FRANCINE BRAMBATE CARVALHINHO LEMOS
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
11 resultados
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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.- 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.
conferenceObject No Impact of One Year of Everolimus, as Compared to MPA, in the Reversal of Left Ventricular Hypertrophy in Elderly Renal Transplant Recipients - Preliminary Data from Then Everold Study(2017) DAVID-NETO, E.; AGENA, F.; FURTADO, M.; RODRIGES, A.; ANDRADE, J.; LEMOS, F.; PAULA, F.conferenceObject Thymoglobulin Induction with Tacrolimus and Everolimus Maintenance Therapy in Elderly Kidney Transplantation Results in Prolonged Lymphocyte Depletion and Do Not Favor Regulatory Profile.(2019) DAVID-NETO, E.; FREITAS, G. Ramos de; FERNANDES, M.; AGENA, F.; LEMOS, F. Brambate Carvalhinho; PAULA, F. Jota de; COELHO, V.; GALANTE, N. ZocolerconferenceObject MORTALITY WITHIN THE FIRST MONTH AFTER KIDNEY TRANSPLANTATION - AN OBSERVATIONAL, COHORT STUDY(2015) ANDRADE, Izquierdo Valeria; LEMOS, Francine Bc; PIERROTTI, Ligia C.; FREIRE, Maristela P.; DAVID, Neto Elias; PAULA, Flavio De; NAHAS, William C.conferenceObject TRANSPLANTABILITY EVALUATION IN HIGH RISK PATIENTS WITH END STAGE RENAL DISEASE ENROLLED IN THE WAITING LIST OF KIDNEY TRANSPLANTATION. AN OBSERVATIONAL COHORT STUDY(2017) IZQUIERDO, Andrea Andrade; ONUSIC, Vivian L.; OTTO JR., Jose; LEMOS, Francine Bc; PAULA, Flavio J. De; NAHAS, William C.; DAVID-NETO, EliasconferenceObject DEFINING PP65ENEMIA AND QPCR CUT-OFFS FOR PRE-EMPTIVE THERAPY OF CMV DISEASE IN LOW-RISK RENAL TRANSPLANTED RECIPIENTS(2013) DAVID-NETO, Elias; LEMOS, Angelica Dias; BOAS, Lucy Santos Vilas; LATIF, Acram Zahredine Abdul; AGENA, Fabiana; PAULA, Flavio Jota de; PIERROTI, Ligia; LEMOS, Francine; NAHAS, William Carlos; CAIAFFA FILHO, Helio; PANNUTI, Claudio Sergio- Severe type 1 upgrading leprosy reaction in a renal transplant recipient: a paradoxical manifestation associated with deficiency of antigen-specific regulatory T-cells?(2017) VIEIRA, Ana Paula; TRINDADE, Maria Angela Bianconcini; PAULA, Flavio Jota de; SAKAI-VALENTE, Neusa Yurico; DUARTE, Alberto Jose da Silva; LEMOS, Francine Brambate Carvalhinho; BENARD, GilBackground: Due to its chronic subclinical course and large spectrum of manifestations, leprosy often represents a diagnostic challenge. Even with proper anti-mycobacteria treatment, leprosy follow up remains challenging: almost half of leprosy patients may develop reaction episodes. Leprosy is an infrequent complication of solid organ transplant recipients. This case report illustrates the challenges in diagnosing and managing leprosy and its reactional states in a transplant recipient. Case presentation: A 53-year-old man presented 34 months after a successful renal transplantation a borderline-tuberculoid leprosy with signs of mild type 1 upgrading reaction (T1R). Cutaneous manifestations were atypical, and diagnosis was only made when granulomatous neuritis was found in a cutaneous biopsy. He was successfully treated with the WHO recommended multidrug therapy (MDT: rifampicin, dapsone and clofazimine). However he developed a severe T1R immediately after completion of the MDT but no signs of allograft rejection. T1R results from flare-ups of the host T-helper-1 cell-mediated immune response against Mycobacterium leprae antigens in patients with immunologically unstable, borderline forms of leprosy and has been considered an inflammatory syndrome in many aspects similar to the immune reconstitution inflammatory syndromes (IRS). The T1R was successfully treated by increasing the prednisone dose without modifying the other immunosuppressive drugs used for preventing allograft rejection. Immunological study revealed that the patient had a profound depletion of both in situ and circulating regulatory T-cells and lack of expansion of the Tregs upon M. leprae stimulation compared to T1R leprosy patients without iatrogenic immunosuppression. Conclusions: Our case report highlights that leprosy, especially in the transplant setting, requires a high degree of clinical suspicion and the contribution of histopathology. It also suggests that the development of upgrading inflammatory syndromes such as T1R can occur despite the sustained immunosuppressors regimen for preventing graft rejection. Our hypothesis is that the well-known deleterious effects of these immunosuppressors on pathogen-induced regulatory T-cells contributed to the immunedysregulation and development T1R.
conferenceObject The Benefit of Kidney Transplantation over the Waitlist Depends on the Patient's Comorbidities.(2019) IZQUIERDO, A. Andrade; REUSING JR., J. V.; ONUSIC, V.; AGENA, F.; LEMOS, F. C.; PAULA, F. de; GERAB, F.; DAVID-NETO, E.conferenceObject Which Induction Therapy Should Be Used in Kidney Transplants with Prolonged Cold Ischemia Time?(2012) ARAUJO, M. J. C. L. N.; ONUSIC, V. L.; BATTAINI, L. C.; BARBOSA, E. A.; BOJIKIAN, R. T.; DAVID, D. R.; ANTONOPOULOS, I. M.; PAULA, F. Jota de; NAHAS, W. C.; NETO, E. D.; LEMOS, F. B. C.; CASTRO, M. C. Ribeiro de