ALLANA CHRISTINA FORTUNATO MACIEL
Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
LIM/37 - Laboratório de Transplante e Cirurgia de Fígado, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Innovative technique avoiding bleeding after reperfusion in living donor liver transplatation using a modified right lobe graft(2021) PINHEIRO, R. S.; ANDRAUS, W.; NACIF, L. S.; MARTINO, R. B.; DUCATTI, L.; ARANTES, R. M.; WAISBERG, D. R.; FORTUNATO, A.; ROCHA-SANTOS, V.; D'ALBUQUERQUE, L. C.- Innovative Technique Avoiding Bleeding After Reperfusion in Living Donor Liver Transplant Using a Modified Right Lobe Graft(2022) PINHEIRO, Rafael S.; ANDRAUS, Wellington; FORTUNATO, Allana C.; FERNANDES, Michel Ribeiro; NACIF, Lucas Souto; MARTINO, Rodrigo Bronze De; DUCATTI, Liliana; WAISBERG, Daniel Reis; ARANTES, Rubens Macedo; ROCHA-SANTOS, Vinicius; GALVAO, Flavio Henrique Ferreira; CARNEIRO-D'ALBUQUERQUE, Luiz AugustoBackground. Living donor liver transplant (LDLT) is a valuable therapeutic option for over-coming the deceased donor shortage. Modified right lobe graft (MRLG) keeps the middle hepatic vein (MHV) trunk with the remnant liver to improve donor safety. Hemostasis in the MHV tributary reconstruction can be tricky; surgical stitches and energy coagulation are ineffective. Fibrin glues are excellent vascular sealants but are poor in maintaining hemostasis in an active hemorrhage or preventing resection surface-related complications after liver resection. We propose applying fibrin sealant during back table graft preparation to seal the hepatic edge and MHV reconstruction to avoid bleeding after graft revascularization. Methods. Our retrospective cohort study included all adult patients undergoing LDLT between August 2017 and December 2021. During the back table procedure, we performed the reconstruction of the inferior right hepatic vein and/or MHV tributaries from segment 5 (V5) and segment 8 (V8) using a vein harvested from a nonrelated deceased donor. Before initiating the hepatic graft implantation, we applied fibrin sealant in the resected parenchyma, especially in the V5 and V8 anastomosis, to seal the hepatic edge and hepatic vein reconstruction. Results. No bleeding was identified in the hepatic edge, and blood product transfusion was unnecessary for any recipients after reperfusion. Conclusion. In LDLT using MRLG with MHV reconstruction, the fibrin sealant, when applied on the raw hepatic surface, and vascular reconstruction during back table graft preparation avoided bleeding after graft revascularization.
article 4 Citação(ões) na Scopus Novel Technique in a Sheep Model of Uterine Transplantation(2020) ARANTES, Rubens Macedo; NACIF, Lucas Souto; PINHEIRO, Rafael Soares; ROCHA-SANTOS, Vinicius; MARTINO, Rodrigo Bronze de; WAISBERG, Daniel Reis; PANTANALI, Carlos Andres Rodriguez; FORTUNATO, Allana; LIMA, Marisa Rafaela; DUCATTI, Liliana; HADDAD, Luciana Bertocco de Paiva; EJZENBERG, Dani; GALVAO, Flavio Henrique; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, LuizconferenceObject Adequate Exposure to Tacrolimus with Sublingual Administration(2021) MACIEL, A.; FORTUNATO, A.; WAISBERG, D.; GALVAO, F.; LEE, A.; ARANTES, Jr R.; ROCHA, M.; TANIGAWA, R.; DUCATTI, L.; MARTINO, R.; NACIF, L.; ROCHA-SANTOS, V; ANDRAUS, W.; D'ALBUQUERQUE, L.- COVID-19 Pandemic Impact on Liver Donation in the Largest Brazilian Transplantation Center(2022) FORTUNATO, Allana C.; PINHEIRO, Rafael S.; FERNANDES, Michel Ribeiro; NACIF, Lucas Souto; ARANTES, Rubens Macedo; ROCHA-SANTOS, Vinicius; WAISBERG, Daniel Reis; MARTINO, Rodrigo Bronze De; DUCATTI, Liliana; HADDAD, Luciana Bertocco; SONG, Alice Tung; ABDALA, Edson; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz AugustoBackground. COVID-19 has spread worldwide and has become a public health emergency and a pandemic of international concern. The solid organ donation system was no different. This study aimed to investigate the effect of COVID-19 on the liver transplant (LT) system in Brazilian territory. Methods. We retrospectively reviewed all liver donor records allocated in Sao Paulo State, Brazil, 1 year before and 1 year during the COVID-19 pandemic. We defined the pre-COVID-19 (PRE) period as between April 2019 and April 2020 and the post-COVID-19 (POST) period as between April 2020 and April 2021. Moreover, we compared LT performed in our institution during these periods. To evaluate outcomes, we compared 30-day survival after LT. Results. In the PRE period, 1452 livers were offered for donation in Sao Paulo State and other Brazilian territories. Of these, 592 were used in LT. In the POST period, 1314 livers were offered for donation, but only 477 were used in LT. Organ refusal was higher in the POST period (P < .05). Our center performed 127 and 156 LTs in these periods, respectively, and an increase above 20% was significant (P = .039). There was no difference in 30-day survival between the periods (87.2% vs 87.9%, P > .5, respectively). Conclusions. The COVID-19 pandemic harmed potential and allocated donors and LTs per-formed. However, it is possible to maintain the LT volume of a transplant center without compromising survival outcomes through preventive strategies against COVID-19 propagation.
conferenceObject Adequate Exposure to Tacrolimus with Sublingual Administration(2021) MACIEL, A.; FORTUNATO, A.; WAISBERG, D.; GALVAO, F.; LEE, A.; ARANTES, Jr R.; ROCHA, M.; TANIGAWA, R.; DUCATTI, L.; MARTINO, R.; NACIF, L.; ROCHA-SANTOS, V; ANDRAUS, W.; D'ALBUQUERQUE, L.- Hepatic Artery Thrombosis in Liver Transplantation in Adult Recipients Using Pediatric Deceased Donors(2020) FORTUNATO, Allana C.; PINHEIRO, Rafael S.; NACIF, Lucas S.; WAISBERG, Daniel R.; DUCATTI, Liliana; ROCHA-SANTOS, Vinicius; GALVAO, Flavio H. F.; HADDAD, Luciana B. P.; ABDALA, Edson; SONG, Alice T. W.; TERRABUIO, Debora R. B.; BEZERRA, Regis O. F.; MACEDO, Rubens A.; MARTINO, Rodrigo B.; ANDRAUS, Wellington; CARNEIRO-D'ALBUQUERQUE, Luiz A.