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‣ Arteriovenous fistula for chronic hemodialysis in pediatric candidates for renal transplantation: Technical details and refinements

TANNURI, Uenis; TANNURI, Ana Cristina Aoun; WATANABE, Andrea
Fonte: WILEY-BLACKWELL PUBLISHING, INC Publicador: WILEY-BLACKWELL PUBLISHING, INC
Tipo: Artigo de Revista Científica
Português
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AVFs may be considered the best type of venous access for chronic hemodialysis in pediatric patients with more than 20 kg who are not likely to receive a kidney transplant or be transitioned to peritoneal dialysis within one yr. The aim of the study was to report the experience in the creation of AVFs in pediatric candidates for renal transplantation using microsurgical vascular techniques, with emphasis on the details of the surgical technique. Forty children underwent 50 fistula creations - 31 radial-cephalic, 11 brachial-cephalic, five brachial-basilic and three saphenous-femoral. The vein was anastomosed to the artery in an end-to-lateral fashion by using two separate 8/0 prolene running sutures. The overall patency rate was 76.0%:22 (70.9%) of the radial-cephalic fistulas, nine (81.8%) of the brachial-cephalic, five (100.0%) of the brachial-basilic and two (66.6%) of the saphenous-femoral. There was no significant difference in patency rates between the brachial-cephalic, brachial-basilic and radial-cephalic fistulas. The incidences of fistula patency were not different for patients weighing < 20 kg compared with patients weighing > 20 kg. AVF remains as a satisfactory method for providing hemodialysis in children. The utilization of microsurgical techniques with some technical refinements described herein permits the achievement of high fistula patency rates.

‣ The impact of pretransplant donor-specific antibodies on graft outcome in renal transplantation: a six-year follow-up study

David-Neto, Elias; Souza, Patricia Soares; Panajotopoulos, Nicolas; Rodrigues, Helcio; Ventura, Carlucci Gualberto; Ribeiro David, Daisa Silva; Carvalhinho Lemos, Francine Brambate; Agena, Fabiana; Nahas, William Carlos; Kalil, Jorge Elias; Ribeiro Castro
Fonte: HOSPITAL CLINICAS, UNIV SAO PAULO; SAO PAULO Publicador: HOSPITAL CLINICAS, UNIV SAO PAULO; SAO PAULO
Tipo: Artigo de Revista Científica
Português
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OBJECTIVE: The significance of pretransplant, donor-specific antibodies on long-term patient outcomes is a subject of debate. This study evaluated the impact and the presence or absence of donor-specific antibodies after kidney transplantation on short-and long-term graft outcomes. METHODS: We analyzed the frequency and dynamics of pretransplant donor-specific antibodies following renal transplantation from a randomized trial that was conducted from 2002 to 2004 and correlated these findings with patient outcomes through 2009. Transplants were performed against a complement-dependent T-and B-negative crossmatch. Pre- and posttransplant sera were available from 94 of the 118 patients (80%). Antibodies were detected using a solid-phase (Luminex (R)), single-bead assay, and all tests were performed simultaneously. RESULTS: Sixteen patients exhibited pretransplant donor-specific antibodies, but only 3 of these patients (19%) developed antibody-mediated rejection and 2 of them experienced early graft losses. Excluding these 2 losses, 6 of 14 patients exhibited donor-specific antibodies at the final follow-up exam, whereas 8 of these patients (57%) exhibited complete clearance of the donor-specific antibodies. Five other patients developed "de novo' posttransplant donor-specific antibodies. Death-censored graft survival was similar in patients with pretransplant donor-specific and non-donor-specific antibodies after a mean follow-up period of 70 months. CONCLUSION: Pretransplant donor-specific antibodies with a negative complement-dependent cytotoxicity crossmatch are associated with a risk for the development of antibody-mediated rejection...

