ANDRE DONG WON LEE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Home Parenteral Nutrition Program and Referral of Potential Candidates for Intestinal and Multivisceral Transplantation in a Single Brazilian Center(2014) LEE, A. D. W.; GALVAO, F. H. F.; DIAS, M. C. G.; CRUZ, M. E.; MARIN, M.; PEDROL, C. N.; DAVID, A. I.; PECORA, R. A. A.; WAITZBERG, D. L.; D'ALBUQUERQUE, L. A. C.Intestinal failure is a multifaceted condition that may require high-complexity treatment and a multidisciplinary program, including home parenteral nutrition therapy (HPNT) and intestinal transplantation. In this article, we profile a Brazilian single-center experience with 128 cases of HTPN followed for the last 30 years and appraise the referral for potential intestinal and multivisceral transplantation.
- Incidence of Donor Hepatic Artery Thrombosis in Liver Grafts Recognized During Organ Procurement and Backtable: A Rare but Treacherous Pitfall In Liver Transplantation(2022) SILVA, Natalie Almeida; WAISBERG, Daniel Reis; FERNANDES, Michel Ribeiro; PINHEIRO, Rafael Soares; SANTOS, Joao Paulo Costa; LIMA, Marisa Rafaela Damasceno; ALVAREZ, Paola Sofia Espinoza; ERNANI, Lucas; LINS-ALBUQUERQUE, Marcos Vinicius; NACIF, Lucas Souto; ROCHA-SANTOS, Vinicius; MARTINO, Rodrigo Bronze; DUCATTI, Liliana; ARANTES, Rubens Macedo; SONG, Alice Tung; LEE, Andre Dong; HADDAD, Luciana Bertocco; RIVA, Daniel Fernandes Dala; SILVA, Amanda Maria; GALVAO, Flavio Henrique; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz AugustoIntroduction. Donor hepatic artery thrombosis (dHAT) identified during liver procurement and backtable is a rare and little-reported event that can make liver transplants unfeasible.Methods. This is a retrospective study of dHAT identified during liver grafts procurements or backtable procedures. All grafts were recovered from brain-dead donors. The demographic characteristics of the donors and the incidence of dHAT were analyzed. The data were also compared to a cohort of donors without dHAT.Results. There was a total of 486 donors during the study period. The incidence of dHAT was 1.85% (n = 9). The diagnosis of dHAT was made during procurement in 5 cases (55.5%) and during the backtable in 4 (44.4%). Most donors were female (n = 5), with an average BMI of 28.14 6.9 kg/m2, hypertensive (n = 5), and with stroke as cause of brain death (n = 8). The most prevalent site of dHAT was a left hepatic artery originating from the left gastric artery (n = 4). Of the 9 cases reported, 2 livers were used for transplantation, and 7 were discarded. Comparing those cases to a cohort of 260 donors without dHAT, we found a higher incidence of anatomic variations in the hepatic artery (P = .01) and of stroke as cause of brain death (P = .05).Conclusion. The occurrence of dHAT before liver procurement is a rare event, however it may become a treacherous pitfall if the diagnosis is late. Grafts with anatomic variations recovered from women with brain death due to stroke and with past history of hypertension seem to be at a higher risk of presenting dHAT.
- Feasibility of Large Liver Grafts in Adults(2020) LIMA, Marisa Rafaela Damasceno; WAISBERG, Daniel Reis; ZANINI, Leonardo Yuri; PINHEIRO, Rafael Soares; NACIF, Lucas Souto; ERNANI, Lucas; ARANTES, Rubens Macedo; LINS-ALBUQUERQUE, Marcos Vinicius; SANTO FILHO, Marco Aurelio; MARTINO, Rodrigo Bronze; ROCHA-SANTOS, Vinicius; DUCATTI, Liliana; HADDAD, Luciana Bertocco; SONG, Alice Tung; LEE, Andre Dong; GALVAO, Flavio Henrique; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto
- Septuagenarian Donors and Recipients in Deceased Donor Liver Transplantation: A Brazilian Single Center Experience and Literature Review(2022) FERNANDES, Michel Ribeiro; WAISBERG, Daniel Reis; LIMA, Marisa Rafaela Damasceno; ROCHA-SANTOS, Vinicius; MARTINO, Rodrigo Bronze; PINHEIRO, Rafael Soares; NACIF, Lucas Souto; DUCATTI, Liliana; ARANTES, Rubens Macedo; SANTOS, Joao Paulo Costa; ALVAREZ, Paola Sofia Espinoza; SILVA, Natalie Almeida; RIVA, Daniel Fernandes Dala; SILVA, Amanda Maria; SONG, Alice Tung; LEE, Andre Dong; HADDAD, Luciana Bertocco; GALVAO, Flavio Henrique; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, LuizBackground: The number of elderly patients who have end-stage liver disease and require liver transplantation has dramatically increased. On the other hand, liver grafts from elderly donors have been offered more frequently for transplantation. The present study aims to analyze the results of liver transplants performed with donors and recipients aged >= 70 years. Methods: We performed a single-center retrospective study of deceased donors liver transplants that involved recipients aged >= 7070 years or recipients who received grafts from donors aged >= 70 years from 2011 to 2021. A literature review on the results of liver transplantation in elderly recipients was also performed. Results: Thirty septuagenarian recipients were included; their overall 1- and 5-years survival was 80% and 76.6%, respectively. The prevalence of recipients aged >= 70 years in our department was 2.65%. Twenty recipients received grafts form septuagenarian donors; their overall 1- and 5-years survival was 75%. The prevalence of donors aged >= 70 years in our department was 1%. In the literature review, 17 articles were analyzed. The 5-years survival of recipients aged >= 70 years ranged from 47.1% to 78.5%. Conclusions: Septuagenarian recipients and patients who received grafts from elderly brain-dead donors present adequate overall survival after liver transplantation. Optimized donor-recipient matching is paramount for achieving good outcomes. The combination of high-risk donors with septuagenarian recipients should be avoided as well as using grafts of elderly donors that present others risk factors. Thus, the age of the donor or recipient alone cannot be considered an absolute contraindication for liver transplantation.
