DAISA SILVA RIBEIRO DAVID
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/16 - Laboratório de Fisiopatologia Renal, Hospital das Clínicas, Faculdade de Medicina
LIM/16 - Laboratório de Fisiopatologia Renal, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
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- Alteracoes vasculares em rins de doadores falecidos retardam a recuperacao da funcao do enxerto apos o transplante renal(2014) MARQUES, Igor Denizarde Bacelar; REPIZO, Liliany Pinhel; PONTELLI, Renato; PAULA, Flavio Jota de; NAHAS, William Carlos; DAVID, Daisa Silva Ribeiro; DAVID NETO, Elias; LEMOS, Francine Brambate CarvalhinhoObjective: The purpose of this study was to evaluate the impact of donor and recipient characteristics on duration of delayed graft function (DGF) and 1-year serum creatinine (SCr), as a surrogate endpoint for allograft survival. Methods: We reviewed 120 first cadaver kidney transplants carried out consecutively at our center to examine the effect on 1-year SCr of the presence and duration of DGF. Results: DGF rate was 68%, with a median duration of 12 days (range, 1-61). Forty-four (38%) patients presented DGF lasting 12 or more days (prolonged DGF group). Mean donor age was 43 ± 13 years, 37% had hypertension and in 59% the cause of brain death was cardiovascular accident. The mean cold ischemia time was 23 ± 5 hours. Twenty-seven (23%) donors were classified as expanded-criteria donors according to OPTN criteria. The mean recipient age was 51 ± 15 years. The recipients median time in dialysis was 43 months (range, 1-269) and 25% of them had panel reactive antibodies > 0%. Patients with prolonged DGF presented higher 1-year SCr in comparison with patients without DGF (1.7 vs. 1.3 mg/dL, respectively, p = 0.03). In multivariate logistic regression analysis, the only significant factor contributing to the occurrence of prolonged DGF was the presence of vascular lesions in the kidney allograft at time of transplantation (HR 3.6, 95% CI 1.2-10.2; p = 0.02). Conclusion: The presence of vasculopathy in the kidney allograft at time of transplantation was identified as an important factor independently associated with prolonged DGF. Prolonged DGF negatively impacts 1-year graft function.
- Expression patterns of CD56+and CD16+cells in renal transplant biopsies with acute rejection: Associations with microcirculation injuries and graft survival(2017) SANTOS, Daniela Cristina Dos; CAMARA, Niels Olsen Saraiva; DAVID, Daisa Silva Ribeiro; MALHEIROS, Denise Maria Avancini CostaBackgroundThe study investigated whether immunohistochemical features of interstitial and glomerular CD56 and CD16 infiltrates - NK cells markers - could be associated with microcirculation injury scores - peritubular capillaritis (ptc) and glomerulitis (g) - and graft survival. MethodsThe research analyzed the immunohistochemical pattern of CD56 and CD16 in interstitial and glomerular compartments of biopsies for-cause biopsies from 59 recipients diagnosed with acute rejection (mean=135.5days post-transplant). ResultsInterstitial CD56+ cells had an increased expression for glomerulitis (g1) (P=0.02) and peritubular capillaritis (ptc2) (P=0.003) presence. It was noted that interstitial CD56+cells with mean above 0.56cells/mm(2) had worse allograft survival. CD56+ cells in the interstitial compartment with mean less than or equal to 0.56cells/mm(2) was related with absence or mild peritubular capillaritis (P=0.012) and mean above 0.56cells/mm(2), respectively, with glomerulitis (P=0.002) presence. Interstitial CD16 cells showed greater positive results in relation to peritubular capillaritis (P=0.0001) cases. Similarly, it was observed that glomerular CD16+ cells had higher positive results in glomerulitis (P=0.009) presence. ConclusionsThe study findings showed that CD56+ cell infiltrated in the interstitial compartment was significantly associated with microcirculation injury scores, especially the glomerulitis, and graft survival. Summary at a Glance This study suggests that increased expression of interstitial natural killer cells in renal allograft biopsies of kidney transplant recipients with rejection may be associated with poorer graft outcomes.
- C4d staining in post-reperfusion renal biopsy is not useful for the early detection of antibody-mediated rejection when CDC crossmatching is negative(2011) DAVID-NETO, Elias; DAVID, Daisa S. R.; GINANI, Giordano F.; RODRIGUES, Helcio; SOUZA, Patricia S.; CASTRO, Maria Cristina R.; KANASHIRO, Hideki; SAITO, Fernando; FALCI JR., Renato; ANTONOPOULOS, Ioannis M.; PIOVESAN, Afonso Celso; NAHAS, William C.Background. Sensitized patients (pts) may develop acute antibody-mediated rejection (AMR) due to preformed donor-specific antibodies, undetected by pre-transplant complement-dependent cytotoxicity (CDC) crossmatch (XM). We hypothesized that C4d staining in 1-h post-reperfusion biopsies (1-h Bx) could detect early complement activation in the renal allograft due to preformed donor-specific antibodies. Methods. To test this hypothesis, renal transplants (n = 229) performed between June 2005 and December 2007 were entered into a prospective study of 1-h Bx and stained for C4d by immunofluorescence. Transplants were performed against a negative T-cell CDC-XM with the exception of three cases with a positive B-cell XM. Results. All 229 1-h Bx stained negative for C4d. Fourteen pts (6%) developed AMR. None of the 14 protocol 1-h Bx stained positive for C4d in peritubular capillaries (PTC). However, all indication biopsies-that diagnosed AMR-performed at a median of 8 days after transplantation stained for C4d in PTC. Conclusions. These data show that C4d staining in 1-h Bx is, in general, not useful for the early detection of AMR when CDC-XM is negative.
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.- Unexplained fever and acute kidney injury in a kidney transplant patient(2016) PAULA, Flavio J.; NEVES, Precil D. M. M.; LAZARI, Carolina S.; RAMOS, Rafael G.; FREDIANI, Marcella M.; SILVA, Marcelo V. A.; MFINDA, Nzuzi; PIERROTTI, Ligia C.; DAVID, Daisa S. R.; TESTAGROSSA, Leonardo A.; DAVID-NETO, Elias
- Rituximab in a B cell-driven regimen for the treatment of recurrent membranoproliferative glomerulonephritis after kidney transplantation(2014) MARQUES, Igor Denizarde Bacelar; RAMALHO, Janaina; DAVID, Daisa Ribeiro; NAHAS, William Carlos; DAVID-NETO, Elias