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
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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.- Innovative Technique Avoiding Bleeding After Reperfusion in Living Donor Liver Transplant Using a Modified Right Lobe Graft(2022) PINHEIRO, Rafael S.; ANDRAUS, Wellington; FORTUNATO, Allana C.; FERNANDES, Michel Ribeiro; NACIF, Lucas Souto; MARTINO, Rodrigo Bronze De; DUCATTI, Liliana; WAISBERG, Daniel Reis; ARANTES, Rubens Macedo; ROCHA-SANTOS, Vinicius; GALVAO, Flavio Henrique Ferreira; CARNEIRO-D'ALBUQUERQUE, Luiz AugustoBackground. Living donor liver transplant (LDLT) is a valuable therapeutic option for over-coming the deceased donor shortage. Modified right lobe graft (MRLG) keeps the middle hepatic vein (MHV) trunk with the remnant liver to improve donor safety. Hemostasis in the MHV tributary reconstruction can be tricky; surgical stitches and energy coagulation are ineffective. Fibrin glues are excellent vascular sealants but are poor in maintaining hemostasis in an active hemorrhage or preventing resection surface-related complications after liver resection. We propose applying fibrin sealant during back table graft preparation to seal the hepatic edge and MHV reconstruction to avoid bleeding after graft revascularization. Methods. Our retrospective cohort study included all adult patients undergoing LDLT between August 2017 and December 2021. During the back table procedure, we performed the reconstruction of the inferior right hepatic vein and/or MHV tributaries from segment 5 (V5) and segment 8 (V8) using a vein harvested from a nonrelated deceased donor. Before initiating the hepatic graft implantation, we applied fibrin sealant in the resected parenchyma, especially in the V5 and V8 anastomosis, to seal the hepatic edge and hepatic vein reconstruction. Results. No bleeding was identified in the hepatic edge, and blood product transfusion was unnecessary for any recipients after reperfusion. Conclusion. In LDLT using MRLG with MHV reconstruction, the fibrin sealant, when applied on the raw hepatic surface, and vascular reconstruction during back table graft preparation avoided bleeding after graft revascularization.
article 4 Citação(ões) na Scopus Novel Technique in a Sheep Model of Uterine Transplantation(2020) ARANTES, Rubens Macedo; NACIF, Lucas Souto; PINHEIRO, Rafael Soares; ROCHA-SANTOS, Vinicius; MARTINO, Rodrigo Bronze de; WAISBERG, Daniel Reis; PANTANALI, Carlos Andres Rodriguez; FORTUNATO, Allana; LIMA, Marisa Rafaela; DUCATTI, Liliana; HADDAD, Luciana Bertocco de Paiva; EJZENBERG, Dani; GALVAO, Flavio Henrique; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, LuizconferenceObject Acute-on-chronic liver failure (ALCF) and liver transplantation(2018) NACIF, L.; AQUINO, F.; TANIGAWA, R.; ANDRAUS, W.; HADDAD, L.; PINHEIRO, R.; MARTINO, R.; ROCHA-SANTOS, V.; FARIAS, A.; D'ALBUQUERQUE, L. Carneiro; ALVES, V.conferenceObject Evaluation of Surfactant Protein A in Hepatopulmonary Syndrome in Rats(2012) NACIF, Lucas Souto; KUBRUSLY, Marcia Saldanha; KUBRUSLY, Flavia Saldanha; D'ALBUQUERQUE, Luiz Augusto Carneiro; ISHIZAWA, Andrea; CAINELLI, Vera C. B.; ANDRAUS, Wellington- Re-Transplantation, Higher Creatinine Levels in Hepatitis C Virus Patients, and Donor Age Are Predictors of Mortality in Long-Term Analysis of Late Acute Rejection in Liver Transplantation(2017) NACIF, Lucas Souto; PINHEIRO, Rafael Soares; PECORA, Rafael Antonio de Arruda; TANIGAWA, Ryan Yukimatsu; ROCHA-SANTOS, Vinicius; ANDRAUS, Wellington; ALVES, Venancio Avancini Ferreira; D'ALBUQUERQUE, Luiz CarneiroBackground: Late acute rejection (LAR) differs in its clinical and histological presentation and management from early acute rejection. This clinical entity is not completely understood; thus, we aimed to identify significant prognostic factors that can influence post-transplant survival in LAR patients. The purpose of this study was to evaluate the incidence and post-transplant survival of patients from a single center with a focus