‣ Malakoplakia after renal transplantation in the current era of immunosuppressive therapy: case report and literature review

Leao, C. A.; Duarte, M. I. S.; Gamba, C.; Ramos, J. F.; Rossi, F.; Galvao, M. M.; David-Neto, E.; Nahas, W.; Shikanai-Yasuda, M. A.; Pierrotti, L. C.
Fonte: WILEY-BLACKWELL; HOBOKEN Publicador: WILEY-BLACKWELL; HOBOKEN
Tipo: Artigo de Revista Científica
Português
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67.526123%
Malakoplakia is a rare chronic granulomatous disease of unknown cause. It is thought to be caused by an acquired bactericidal defect of macrophages. Malakoplakia is associated with chronic infections and immunosuppression. Although it occurs mainly in the urinary tract, it has already been reported in almost every organ system. The isolation of bacteria, especially Escherichia coli, is common in malakoplakia patients. Here, we present a case of primary cutaneous malakoplakia in a kidney transplant recipient who had been taking prednisone, tacrolimus, and mycophenolate. Culture of a lesion grew Burkholderia cepacia complex. Treatment with high doses of trimethoprim-sulfamethoxazole was successful. We also present a systematic review of the literature, identifying 4 previously reported cases of malakoplakia after renal transplantation under similar immunosuppressive therapy, most occurring in the urinary tract or perineum and following benign courses to cure. Data in the literature suggest that malakoplakia has become even rarer since changes were made in the immunosuppressive therapy employed after kidney transplantation.

‣ Which patients are more likely to benefit from renal transplantation?

Galvao De Lima, Jose Jayme; Wolff Gowdak, Luis Henrique; de Paula, Flavio Jota; Machado Cesar, Luiz Antonio; Franchini Ramires, Jose Antonio; Bortolotto, Luiz A.
Fonte: WILEY-BLACKWELL; HOBOKEN Publicador: WILEY-BLACKWELL; HOBOKEN
Tipo: Artigo de Revista Científica
Português
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Background: We evaluated whether the advantages conferred by renal transplantation encompass all individuals or whether they favor more specific groups of patients. Methods: One thousand and fifty-eight patients on the transplant waiting list and 270 receiving renal transplant were studied. End points were the composite incidence of CV events and death. Patients were followed up from date of placement on the list until transplantation, CV event, or death (dialysis patients), or from the date of transplantation, CV event, return to dialysis, or death (transplant patients). Results: Younger patients with no comorbidities had a lower incidence of CV events and death independently of the treatment modality (log-rank = 0.0001). Renal transplantation was associated with better prognosis only in high-risk patients (p = 0.003). Conclusions: Age and comorbidities influenced the prevalence of CV complications and death independently of the treatment modality. A positive effect of renal transplantation was documented only in high-risk patients. These findings suggest that age and comorbidities should be considered indication for early transplantation even considering that, as a group, such patients have a shorter survival compared with low-risk individuals.; Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP); Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP); Fundacao Zerbini...

‣ Clinical impact of an angiotensin I-converting enzyme insertion/deletion and kinin B2 receptor +9/-9 polymorphisms in the prognosis of renal transplantation

Amorim, Carlos E.N.; Nogueira, Eliana; Almeida, Sandro S.; Gomes, Pedro P. G.; Bacurau, Reury Frank Pereira; Ozaki, K. Suzete; Cenedeze, Marcos A.; Silva Filho, Alvaro P.; Câmara, Niels Olsen Saraiva; Araujo, Ronaldo C.
Fonte: Walter de Gruyter GmbH; Berlim Publicador: Walter de Gruyter GmbH; Berlim
Tipo: Artigo de Revista Científica
Português
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There is a consensus in the scientific literature that supports the importance of the kallikrein kinin and renin angiotensin systems in renal physiology, but few studies have investigated their importance after renal transplantation. The aim of this study was to investigate the clinical effects of the insertion/deletion polymorphism in the angiotensin I-converting enzyme (ACE) gene and the +9/-9 polymorphism in the kinin B2 receptor (B2R) gene in kidney-transplanted patients (n=215 ACE, n=203 B2R) compared with 443 healthy individuals. Demographic results showed that there is a higher frequency of the D allele (high plasma ACE activity) and +9 allele (lower B2R expression) in transplant patients compared with control individuals. We also observed a higher frequency of these alleles in patients who had an elevated level of plasma creatinine. At day 7 post-transplantation, we found a higher prevalence of individuals with the DD genotype with elevated plasma creatinine level. Furthermore, individuals with the DD genotype had a higher chronic allograft dysfunction and graft loss compared with the II patient genotype, which showed no loss of graft. Taken together, our data suggest that the DD genotype is an indicator of an unfavorable prognosis following renal transplantation and could be related to kinin modulation.

