LUCAS SOUTO NACIF
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
18 resultados
Resultados de Busca
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conferenceObject Innovative technique avoiding bleeding after reperfusion in living donor liver transplatation using a modified right lobe graft(2021) PINHEIRO, R. S.; ANDRAUS, W.; NACIF, L. S.; MARTINO, R. B.; DUCATTI, L.; ARANTES, R. M.; WAISBERG, D. R.; FORTUNATO, A.; ROCHA-SANTOS, V.; D'ALBUQUERQUE, L. C.conferenceObject Adequate Exposure to Tacrolimus with Sublingual Administration(2021) MACIEL, A.; FORTUNATO, A.; WAISBERG, D.; GALVAO, F.; LEE, A.; ARANTES, Jr R.; ROCHA, M.; TANIGAWA, R.; DUCATTI, L.; MARTINO, R.; NACIF, L.; ROCHA-SANTOS, V; ANDRAUS, W.; D'ALBUQUERQUE, L.- CIRRHOTIC PATIENTS WITH ACUTE KIDNEY INJURY (AKI) HAVE HIGHER MORTALITY AFTER ABDOMINAL HERNIA SURGERY(2021) DUCATTI, Liliana; HADDAD, Luciana B. P.; MEYER, Alberto; NACIF, Lucas S.; ARANTES, Rubens M.; MARTINO, Rodrigo B.; ROCHA-SANTOS, Vinicius; WAISBERG, Daniel R.; PINHEIRO, Rafael S.; D'ALBUQUERQUE, Luiz A. C.; ANDRAUS, WellingtonBackground: The incidence of abdominal hernia in cirrhotic patients is as higher as 20%; in cases of major ascites the incidence may increase up to 40%. One of the main and most serious complications in cirrhotic postoperative period (PO) is acute kidney injury (AKI). Aim: To analyze the renal function of cirrhotic patients undergoing to hernia surgery and evaluate the factors related to AKI. Methods: Follow-up of 174 cirrhotic patients who underwent hernia surgery. Laboratory tests including the renal function were collected in the PO.AKI was defined based on the consensus of the ascite's club. They were divided into two groups: with (AKI PO) and without AKI .Results: All 174 patients were enrolled and AKI occurred in 58 (34.9%). In the AKI PO group, 74.1% had emergency surgery, whereas in the group without AKI PO it was only 34.6%.In the group with AKI PO, 90.4% presented complications, whereas in the group without AKI PO they occurred only in 29.9%. Variables age, baseline MELD, baseline creatinine, creatinine in immediate postoperative (POI), AKI and the presence of ascites were statistically significant for survival. Conclusions: There is association between AKI PO and emergency surgery and, also, between AKI PO and complications after surgery. The factors related to higher occurrence were initial MELD, basal Cr, Cr POI. The patients with postoperative AKI had a higher rate of complications and higher mortality.
conferenceObject Elastography for the Diagnosis and Graduation of Liver Disease in Patients with Long Term Parenteral Nutrition(2021) GALVAO, F.; VEZOZZO, D.; LEE, A.; WAISBERG, D.; ROCHA, M.; NACIF, L.; PINHEIRO, R.; FIGUEIRA, E.; CASSENOTE, A.; CARRILHO, F.; WAITZBERG, D.; CARNEIRO-D'ALBUQUERQUE, L.- Living-donor liver transplantation in Budd-Chiari syndrome with inferior vena cava complete thrombosis: A case report and review of the literature(2021) ROCHA-SANTOS, Vinicius; WAISBERG, Daniel Reis; PINHEIRO, Rafael Soares; NACIF, Lucas Souto; ARANTES, Rubens Macedo; DUCATTI, Liliana; MARTINO, Rodrigo Bronze; HADDAD, Luciana Bertocco; GALVAO, Flavio Henrique; ANDRAUS, Wellington; CARNEIRO-D'ALBURQUERQUE, Luiz AugustoBACKGROUND Budd-Chiari syndrome (BCS) is a challenging indication for liver transplantation (LT) due to a combination of massive liver, increased bleeding, retroperitoneal fibrosis and frequently presents with stenosis of the inferior vena cava (IVC). Occasionally, it may be totally thrombosed, increasing the complexity of the procedure, as it should also be resected. The challenge is even greater when performing living-donor LT as the graft does not contain the retrohepatic IVC; thus, it may be necessary to reconstruct it. CASE SUMMARY A 35-year-old male patient with liver cirrhosis due to BCS and hepatocellular carcinoma beyond the Milan criteria underwent living-donor LT with IVC reconstruction. It was necessary to remove the IVC as its retrohepatic portion was completely thrombosed, up to almost the right atrium. A right-lobe graft was retrieved from his sister, with outflow reconstruction including the right hepatic vein and the branches of segment V and VIII to the middle hepatic vein. Owing to massive subcutaneous collaterals in the abdominal wall, venovenous bypass was implemented before incising the skin. The right atrium was reached via a transdiaphragramatic approach. Hepatectomy was performed en bloc with the retrohepatic vena cava. It was reconstructed with an infra-hepatic vena cava graft obtained from a deceased donor. The patient remains well on outpatient clinic follow-up 25 mo after the procedure, under an anticoagulation protocol with warfarin. CONCLUSION Living-donor LT in BCS with IVC thrombosis is feasible using a meticulous surgical technique and tailored strategies.
