Commonest cause of death was cardiac related events (24%), followed by sepsis (23%) or liver related complications (14%). Disease duration prior to transplantation, initial presentation with autonomic rather than peripheral neuropathy, TTR mutation, and modified body mass index (mBMI) of <600, indicating poor nutritional status, were identified as significant factors influencing survival after LT (p<0.01). Conclusion Liver transplantation is rational and effective treatment for FAP with excellent long-term outcomes and 10-year survival >70%. Type of mutation, nutritional status, disease duration and degree of autonomic involvement are significant prognostic factors. Introduction The risk of acute liver failure (ALF) related to NSAIDs is still discussed and the European Medicines Agency requested a study investigating this. University Bordeaux Segalen conducted the study independently. Aim To estimate the incidence rates of ALF leading to registration for liver transplantation (LT) in patients exposed to NSAIDs. Method Multinational, multicentre, case-population study performed in France, Greece, Ireland, Italy, the Netherlands, Portugal, and the UK retrospectively evaluating a 3-year period (2005e2007) in adults. Data of ALF cases were sought through liver transplant registries and hospital records. Demographic and clinical data were collected for all ALF cases and drug use information was collected for the exposure window of 30 days prior to index date (ID, initial symptoms of liver disease). For ALF cases exposed to NSAIDs (ATC code M01A), rate per million treatment-years (tt-yrs) was calculated using sales data from IMS. Poisson CIs (95% CI) were estimated. Results In the seven participating countries, 62 LT centres were identified and contacted, five were excluded (four paediatric, one oncology), and 50 actively contributed data before database lock. Among the 8824 patients identified from LT lists for the period 2005e2007, 500 were cases of ALF: 197 with identified clinical cause, 21 with incomplete or unavailable medical files, and 241 drugexposed without identified clinical cause. Among the latter, 34 were exposed to at least one NSAID, 123 exposed to other drugs, and 84 were acute drug intoxications. Mean age of NSAID-exposed ALF cases was 43.8 years, 24 were female. Event rates per million treatment-years were 4.4 (95% CI 3.0 to 6 P73

Resumo Introdução: A cirrose hepática é uma doença crônica que cursa com diversas repercussões sistêmicas, uma delas é a disfunção cardiovascular, caracterizada pela queda da resistência vascular periférica e pelo aumento compensatório do débito cardíaco. Tal disfunção manifesta-se principalmente em situações de estresse hemodinâmico, estando muitas vezes normal no repouso. Objetivo: Avaliar a aplicabilidade do Teste de Caminhada de 6 minutos (TC6min) como instrumento sugestivo de disfunção cardiovascular nos pacientes cirróticos, através da correlação entre o desempenho no teste e o status funcional do paciente. Material e Métodos: Trata-se de estudo observacional e transversal do tipo inquérito, realizado em vinte e nove pacientes cirróticos, submetidos ao TC6min. Foram avaliados a distância percorrida por eles e parâmetros clínicos antes e após o teste, sendo o resultado comparado de acordo com sua classificação funcional. Resultados: Dentre os pacientes classe A de Child-Pugh, 6 deles (26,09% do total dessa classe) não atingiram a distância mínima prevista para o TC6min. Ao se analisar a classe B de Child-Pugh, 5 deles (83,33% do total dessa classe) não atingiram a distância mínima. A média da distância percorrida para pacientes Child A foi de 631,5 m, enquanto o previsto foi de 587,2 m. Em relação aos pacientes Child B, a média da distância percorrida foi de 441,0 m, com distância prevista de 541,2m. Foi observada uma significativa correlação inversa entre a distância percorrida e o escore de 001). Conclusão: A distância percorrida no teste de caminhada de 6 minutos apresentou correlação inversa com a classificação de Child--Pugh-Turcotte o que demonstra um prejuízo funcional paralelo à piora da doença hepática de base. Ao considerar que os pacientes do estudo não apresentavam comorbidades previamente diagnosticadas que pudessem justificar tal prejuízo, essa associação pode indicar disfunção cardiovascular. Esta, por sua vez, provavelmente está relacionada ao comprometimento sistêmico secundário à cirrose hepática. AbstractIntroduction: Hepatic cirrhosis is a chronic disease that has several systemic repercussions. One of them is the cardiovascular dysfunction, characterized by the decrease of the peripheral vascular resistance and the compensatory increase of the cardiac output. Such dysfunction manifests itself mainly in situations of hemodynamic stress, and is often normal at rest. Objective: To evaluate the applicability of the 6-minute walk test (6MinWT) as an instrument suggestive of cardiovascular dysfunction in cirrhotic patients, through correlation between the test performance and the functional status of the patient. Methods: This is an observational and cross-sectional study of the survey type, performed in twenty-nine cirrhotic patients submitted to 6MinWT. The distance walked by them and the clinical parameters before and after the test were evaluated, and the results were compared according to their functional classification. Results: Among Child-Pugh A patients, 6 (26.09% of the total of this...

