ANDRE IBRAHIM DAVID
Projetos de Pesquisa
Unidades Organizacionais
20 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 20
- 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.
- Transplante de intestino delgado(2013) PÉCORA, Rafael Antonio Arruda; DAVID, André Ibrahim; LEE, André Dong; GALVÃO, Flávio Henrique; CRUZ-JUNIOR, Ruy Jorge; D'ALBUQUERQUE, Luiz Augusto CarneiroBACKGROUND: Small bowel transplantation evolution, because of its complexity, was slower than other solid organs. Several advances have enabled its clinical application. AIM: To review intestinal transplantation evolution and its current status. METHOD: Search in MEDLINE and ScIELO literature. The terms used as descriptors were: intestinal failure, intestinal transplantation, small bowel transplantation, multivisceral transplantation. Were analyzed data on historical evolution, centers experience, indications, types of grafts, selection and organ procurement, postoperative management, complications and results. CONCLUSION: Despite a slower evolution, intestinal transplantation is currently the standard therapy for patients with intestinal failure and life-threatening parenteral nutrition complications. It involves some modalities: small bowel transplantation, liver-intestinal transplantation, multivisceral transplantation and modified multivisceral transplantation. Currently, survival rate is similar to other solid organs. Most of the patients become free of parenteral nutrition.
conferenceObject A new Model of Hipothermic Pancreas Ischemia-Reperfusion in Rats(2013) SANTOS, Vinicius; FERRO, Oscar; PANTANALI, Carlos; ARANTES, Rubens; PECORA, Rafael; DAVID, Andre; CHAIB, Eleazar; D'ALBUQUERQUE, LuizbookPart Aspectos Técnicos dos Transplantes de Órgãos do Aparelho Digestório(2013) DAVID, André Ibrahim; PéCORA, Rafael Antonio Arruda; PUGLIESE, Vincenzo- Ten Years' Evaluation of Potential Pancreas Donors in Sao Paulo, Brazil(2014) PINHEIRO, R. S.; ROCHA-SANTOS, V.; PECORA, R. A.; MACEDO, R. A.; NACIF, L. S.; ANDRAUS, W.; DAVID, A. I.; PANTANALI, C. A.; BENITES, C. M.; D'ALBUQUERQUE, L. A. C.Background. Pancreas transplantation is a treatment for advanced type 1 diabetes and offers significant improvement in quality of life. Recent advances in surgical techniques and immunosuppression regimes lead to good outcomes. However, despite significant higher rates of multiorgan donors in Brazil, pancreas transplantation seems to have remained stable. This study aimed to investigate the acceptance rate of potential pancreas donors in the past 10 years in Sao Paulo State. Methods. We retrospectively evaluated potential pancreas donors characteristics and its acceptance rate in Sao Paulo State in the past 10 years. We divided this period into 2 eras: 1st era from January 2003 to January 2008; and 2nd era from January 2008 to January 2013. Data were obtained from Sao Paulo's government official website. Results. During the whole period, 5,005 deceased donors of all ages were available for pancreas transplantation. According to eras, we had 1,588 donors in the 1st and 3,417 in the 2nd era. In the 2nd era, donors >49 years old were significantly more common (P < .001). Blood test abnormalities, donor comorbidities, and high dosage of vasopressors also were significantly higher in the 2nd era. Rate of graft acceptance had a significant decrease in the 2nd era, from 46.4% to 25% (P < .05). Conclusions. Despite greater organ availability, pancreas transplantations performed in Sao Paulo State remained stable. Rate of graft acceptance is dramatically lower in more recent years.
