JOSE OTTO REUSING JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
7 resultados
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- Cytomegalovirus prophylaxis in seropositive renal transplant recipients receiving thymoglobulin induction therapy: Outcome and risk factors for late CMV disease(2018) JR, Jose O. Reusing; FEITOSA, Emanoela B.; AGENA, Fabiana; PIERROTTI, Ligia C.; AZEVEDO, Luiz S. F.; KOTTON, Camille N.; DAVID-NETO, EliasBackgroundAnti-thymocyte globulin (ATG) therapy is a risk factor for cytomegalovirus (CMV) disease in renal transplant (RTx) recipients and therefore antiviral prophylaxis is commonly used. We evaluated the outcome of our current policy of 90days of CMV prophylaxis in seropositive recipients given ATG and the risk factors for the occurrence of CMV disease after prophylaxis. MethodsWe studied a retrospective cohort of 423 RTx (2010-2014) CMV-seropositive adults given ATG induction therapy. Results54 (13%) patients developed CMV disease at a median of 163days after transplant, of which 29 (54%) had viral syndrome and 25 (46%) had invasive disease. Median prophylaxis time (94days) and immunosuppressive drugs were similar between groups (CMV vs no-CMV). Those with CMV disease had more deceased donors and higher donor age, lower lymphocyte count, and lower median eGFR at day 90. Multivariable logistic regression analysis at day 90 and 180 found that eGFR 40ml/min/1.73m(2) (but not acute rejection) was associated with late CMV disease. In a separate validation cohort of 124 patients with 8% late CMV disease, eGFR 45 and lymphocyte count 800cells/mm(3) at the end of prophylaxis remained predictive of late CMV disease occurrence. ConclusionsThese data indicate that antiviral prophylaxis adequately prevented CMV in seropositive recipients given ATG, but late disease still occurred. Low eGFR and low lymphocyte count at the end of prophylaxis may help identify patients at higher risk of CMV disease.
- Prioritization Due to Dialysis Access Failure Impacts on Patient Survival after Kidney Transplantation(2013) REUSING JR., J.; SOUZA, P.; GALANTE, N.; AGENA, F.; PAULA, F. de; NAHAS, W.; DAVID-NETO, E.Dialysis vascular access failure, recipient of a non-renal solid organ transplantation and previous kidney donation are current indications of priority allocation (PA) for kidney transplant (KT) at our centre. Mortality among PA patients under dialysis is high and risk factors for long-term patient outcomes after transplantation remain largely elusive. In this study we analyzed a cohort of patients that received KT from Jan/2007 to Dec/2011. Long-term patient survival was compared between PA and non PA recipients transplanted in this period of time and clinical relevant data were analyzed. Data were recorded as of Aug/2012. Results: 948 KT were performed at our institution and 93 (9.8%) were included in our PA program. Most PA patients (n=86) had access failure. The mean follow up time was 32 (0 – 69) months. 5-year patient survival was lower in PA patients (76vs 86%, p=0.001). Twenty (21.5%) PA patients died and all deaths occurred in those with access failure, being 70% of them in the first 3 months. Causes of death were infection in 10 patients, bleeding complications (n=6), uremia (n=1), mesenteric ischemia (n=1) and unspecified shock (n=2). Considering this high mortality rate in the first 3 months after transplantation, we compared patients who died in this period of time (group A) vs. those who survived more than 3 months (group B). Age, gender, previous kidney transplants, sensitization, number of HLA mismatches, pre-transplant DSA, pre-transplant diabetes, induction therapy, DGF, rejection, use of heparin, IVIg and time from inscription in the PA program to transplantation were not statistically different between groups. Among 47 patients who were screened for thrombophilia, 83.3% from group A were positive vs. 31.7% from group B (p=0.01). Infection after transplantation and hemorrhagic complications were more frequent in group A. Groups were not different regarding causes of death. PA patients have a lower survival and this excessive death rate occur in the first three months after transplantation mainly due to infections and bleeding. Thrombophilia is very frequent in PA patients with HR....... for death.
conferenceObject Is 90-days CMV prophylaxis effective in CMV-seropositive patients receiving thymoglobulin as induction therapy?(2016) DAVID-NETO, Elias; FEITOSA, Emanoela B.; AGENA, Fabiana; REUSING, Jose Otto; LEMOS, Francine B. C.conferenceObject THROMBOPHILIA AND PRIORITIZATION DUE TO DIALYSIS ACCESS FAILURE IMPACT EARLY ON PATIENT SURVIVAL AFTER KIDNEY TRANSPLANTATION(2013) REUSING JR., Jose O.; SOUZA, Patricia S.; GALANTE, Nelson Z.; AGENA, Fabiana; PAULA, Flavio J.; NAHAS, William Carlos; DAVID-NETO, EliasconferenceObject IMPACT OF EVEROLIMUS ADDED TO TACROLIMUS/MYCOPHENOLATE/ PREDNISONE ON CMV DISEASE AND ACUTE REJECTION IN SENSITIZED KIDNEY TRANSPLANT RECIPIENTS. A SINGLE CENTER, RANDOMIZED AND CONTROLLED, PILOT STUDY(2017) SOUZA, Patricia; VENTURA, Carlucci; AGENA, Fabiana; BARRETO, Noemia; REUSING, Jose Otto; ONUSIC, Vivian; ZOCOLER, Nelson; PAULA, Flavio De; DAVID-NETO, EliasconferenceObject Prediction Model With Quantiferon-CMV for Clinically Significant Cytomegalovirus Event in Seropositive Kidney Transplant Recipients(2022) REUSING JUNIOR, Jose Otto; AGENA, Fabiana; CAMPANA, Gustavo A.; PIERROTTI, Ligia C.; DAVID-NETO, EliasconferenceObject Is CMV Prophylaxis Effective in CMV-Seropositive Patients Receiving Thymoglobulin as Induction Therapy?(2016) FEITOSA, E.; AGENA, F.; REUSING JR., J.; LEMOS, F.; DAVID-NETO, E.