Introdução: KDPI e EPTS são escores implantados nos Estados Unidos em 2014 para guiar a alocação de enxertos renais. O objetivo deste trabalho é correlacionar valores desses escores com desfechos dos transplantes renais realizados em um Centro de Transplantes brasileiro, avaliando sua capacidade de predizer prognóstico nesta população. Métodos: Estudo observacional, individuado, longitudinal e retrospectivo com 163 pares receptor-doador de transplantes renais com doadores falecidos, realizados entre 2012 e 2017, com acompanhamento até 2019. Resultados: Pacientes com enxertos de KDPI menor ou igual à mediana obtiveram menor mortalidade após um ano (p = 0,02); menor taxa de perda de enxerto até um ano (p = 0,00) e após um ano (p = 0,03) e menor nível de creatinina (p = 0,00). Receptores com EPTS menor ou igual à mediana obtiveram taxa de perda de enxerto significativamente menor, se comparados aos com valores acima da mediana (p = 0,01). O coeficiente de correlação entre KDPI e EPTS foi da ordem de 0,016 (p = 0,84). Conclusão: O KDPI evidenciou-se como ferramenta objetiva e de fácil aplicação para predizer prognóstico e, assim, direcionar os rins a serem transplantados. O EPTS mostrou caráter promissor para avaliação dos receptores renais. Esses dados podem ser complementados com futuros estudos nacionais para possível validação e implementação dos escores no país. Conclusão: Por fim, observou-se que não houve correlação direta entre os valores de KDPI do enxerto com os valores de EPTS de seus receptores, distanciando-se do que é preconizado pela literatura norte-americana.Palavras Chave: Transplante de rim, Seleção de doadores, Sobrevivência de enxertoABSTRACTIntroduction: KDPI and EPTS are scores implemented in the United States in 2014 to guide the allocation of kidney grafts. The objective of this work is to correlate values of these scores with outcomes of kidney transplants performed in a Brazilian Transplant Center, evaluating their ability to predict prognosis in this population. Methods: Observational, individual, longitudinal and retrospective study with 163 recipient-donor pairs of kidney transplants with deceased donors, carried out between 2012 and 2017, with follow-up until 2019. Results: Patients with grafts with KDPI less than or equal to the median had lower mortality after one year (p = 0.02); lower graft loss rate up to one year (p = 0.00) and after one year (p = 0.03) and lower creatinine level (p = 0.00). Recipients with EPTS less than or equal to the median had a significantly lower graft loss rate, compared to those with values greater than the median (p = 0.01). The correlation coefficient between KDPI and EPTS was of about 0.016 (p = 0.84). Conclusion: KDPI proved to be an objective and easy to apply tool to predict prognosis and, thus, direct the kidneys to be transplanted. EPTS showed a promising character for the evaluation of kidney recipients. These data can be complemented with future national studies for possible validation and implementation of such scores in the country. Conclusion: Finally, it was observed that there was no direct correlation between the KDPI values of grafts and the EPTS values of its recipients, distancing from what is recommended by the North American literature.Keywords: Kidney transplantation, Donor selection, Graft survival