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
32 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 32
conferenceObject URINARY BIOMARKER NGAL IN PATIENTS WITH HEPATORENAL SYNDROME: ACCURACY STUDY IN PREDICTION OF NO RESPONSE TO THERAPY WITH ALBUMIN AND TERLIPRESSIN(2016) XIMENES, R. O.; HELOU, C.; DINIZ, M.; BARBEIRO, D.; SOUZA, H.; D'ALBUQUERQUE, L. A.; CARRILHO, F.; FARIAS, A.- I BRAZILIAN CONSENSUS ON MULTIMODAL TREATMENT OF COLORECTAL LIVER METASTASES. MODULE 2: APPROACH TO RESECTABLE METASTASES(2016) RIBEIRO, Heber Salvador de Castro; TORRES, Orlando Jorge Martins; MARQUES, Marcio Carmona; HERMAN, Paulo; KALIL, Antonio Nocchi; FERNANDES, Eduardo de Souza Martins; OLIVEIRA, Fabio Ferreira de; CASTRO, Leonaldson dos Santos; HANRIOT, Rodrigo; OLIVEIRA, Suilane Coelho Ribeiro; BOFF, Marcio Fernando; COSTA JR., Wilson Luiz da; GIL, Roberto de Almeida; PFIFFER, Tulio Eduardo Flesch; MAKDISSI, Fabio Ferrari; ROCHA, Manoel de Souza; AMARAL, Paulo Cezar Galvao do; COSTA, Leonardo Atem Goncalves de Arujo; ALOIA, Tomas A.; D'ALBUQUERQUE, Augusto Carneiro; COIMBRA, Felipe Jose FernandezBackground: Liver metastases of colorectal cancer are frequent and potentially fatal event in the evolution of patients. Aim: In the second module of this consensus, management of resectable liver metastases was discussed. Method: Concept of synchronous and metachronous metastases was determined, and both scenarius were discussed separately according its prognostic and therapeutic peculiarities. Results: Special attention was given to the missing metastases due to systemic preoperative treatment response, with emphasis in strategies to avoid its reccurrence and how to manage disappeared lesions. Conclusion: Were presented validated ressectional strategies, to be taken into account in clinical practice.
- Consensus, Dilemmas, and Challenges in Living Donor Liver Transplantation in Latin America(2016) SALVALAGGIO, Paolo R.; NETO, Joao Seda; ALVES, Jefferson Andre; FONSECA, Eduardo A.; ALBUQUERQUE, Luiz Carneiro de; ANDRAUS, Wellington; MASSAROLLO, Paulo B.; GARCIA, Valter Duro; MAURETTE, Rafael J.; RUF, Andres E.; PACHECO-MOREIRA, Lucio F.; RUSCA, Luis A. Caicedo; OSORIO, Veronica Botero; MATAMOROS, Maria Amalia; VARELA-FASCINETTO, Gustavo; JARUFE, Nicolas P.We reviewed the history, volume, outcomes, uniqueness, and challenges of living donor liver transplantation (LDLT) in Latin America. We used the data from the Latin American and Caribbean Transplant Society, local transplant societies, and opinions from local transplant experts. There are more than 160 active liver transplant teams in Latin America, but only 30 centers have used LDLT in the past 2 years. In 2014, 226 LDLTs were done in the region (8.5% of liver transplant activities). Living donor liver transplantation is mainly restricted to pediatric patients. Adult-to-adult LDLT activities decreased after the implementation of the model for end-stage liver disease score and a concomitant increase on the rate of deceased donors per million population. Posttransplant outcome analysis is notmandatory, transparent or regulated in most countries. More experienced teams have outcomes comparable to international expert centers, but donor and recipient morbidity might be underreported. Latin America lags behind in terms of the number of adult LDLT and the rate of living donor utilization in comparison with other continents with similar donation rates. Local alliances and collaborations with major transplant centers in the developed world will contribute to the development of LDLT in Latin America.
