RAFAEL MARCONDES GONCALVES LEITE

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FMUSP, Hospital das Clínicas, Faculdade de Medicina - Médico

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    POSTTRANSPLANT LYMPHOPROLIFERATIVE DISEASE IN CHILDREN AFTER HEART TRANSPLANTATION
    (2013) MARCONDES, Rafael; JATENE, Marcelo; CRISTOFANI, Lilian; TANAMATI, Carla; FERNANDES, Marcos; BENVENUTI, Luiz; ODONI, Vicente; MIURA, Nana; AZEKA, Estela
    OBJECTIVE: The purpose of this study was to evaluate the prevalence of PTLD after pediatric heart transplantation in a single center. PATIENTS AND METHODS: From 1992 to 2012, 115 patients were submitted to heart transplantation. One hundred and twenty transplants were performed. The clinical findings and outcome were evaluated. RESULTS: Nine (7.8%) of 115 patients developed PTLD. The presentation of PTLD was cervical tumor in three patients, abdominal tumor in three patients and pulmonary nodules in three patients. Five (55.5%) patients are alive. All had positive serology for EBV. CONCLUSION: PTLD is a severe complication after heart transplantation. Therapeutic strategies need to be developed to improve the survival in this
  • article 1 Citação(ões) na Scopus
    Long-Term Evaluation of Post-transplant Lymphoproliferative Disorders in Paediatric Heart Transplantation in Sao Paulo, Brazil
    (2019) ARSHAD, Adam; AZEKA, Estela; BARBAR, Samia; MARCONDES, Raphael; SIQUEIRA, Adailson; BENVENUTI, Luiz; MIURA, Nana; JATENE, Marcelo; ODONE FILHO, Vicente
    We sought to better define the demographics and characteristics of post-transplant lymphoproliferative disorders (PTLD) in a cohort of paediatric OHT patients from a developing country. Data were collected from the Heart Institute, Sao Paulo, for all paediatric OHT recipients from October 1992 to October 2018. Group differences between the PTLD and non-PTLD cohorts were assessed by Fisher exact and Mann-Whitney U tests. Kaplan-Meier curves analysed the survival in each group. Data were reviewed for 202 paediatric OHT recipients. Overall 1-, 5- and 10-year survival for the entire cohort was 76.5%, 68.3% and 62.9%; 24 patients (11.9%) developed PTLD at a median 3.1 years (IQR 0.8-9.0) after OHT. Cases were evenly spread over the follow-up period, with PTLD diagnosed in 9.8% (n = 137) of patients who were alive at 3 years, 15.3% (n = 78) of patients who were alive at 5 years and 29.3% (n = 41) of patients who were alive at 10 years. The commonest form of PTLD was diffuse large B cell lymphoma (n = 9), and most patients received rituximab with immunosuppression and chemotherapy as treatment (n = 15). We identified no increased risk in mortality amongst the PTLD vs. non-PTLD cohorts in multivariate analysis (P = 0.365). PTLD after paediatric OHT had acceptable outcomes. However, risk factors for PTLD were not identified and warrant further investigation.