conferenceObject Intestinal and Multivisceral Retransplantation - The Indiana University Experience(2013) DAVID, Andre I.; TREVIZOL, Alisson; MANGUS, Richard; TECTOR, A. Joseph; VIANNA, Rodrigo M.Introduction : Despite recent advances in immunosuppression protocols, acute cellular rejection (ACR) remains the main cause of graft loss after transplantation. Intestinal/Multivisceral retransplantation (IMVRT) became possible with early diagnosis and better handle of the recipient. Aim : Study the results of Indiana University with IMVRT. Methods : We analyzed retrospectively 10 patients submitted to retransplantation. Results : Ten recipients composed the study (five women, two men and three children) with mean age of 38 years (26 to 58) for adult recipients and 10 years (7 to 12) for child recipients. The causes for first multivisceral transplants were pseudoobstruction (3), GIST, short gut syndrome (2), volvulus, multiple organ infarction, hepatitis C and extensive portal mesentery thrombosis and gastroschisis. Severe ACR occured in 9 patients (90%). The cause for retransplant was : ACR, chronic rejection, pancreatic leak and rejection after isolated intestinal transplant. The mean interval for IMVRT was 13,9 months (1 to 47) for adults and 28,9 (2,14 and 71) for pediatrics. Eight IMVRT (2 pediatrics), one modified multivisceral retransplantation and one multivisceral and kidney retransplantation were performed. Three deaths occured 4, 6 months and 9 months after retransplant. One-year patient survial rate was 71,4% for adult recipients and 66,6% for pediatric recipients. Conclusion : Survival is feasible after IMVRT compared with usual primary transplants results. New studies are necessary for better understanding of in fluencing factors for IMVRT.conferenceObject The Shortage of Donor for Intestinal and Multivisceral Transplantation in Brazil.(2015) CALIL, Igor; LEITE, Andre Z.; ANDRADE, Guilherme; MALBOUISSON, Luis Marcelo; SALIBA, Gustavo; DUCATTI, Liliana; PINHEIRO, Rafael S.; ROCHA, Vinicius S.; BRONZE, Rodrigo M.; ANDRAUS, Wellington; SOLER, Wangles V.; HADDAD, Luciana; NACIF, Lucas S.; PANTANALI, Carlos; PECORA, Rafael A.; DAVID, Andre I.; GALVAO, Flavio H.; D'ALBUQUERQUE, Luiz Augusto C.conferenceObject Double Balloon Enteroscopy Assessment as a Relevant Approach to Evaluate the Evolution and Diagnosis of Intestinal Failure Complications(2015) LEE, Andre; SAFATLE-RIBEIRO, Adriana V.; ROCHA, Mariana H.; MINCHELONI, Natalia D.; NOVA, Lidiane C. Casa; GUIDI, Paula; GALVAO, Flavio H.; GONCALVES-DIAS, Maria C.; CALIL, Igor L.; DAVID, Andre I.; SOLER, Wangles V.; PECORA, Rafael A.; WAITZBERG, Dan L.; D'ALBUQUERQUE, Luis C.- Intestinal and Multivisceral Retransplantation Results: Literature Review(2013) TREVIZOL, A. P.; DAVID, A. I.; YAMASHITA, E. T.; PECORA, R. A.; D'ALBUQUERQUE, L. A.Background. Intestinal/multivisceral transplantation (IT/MVT) is the gold standard treatment for patients with intestinal failure and complications related to total parenteral nutrition, gastrointestinal inoperable indolent tumors, or diffuse portal trombosis. Currently, the reported 1-year patient survival rate is around 80%, similar to other solid organ abdominal transplantations. Unfortunately, the patient survival decreases after the first year with the 5-year rate not close to 70% yet. Acute cellular rejection is the main cause of graft loss. Its early diagnosis may make it possible to improve survival of retransplantations. Objective. To analyze the reported results published in the last 5 years by leading transplant centers to evaluate IT/MVT retransplantation results. Methods. We performed a literature review using PubMed focusing on multivisceral and intestinal retransplantation in articles published between 2006 and 2012. In relation to the first transplantation, we analyzed demographics, imunosuppression, rejection, infection as well as graft and patient survival rates. Results. Two centers reported results on intestinal and multivisceral retransplantations. Mazariegos et al reported their experience with 15 intestinal retransplantations in 14 pediatric recipients. Four patients died from posttransplant lymphoperliferative disease, severe acute cellular rejection, fungal sepsis, or bleeding from a pseudoaneurysm at a mean time of 5.7 months post-transplantation. Total parenteral nutrition was weaned at a median time of 32 days. Abu-Elmaged et al reported 47 cases with a 5-year survival of 47% for all retransplant modalities. Retransplantation with liver-contained visceral allograft achieved a 5-year survival rate of 61% compared with 16% for liver-free visceral grafts. Conclusion. Despite those huge improvements, some transplanted patients develop severe acute cellular rejection, culminating in graft loss and retransplantation. Repots on multivisceral and intestinal retransplantation outcomes suggest that it is a viable procedure with appropriate patient survival after primary graft loss.
conferenceObject One Hundred Pancreas Transplantation in University of Sao Paulo - Brazil Analysis of the Recipients and Complications(2013) SANTOS, Vinicius; PECORA, Rafael; ARANTES, Rubens; FERRO, Oscar; PANTANALI, Carlos; DAVID, Andre; CHAIB, Eleazar; DAVID-NETO, Elias; NAHAS, Willian; D'ALBUQUERQUE, Luiz