- First Successful Isolated Intestinal Transplant in a Brazilian Series(2021) ANDRAUS, Wellington; PINHEIRO, Rafael Soares; FORTUNATO, Allana Christina; GALVAO, Flavio Henrique Ferreira; ARANTES JUNIOR, Rubens Macedo; WAISBERG, Daniel Reis; LEE, Andre Dong; ROCHA, Mariana Hollanda Martins da; NACIF, Lucas Souto; SANTOS, Vinicius Rocha; DUCATTI, Liliana; MARTINO, Rodrigo Bronze de; HADDAD, Luciana Bertocco de Paiva; TANIGAWA, Ryan Yukimatsu; BEZERRA, Regis O. F.; SONG, Alice Tung Wan; CARNEIRO-D'ALBUQUERQUE, Luiz Augusto
- Safety and effectiveness of mycophenolate mofetil associated with tacrolimus for liver transplantation immunosuppression: a systematic review and meta-analysis of randomized controlled trials(2021) TUSTUMI, Francisco; MIRANDA NETO, Antonio Afonso de; SILVEIRA JUNIOR, Sergio; FERNANDES, Felipe Alexandre; SILVA, Miller Barreto de Brito e; ERNANI, Lucas; NACIF, Lucas Souto; COELHO, Fabricio Ferreira; ANDRAUS, Wellington; BERNARDO, Wanderley Marques; HERMAN, Paulo; CARNEIRO-D'ALBUQUERQUE, Luiz AugustoA combination of immunosuppressants may improve outcomes due to the synergistic effect of their different action mechanisms. Currently, there is no consensus regarding the best immunosuppressive protocol after liver transplantation. This review aimed to evaluate the effectiveness and safety of tacrolimus associated with mycophenolate mofetil (MMF) in patients undergoing liver transplantation. We performed a systematic review and meta-analysis of randomized clinical trials. Eight randomized trials were included. The proportion of patients with at least one adverse event related to the immunosuppression scheme with tacrolimus associated with MMF was 39.9%. The tacrolimus with MMF immunosuppression regimen was superior in preventing acute cellular rejection compared with that of tacrolimus alone (risk difference [RD]=-0.11; p=0.001). The tacrolimus plus MMF regimen showed no difference in the risk of adverse events compared to that of tacrolimus alone (RD=0.7; p=0.66) and cyclosporine plus MMF (RD=-0.7; p=0.37). Patients undergoing liver transplantation who received tacrolimus plus MMF had similar adverse events when compared to patients receiving other evaluated immunosuppressive regimens and had a lower risk of acute rejection than those receiving in the monodrug tacrolimus regimen.
conferenceObject Elastography for the Diagnosis and Graduation of Liver Disease in Patients with Long Term Parenteral Nutrition(2021) GALVAO, F.; VEZOZZO, D.; LEE, A.; WAISBERG, D.; ROCHA, M.; NACIF, L.; PINHEIRO, R.; FIGUEIRA, E.; CASSENOTE, A.; CARRILHO, F.; WAITZBERG, D.; CARNEIRO-D'ALBUQUERQUE, L.conferenceObject Small Bowel Transplantation at Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Brazil(2021) GALVAO, F.; LEE, A.; WAISBERG, D.; ARANTES, R.; NACIF, L.; MARTINO, R.; SANTOS, V; LOPES, L.; ANDRAUS, W.; CARNEIRO-D'ALBUQUERQUE, L.- Hypertonic saline solution decreases oxidative stress in liver hypothermic ischemia(2021) NUNES, Giolana; FIGUEIRA, Estela Regina Ramos; ROCHA-FILHO, Joel Avancini; LANCHOTTE, Cinthia; NACIF, Lucas Souto; FERREIRA, Diego Mendes; ROMANO, Vitor Carminatti; ABDO, Emilio Elias; D'ALBUQUERQUE, Luiz Augusto Carneiro; GALVAO, Flavio Henrique FerreiraBackground: Liver ischemia reperfusion injury is still an unsolved problem in liver surgery and transplantation. In this setting, hypothermia is the gold standard method for liver preservation for trans-plantation. Hypertonic saline solution reduces inflammatory response with better hemodynamic recovery in several situations involving ischemia reperfusion injury. Here, we investigated the effect of hypertonic saline solution in hypothermic liver submitted to ischemia reperfusion injury. Methods: Fifty male rats were divided into 5 groups: SHAM, WI (animals submitted to 40 minutes of partial warm liver ischemia and reperfusion), HI (animals submitted to 40 minutes hypothermic ischemia), HSPI (animals submitted to hypothermic ischemia and treated with 7.5% hypertonic saline solution preischemia), and HSPR (animals submitted to hypothermic ischemia and treated with hypertonic saline solution previously to liver reperfusion). Four hours after reperfusion, the animals were euthanized to collect liver and blood samples. Results: Aspartate aminotransferase and alanine aminotransferase, histologic score, and hepatocellular necrosis were significantly decreased in animals submitted to hypothermia compared with the warm ischemia group. Malondialdehyde was significantly decreased in hypothermic groups with a further decrease when hypertonic saline solution was administrated preischemia. Hypothermic groups also showed decreased interleukin-6, interleukin-10, and tumor necrosis factor-alpha concentrations and better recovery of bicarbonate, base excess, lactate, and glucose blood concentrations. Moreover, hypertonic saline solution preischemia was more effective at controlling serum potassium concentrations. Conclusion: Hypertonic saline solution before hypothermic hepatic ischemia decreases hepatocellular oxidative stress, cytokine concentrations, and promotes better recovery of acid-base disorders secondary to liver ischemia reperfusion.