- Trisulfate Disaccharide Decreases Calcium Overload and Protects Liver Injury Secondary to Liver Ischemia/Reperfusion(2016) VASQUES, Enio Rodrigues; CUNHA, Jose Eduardo Monteiro; COELHO, Ana Maria Mendonca; SAMPIETRE, Sandra N.; PATZINA, Rosely Antunes; ABDO, Emilio Elias; NADER, Helena B.; TERSARIOL, Ivarne L. S.; LIMA, Marcelo Andrade; GODOY, Carlos M. G.; RODRIGUES, Tiago; CHAIB, Eleazar; D'ALBUQUERQUE, Luiz A. C.Background Ischemia and reperfusion (I/R) causes tissue damage and intracellular calcium levels are a factor of cell death. Sodium calcium exchanger (NCX) regulates calcium extrusion and Trisulfated Disaccharide (TD) acts on NCX decreasing intracellular calcium through the inhibition of the exchange inhibitory peptide (XIP). Objectives The aims of this research are to evaluate TD effects in liver injury secondary to I/R in animals and in vitro action on cytosolic calcium of hepatocytes cultures under calcium overload. Methods Wistar rats submitted to partial liver ischemia were divided in groups: Control: (n = 10): surgical manipulation with no liver ischemia; Saline: (n = 15): rats receiving IV saline before reperfusion; and TD: (n = 15): rats receiving IV TD before reperfusion. Four hours after reperfusion, serum levels of AST, ALT, TNF-alpha, IL-6, and IL-10 were measured. Liver tissue samples were collected for mitochondrial function and malondialdehyde (MDA) content. Pulmonary vascular permeability and histologic parameters of liver were determined. TD effect on cytosolic calcium was evaluated in BRL3A hepatic rat cell cultures stimulated by thapsigargin pre and after treatment with TD. Results AST, ALT, cytokines, liver MDA, mitochondrial dysfunction and hepatic histologic injury scores were less in TD group when compared to Saline Group (p<0.05) with no differences in pulmonary vascular permeability. In culture cells, TD diminished the intracellular calcium raise and prevented the calcium increase pre and after treatment with thapsigargin, respectively. Conclusion TD decreases liver cell damage, preserves mitochondrial function and increases hepatic tolerance to I/R injury by calcium extrusion in Ca2+ overload situations.
- A first report of leptospirosis after liver transplantation(2016) SONG, A. T. W.; ABAS, L.; ANDRADE, L. C.; ANDRAUS, W.; D'ALBUQUERQUE, L. A. C.; ABDALA, E.Leptospirosis has been rarely reported in solid organ transplant recipients. We report the first case to our knowledge of leptospirosis in a liver transplant recipient who developed jaundice and renal insufficiency. We describe his favorable clinical progression and discuss the possible mechanisms involved in the more benign disease course. We also review the previously published cases of leptospirosis in solid organ transplant recipients. Although this disease does not appear to present any particularities in this context, we highlight the importance of clinical suspicion in this setting, particularly after 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.
- Predictive factors for survival and score application in liver retransplantation for hepatitis C recurrence(2016) SONG, Alice Tung Wan; SOBESKY, Rodolphe; VINAIXA, Carmen; DUMORTIER, Jerome; RADENNE, Sylvie; DURAND, Franois; CALMUS, Yvon; ROUSSEAU, Geraldine; LATOURNERIE, Marianne; FERAY, Cyrille; DELVART, Valerie; ROCHE, Bruno; HAIM-BOUKOBZA, Stephanie; ROQUE-AFONSO, Anne-Marie; CASTAING, Denis; ABDALA, Edson; D'ALBUQUERQUE, Luiz Augusto Carneiro; DUCLOS-VALLEE, Jean-Charles; BERENGUER, Marina; SAMUEL, DidierAIM: To identify risk factors associated with survival in patients retransplanted for hepatitis C virus (HCV) recurrence and to apply a survival score to this population. METHODS: We retrospectively identified 108 patients retransplanted for HCV recurrence in eight European liver transplantation centers (seven in France, one in Spain). Data collection comprised clinical and laboratory variables, including virological and antiviral treatment data. We then analyzed the factors associated with survival in this population. A recently published score that predicts survival in retransplantation in patients with hepatitis C was applied. Because there are currently no uniform recommendations regarding selection of the best candidates for retransplantation in this setting, we also described the clinical characteristics of 164 patients not retransplanted, with F3, F4, or fibrosing cholestatic hepatitis (FCH) post-first graft presenting with hepatic decompensation. RESULTS: Overall retransplantation patient survival rates were 55%, 47%, and 43% at 3, 5, and 10 years, respectively. Patients who were retransplanted for advanced cirrhosis had survival rates of 59%, 52%, and 49% at 3, 5, and 10 years, while those retransplanted for FCH had survival rates of 34%, 29%, and 11%, respectively. Under