NANA MIURA IKARI

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Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina

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Revista / Livro: Pediatric Transplantation ×

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  • conferenceObject
    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, Marcelo
    OBJECTIVE: 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.
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    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.
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    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, Estela
    PURPOSE: 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.
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    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, Estela
    OBJECTIVE: 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
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  • article 0 Citação(ões) na Scopus
    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, Estela
    IntroductionHeart 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.
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    RESTRICTIVE SYNDROME AND HYPERTROPHIC CARDIOMIOPATHY AS INDICATION FOR HEART TRANSPLANTATION: CLINICAL OUTCOME IN A SINGLE CENTER
    (2013) TANAKA, Ana Cristina; MIURA, Nana; THOMAZ, Ana Maria; FERNANDES, Marcos; VALE, Natalia Freitas de Deus; AIELLO, Vera; BENVENUTI, Luiz; TAVARES, Glaucia; NOMURA, Cesar; JATENE, Marcelo; AZEKA, Estela
    OBJECTIVES: The purpose of this study was to evaluate the prevalence and outcome of restrictive syndrome in a cohort of pediatric heart transplantation. MATERIAL AND METHODS: To evaluate the prevalence and clinical outcome of children with restrictive syndrome and hypertrophic cardiomiopathy submitted to heart transplantation. RESULTS: From October 1992 to 2012, 115 patients were submitted to heart transplantation. One hundred and twenty transplants were performed at Heart Institute (InCor) University of Sao Paulo Medical School. Seventeen (14.7%) of these patients had restrictive syndrome and have undergone to heart transplantation. The mean age was 10.4 yrs. Survival was 76.4%. Follow up period ranged from 26 days to 6.6 yrs. CONCLUSION: Restrictive syndrome and hypertrophic cardiomyopathy can be an indication for heart transplantation with a favorable outcome.