RAFAEL MEDEIROS CARRARO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Posterior Reversible Encephalopathy Syndrome in Lung Transplantation: 5 Case Reports(2014) ARIMURA, F. E.; CAMARGO, P. C. L. B.; COSTA, A. N.; TEIXEIRA, R. H. O. B.; CARRARO, R. M.; AFONSO JR., J. E.; CAMPOS, S. V.; SAMANO, M. N.; FERNANDES, L. M.; ABDALLA, L. G.; PEGO-FERNANDES, P. M.Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiologic entity characterized by typical neurologic symptoms with characteristic cerebral image alterations. It has been reported in solid organ transplantations, especially related to the use of calcineurin inhibitors. The incidence of PRES in lung transplantation is unknown and probably under-reported in the literature. Here we describe 5 cases of PRES after bilateral lung transplantation. One of the reported cases was the first in the literature in which the neurologic onset precluded the introduction of calcineurin inhibitor. Therefore, although calcineurin inhibitors are known to play an important role in the development of PRES in the setting of lung transplantation, other causes seems to be involved in the physiopathology of this syndrome.
- Fungal Infection by Mucorales Order in Lung Transplantation: 4 Case Reports(2014) NETO, F. M. F. D.; CAMARGO, P. C. L. B.; COSTA, A. N.; TEIXEIRA, R. H. O. B.; CARRARO, R. M.; AFONSO JR., J. E.; CAMPOS, S. V.; SAMANO, M. N.; FERNANDES, L. M.; ABDALLA, L. G.; PEGO-FERNANDES, P. M.Mucorales is a fungus that causes systemic, highly lethal infections in immunocompromised patients. The overall mortality of pulmonary mucormycosis can reach 95%. This work is a review of medical records of 200 lung transplant recipients between the years of 2003 and 2013, in order to identify the prevalence of Mucorales in the Lung Transplantation service of Heart Institute (InCor), Hospital das Clinicas da Universidade de Sao Paulo, Brazil, by culture results from bronchoalveolar lavage and necropsy findings. We report 4 cases found at this analyses: 3 in patients with cystic fibrosis and 1 in a patient with bronchiectasis due to Kartagener syndrome. There were 2 unfavorable outcomes related to the presence of Mucorales, 1 by reduction of immunosuppression, another by invasive infection. Another patient died from renal and septic complications from another etiology. One patient was diagnosed at autopsy just 5 days after lung transplantation, with the Mucor inside the pulmonary vein with a precise, well-defined involvement only of donor's segment, leading to previous colonization hypothesis. There are few case reports of Mucorales infection in lung transplantation in the literature. Surveillance for the presence of Mucor can lead to timely fungal treatment and reduce morbidity and mortality in the immunocompromised patients, especially lung transplant recipients.
- Surveillance Bronchoscopy in Lung Transplantation Recipients: A Single Center Experience Analysis(2020) TAKIZAWA, Daniel B.; CASTRO, Caio C. B. de; PAIVA, Michelle A.; CAMPOS, Silvia V.; CARRARO, Rafael M.; COSTA, Andre N.; NASCIMENTO, Ellen C. T. do; SAMANO, Marcos N.; TEIXEIRA, Ricardo H. de Oliveira Braga
- Histopathological Findings Associated With Gastroesophageal Reflux Disease and Aspiration After Lung Transplantation: Initial Brazilian Single-Center Experience(2017) CARRARO, R. M.; NASCIMENTO, E. C. T.; SZACHNOWICZ, S.; CAMARGO, P. C. L. B.; CAMPOS, S. V.; AFONSO JR., J. E.; SAMANO, M. N.; PEGO-FERNANDES, P. M.; DOLHNIKOFF, M.; TEIXEIRAA, R. H. O. B.; COSTA, A. N.Background. Gastro-esophageal reflux disease (GERD) and broncho-aspiration (BA) are known to increase the risk for chronic lung allograft dysfunction (CLAD). However, specific lung injury mechanisms are not clearly known. The objective of the study was to describe histopathological findings in surveillance lung transbronchial biopsies that can be correlated with episodes of BA in the lung allograft. Methods. This retrospective analysis of surveillance transbronchial biopsies was performed in lung transplant recipients, with available data of broncho-alveolar fluid (cultures and cytology), lung function parameters, and esophageal functional tests. Results. Were analyzed 11 patients, divided into 3 groups: (1) GERD group: 4 patients with GERD and CLAD diagnosis; (2) control group: 2 patients without GERD or CLAD; and (3) BA group: 5 patients with foreign material in lung biopsies. A histopathological pattern of neutrophilic bronchitis (NB) was present in 4 of 4 cases in the GERD group and in 1 of 5 cases in the BA group in 2 or more biopsy samples; culture samples were all negative; the 5 NB-positive patients developed CLAD and died (3/5) or needed re-transplantation (2/5). The other 3 patients in the BA group had GERD without NB or CLAD. Both patients in the control group had transient NB in biopsies with positive cultures but remained free of CLAD. Conclusions. Surveillance transbronchial biopsies may provide useful information other than the evaluation of acute cellular rejection and can help to identify high-risk patients for allograft dysfunction related to gastro-esophageal reflux.