DOMINGOS DIAS LOURENCO FILHO
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Profile of Heart Transplant Recipients in a Brazilian Center: Comparison With International Registry(2014) SEGURO, L. F.; BRAGA, F. G. Marcondes; AVILA, M. S.; MANGINI, S.; BISELLI, B.; FRANCO, G. P.; LIMA, C. G.; SANTOS, R. H.; LOURENCO FILHO, D. D.; GAIOTTO, F. A.; BACAL, F.
conferenceObject Reduction of right ventricle dysfunction and tricuspid regurgitation after bicaval orthotopic heart transplantation with HTK-Custodiol(2014) MANGINI, SSandrigo; GAIOTTO, F. A.; SANTOS, R. H. B.; FILHO, D. D. L.; MARCONDES-BRAGA, F. G.; POMERANTZEFF, P. M. A.; IMBERG, C.; KAWABE, L.; BACAL, F.; JATENE, F. B.- Frofile of Donor Hearts in Brazil(2014) MELO, J. L.; PAULO, A. R.; SOUZA, J. A.; OHE, L. A.; BARBOSA, M. B.; AVILA, M. S.; MARCONDES-BRAGA, E. G.; SEGURO, L. B.; MANGINI, S.; SANTOS, R. H.; LOURENCO FILHO, D. D.; GAIOTTO, F. A.; KAWABE, L. T.; BACAL, F.
conferenceObject Heart Transplant Team and Its Impact in the Results of Heart Transplant in a Brazilian Center(2015) SEGURO, L. F.; MARCONDES-BRAGA, F.; AVILA, M. S.; MANGINI, S.; LOURENCO FILHO, D. D.; SANTOS, R. H.; GAIOTTO, F. A.; BACAL, F.- Immunohistochemical Quantification of Inflammatory Cells in Endomyocardial Biopsy Fragments After Heart Transplantation: A New Potential Method to Improve the Diagnosis of Rejection After Heart Transplantation(2014) BOCCHI, E. A.; TANIGAWA, R. Y.; BRENDAO, S. M. G.; CRUZ, F.; ISSA, V.; AYUB-FERREIRA, S.; CHIZZOLA, P.; SOUZA, G.; FIORELLI, A. I.; BACAL, F.; POMERANTZEFF, P. M. A.; HONORATO, R.; LOURENCO-FILHO, D.; GUIMARAES, G.; BENVENUTI, L. A.Inconsistencies in cardiac rejection grading systems corroborate the concept that the evaluation of inflammatory intensity and myocyte damage seems to be subjective. We studied in 36 patients the potential role of the immunohistochemical (IHC) counting of inflammatory cells in endomyocardial biopsy (EMB) as an objective tool, testing the hypothesis of correlation between the International Society for Heart and Lung Transplantation 2004 rejection and IHC counting of inflammatory cells. We observed a progressive increment in CD68+ cells/mm(2) (P = .000) and CD3+ cells/mm(2) (P = .000) with higher rejection grade. A strong correlation between the grade of cellular rejection and both CD68+ cells/mm(2) and CD3+ cells/mm(2) was obtained (P =.000). One patient with CD3+ and CD68+ cells/mm(2) above the upper limit of the 95% confidence interval for cells/mm(2) found in rejection grade 1R evolved to rejection grade 2R without treatment. In patients with 2R that did not respond to treatment the values of CD68+ or CD3+ cells were higher than the overall median values for rejection grade 2R. For diagnosis of rejection needing treatment, the CD68+ and CD3+ cells/mm(2) areas under the receiver operating characteristic curves were 0.956 and 0.934, respectively. IHC counting of mononuclear inflammatory infiltrate in EMB seems to have additive potential role in evaluation of EMB for the diagnosis and prognosis of rejection episodes.
- Heart Transplantation in 107 Cases of Chagas' Disease(2011) FIORELLI, A. I.; SANTOS, R. H. B.; OLIVEIRA JR., J. L.; LOURENCO-FILHO, D. D.; DIAS, R. R.; OLIVEIRA, A. S.; SILVA, M. F. A. da; AYOUB, F. L.; BACAL, F.; SOUZA, G. E. C.; BOCCHI, E. A.; STOLF, N. A. G.Introduction. Chagas' disease is endemic in South America. Objective. This research reviewed the experience with cardiac transplantation in Chagas' disease, emphasizing reactivation, immunosuppression, and mortality. Methods. Over 25 years from March 1985 to March 2010, 107/409 (26.2%) patients with Chagas' disease underwent heart transplantation, patients including 74 (71.1%) men and 72 (67.2%), in functional class IV with 33 (30.8%) on vasopressors and 17 (10.7%) on mechanical circulatory support. Results. The diagnosis of disease reactivation was performed by identifying the parasite in the myocardium (n = 23; 71.8%) in the subcutaneous tissue (n = 8; 25.0%), in blood (n = 11; 34.3%), or in central nervous tissue (n = 1; 3.1%). Hospital mortality was 17.7% (n = 19) due to infection (n = 6; 31.5%), graft dysfunction (n = 6; 31.5%), rejection (n 4; 21.1%), or sudden death (n = 2; 10.5%). Late mortality was 27 (25.2%) cases, which were distributed as: rejection (n = 6; 22.2%), infection (n = 6; 22.2%), (n = lymphoma 4; 14.8%), sarcoma (n = 2; 7.4%), for constrictive pericarditis (n = 2; 7.4%) reactivation of Chagas' disease in the central nervous system (n = 1; 7.1%). Conclusions. Transplantation in Chagas' disease has peculiar problems that differ from other etiologies due to the possibility of disease reactivation and the increased possibility of emergence of cancers. However, transplantation is the only treatment able to modify the natural progression of the disease in its terminal phase. Early diagnosis and rapid introduction of benzonidazole reverses the histological patterns. Immunosuppression, especially steroids, predisposes to the development of cancer and disease reactivation.
conferenceObject Immunohistochemical Counting of Mononuclear Infiltrates in Endomyocardial Biopsy Fragments: A New Method To Improve the Diagnosis of Rejection after Heart Transplantation(2013) BOCCHI, E. A.; BENVENUTTI, L. A.; TANIGAWA, R.; BRANDAO, S.; ISSA, V. S.; AYUB-FERREIRA, S.; CRUZ, F.; POMERANTZEFF, P.; HONORATO, R.; LOURENCO-FILHO, D. D.; FIORELLI, A. I.; CHIZZOLA, P.; SOUZA, G.; BACAL, F.