VICTOR EDMOND SEID

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Assunto: autotransplantation ×

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  • article 4 Citação(ões) na Scopus
    Functional outcome of autologous anorectal transplantation in an experimental model
    (2015) SEID, V. E.; GALVAO, F. H. F.; VAIDYA, A.; WAISBERG, D. R.; CRUZ JR., R. J.; CHAIB, E.; NAHAS, S. C.; ARAUJO, S. E. A.; D'ALBUQUERQUE, L. A. C.; ARAKI, J.
    Background: Although anorectal transplantation is a challenging procedure, it is a promising option for patients who have completely lost anorectal function or in whom it failed to develop, as in congenital malformations. The paucity of animal models with which to test functional outcomes was addressed in this study of anorectal manometry in rats. Methods: Wistar rats were assigned randomly to four groups: orthotopic anorectal transplantation, heterotopic transplantation, sham operation, or normal control. Bodyweight and anal pressure were measured immediately before and after operation, and on postoperative days 7 and 14. ANOVA and Tukey's test were used to compare results for bodyweight, anal manometry and length of procedure. Results: Immediately after the procedure, mean(s.d.) anal pressure in the orthotopic group (n=13) dropped from 31.4(13.1) to 1.6(13.1) cmH(2)O (P < 0.001 versus both sham operation (n=13) and normal control (n=15)), with partial recovery on postoperative day 7 (14.9(13.9) cmH(2)O) (P=0.009 versus normal control) and complete recovery on day 14 (23.7(12.2) cmH(2)O). Heterotopic rats (n=14) demonstrated partial functional recovery: mean(s. d.) anal pressure was 26.9(10.9) cmH(2)O before operation and 8.6(6.8) cmH(2)O on postoperative day 14 (P < 0.001 versus both sham and normal control). Conclusion: Orthotopic anorectal transplantation may result in better functional outcomes than heterotopic procedures.
  • article 4 Citação(ões) na Scopus
    Evidence That Anorectal Transplantation Is the Logical Treatment for Serious Anorectal Dysfunction and Permanent Colostomy
    (2016) GALVAO, F. H. Ferreira; ARAKI, J.; SEID, V. E.; WAISBERG, D. R.; TRALDI, M. C.; NAITO, M.; ARAUJO, B. C.; LANCHOTTE, C.; CHAIB, E.; D'ALBUQUERQUE, L. A. C.
    Anorectal dysfunction resulting in fecal incontinence or permanent colostomy is a current public health concern that strongly impairs patient quality of life. Present treatment options for this complex disease are expensive and usually ineffective. Anorectal transplantation is the logical treatment for fecal incontinence and permanent colostomy. This procedure has been clinically effective in a few cases reported in the medical literature. Furthermore, experiments in rats, pigs, and dogs have shown promising results, with functional recovery of the graft. In this article we describe the scientific evidence that anorectal transplantation may be an important option for treating anorectal dysfunction.
  • article 2 Citação(ões) na Scopus
    Allogeneic anorectal transplantation in rats: technical considerations and preliminary results
    (2016) GALVAO, Flavio H. F.; WAISBERG, Daniel R.; SEID, Victor E.; COSTA, Anderson C. L.; CHAIB, Eleazar; BAPTISTA, Rachel Rossini; CAPELOZZI, Vera Luiza; LANCHOTTE, Cinthia; CRUZ, Ruy J.; ARAKI, Jun; D'ALBUQUERQUE, Luiz Carneiro
    Fecal incontinence is a challenging condition with numerous available treatment modalities. Success rates vary across these modalities, and permanent colostomy is often indicated when they fail. For these cases, a novel potential therapeutic strategy is anorectal transplantation (ATx). We performed four isogeneic (Lewis-to-Lewis) and seven allogeneic (Wistar-to-Lewis) ATx procedures. The anorectum was retrieved with a vascular pedicle containing the aorta in continuity with the inferior mesenteric artery and portal vein in continuity with the inferior mesenteric vein. In the recipient, the native anorectal segment was removed and the graft was transplanted by end-to-side aorta-aorta and porto-cava anastomoses and end-to-end colorectal anastomosis. Recipients were sacrificed at the experimental endpoint on postoperative day 30. Surviving animals resumed normal body weight gain and clinical performance within 5 days of surgery. Isografts and 42.9% of allografts achieved normal clinical evolution up to the experimental endpoint. In 57.1% of allografts, signs of immunological rejection (abdominal distention, diarrhea, and anal mucosa inflammation) were observed three weeks after transplantation. Histology revealed moderate to severe rejection in allografts and no signs of rejection in isografts. We describe a feasible model of ATx in rats, which may allow further physiological and immunologic studies.