MELANI RIBEIRO CUSTODIO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/16 - Laboratório de Fisiopatologia Renal, Hospital das Clínicas, Faculdade de Medicina

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Assunto: Transplantation ×

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  • article 52 Citação(ões) na Scopus
    Osteoporosis After Transplantation
    (2012) KULAK, Carolina A. Moreira; BORBA, Victoria Z. Cochenski; KULAK JUNIOR, Jaime; CUSTODIO, Melani Ribeiro
    Transplantation is an established therapy for end-stage diseases of kidney, lung, liver, and heart among others. Osteoporosis and fragility fractures are serious complications of organ transplantation, particularly in the first post-transplant year. Many factors contribute to the pathogenesis of osteoporosis following organ transplantation. This review addresses the mechanisms of bone loss that occurs both in the early and late post-transplant periods, including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver, cardiac, and bone marrow transplantation. Prevention and treatment for osteoporosis in the transplant recipient are also discussed.
  • article 34 Citação(ões) na Scopus
    Persistence of Bone and Mineral Disorders 2 Years After Successful Kidney Transplantation
    (2013) NEVES, Carolina L.; REIS, Luciene M. dos; BATISTA, Daniella G.; CUSTODIO, Melani R.; GRACIOLLI, Fabiana G.; MARTIN, Rita de Cassia T.; NEVES, Katia R.; DOMINGUEZ, Wagner V.; MOYSES, Rosa M.; JORGETTI, Vanda
    Background. Studies that have conducted bone biopsies after kidney transplantation are scarce, and the results are conflicting. Methods. We evaluate the bone histomorphometry, in vitro proliferation, and alkaline phosphatase expression in osteoblasts isolated from bone biopsies from 27 kidney transplant patients. The patients had preserved renal function and were treated with the same immunosuppressive therapy, receiving a minimum dose of corticosteroids. Results. The biochemical analysis revealed that 41% of the patients presented with hypercalcemia, 26% presented with hypophosphatemia, and hypovitaminosis D was detected in 63%. The histomorphometric analysis showed a reduced trabecular number and increased trabecular separation, mineral apposition rate, and mineralization lag time, as well as higher osteoid surface, osteoblastic surface, resorption surface, and osteoclastic surface and a lower mineralizing surface, compared with the controls. Based on the TMV classification, bone turnover was normal in 48%, high in 26%, and low in 26% of patients. Bone mineralization was delayed in 48% of the patients, and 58% of the patients with hypovitaminosis D presented with delayed bone mineralization. Bone volume was low in 37% of the patients. The osteoblasts from patients exhibited a higher degree of proliferation compared with those from controls. Conclusion. Eight-two percent of our patients presented with alterations in at least one of the TMV parameters. Persistence of hyperparathyroidism, hypovitaminosis D, and immunosuppressive drugs may have influenced osteoblast function, which would explain many of the bone alterations found in these patients.
  • conferenceObject
    EVALUATION OF BONE MICROARCHITECTURE BY HIGH-RESOLUTION PERIPHERAL QUANTITATIVE COMPUTED TOMOGRAPHY IN PATIENTS WITH CHRONIC KIDNEY DISEASE: COMPARISON WITH TRANSILIAC BONE BIOPSY
    (2015) MARQUES, Igor; ARAUJO, Maria Julia; GRACIOLLI, Fabiana; REIS, Luciene dos; CUSTODIO, Melani; PEREIRA, Rosa; JAMAL, Sophie; JORGETTI, Vanda; DAVID-NETO, Elias; MOYSES, Rosa
  • article 32 Citação(ões) na Scopus
    Bone disease after transplantation: osteoporosis and fractures risk
    (2014) KULAK, Carolina A. M.; BORBA, Victoria Z. C.; KULAK JUNIOR, Jaime; CUSTODIO, Melani Ribeiro
    Organ transplantation is the gold standard therapy for several end-stage diseases. Bone loss is a common complication that occurs in transplant recipients. Osteoporosis and fragility fractures are serious complication, mainly in the first year post transplantation. Many factors contribute to the pathogenesis of bone disease following organ transplantation. This review address the mechanisms of bone loss including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver, cardiac and bone marrow transplantation. Prevention and management of bone loss in the transplant recipient should be included in their post transplant follow-up in order to prevent fractures.
  • conferenceObject
    LIVER, HEART AND BONE: THE PATH OF IRON OVERLOAD IN HEMODIALYSIS PATIENTS
    (2020) NUNES, Lucas Acatauassu; REIS, Luciene; MACHADO, Hanna; OSORIO, Rosse; MOYSES, Rosa; LEAO-FILHO, Hilton; MOTTA, Rosilene; ROCHITTE, Carlos; JORGETTI, Vanda; CUSTODIO, Melani