BENITA GALASSI SOARES SCHVARTSMAN
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bookPart Infecção do Trato Urinário(2013) SCHVARTSMAN, Benita Galassi SoaresbookPart Hematúria(2021) SCHVARTSMAN, Benita Galassi Soares; MIOTO, Bianca Massaroppe; ESPOSITO, Camila Sanches LanetzkiconferenceObject PEDIATRIC KIDNEY TRANSPLANTATION: STUDYING DONOR AND RECIPIENT CHARACTERISTICS ON LONG-TERM OUTCOMES(2013) TORRICELLI, Fabio C. M.; MESSI, Gustavo B.; ANTONOPOULOS, Ioannis M.; PIOVESAN, Affonso C.; FALCI JR., Renato; KANASHIRO, Hideki; EBAID, Gustavo X.; SCHVARTSMAN, Benita G. S.; WATANABE, Andreia; VAISBICH, Maria H.; DAVID-NETO, Elias; NAHAS, William C.PURPOSE: To study donor and recipient characteristics on graft and pediatric patient survival rates. METHOD: We retrospectively reviewed 287 electronic charts of patients (under 18 year-old) underwent kidney transplantation from 01/1985 to 10/2012. Outcomes were analyzed based on the type of donor (deceased vs. living kidney donor) and recipient ESRD cause (nephrological vs. urological disease). The outcomes from recipients of deceased donors were also analyzed based on age of donors (< 17 vs. ≥ 18 years). Thereafter, the outcomes from first transplant and retransplant were compared apart. Graft and patient survival rates were compared with Kaplan-Meier curve and analyzed with Log-rank test. RESULTS: There were 309 pediatric kidney transplants in 287 children. 274 were first, 33 were second, and 2 were third grafts. 193 of 274 (67.2%) and 18 of 33 (54.5%) were living kidney transplantation. 62% of deceased donors were under 17 year-old. Regarding ESRD 195 (68%) patients presented with a nephrological cause, while 92 (32%) presented with a urological one. Of those with a urological cause, 28 (30.4%) underwent bladder augmentation. Mean follow-up was 13.7 (0–27) years. Overall, graft survival rate in one, 5 and 10 years of follow-up was 90.1%, 73.2% and 57.9%, while patient survival rate was 96.0%, 91.9% and 87.2%, respectively. There was a tendency of a higher graft survival rate in children with living kidney donors (p=0.058). There was no difference in the outcomes from first and second transplant, except by a higher immunological graft loss in retransplant group (p=0.032). There was also no difference in the graft survival rates regarding age of donor (p=0.630) and recipient ESRD cause (p=0.890). CONCLUSION: Long-term outcomes from pediatric kidney transplantation are not related to age of donor and recipient ESRD cause, since the urogenital abnormality has been corrected. Living kidney transplantation seems to present a higher graft survival rate.- Collaborative Brazilian Pediatric Renal Transplant Registry (CoBrazPed-RTx): A Report From 2004 to 2013(2015) GARCIA, C.; PESTANA, J. M.; MARTINS, S.; NOGUEIRA, P.; BARROS, V.; ROHDE, R.; CAMARGO, M.; FELTRAN, L.; ESMERALDO, R.; CARVALHO, R.; SCHVARTSMAN, B.; VAISBICH, M.; WATANABE, A.; CUNHA, M.; MENESES, R.; PRATES, L.; BELANGERO, V.; PALMA, L.; CARVALHO, D.; MATUK, T.; BENINI, V.; LARANJO, S.; ABBUD-FILHO, M.; CHARPIOT, I. M. M.; RAMALHO, H. J.; LIMA, E.; PENIDO, J.; ANDRADE, C.; GESTEIRA, M.; TAVARES, M.; PENIDO, M.; SOUZA, V. De; WAGNER, M.Background. The Collaborative Brazilian Pediatric Renal Transplant Registry started in 2004 as a multicenter initiative aiming to analyze, report, and share the results of pediatric kidney transplantation in Brazil. Data from all pediatric kidney transplants performed between January 2004 and December 2013 were recorded electronically and periodically updated. All patients under 18 years old from the participating centers were enrolled. Demographic data, etiology of chronic kidney disease, and patient and graft survival were analyzed. From a total of 2443 pediatric kidney transplants performed in Brazil during the study period, we report data from 1751 pediatric renal transplants performed in 13 centers