FLAVIO JOTA DE PAULA
Índice h a partir de 2011
13
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
conferenceObject Plasma Cell Infiltration: General Overview of Clinical and Pathological Correlations in Renal Transplantation(2015) NIHEI, C.; LEMOS, F.; DAVID, D.; SOUZA, P.; PAULA, F. de; NAHAS, W.; DAVID-NETO, E.- Alteracoes vasculares em rins de doadores falecidos retardam a recuperacao da funcao do enxerto apos o transplante renal(2014) MARQUES, Igor Denizarde Bacelar; REPIZO, Liliany Pinhel; PONTELLI, Renato; PAULA, Flavio Jota de; NAHAS, William Carlos; DAVID, Daisa Silva Ribeiro; DAVID NETO, Elias; LEMOS, Francine Brambate CarvalhinhoObjective: The purpose of this study was to evaluate the impact of donor and recipient characteristics on duration of delayed graft function (DGF) and 1-year serum creatinine (SCr), as a surrogate endpoint for allograft survival. Methods: We reviewed 120 first cadaver kidney transplants carried out consecutively at our center to examine the effect on 1-year SCr of the presence and duration of DGF. Results: DGF rate was 68%, with a median duration of 12 days (range, 1-61). Forty-four (38%) patients presented DGF lasting 12 or more days (prolonged DGF group). Mean donor age was 43 ± 13 years, 37% had hypertension and in 59% the cause of brain death was cardiovascular accident. The mean cold ischemia time was 23 ± 5 hours. Twenty-seven (23%) donors were classified as expanded-criteria donors according to OPTN criteria. The mean recipient age was 51 ± 15 years. The recipients median time in dialysis was 43 months (range, 1-269) and 25% of them had panel reactive antibodies > 0%. Patients with prolonged DGF presented higher 1-year SCr in comparison with patients without DGF (1.7 vs. 1.3 mg/dL, respectively, p = 0.03). In multivariate logistic regression analysis, the only significant factor contributing to the occurrence of prolonged DGF was the presence of vascular lesions in the kidney allograft at time of transplantation (HR 3.6, 95% CI 1.2-10.2; p = 0.02). Conclusion: The presence of vasculopathy in the kidney allograft at time of transplantation was identified as an important factor independently associated with prolonged DGF. Prolonged DGF negatively impacts 1-year graft function.
conferenceObject Early Protocol Biopsies Can Identify Antibody-Mediated Rejection in Sensitized Patients(2013) SOUZA, P.; MACHADO, D.; AGUIRRE, A.; DAVID, D.; BARBOSA, E.; PAULA, F. de; NAHAS, W.; DAVID-NETO, E.; CASTRO, M.HLA sensitized patients are at risk for antibody-mediated rejection (ABMR). Our purpose was to evaluate the importance of early protocol biopsies. From Jul/2010 to Jun/2012, 101 sensitized patients defined as PRA>10% (class I and/or II by Flow-PRA) were transplanted at our institution. Out of them, 60 performed donor-specific antibodies (DSA) at transplant and a protocol-bx at day 7 (D7) and were included in this study. A second for cause indication biopsy (IB) was done at the physician’s discretion in 18 patients without previous acute rejection (AR) diagnosis. DSA were analyzed by single antigen bead assays at the time of biopsies (classified according to Banff’09 criteria). Patients (pts) mean age was 48±12 years, 48 were female (80%),45 first transplant (75%) and 42 (70%) received a kidney from deceased donor. 