- Shortage of Donors for Intestinal Transplantation in Sao Paulo, Brazil(2016) CALIL, I. L.; ANDRADE, G. M.; GALVAO, F. H.; LEITE, A. Z. A.; PECORA, R. A.; LEE, A. W.; D'ALBUQUERQUE, L. A. C.Background. The number of deceased organ donors has decreased slightly over the past 4 years. Although the pool of intestinal transplantation candidates is relatively small, donor allocation is challenging because of the inability to maintain the donor in a good condition and the complexities involved in making a suitable weight match between donors and recipients. Our goal was to analyze the epidemiologic profile of potential donors based on the organs offered by the regional Organ Procurement Organization from Hospital das Clinicas-USP (OPO/HC-USP) and attempt to estimate possible matches and program viability. Methods. We retrospectively analyzed information from the OPO/HC-USP database regarding organs offered over the past 7 years as well as patients listed in our program. Data were collected regarding donor characteristics (eg, sex, age, race, body mass index, blood type, cause of death) and medical care details (eg, intensive care unit stay, use of vasopressor agents and antibiotics). Results. In this time period, there were 18,103 brain death notifications in the state of Sao Paulo; 5,202 (35%) became viable donors, resulting in 5,201 (99%) effectively used livers and kidneys. Most potential donors were male, in their 40s, white, and had blood type O. Only 3 potential donors from OPO/HC-USP would have reached the established minimum criteria for intestinal donation over these 7 years.
- Hepatic Venous Outflow Obstruction in Adult Deceased Donor Liver Transplantation: Classic Piggyback Implantation Versus a Modified Technique that Widens the Ostium of the Recipient's Left and Middle Hepatic Veins(2022) SILVA, Amanda Maria; WAISBERG, Daniel Reis; FERNANDES, Michel Ribeiro; MARTINO, Rodrigo Bronze; ROCHA-SANTOS, Vinicius; PINHEIRO, Rafael Soares; NACIF, Lucas Souto; ARANTES, Rubens Macedo; DUCATTI, Liliana; GALVAO, Flavio Henrique; LEE, Andre Dong; HADDAD, Luciana Bertocco; SILVA, Natalie Almeida; RIVA, Daniel Fernandes Dala; MOREIRA, Airton Mota; OLIVEIRA, Ricardo Abdala; CARNEVALE, Francisco Cesar; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz AugustoBackground. The classic piggyback technique uses the union of the 3 hepatic veins to perform the cavo-caval anastomosis. However, due to the lateral localization of the right hepatic vein, the partial clamping of the vena cava in this technique significantly reduces the venous return to the right atrium. To avoid this, we adopted in 2015 a modified piggyback technique, in which we use the common trunk of the middle and left hepatic veins and also perform a lateral incision toward the right in the anterior wall of the vena cava in order to widen the final ostium of the cavo-caval anastomosis. The aim of the study was to analyze the incidence of hepatic venous out-flow obstruction between those 2 techniques. Methods. Retrospective study of liver transplant recipients undergoing venography for sus-pected hepatic venous outflow obstruction from January 2009 to June 2021. Patients undergoing transplantation with living donors or split grafts and pediatric cases were excluded from the study. Results. From January 2009 to December 2014 and from January 2015 to June 2021, 587 (group 1) and 730 (group 2) deceased-donor liver transplants were performed with the classic and the modified piggyback techniques, respectively. The incidence of cases with suspected hepatic venous outflow obstruction in groups 1 and 2 were 1.87% (n = 11) and 0.95% (n = 7), respectively (P = 0,15). The number of confirmed patients with outflow blockage that required endovascular treatment during venography in groups 1 and 2 were 4 (0.68%) and 5 (0.68%), respectively (P = 0,31). Conclusions. This modified piggyback technique did not increase the incidence of hepatic venous outflow obstruction at our service.