enrolled in the collaborative study. Median age at transplantation was 12.4 years, and most of recipients were male (56%). The most common underlying renal etiologies were obstructive uropathy (31%) and glomerulopathy (26%). Methods. According to donor source, 1155 (66%) of transplants were performed with deceased donors (DD). Initial immunosuppression consisted mainly of tacrolimus, mycophenolate, steroids, and induction therapy with anti-IL-2R antibodies. Results. One-year graft survival (death-censored) was 93% and 90% (log rank test, P < .01), respectively, for living donor (LD) and DD. Graft losses (15%) were most frequently caused by vascular thrombosis, chronic allograft nephropathy, death with functioning kidney, acute rejection, and recurrent renal disease. Recipients of DD had 2.02 (95% confidence interval: 1.14-3.59) times the hazard of graft loss compared with those of LD (P = .015). Patient survival rates at 1 and 5 years were 98% and 97% for LD and 97% and 93% for DD, respectively. The mortality rate was 3.8%, mainly as the result of infection and cardiovascular disease. Conclusions. The results of this collaborative pediatric transplant study are comparable to international registries. Our effort has been able to maintain an exchange of information, both among the participating centers and with other international registries.
conferenceObject Rituximab - Efficacy and adverse events in selected children and adolescents with challenging idiopathic nephrotic syndrome (INS)(2016) PADOVAN, F. L.; SOUZA, K. M.; LANDENBERGER, C. F. S.; HENRIQUES, L. S.; SCHVARTSMAN, B. G. S.; VAISBICH, M. H.- Celiac crisis with ataxia in a child(2011) OBA, Jane; ESCOBAR, Ana Maria; SCHVARTSMAN, Benita G. S.; GHERPELLI, Jose Luiz
conferenceObject COLLABORATIVE BRAZILIAN PEDIATRIC RENAL TRANSPLANT REGISTRY (COBRAZPED-RTX): A REPORT FROM 2004-2014(2015) GARCIA, Clotilde; PESTANA, Jose Medina; MARTINS, Suelen; NOGUEIRA, Paulo; BITTENCOURT, Viviane; ROHDE, Roberta; CAMARGO, Maria; CAMARGO, Maria; FELTRAN, Luciana; ESMERALDO, Ronaldo; CARVALHO, Rebeca; SCHVARTSMAN, Benita; VAISBICH, Maria; KOCH, Vera; WATANABE, Andrea; CUNHA, Mariana; MENESES, Rejane; PRATES, Liliane; BELANGERO, Vera; PALMA, Lilian; CARVALHO, Deise; MATUK, Teresa; BENINI, Vanda; LARANJO, Simone; ABBUD FILHO, Mario; FERNANDES, Ida; RAMALHO, Horacio; LIMA, Eleonora; PENIDO, Jose; ANDRADE, Claudia; GESTEIRA, Maria; TAVARES, Marcelo; PENIDO, Mariana; SOUZA, Vandrea De; WAGNER, Mario- Hypotonic solution decreases serum sodium in infants with moderate bronchiolitis(2014) RODRIGUES, Regina M.; SCHVARTSMAN, Benita G. S.; FARHAT, Sylvia C. L.; SCHVARTSMAN, ClaudioAimTo investigate the influence of hypotonic parenteral hydration on serum and urinary sodium and osmolality in infants with moderate bronchiolitis. MethodsWe studied 36 infants (mean age 3.72.3months), with a diagnosis of moderate bronchiolitis admitted to a paediatric emergency unit in SAo Paulo, Brazil. Patients received a standard parenteral hypotonic solution, according to Holliday and Segar, during the first 24h, due to respiratory distress. The disease was monitored by a respiratory severity score (RDAI-Respiratory Distress Assessment Instrument), respiratory rate and oxygen saturation. Serum and urinary sodium and osmolality were monitored at admission, 24 and 48h after admission. ResultsAll respiratory parameters improved during hospitalisation. Serum sodium and osmolality dropped after 24h (136.8 +/- 2.8 and 135.8 +/- 2.6mEq/L, p=0.031; 283.4 +/- 4.1 and 281.6 +/- 3.9 mOsm/kg, p=0.004 respectively) as well as urinary osmolality (486.8 +/- 243.4 mOsm/kg and 355.7 +/- 205.0 mOsm/kg, p<0.001) when compared to admission. ConclusionThis study reinforces the occurrence of hyponatraemia in bronchiolitis even in patients with moderate disease and highlights the risk of serum sodium drop caused by hypotonic parenteral hydration.