multivariate analysis, and adjusting for the center effect and the occurrence of FCH, factors associated with better survival after retransplantation were: negative HCV viremia before retransplantation, antiviral therapy after retransplantation, non-genotype 1, a Model for End-stage Liver Disease (MELD) score < 25 when replaced on the waiting list, and a retransplantation donor age < 60 years. Although the numbers were small, in the context of the new antivirals era, we showed that outcomes in patients who underwent retransplantation with undetectable HCV viremia did not depend on donor age and MELD score. The Andres score was applied to 102 patients for whom all score variables were available, producing a mean score of 43.4 (SD = 6.6). Survival rates after the date of the first decompensation post-first liver transplantation (LT1) in the liver retransplantation (reLT) group (94 patients decompensated) at 3, 5, and 10 years were 62%, 59%, and 51%, respectively, among 78 retransplanted individuals with advanced cirrhosis, and 42%, 32%, and 16% among 16 retransplanted individuals with FCH. In the non-reLT group with hepatic decompensation, survival rates were 27%, 18%, and 9% at 3, 5, and 10 years, respectively (p < 0.0001). Compared with non-retransplanted patients, retransplanted patients were younger at LT1 (mean age 48 +/- 8 years compared to 53 +/- 9 years in the no reLT group, p < 0.0001), less likely to have human immunodeficiency virus (HIV) co-infection (4% vs 14% among no reLT patients, p = 0.005), more likely to have received corticosteroid bolus therapy after LT1 (25% in reLT vs 12% in the no reLT group, p = 0.01), and more likely to have presented with sustained virological response (SVR) after the first transplantation (20% in the reLT group vs 7% in the no reLT group, p = 0.028). CONCLUSION: antiviral therapy before and after retransplantation had a substantial impact on survival in the context of retransplantation for HCV recurrence, and with the new direct-acting antivirals now available, outcomes should be even better in the future.
- Twenty Years of Experience in Pediatric Living Donor Liver Transplantation: Focus on Hepatic Artery Reconstruction, Complications, and Outcomes(2016) SEDA-NETO, Joao; FONSECA, Eduardo Antunes da; PUGLIESE, Renata; CANDIDO, Helry L.; BENAVIDES, Marcel R.; AFONSO, Rogerio Carballo; NEIVA, Romerito; PORTA, Gilda; MIURA, Irene K.; TENG, Hsiang W.; IWASE, Fernanda C.; RODRIGUES, Monica L.; ALBUQUERQUE, Luis Augusto Carneiro de; KONDO, Mario; CHAPCHAP, PauloBackground. Hepatic artery thrombosis (HAT) increases morbidity and mortality after liver transplantation (LT). The identification of risk factors for HAT may aid transplant teams in the development of strategies aimed at reducing HAT. This article describes the risk factors for HAT and outcomes after LT. Methods. This report describes a retrospective study (1995 to 2015) of primary pediatric living donor LT (LDLT). Pretransplant and technical variables were included in the study. Binary logistic regression was used for data analysis. Results. This study included 656 primary LDLT. The median age, body weight, and pediatric end-stage liver disease score at the time of transplant were 13 months, 8.4 kg and 15, respectively. Twenty-one (3.2%) patients developed HAT. Intraoperative HAT (odds ratio, 62.63; 95% confidence interval, 12.64-310.19; P < 0.001) and the use of liver grafts with a graft-to-recipient weight ratio less than 1.1% (odds ratio, 24.46; 95% confidence interval, 4.55-131.56; P < 0.001) retained statistical significance in the multivariate model. Patient and graft survivals were significantly worse in cases with HAT. The overtime trend analysis revealed a decrease in the incidence of HAT (P = 0.008) and an increase in the use of 2-arterial anastomosis (P < 0.001). Conclusions. A graft-to-recipient weight ratio of 1.1% or less and intraoperative HAT were independently associated with HAT. Trend analysis further revealed a significant reduction in the incidence of HAT over time, as well as the increased use of 2 hepatic arteries for anastomosis during graft implantation. The double artery anastomosis may represent an extra protection to pediatric recipients undergoing LDLT.
conferenceObject Endoscopic Ultrasound Evaluation After Endoscopic Eradication of Esophageal Varices With Band Ligation: Does It Predict Variceal Recurrence?(2016) CARNEIRO, Fred O.; RETES, Felipe A.; MATUGUMA, Sergio E.; ALBERS, Debora V.; CHAVES, Dalton M.; SANTOS, Marcos E.; HERMAN, Paulo; CHAIB, Eleazar; SAKAI, Paulo; ALBUQUERQUE, Luiz C. D.; MALUF-FILHO, Fauze- First Latin uterine transplantation: we can do it!(2016) SOARES JUNIOR, Jose Maria; EJZENBERG, Dani; ANDRAUS, Wellington; D'ALBUQUERQUE, Luiz Augusto Carneiro; BARACAT, Edmund Chada