FLAVIO JOTA DE PAULA
Índice h a partir de 2011
13
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
conferenceObject Desensitization Using Only IVIG: Is That an Option for Highly-Sensitized Patients Waiting for Kidneys from Cadaveric Donors?(2019) PAIXAO, J. O.; ULISSES, L. R.; SOUZA, P. S.; BEZERRA, G.; AGENA, F.; RODRGUES, H. P.; PANAJOTOPOULOS, N.; PAULA, F. J.; DAVID-NETO, E.; CASTRO, M. R.conferenceObject Desensitization Using Only Polyvalent Immunoglobulins (IVIG) for Kidney Transplantation with Living Donors (LD)(2019) ULISSES, L. R.; PAIXAO, J. O.; SOUZA, P. S.; BEZERRA, G.; RODRIGUES, H.; PANAJATOPOULOS, N.; PAULA, F. J. De; DAVID-NETO, E.; CASTRO, M. C. R.conferenceObject Plasma Cell Infiltration: General Overview of Clinical and Pathological Correlations in Renal Transplantation(2015) NIHEI, C.; LEMOS, F.; DAVID, D.; SOUZA, P.; PAULA, F. de; NAHAS, W.; DAVID-NETO, E.- Prioritization Due to Dialysis Access Failure Impacts on Patient Survival after Kidney Transplantation(2013) REUSING JR., J.; SOUZA, P.; GALANTE, N.; AGENA, F.; PAULA, F. de; NAHAS, W.; DAVID-NETO, E.Dialysis vascular access failure, recipient of a non-renal solid organ transplantation and previous kidney donation are current indications of priority allocation (PA) for kidney transplant (KT) at our centre. Mortality among PA patients under dialysis is high and risk factors for long-term patient outcomes after transplantation remain largely elusive. In this study we analyzed a cohort of patients that received KT from Jan/2007 to Dec/2011. Long-term patient survival was compared between PA and non PA recipients transplanted in this period of time and clinical relevant data were analyzed. Data were recorded as of Aug/2012. Results: 948 KT were performed at our institution and 93 (9.8%) were included in our PA program. Most PA patients (n=86) had access failure. The mean follow up time was 32 (0 – 69) months. 5-year patient survival was lower in PA patients (76vs 86%, p=0.001). Twenty (21.5%) PA patients died and all deaths occurred in those with access failure, being 70% of them in the first 3 months. Causes of death were infection in 10 patients, bleeding complications (n=6), uremia (n=1), mesenteric ischemia (n=1) and unspecified shock (n=2). Considering this high mortality rate in the first 3 months after transplantation, we compared patients who died in this period of time (group A) vs. those who survived more than 3 months (group B). Age, gender, previous kidney transplants, sensitization, number of HLA mismatches, pre-transplant DSA, pre-transplant diabetes, induction therapy, DGF, rejection, use of heparin, IVIg and time from inscription in the PA program to transplantation were not statistically different between groups. Among 47 patients who were screened for thrombophilia, 83.3% from group A were positive vs. 31.7% from group B (p=0.01). Infection after transplantation and hemorrhagic complications were more frequent in group A. Groups were not different regarding causes of death. PA patients have a lower survival and this excessive death rate occur in the first three months after transplantation mainly due to infections and bleeding. Thrombophilia is very frequent in PA patients with HR....... for death.