34 pts never presented AR episodes while 26 did. 20/26 (77%) of AR were diagnosed in the first 3 weeks after transplantation (median 13 days). Day 7 protocol biopsies (PB) showed AR in 12/26 (46%): 10 (85%) ABMR and 2 (15%) T-cell-mediated rejection (TCMR). The IB (n=18) done at a median of 11 days from the PB (range 3-112), showed AR in another 14 pts (56%): 10(71%) ABMR and 4 (29%) TCMR, as presented in Table 1 Pre-Tx mean MFI in ABMR pts did not differ among PB: 6001 (1596-11181) vs IB 2304 (840-14600)(p=NS). It also did not differ at the time of biopsy (2823 vs. 2277 in PB vs IB, respectively; p=NS). Patients with early ABMR diagnosis at PB had a trend to higher long-term MDRD (49±12mL/min) compared to patients with ABMR at IB (41±11mL/min) and similar to the whole non-ABMR patients (50±17mL/min). In conclusion, protocol biopsy is useful to diagnosis ABMR as early as in the first week pos-Tx. Early recognition of ABMR allows earlier treatment and possibly better long-term graft function in sensitized patients.conferenceObject Microcirculation Inflammation in Early Surveillance Renal Biopsy in Sensitized Patients Did Not Correlate With Graft Outcome(2015) SOUZA, P.; MACHADO, D.; DAVID, D.; BEZERRA, G.; PAULA, F. Jota de; RODRIGES, H.; NAHAS, W.; DAVID NETO, E.; CASTRO, M.conferenceObject DIAGNOSIS OF ANTIBODY-MEDIATED REJECTION THROUGH EARLY PROTOCOL BIOPSIES IN SENSITIZED PATIENTS(2013) SOUZA, Patricia S.; MACHADO, David; AGUIRRE, Anna Rita; DAVID, Daisa; BARBOSA, Erick; PAULA, Flavio Jota de; NAHAS, Willian; DAVID-NETO, Elias; CASTRO, Maria Cristina R.- Unexplained fever and acute kidney injury in a kidney transplant patient(2016) PAULA, Flavio J.; NEVES, Precil D. M. M.; LAZARI, Carolina S.; RAMOS, Rafael G.; FREDIANI, Marcella M.; SILVA, Marcelo V. A.; MFINDA, Nzuzi; PIERROTTI, Ligia C.; DAVID, Daisa S. R.; TESTAGROSSA, Leonardo A.; DAVID-NETO, Elias
conferenceObject Graft Survival in Sensitized and Non-Sensitized Patients: Role of the Combination of Donor-Specific Antibodies and Acute Rejection(2016) SOUZA, P.; AGUIRRE, A.; BEZERRA, G.; RODRIGUES, H.; AGENA, F.; DAVID, D.; PAULA, F. de; DAVID-NETO, E.; CASTRO, M.conferenceObject Everolimus/Low Tacrolimus Exposure versus Sodium Mycophenolate/ Standard Tacrolimus for the Elderly Kidney Transplant Recipient. A 4-y Follow -Up of the nEverOld Trial(2019) DAVID-NETO, E.; AGENA, F.; PAULA, F. J.; GALANTE, N. Z.; DAVID, D. S.; RAMOS, F.; TRIBONI, A. K.; ROMANO, P.; EBNER, P. A.; COELHO, V.; ALTONA, M.; FALCI, R.; PIOVESAN, A.; NAHAS, W. C.- Recipient of kidney from donor with asymptomatic infection by Paracoccidioides brasiliensis(2012) BATISTA, Marjorie V.; SATO, Paula K.; PIERROTTI, Ligia C.; PAULA, Flavio J. de; FERREIRA, Gustavo F.; RIBEIRO-DAVID, Daisa S.; NAHAS, William C.; DUARTE, Maria I. S.; SHIKANAI-YASUDA, Maria A.The increase in solid organ transplantations may soon create a rise in the occurrence of endemic fungal diseases, such as paracoccidioidomycosis, due to the lack of rigorous screening of donors from endemic areas. Here we present the first case of an immunocompetent and asymptomatic kidney donor who had Paracoccidioides brasiliensis infected-adrenal tissue but no glandular dysfunction.
conferenceObject Which Induction Therapy Should Be Used in Kidney Transplants with Prolonged Cold Ischemia Time?(2012) ARAUJO, M. J. C. L. N.; ONUSIC, V. L.; BATTAINI, L. C.; BARBOSA, E. A.; BOJIKIAN, R. T.; DAVID, D. R.; ANTONOPOULOS, I. M.; PAULA, F. Jota de; NAHAS, W. C.; NETO, E. D.; LEMOS, F. B. C.; CASTRO, M. C. Ribeiro de