‣ Freqüência de câncer de próstata em pacientes transplantados renais: estudo caso-controle; Frequency of prostate cancer in patients submitted to renal transplantation: a case-control study

Alvarez, Gilberto Antunes
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 03/09/2007 Português
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INTRODUÇÃO: Os pacientes submetidos a transplante renal estão sujeitos a um risco muito aumentado para câncer, porém inexistem dados concretos quanto a maior chance de tumor de próstata nesses pacientes. Neste estudo, avaliou-se a freqüência de câncer de próstata em transplantados renais comparada à de pacientes-controle, bem como a sua relação com etnia, antecedentes familiares, toque prostático, níveis de PSA e aos esquemas de imunossupressão nos pacientes transplantados renais. MÉTODOS: Neste estudo caso-controle realizado entre agosto de 2004 e junho de 2006 comparou-se a freqüência de câncer de próstata entre pacientes transplantados renais (n=119) há mais de um ano e pacientes do grupo-controle (n=184), bem como as variáveis: etnia, idade, presença de antecedentes familiares, escore internacional de sintomas prostáticos, toque retal, níveis de PSA e índice de massa corpórea (IMC). Os pacientes com PSA e/ou toque retal alterado foram submetidos à biópsias prostáticas guiadas por ultra-som transretal. As comparações das freqüências entre os dois grupos deram-se através das variáveis: idade, etnia, presença de antecedentes familiares, toque suspeito e valores de PSA>2,5ng/mL e >4,0ng/mL. Avaliou-se também a relação entre os tipos e doses de imunossupressor e presença de câncer. RESULTADOS: Não houve maior freqüência de tumor de próstata em transplantados (6...

‣ Sobrevida de alotransplante renal com doador cadáver relacionada à idade do doador, tempo de isquemia fria e compatibilidade HLA; Impact of aged donors, HLA compatibility and cold ischemia time on survival rate of cadaver renal transplantation.

Cassini, Marcelo Ferreira
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 03/04/2009 Português
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Introdução: O transplante renal é amplamente reconhecido como a melhor forma de tratamento para os pacientes que necessitam de terapia de substituição renal, e isso o torna vítima de seu próprio sucesso. Apesar de ser considerado um triunfo clínico-cirúrgico, é igualmente uma fonte de frustração, pela carência de doadores de órgãos e pelo crescimento das listas de espera. Há necessidade do desenvolvimento de estratégias que tornem maior o número de rins disponíveis para transplante. A idade do doador, o tempo de isquemia fria (TIF) e o HLA (antígeno leucocitário humano de histocompatibilidade) são fatores que estão relacionados à sobrevida do enxerto e, desta forma, envolvidos na diminuição da demanda e no aumento da oferta de órgãos. Objetivos: Avaliar o impacto das variáveis, idade do doador, compatibilidade HLA e tempo de isquemia fria, na sobrevida do enxerto de pacientes submetidos à alotransplantes renais com doador cadáver. Materiais e Métodos: Foram analisados retrospectivamente 454 pacientes submetidos a transplantes renais com doadores cadáveres realizados de abril de 1987 a dezembro de 2003, no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP). Resultados: Das variáveis analisadas...

‣ Determinação da incidência e caracterização molecular do poliomavírus humano BK em pacientes submetidos a transplante renal; Incidence and molecular characterization of human polyomavirus BK in patients undergoing renal transplantation

Oliveira, Renato dos Reis
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 08/04/2013 Português
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Atualmente é reconhecida a importância clínica dos poliomavírus, especialmente a morbidade relacionada à infecção por BKV em pacientes submetidos a transplante renal. Apesar de já bem estabelecidas no exterior, existem em nosso meio poucas informações disponíveis sobre a incidência do poliomavirus BK nestes pacientes. O principal objetivo deste estudo foi o de determinar a incidência do poliomavírus BK em amostras sequenciais de urina e plasma de pacientes submetidos a transplante renal da Unidade de Transplante Renal do HC-FMUSP. Outros objetivos foram a genotipagem dos vírus circulantes, o sequenciamento da região VP1 do vírus para avaliar se a origem da infecção no receptor é oriunda do doador e ainda a investigação se rearranjos na região NCCR do BKV estariam associados a evolução para viremia. Os resultados mostraram que a densidade de incidência do BKV em receptores de transplante renal é de 8,1 casos de viruria por 100 receptores/mês e, entre os receptores virúricos, a densidade de incidência de viremia foi de 3,5 casos observados por cada 100 receptores/mês. A distribuição dos genótipos do BKV entre os receptores mostrou predomínio do genótipo I, em sua maioria pertencentes ao subgrupo Ia. Foram identificados os genótipos III e IV...