conferenceObject Early Protocol Biopsies Can Identify Antibody-Mediated Rejection in Sensitized Patients(2013) SOUZA, P.; MACHADO, D.; AGUIRRE, A.; DAVID, D.; BARBOSA, E.; PAULA, F. de; NAHAS, W.; DAVID-NETO, E.; CASTRO, M.HLA sensitized patients are at risk for antibody-mediated rejection (ABMR). Our purpose was to evaluate the importance of early protocol biopsies. From Jul/2010 to Jun/2012, 101 sensitized patients defined as PRA>10% (class I and/or II by Flow-PRA) were transplanted at our institution. Out of them, 60 performed donor-specific antibodies (DSA) at transplant and a protocol-bx at day 7 (D7) and were included in this study. A second for cause indication biopsy (IB) was done at the physician’s discretion in 18 patients without previous acute rejection (AR) diagnosis. DSA were analyzed by single antigen bead assays at the time of biopsies (classified according to Banff’09 criteria). Patients (pts) mean age was 48±12 years, 48 were female (80%),45 first transplant (75%) and 42 (70%) received a kidney from deceased donor. 34 pts never presented AR episodes while 26 did. 20/26 (77%) of AR were diagnosed in the first 3 weeks after transplantation (median 13 days). Day 7 protocol biopsies (PB) showed AR in 12/26 (46%): 10 (85%) ABMR and 2 (15%) T-cell-mediated rejection (TCMR). The IB (n=18) done at a median of 11 days from the PB (range 3-112), showed AR in another 14 pts (56%): 10(71%) ABMR and 4 (29%) TCMR, as presented in Table 1 Pre-Tx mean MFI in ABMR pts did not differ among PB: 6001 (1596-11181) vs IB 2304 (840-14600)(p=NS). It also did not differ at the time of biopsy (2823 vs. 2277 in PB vs IB, respectively; p=NS). Patients with early ABMR diagnosis at PB had a trend to higher long-term MDRD (49±12mL/min) compared to patients with ABMR at IB (41±11mL/min) and similar to the whole non-ABMR patients (50±17mL/min). In conclusion, protocol biopsy is useful to diagnosis ABMR as early as in the first week pos-Tx. Early recognition of ABMR allows earlier treatment and possibly better long-term graft function in sensitized patients.conferenceObject Microcirculation Inflammation in Early Surveillance Renal Biopsy in Sensitized Patients Did Not Correlate With Graft Outcome(2015) SOUZA, P.; MACHADO, D.; DAVID, D.; BEZERRA, G.; PAULA, F. Jota de; RODRIGES, H.; NAHAS, W.; DAVID NETO, E.; CASTRO, M.conferenceObject DIAGNOSIS OF ANTIBODY-MEDIATED REJECTION THROUGH EARLY PROTOCOL BIOPSIES IN SENSITIZED PATIENTS(2013) SOUZA, Patricia S.; MACHADO, David; AGUIRRE, Anna Rita; DAVID, Daisa; BARBOSA, Erick; PAULA, Flavio Jota de; NAHAS, Willian; DAVID-NETO, Elias; CASTRO, Maria Cristina R.conferenceObject Graft Survival in Sensitized and Non-Sensitized Patients: Role of the Combination of Donor-Specific Antibodies and Acute Rejection(2016) SOUZA, P.; AGUIRRE, A.; BEZERRA, G.; RODRIGUES, H.; AGENA, F.; DAVID, D.; PAULA, F. de; DAVID-NETO, E.; CASTRO, M.conferenceObject THROMBOPHILIA AND PRIORITIZATION DUE TO DIALYSIS ACCESS FAILURE IMPACT EARLY ON PATIENT SURVIVAL AFTER KIDNEY TRANSPLANTATION(2013) REUSING JR., Jose O.; SOUZA, Patricia S.; GALANTE, Nelson Z.; AGENA, Fabiana; PAULA, Flavio J.; NAHAS, William Carlos; DAVID-NETO, EliasconferenceObject IMPACT OF EVEROLIMUS ADDED TO TACROLIMUS/MYCOPHENOLATE/ PREDNISONE ON CMV DISEASE AND ACUTE REJECTION IN SENSITIZED KIDNEY TRANSPLANT RECIPIENTS. A SINGLE CENTER, RANDOMIZED AND CONTROLLED, PILOT STUDY(2017) SOUZA, Patricia; VENTURA, Carlucci; AGENA, Fabiana; BARRETO, Noemia; REUSING, Jose Otto; ONUSIC, Vivian; ZOCOLER, Nelson; PAULA, Flavio De; DAVID-NETO, Elias