retransplantation for Severe Hepatitis C Recurrence: The Importance of HCV Therapy before and after Retransplantation
    (2013) SONG, A. T. W.; SOBESKY, R.; VINAIXA, C.; DUMORTIER, J.; RADENNE, S.; ROUSSEAU, G.; DURAND, F.; DELVART, V.; ROCHE, B.; HAIM-BOUKOBZA, S.; VIBERT, E.; CASTAING, D.; ABDALA, E.; BERENGUER, M.; DUCLOS-VALLEE, J. C.; SAMUEL, D.
    Indications and results of retransplantation (RT) for HCV recurrence are debatable. Recently, a Swiss group proposed the Andres RT survival score specifically designed for HCV-positive patients. Aim: To identify risk factors associated with survival in RT patients for HCV recurrence and to evaluate the Andres score. Methods: Retrospective and multicentric study to determine prognostic factors of survival. A cohort of patients presenting F4 or FCH without RT was also analysed. Results: From 1984 to 2012, 77 patients were retransplanted for HCV recurrence. 79% were males, mean age 53±9 years, genotype 1 in 74%, 58.4% received HCV therapy preRT. MELD at RT was 24±8 and 25.7% received steroid boluses post-RT. Overall, 3, 5 and 10-year survival rates were 63%, 55%, and 52% respectively. 79% had an Andres score >40 (n=48). Andres score underestimated survival, as in their cohort, those with a score >40 presented a 5y survival of 27%. 42 patients with F4 or FCH post-transplant presenting decompensation presented survival rates of 15%, 7% and 0% at 3, 5 and 10 ys (p<0.0001). In univariate analysis, factors associated with better survival post-RT were: male gender (p=0.08), non-genotype 1 (p=0.06), interval between 1st transplant and acute hepatitis (p=0.006), undetectable viremia preRT (p=0.04), tacrolimus post-RT (p=0.08), HCV therapy post-RT (p=0.002), preRT bilirubin (p=0.04), RT donor age (p=0.06), recipient age at 1st transplant (p=0.06), interval between 1st transplant and RT (p=0.05), lower Andres score (p=0.006). In multivariate analysis, factors associated with survival were: HCV therapy post-RT (p=0.01), recipient age at 1st transplant (p=0.03), RT donor age (p=0.03), pre-RT bilirubin (p=0.01), non-genotype 1 (p=0.02). Conclusions: HCV therapy post-RT, non-genotype 1, recipient and RT donor age represent major prognostic factors for RT.
  • article 25 Citação(ões) na Scopus
    Carbapenem-Resistant Acinetobacter baumannii Acquired Before Liver Transplantation: Impact on Recipient Outcomes
    (2016) FREIRE, Maristela Pinheiro; PIERROTTI, Ligia Camera; OSHIRO, Isabel Cristina Villela Soares; BONAZZI, Patricia Rodrigues; OLIVEIRA, Larissa Marques de; MACHADO, Anna Silva; HEIJDEN, Inneke Marie Van der; ROSSI, Flavia; COSTA, Silvia Figueiredo; D'ALBUQUERQUE, Luiz Augusto Carneiro; ABDALA, Edson
    Infection with carbapenem-resistant Acinetobacter baumannii (CRAB) after liver transplantation (LT) is associated with high mortality. This study aimed to identify risk factors for post-LT CRAB infection, as well as to evaluate the impact of pre-LT CRAB acquisition on the incidence of post-LT CRAB infection. This was a prospective cohort study of all patients undergoing LT at our facility between October 2009 and October 2011. Surveillance cultures (SCs) were collected immediately before LT and weekly thereafter, until discharge. We analyzed 196 patients who were submitted to 222 LTs. CRAB was identified in 105 (53.6%); 24 (22.9%) of these patients were found to have acquired CRAB before LT, and 85 (81.0%) tested positive on SCs. Post-LT CRAB infection occurred in 56 (28.6%), the most common site being the surgical wound. Multivariate analysis showed that the risk factors for developing CRAB infection were prolonged cold ischemia, post-LT dialysis, LT due to fulminant hepatitis, and pre-LT CRAB acquisition with pre-LT CRAB acquisition showing a considerable trend toward significance (P = 0.06). Among the recipients with CRAB infection, 60-day mortality was 46.4%, significantly higher than among those without (P < 0.001). Mortality risk factors were post-LT infection with multidrug-resistant bacteria, LT performed because of fulminant hepatitis, retransplantation, prolonged cold ischemia, longer LT surgical time, and pre-LT CRAB acquisition, the last showing a trend toward significance (P = 0.08). In conclusion, pre-LT CRAB acquisition appears to increase the risk of post-LT CRAB infection, which has a negative impact on recipient survival.