‣ The use of cyclosporine modifies the clinical and histopathological presentation of tuberculosis after renal transplantation

BIZ,Eloir; PEREIRA,Carlos Alberto Pires; MOURA,Luis Antonio Ribeiro de; SESSO,Ricardo; VAZ,Maria Lucia dos Santos; SILVA FILHO,Alvaro Pacheco; PESTANA,José Osmar Medina
Fonte: Instituto de Medicina Tropical Publicador: Instituto de Medicina Tropical
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2000 Português
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Tuberculosis is one of the most frequent opportunistic infections after renal transplantation and occurred in 30 of 1264 patients transplanted between 1976 and 1996 at Hospital São Paulo - UNIFESP and Hospital Dom Silvério, Brazil. The incidence of 2.4% is five times higher than the Brazilian general population. The disease occurred between 50 days to 18 years after the transplant, and had an earlier and worse development in patients receiving azathioprine, prednisone and cyclosporine, with 35% presenting as a disseminated disease, while all patients receiving azathioprine and prednisone had exclusively pulmonary disease. Ninety percent of those patients had fever as the major initial clinical manifestation. Diagnosis was made by biopsy of the lesion (50%), positivity to M. tuberculosis in the sputum (30%) and spinal cerebral fluid analysis (7%). Duration of treatment ranged from 6 to 13 months and hepatotoxicity occurred in 3 patients. The patients who died had a significant greater number of rejection episodes and received higher doses of corticosteroid. In conclusion, the administration of cyclosporine changed the clinical and histopathological pattern of tuberculosis occurring after renal transplantation.

‣ Improvement of adynamic bone disease after renal transplantation

Abdallah,K.A.; Jorgetti,V.; Pereira,R.C.; dos Reis,L.M.; Pereira,L.M.; Corrêa,P.H.S.; Borelli,A.; Ianhez,L.E.; Moysés,R.M.A.; David-Neto,E.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2006 Português
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Low bone remodeling and relatively low serum parathyroid hormone (PTH) levels characterize adynamic bone disease (ABD). The impact of renal transplantation (RT) on the course of ABD is unknown. We studied prospectively 13 patients with biopsy-proven ABD after RT. Bone histomorphometry and bone mineral density (BMD) measurements were performed in the 1st and 12th months after RT. Serum PTH, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and osteocalcin were measured regularly throughout the study. Serum PTH levels were slightly elevated at transplantation, normalized at the end of the third month and remained stable thereafter. Bone biopsies performed in the first month after RT revealed low bone turnover in all patients, with positive bone aluminum staining in 5. In the 12th month, second biopsies were performed on 12 patients. Bone histomorphometric dynamic parameters improved in 9 and were completely normalized in 6, whereas no bone mineralization was detected in 3 of these 12 patients. At 12 months post-RT, no bone aluminum was detected in any patient. We also found a decrease in lumbar BMD and an increase in femoral BMD. Patients suffering from ABD, even those with a reduction in PTH levels, may present partial or complete recovery of bone turnover after successful renal transplantation. However...

‣ Successful use of gentamycin as an antibiotic prophylaxis regimen to reduce the rate of healthcare-associated infections after renal transplantation

