JOSE EDUARDO AFONSO JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
- Lung transplantation: overall approach regarding its major aspects(2015) CAMARGO, Priscila Cilene Leon Bueno de; TEIXEIRA, Ricardo Henrique de Oliveira Braga; CARRARO, Rafael Medeiros; CAMPOS, Silvia Vidal; AFONSO JUNIOR, Jose Eduardo; COSTA, Andre Nathan; FERNANDES, Lucas Matos; ABDALLA, Luis Gustavo; SAMANO, Marcos Naoyuki; PEGO-FERNANDES, Paulo ManuelO transplante pulmonar é uma terapia bem estabelecida para pacientes com doença pulmonar avançada.A avaliação do candidato para o transplante é uma tarefa complexa e envolve uma equipe multidisciplinar que acompanha o paciente para além do período pós-operatório.O tempo médio atual em lista de espera para transplante pulmonar é de aproximadamente 18 meses no estado de São Paulo. Em 2014, dados da Associação Brasileira de Transplante de Órgãos mostram que 67 transplantes pulmonares foram realizados no Brasil e que 204 pacientes estavam na lista de espera para transplante pulmonar.O transplante pulmonar é principalmente indicado no tratamento de DPOC, fibrose cística, doença intersticial pulmonar, bronquiectasia não fibrocística e hipertensão pulmonar.Esta revisão abrangente teve como objetivos abordar os aspectos principais relacionados ao transplante pulmonar: indicações, contraindicações, avaliação do candidato ao transplante, avaliação do candidato doador, gestão do paciente transplantado e complicações maiores. Para atingirmos tais objetivos, utilizamos como base as diretrizes da Sociedade Internacional de Transplante de Coração e Pulmão e nos protocolos de nosso Grupo de Transplante Pulmonar localizado na cidade de São Paulo.
- Acute Fibrinoid Organizing Pneumonia in Lung Transplant: The Most Feared Allograft Dysfunction(2016) COSTA, Andre Nathan; CARRARO, Rafael Medeiros; NASCIMENTO, Ellen Caroline Toledo; AFONSO JUNIOR, Jose Eduardo; CAMPOS, Silvia Vidal; CAMARGO, Priscila Cilene Leon Bueno de; TEIXEIRA, Ricardo Henrique de Oliveira Braga; SAMANO, Marcos Naoyuki; FERNANDES, Lucas Matos; ABDALLA, Luis Gustavo; DOLHNIKOFF, Marisa
conferenceObject Management of Tuberculosis After Lung Transplantation in na Endemic Region(2017) CAMPOS, S. V.; SAMANO, M. N.; PEGO-FERNANDES, P. M.; TEIXEIRA, R. O.; FERNANDES, L. M.; ABDALLA, L. G.; CARRARO, R. M.; AFONSO-JUNIOR, J. E.; COSTA, A. N.- 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.
conferenceObject Long-Term Follow-Up of Non CF Bronchiectasis Patients After Lung Transplantation in a Single Brazilian Center(2018) SERRA, J. P.; JESUS, R. M. De; ATHANAZIO, R. A.; RACHED, S. Z.; CAMPOS, S. V.; COSTA, A. N.; AFONSO, J. E.; CARRARO, R. M.; TEIXEIRA, R. D.; FERNANDES, L. M.; ABDALLA, L.; SAMANO, M. N.conferenceObject Evaluation Of Bronchial Anastomosis Stenosis After Lung Transplantation With Electrical Impedance Tomography: A Case Report(2014) CAMARGO, P. C. L. B. D.; AFONSO JR., J. E.; COSTA, A. N.; CARRARO, R. M.; CAMPOS, S. V.; ABDALLA, L. G.; FERNANDES, L. M.; SAMANO, M. N.; TORSANI, V.; PEGO-FERNANDES, P. M.; AMATO, M. B. D. P.- Risk Factors and Survival Impact of Primary Graft Dysfunction After Lung Transplantation in a Single Institution(2012) SAMANO, M. N.; FERNANDES, L. M.; BARANAUSKAS, J. C. B.; CORREIA, A. T.; AFONSO JR., J. E.; TEIXEIRA, R. H. O. B.; CARAMORI, M. L.; PEGO-FERNANDES, P. M.; JATENE, F. B.Background. Lung transplantation has become a standard procedure for some end-stage lung diseases, but primary graft dysfunction (PGD) is an inherent problem that impacts early and late outcomes. The aim of this study was to define the incidence, risk factors, and impact of mechanical ventilation time on mortality rates among a retrospective cohort of lung transplantations performed in a single institution. Methods. We performed a retrospective study of 118 lung transplantations performed between January 2003 and July 2010. The most severe form of PGD (grade III) as defined at 48 and 72 hours was examined for risk factors by multivariable logistic regression models using donor, recipient, and transplant variables. Results. The overall incidence of PGD at 48 hours was 19.8%, and 15.4% at 72 hours. According multivariate analysis, risk factors associated with PGD were donor smoking history for 48 hours (adjusted odds ratio [OR], 4.83; 95% confidence interval [CI], 1.236-18.896; P = .022) and older donors for 72 hours (adjusted OR, 1.046; 95% CI, 0.997-1.098; P = .022). The operative mortality was 52.9% among patients with PGD versus 20.3% at 48 hours (P = .012). At 72 hours, the mortality rate was 58.3% versus 21.2% (P = .013). The 90-days mortality was also higher among patients with PGD. The mechanical ventilation time was longer in patients with PGD III at 48 hours namely, a mean time of 72 versus 24 hours (P = .001). When PGD was defined at 72 hours, the mean ventilation time was even longer, namely 151 versus 24 hours (P < .001). The mean overall survival for patients who developed PGD at 48 hours was 490.9 versus 1665.5 days for subjects without PGD (P = .001). Considering PGD only at 72 hours, the mean survival was 177.7 days for the PGD group and 1628.9 days for the other patients (P < .001). Conclusion. PGD showed an important impacts on operative and 90-day mortality rates, mechanical ventilation time, and overall survival among lung transplant patients. PGD at 72 hours was a better predictor of lung transplant outcomes than at 48 hours. The use of donors with a smoking history or of advanced age were risk factors for the development of PGD.
conferenceObject Clinical Assessment of Cytomegalovirus Specific Cell Mediated Immunity in a Prospective Cohort of Lung Transplant Recipients(2017) CAMPOS, S. V.; SAMANO, M. N.; PEGO-FERNANDES, P. M.; TEIXEIRA, R. O.; CARRARO, R. M.; AFONSO-JUNIOR, J. E.; COSTA, A. N.; MACHADO, C. M.; SOUZA, A. C.; PEREIRA, B. B.; FERNANDES, L. M.; ABDALLA, L.- 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.
conferenceObject Venous Thromboembolism: A Retrospective Analysis Of 87 Lung Transplant Patients(2014) DIDIER-NETO, F. M. F.; CAMARGO, P. C. L. B.; COSTA, A. N.; TEIXEIRA, R. H. O. B.; CARRARO, R. M.; AFONSO, J. E.; CAMPOS, S. V.; SAMANO, M. N.; FERNANDES, L. M.; ABDALLA, L. G.; PEGO-FERNANDES, P. M.