LUIZ AUGUSTO CARNEIRO D ALBUQUERQUE
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Gastroenterologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina - Líder
6 resultados
Resultados de Busca
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conferenceObject Evidences that Anorectal Transplantation is the Logical Treatment for Serious Anorectal Dysfunction and Permanente Colostomy.(2015) GALVAO, Flavio; SEID, Victor E.; WAISBERG, Daniel R.; COSTA, Anderson C.; LANCHOTTE, Cinthia; BAPTISTA, Rachel R.; NAITO, Chaib E. Munekazu; ARAKI, Jun; D'ALBUQUERQUE, Luiz A.conferenceObject Multivisceral Transplantation of Pelvic Organs.(2015) GALVAO, Flavio; SEID, Victor E.; WAITSBERG, Daniel R.; BAPTISTA, Rachel; ARAKI, Jun; D'ALBUQUERQUE, Luiz A.- Functional outcome of autologous anorectal transplantation in an experimental model(2015) SEID, V. E.; GALVAO, F. H. F.; VAIDYA, A.; WAISBERG, D. R.; CRUZ JR., R. J.; CHAIB, E.; NAHAS, S. C.; ARAUJO, S. E. A.; D'ALBUQUERQUE, L. A. C.; ARAKI, J.Background: Although anorectal transplantation is a challenging procedure, it is a promising option for patients who have completely lost anorectal function or in whom it failed to develop, as in congenital malformations. The paucity of animal models with which to test functional outcomes was addressed in this study of anorectal manometry in rats. Methods: Wistar rats were assigned randomly to four groups: orthotopic anorectal transplantation, heterotopic transplantation, sham operation, or normal control. Bodyweight and anal pressure were measured immediately before and after operation, and on postoperative days 7 and 14. ANOVA and Tukey's test were used to compare results for bodyweight, anal manometry and length of procedure. Results: Immediately after the procedure, mean(s.d.) anal pressure in the orthotopic group (n=13) dropped from 31.4(13.1) to 1.6(13.1) cmH(2)O (P < 0.001 versus both sham operation (n=13) and normal control (n=15)), with partial recovery on postoperative day 7 (14.9(13.9) cmH(2)O) (P=0.009 versus normal control) and complete recovery on day 14 (23.7(12.2) cmH(2)O). Heterotopic rats (n=14) demonstrated partial functional recovery: mean(s. d.) anal pressure was 26.9(10.9) cmH(2)O before operation and 8.6(6.8) cmH(2)O on postoperative day 14 (P < 0.001 versus both sham and normal control). Conclusion: Orthotopic anorectal transplantation may result in better functional outcomes than heterotopic procedures.
- Evidence That Anorectal Transplantation Is the Logical Treatment for Serious Anorectal Dysfunction and Permanent Colostomy(2016) GALVAO, F. H. Ferreira; ARAKI, J.; SEID, V. E.; WAISBERG, D. R.; TRALDI, M. C.; NAITO, M.; ARAUJO, B. C.; LANCHOTTE, C.; CHAIB, E.; D'ALBUQUERQUE, L. A. C.Anorectal dysfunction resulting in fecal incontinence or permanent colostomy is a current public health concern that strongly impairs patient quality of life. Present treatment options for this complex disease are expensive and usually ineffective. Anorectal transplantation is the logical treatment for fecal incontinence and permanent colostomy. This procedure has been clinically effective in a few cases reported in the medical literature. Furthermore, experiments in rats, pigs, and dogs have shown promising results, with functional recovery of the graft. In this article we describe the scientific evidence that anorectal transplantation may be an important option for treating anorectal dysfunction.
- Allogeneic anorectal transplantation in rats: technical considerations and preliminary results(2016) GALVAO, Flavio H. F.; WAISBERG, Daniel R.; SEID, Victor E.; COSTA, Anderson C. L.; CHAIB, Eleazar; BAPTISTA, Rachel Rossini; CAPELOZZI, Vera Luiza; LANCHOTTE, Cinthia; CRUZ, Ruy J.; ARAKI, Jun; D'ALBUQUERQUE, Luiz CarneiroFecal incontinence is a challenging condition with numerous available treatment modalities. Success rates vary across these modalities, and permanent colostomy is often indicated when they fail. For these cases, a novel potential therapeutic strategy is anorectal transplantation (ATx). We performed four isogeneic (Lewis-to-Lewis) and seven allogeneic (Wistar-to-Lewis) ATx procedures. The anorectum was retrieved with a vascular pedicle containing the aorta in continuity with the inferior mesenteric artery and portal vein in continuity with the inferior mesenteric vein. In the recipient, the native anorectal segment was removed and the graft was transplanted by end-to-side aorta-aorta and porto-cava anastomoses and end-to-end colorectal anastomosis. Recipients were sacrificed at the experimental endpoint on postoperative day 30. Surviving animals resumed normal body weight gain and clinical performance within 5 days of surgery. Isografts and 42.9% of allografts achieved normal clinical evolution up to the experimental endpoint. In 57.1% of allografts, signs of immunological rejection (abdominal distention, diarrhea, and anal mucosa inflammation) were observed three weeks after transplantation. Histology revealed moderate to severe rejection in allografts and no signs of rejection in isografts. We describe a feasible model of ATx in rats, which may allow further physiological and immunologic studies.
- Multivisceral transplantation of pelvic organs in rats(2023) GALVAO, Flavio Henrique Ferreira; ARAKI, Jun; FONSECA, Ana Bruna Salles; CRUZ JR., Ruy Jorge; LANCHOTTE, Cinthia; WAISBERG, Daniel Reis; CHAIB, Eleazar; NACIF, Lucas Souto; TRALDI, Maria Clara de Camargo; MELLO, Estrella Bianco de; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, LuizBackground: Multivisceral transplantation of pelvic organs would be a potential treatment for severe pelvic floor dysfunction with fecal and urinary incontinence, extensive perineal trauma, or congenital disorders. Here, we describe the microsurgical technique of multivisceral transplantation of pelvic organs, including the pelvic floor, in rats. Donor operation: We performed a perineal (including the genitalia, anus, muscles, and ligaments) and abdominal incision. The dissection progressed near the pelvic ring, dividing ligaments, muscles, external iliac vessels, and pudendal nerves, allowing pelvic floor mobilization. The aorta and vena cava were isolated distally, preserving the internal iliac and gonadal vessels. The graft containing the skin, muscles, ligaments, bladder, ureter, rectum, anus and vagina, uterus and ovarian (female), or penile, testis and its ducts (male) was removed en bloc, flushed, and cold-stored. Recipient operation: The infrarenal aorta and vena cava were isolated and donor/ recipient aorta-aorta and cava-cava end-to-side microanastomoses were performed. After pelvic floor and viscera removal, we performed microanastomoses between the donor and the recipient ureter, and the rectum and pudenda nerves. The pelvic floor was repositioned in its original position (orthotopic model) or the abdominal wall (heterotopic model). We sacrificed the animals 2 h after surgery. Results: We performed seven orthotopic and four heterotopic transplantations. One animal from the orthotopic model and one from the heterotopic model died because of technical failure. Six orthotopic and three heterotopic recipients survived up to 2 h after transplantation. Conclusion: The microsurgical technique for pelvic floor transplantation in rats is feasible, achieving an early survival rate of 81.82%.