Abboud,Cely S.; Bergamasco,Maria Daniela; Sousa,Ercilia Evangelista de; Zandonadi,Eliana de Cássia; Cortez,Doralice
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2013 Português
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At our institution, we observed an increase in the incidence of healthcare-associated infections (HAI) due to Gram-negative bacilli, including three cases of carbapenem-resistant Klebsiella pneumoniae, among patients who underwent renal transplantation. In addition to strengthening infection control measures, we chose to add gentamycin to the antibiotic prophylaxis regimen of patients undergoing renal transplantation. We assessed the number of HAI occurring within 30 days of renal transplantation during two time periods: (1) the preintervention period, between September 2009 and June 2010, and (2) the post-intervention period, between July 2010 and April 2011. The intervention consisted of the addition of gentamycin to the surgical antibiotic prophylaxis regimen. The percentage of patients with HAIs was 31% lower during the post-intervention period (p = 0.03), with the greatest reductions observed for urinary tract infections (p = 0.024). Carbapenem-resistant K. pneumoniae was not isolated during this period. The investigated patients did not exhibit worsening renal function. Further studies are needed to assess antibiotic prophylaxis in renal transplantation patients at institutions where there is a high prevalence of multidrug-resistant Gram-negative bacteria.

‣ Renal Transplantation Is Not Associated with Regression of Left Ventricular Hypertrophy: A Magnetic Resonance Study

Patel, Rajan K.; Mark, Patrick B.; Johnston, Nicola; McGregor, Ellon; Dargie, Henry J.; Jardine, Alan G.
Fonte: American Society of Nephrology Publicador: American Society of Nephrology
Tipo: Artigo de Revista Científica
Publicado em /11/2008 Português
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Background and objectives: Patients with end-stage renal failure (ESRD) have an increased risk of premature cardiovascular (CV) disease. Left ventricular hypertrophy is an independent risk factor for CV events and death in ESRD. Renal transplantation has been associated with reduction in CV risk and echocardiographic regression of left ventricular hypertrophy. However, echocardiography overestimates LV mass in ESRD patients. Cardiac magnetic resonance (CMR) provides more detailed, volume-independent, measures of cardiac structure. Changes in LV mass measured by CMR after renal transplantation were studied.

‣ Colorectal cancer in patients with chronic renal failure: the effect of dialysis or renal transplantation

Ho, H.; Russ, G.; Stephens, J.; Rieger, N.
Fonte: Blackwell Science Ltd. Publicador: Blackwell Science Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2002 Português
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Objective: This study reports the characteristics and surgical outcome of colorectal cancer in patients with chronic renal failure treated either by renal transplantation or dialysis. Methods: Two thousand four hundred and seventeen patients with CRF (1387 transplant and 1030 dialysis) were treated at The Queen Elizabeth Hospital, South Australia, between January 1967 and September 2000. Results: Fourteen have developed colorectal cancer and had their clinical records reviewed. Nine patients were renal transplant recipients and 5 patients were treated with dialysis. Eight patients had surgery. Chemotherapy was given palliatively to 3 patients. One patient died in hospital postoperatively. Seven patients with a renal transplant had notes available. Six presented with late stage disease and all were dead within 9 months of presentation from their disease. In the dialysis patients, tumour stage at presentation was not so advanced and although all the patients have died, the cause of death was secondary to the colorectal cancer in only 2 patients. Conclusions: This study highlights the poor outcome of patients who have had renal transplant and develop colorectal cancer. Immunosuppression and late diagnosis are implicated in this poor outcome; Hanh-Tam Ho...

‣ Pre-emptive renal transplantation from living donors in Australia: Effect on allograft and patient survival

Milton, C.; Russ, G.; McDonald, S.
Fonte: Blackwell Publishing Asia Publicador: Blackwell Publishing Asia
Tipo: Artigo de Revista Científica
Publicado em //2008 Português
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Aim: Pre-emptive renal transplantation has become the preferred first-line therapy for patients with end-stage kidney failure. This study examines the outcome of allograft and patient survival in pre-emptive transplantation compared with non-pre-emptive transplantation from living donors in Australia and New Zealand. Methods: We have performed a retrospective study using the Australian and New Zealand Dialysis and Transplantation Registry. Allograft and patient survival were compared at 1, 5 and 10 years in pre-emptive transplantation and non-pre-emptive transplantation following a living donor transplant. Results: Allograft survival at 1, 5 and 10 years post pre-emptive transplantation was better than post non-pre-emptive transplantation (multivariate hazard ratio (HR) 0.80 [95% confidence interval 0.64–0.99], P = 0.036). Pre-emptive transplantation was associated with a significant patient survival advantage over non-pre-emptive transplantation when analysed from the time of transplantation and adjusted for age and gender (multivariate HR 0.46 [0.27–0.80], P = 0.006). Patient survival for pre-emptive transplantation and non-pre-emptive transplantation was 97% [0.95–0.98] and 93% [0.91–0.94] at 5 years and 93% [0.88–0.96] and 84% [0.82–0.87] at 10 years post transplant respectively. There was no difference in the overall rejection rate between pre-emptive transplantation and non-pre-emptive transplantation. Vascular rejection was less common in pre-emptive transplantation (HR 0.70 [0.50–0.98]...

