LUCIANA DOS SANTOS HENRIQUES
Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
3 resultados
Resultados de Busca
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- POSTOPERATIVE OUTCOME OF PEDIATRIC PATIENTS UNDERGOING RENAL TRANSPLANTATION(2013) PADOVAN, Fabiola Lucia; COUTO, Saulo Brasil do; PINTO, Gabriela; MENEZES, Aline Motta; SAKITA, Luciana Henrique dos Santos; METRAN, Camila Cardoso; SILVA, Joao Domingos Montoni da; WATANABE, Andreia; VAISBICH, Maria Helena; DELGADO, Arthur Figueiredo; NAHAS, William Carlos; SCHVARTSMAN, Benita Galassi SoaresBJECTIVE: To evaluate the postoperative outcome in the Intensive Care Unit (ICU) in the first month after kidney transplant. PATIENTS AND METHODS: Thirty-two patients (33 transplants), 21 male, age: 9.5 ± 3.1 yrs. Retrospective study from July/2008 to March/2012 through the variables: cold ischemia time, PRISM, mechanical ventilation (MV), vasoactive drugs (VAD), immunosuppression, infection, surgical complications, dialysis, renal function (CrCl), diuresis, hospitalization length and mortality. Statistics: Fischer and Pearson. RESULTS: Causes of CKF: uropathy-19, glomerulopathy-3, tubulopathy-2, other-7. Cold ischemia: 20hs median. PRISM score: 1.3% (0.2–6.2%), FiO2 max: 30% (21–60%), MV: 1d (0–10d), VAD 18/33 1D(0–6d). 10/33 transplants used thymoglobulin, 23/33 basiliximab. Infections: catheter-related-4, urinary-2,peritonitis-2, sepsis-1. Surgical complications: bleeding-4, thrombosis-3, urinary fistula-1. Of 5/32 dialyzed. CrCl and diuresis first postoperative day: 20 mL/min/1.73 m2 and 3.6 mL/kg/h and at 30 days: 90 mL/min/1.73 m2 and 3.7 mL/kg/h. There was an inverse correlation between cold ischemia time and CrCl in the 1st postoperative day (p = 0.01 and r = 0.45), not seen at 30d. Hospitalization length ICU = 4d (2–23d), total 15d (5 – 45d). There was no difference in infection, MV duration, use of VAD, CrCl, ICU and total hospitalization length between thymoglobulin X basiliximab use (p > 0.05). However duration of VAD utilization was higher for Thymoglobulin (p = 0.05). One patient died from sepsis (3%). CONCLUSION: The outcome after renal transplantation was satisfactory, with short ICU stay, but high use of vasoactive drugs. Bleeding was the most common surgical complication. The patient and graft survival after 1 month of transplantation was 97% and 91%, respectively.
- Uso do eculizumab na síndrome hemolítica urêmica atípica: relato de caso e revisão da literatura(2013) VAISBICH, Maria Helena; HENRIQUES, Luciana dos Santos; WATANABE, Andréia; PEREIRA, Lilian Monteiro; METRAN, Camila Cardoso; MALHEIROS, Denise Avancini; MODANEZ, Flávia; SILVA, João Domingos Montoni da; VIEIRA, Simone; MACEDO, Ana Catarina Lunz; MASSAROPE, Bianca; FURUSAWA, Érika Arai; SCHVARTSMAN, Benita Galassi SoaresSHU atypical (aHUS), that is, not associated with Escherichia coli Shiga toxinproducing, is seen in 5 to 10% of cases of Hemolytic Uremic Syndrome (HUS), and can occur at any age and may be sporadic or familial. The prognosis in these cases is reserved, with high mortality and morbidity in the acute phase of the disease, and about 50% of cases can develop chronic kidney disease. The increased knowledge of the pathogenesis of aHUS (overactivation of the alternative pathway of complement), was accompanied by the appearance of a drug, eculizumab, which acts as an inhibitor of membrane attack complex. Our goal is to report a case of infant with aHUS with excellent clinical and laboratory response with the use of eculizumab. 14 month old infant, previously healthy, male, presented anemia and thrombocytopenia at 12 months of age. He was treated with corticosteroids and forwarded to our service for high blood pressure. However, the scans showed nephrotic proteinuria with renal involvement and hypoalbuminemia with direct Coombs negative. He developed anemia, thrombocytopenia, worsening of renal function and hypertension. Renal biopsy showed thrombotic microangiopathy (TMA). On the non-hemolytic anemia, thrombocytopenia and acute renal failure with histological substrate MAT, was diagnosed of aHUS. The patient received eculizumab excellent clinical and laboratory response. This case shows the importance of early diagnosis and treatment of the aHUS. Eculizumab is effective and keeps long-term remission, avoiding invasive measures such as plasmapheresis, which resolves only part of the picture.
conferenceObject BK virus nephropathy management in pediatric renal transplant recipients: a series of cases(2016) CARDOSO, R.; WATANABE, A.; METRAN, C.; HENRIQUES, L.; DAVID, D.