bookPart Infecção urinária(2018) SCHVARTSMAN, Benita Galassi Soares- POSTOPERATIVE OUTCOME OF PEDIATRIC PATIENTS UNDERGOING RENAL TRANSPLANTATION(2013) PADOVAN, Fabiola Lucia; COUTO, Saulo Brasil do; PINTO, Gabriela; MENEZES, Aline Motta; SAKITA, Luciana Henrique dos Santos; METRAN, Camila Cardoso; SILVA, Joao Domingos Montoni da; WATANABE, Andreia; VAISBICH, Maria Helena; DELGADO, Arthur Figueiredo; NAHAS, William Carlos; SCHVARTSMAN, Benita Galassi SoaresBJECTIVE: To evaluate the postoperative outcome in the Intensive Care Unit (ICU) in the first month after kidney transplant. PATIENTS AND METHODS: Thirty-two patients (33 transplants), 21 male, age: 9.5 ± 3.1 yrs. Retrospective study from July/2008 to March/2012 through the variables: cold ischemia time, PRISM, mechanical ventilation (MV), vasoactive drugs (VAD), immunosuppression, infection, surgical complications, dialysis, renal function (CrCl), diuresis, hospitalization length and mortality. Statistics: Fischer and Pearson. RESULTS: Causes of CKF: uropathy-19, glomerulopathy-3, tubulopathy-2, other-7. Cold ischemia: 20hs median. PRISM score: 1.3% (0.2–6.2%), FiO2 max: 30% (21–60%), MV: 1d (0–10d), VAD 18/33 1D(0–6d). 10/33 transplants used thymoglobulin, 23/33 basiliximab. Infections: catheter-related-4, urinary-2,peritonitis-2, sepsis-1. Surgical complications: bleeding-4, thrombosis-3, urinary fistula-1. Of 5/32 dialyzed. CrCl and diuresis first postoperative day: 20 mL/min/1.73 m2 and 3.6 mL/kg/h and at 30 days: 90 mL/min/1.73 m2 and 3.7 mL/kg/h. There was an inverse correlation between cold ischemia time and CrCl in the 1st postoperative day (p = 0.01 and r = 0.45), not seen at 30d. Hospitalization length ICU = 4d (2–23d), total 15d (5 – 45d). There was no difference in infection, MV duration, use of VAD, CrCl, ICU and total hospitalization length between thymoglobulin X basiliximab use (p > 0.05). However duration of VAD utilization was higher for Thymoglobulin (p = 0.05). One patient died from sepsis (3%). CONCLUSION: The outcome after renal transplantation was satisfactory, with short ICU stay, but high use of vasoactive drugs. Bleeding was the most common surgical complication. The patient and graft survival after 1 month of transplantation was 97% and 91%, respectively.