‣ Indigenous people in Australia, Canada, New Zealand and the United States are less likely to receive renal transplantation

Yeates, K.; Cass, A.; Sequist, T.; McDonald, S.; Jardine, M.; Trpeski, L.; Ayanian, J.
Fonte: Blackwell Publishing Inc Publicador: Blackwell Publishing Inc
Tipo: Artigo de Revista Científica
Publicado em //2009 Português
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In Australia, Canada, New Zealand, and the United States indigenous people have high rates of chronic kidney disease but poor access to effective therapies. To more fully define these issues, we compared the demographics of renal transplantation of indigenous patients in these 4 countries. Data encompassing 312,507 indigenous and white patients (18–64 years of age) who initiated dialysis within an 11-year period ending in 2005 were obtained from each country's end-stage kidney disease registry. By the study's end, 88,173 patients had received a renal transplant and 130,261 had died without receiving such. Compared with white patients, the adjusted likelihood of receiving a transplant for indigenous patients was significantly lower in Australia (hazard ratio (HR) 0.23), Canada (HR 0.34), New Zealand (HR 0.23), and the United States (HR 0.44). In all four countries, indigenous patients had significantly longer overall median waiting times compared to white patients. Our study shows that despite marked differences in health care delivery systems, indigenous patients are less likely than white patients to receive a renal transplant in these countries. Understanding and addressing barriers to renal transplantation of indigenous patients remains an important concern.; Karen E Yeates...

‣ Avaliação da função vesical antes e após transplante renal em pacientes sem doença urológica = : Evaluation of bladder function pre and post renal transplantation in patients without urological cause; Evaluation of bladder function pre and post renal transplantation in patients without urological cause

Daniel Carlos da Silva
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 24/07/2012 Português
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Objetvos: Avaliar com realização do estudo urodinâmico, a recuperação da função vesical em pacientes com doença renal crônica sem causa urológica de base com longos períodos de oligúria / anúria, submetidos a transplante renal. Pacientes e Métodos: De abril de 2009 a junho de 2010, 30 pacientes apresentando oligúria / anúria, foram prospectivamente avaliados com estudo urodinâmico. Este foi realizado imediatamente antes e seis meses após o transplante renal. Os critérios de inclusão foram: idade > 18 anos, doença renal crônica sem causa urológica envolvida na sua etiologia, tempo de diálise superior a 12 meses, nome em lista de transplante com doador falecido. Foram excluídos pacientes com alteração no ultrassom de vias urinárias, uretrocistografia miccional e urianálise e com diurese residual de 24 horas superior a 1000ml. Resultados: Observou-se completa recuperação da função vesical após o retorno da diurese, no sexto mês pós-transplante, independente de haver ou não disfuncionalização vesical. As variações nos parâmetros urodinâmicos foram: primeira sensação de enchimento vesical: 88,8 para 168,7ml (p = 0,0005); primeiro desejo miccional: 137,2 para 251,1ml (p <0,0001); capacidade cistométrica máxima: 221...

‣ Longitudinal study of the indirect immunofluorescence and complement fixation tests for diagnosis of chagas' disease in immunosuppressed patients submitted to renal transplantation