on late acute rejection. Material/Methods: From January 2002 to June 2013, all liver biopsies from patients with rejection were scored using the Banff criteria. The groups were compared, and simple and multiple logistic regression and survival curves were created. Results: A total of 779 liver transplants were performed; 585 patients with no rejections and 194 patients with rejections were analyzed. The overall incidence of LAR was 6.7%, and there was a higher prevalence of early acute cellular rejection than LAR. The mean time to LAR was 564 days (median 214 days, range 91-2642). LAR had a more severe grade (35.3%) than early acute rejection (23.5%). The survival rates were similar between both modalities for the long-term period. Worse mortality rates were observed in liver re-transplantation (HR 4.77; p<0.0001); in hepatitis C virus patients with increased creatinine levels (HR 22.48; p=0.016); and in donors > 41 years of age (OR 2.1; p=0.047) in a long-term analysis of LAR. Conclusions: Liver re-transplantation, higher creatinine levels in hepatitis C virus patients, and donor age were predictors of mortality in this long-term analysis of late acute rejection in liver transplantation.
- Successful liver allograft inflow reconstruction with the right gastroepiploic vein(2016) PINHEIRO, Rafael S.; CRUZ JR., Ruy J.; NACIF, Lucas S.; VANE, Matheus F.; D'ALBUQUERQUE, Luiz A. C.Portal vein thrombosis is a common complication in cirrhotic patients. When portal vein thrombectomy is not a suitable option, a large collateral vessel can be used for allograft venous inflow reconstruction. We describe an unusual case of successful portal revascularization using the right gastroepiploic vein. The patient underwent a cadaveric orthotropic liver transplantation with end-to-end anastomosis of the portal vein to the right gastroepiploic vein. Six months after liver transplantation the patient is well with good liver function. The use of the right gastroepiploic vein for allograft venous reconstruction is feasible and safe, with a great advantage of avoiding the need of venous jump graft.
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.- 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.
- Translational medical research and liver transplantation: systematic review(2018) NACIF, Lucas Souto; KIM, Vera; GALVAO, Flavio; ONO, Suzane Kioko; PINHEIRO, Rafael Soares; CARRILHO, Flair Jose; D'ALBUQUERQUE, Luiz CarneiroTranslational medicine has become a priority, but there is still a big difference between the arrival of new treatments and investment. Basic science should not be neglected because the translation from basic research is not sustained in the absence of basic research. The purpose of this literature review was to analyze the translational medicine in the liver transplant field: liver ischemia-reperfusion injury (IRI), immunosuppression, clinical and surgical complications, small-for-size syndrome (SFSS), rejection, and ongoing innovations (liver machine, liver preservation, artificial livers, and regenerative medicine). We performed a systematic literature review that were updated in October 2016. The searches were performed in the Cochrane Central Register of Controlled Trials and Review, PubMed/Medline, Embase, and LILACS databases. All the selected studies on the management of translational medical research in liver transplantation (LT) were analyzed. Initially the search found 773 articles. Methodological viewing and analysis of the articles, followed by the application of scientific models, including translational medicine in the liver transplant field. In conclusions, this review demonstrates the application of scientific research with translation medical benefits regarding the LT. The literature has a great tendency, improvements and investments in the study of translational medicine in LT. Innovative studies and technologies from basic science help to clarify clinical doubts. Moreover, evidence increases the importance of scientific research in quality of clinical practice care.