Figueiredo,José Fernando de Castro; Fiorillo,Adhemar Mário; Ferraz,Agenor Spallini
Fonte: Sociedade Brasileira de Medicina Tropical - SBMT Publicador: Sociedade Brasileira de Medicina Tropical - SBMT
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/1993 Português
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Clinical and serological follow-up of 7 patients submitted to renal transplantation and presenting positive serological reactions to Chagas 'disease before immunossupression did not show significant changes in indirect immunofluorescence and complement fixation titres for Chagas ' disease, or signs and symptoms indicating exacerbation of the disease during follow- up. In addition, 18 of 66 recipients of renal transplants considered to be non-chagasic before immunosuppression showed at least one positive result to the indirect immunofluorescence test for Chagas ' disease during the study period. The results suggest that the immunosuppression State induced in chagasic patients submitted to renal transplant did notpromoted exacerbation of the chronic infection in these patients and not interfere with the serological response of chronic chagasics, thus permitting the use of these serologic reactions for diagnostic purposes in these cases. However, the positive results ofthe indirect immunofluorescence test in non- chagasic patients indicate the needforjudicious interpretation ofthe indirect immunofluorescence test for the diagnosis of Chagas' disease in renal transplanted patients.

‣ Complete atrioventricular block during renal transplantation in a patient with Alport's syndrome: case report

Ferrari,Fábio; Nascimento Junior,Paulo do; Vianna,Pedro Thadeu Galvão
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2001 Português
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CONTEXT: Patients with Alport's syndrome (causing 5% of end-stage renal disease) have a higher risk of heart conduction abnormalities. OBJECTIVE: To report a case of Alport's syndrome developing complete atrioventricular block during renal transplantation. CASE REPORT: A 21-year-old man with chronic renal failure due to Alport's syndrome was submitted to a renal transplantation under epidural anesthesia and, during the intraoperative period, a complete atrioventricular block was diagnosed and promptly treated with a transcutaneous pacemaker. This extensive sympathetic block can contribute towards disturbances in the heart conduction system, particularly in patients with chronic renal disease in hemodialysis. Even in patients with a normal preoperative electrocardiogram or no conduction system disturbances, some degree of atrioventricular block, including complete atrioventricular block, can occur. In this situation, a transcutaneous pacemaker provides rapid and effective treatment in the operating room, thereby permitting the planning of a definitive treatment.

‣ A reabilitação profissional como proposta de intervenção da terapia ocupacional no pós-transplante renal; Rehab work as proposed intervention in occupational therapy after renal transplantation

Cardoso, Jordana Santos; Cavalcante, Milady Cutrim Vieira; Miranda, Ana Teresa Mendes de
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 28/04/2014 Português
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Introdução: O transplante renal possibilita a minimização das limitações impostas pela terapia dialítica e o retorno ou ingresso em atividade produtiva. Entretanto, apenaspequeno percentual dos pacientes é recolocado em atividadelaborativa. Objetivo: Descrever a proposta de atuação da Terapia Ocupacional (TO) voltada para a reabilitação profissional no Ambulatório de Pós-Transplante Renal de um Hospital Universitário. Procedimentos metodológicos: Relato de experiência sobre a atuação da TO junto a pacientes transplantados renais. Para tal foram utilizados protocolos e relatórios de TO além das fichas de avaliação terapêutica ocupacional aplicadas a estes pacientes. A coleta de dados foi realizada no período de junho a dezembro de 2011. Resultados: O comprometimento das áreas do desempenho ocupacional em pacientes renais é instalado durante a fase dialítica e perduram após a realização do transplante renal. A temática da manutenção, ingresso ou retorno ao trabalho ainda comparece de forma incipiente na fase pré-transplante. Fatores sociais, econômicos, psicológicos e línicos influenciam a adesão à reabilitação profissional. Conclusão: O sucesso das ações da TO poderá tornar os transplantados renais mais produtivos e reintegrados à sociedade reduzindo o custo social de seu tratamento.; Introduction: Kidney transplantation enables the minimization of the limitations imposed by dialysis and return or entry into productive activity. However...

‣ Acute fulminant colon cancer metastasis after renal transplantation

Lin,C. T.; Cha,T. L.; Wu,S. T.; Chuang,F. P.
Fonte: Revista Española de Enfermedades Digestivas Publicador: Revista Española de Enfermedades Digestivas
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/07/2010 Português
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We report a 52-year-old male with no family history of colonic cancer, who was found to have advanced colonic cancer with metastases two months post renal transplantation. With this case, we highlight the possibility of acute fulminant cancer metastases within short period after renal transplantation and the importance of periodic colorectal cancer screening pre-transplant. To our knowledge, this case is not yet reported in the literature, especially with such presentation of acute fulminant colonic cancer metastases post renal transplantation.