Fatores de risco para a falência do transplante ortotópico de fígado no Rio Grande do Sul, Brasil

Abstract

Fatores de risco para falência do transplante ortotópico de fígado com doador cadáver foram investigados em estudo longitudinal retrospectivo com informações da Central Estadual de Transplantes e prontuário clínico de residentes no Rio Grande do Sul, Brasil, submetidos, após os 15 anos de idade, pela primeira vez, a esse transplante de janeiro de 1999 a julho de 2003 (n = 313). Houve 13% de falências (n = 41) no primeiro mês, 11% (n = 34) de 2 a 12 meses e 5% (n = 17) após esse período; 88% das falências resultaram em óbito, 12%, em retransplante. Nos modelos multivariados, a taxa de falência foi maior para renda familiar menor que dez salários-mínimos, idade maior que 45 anos, cor não branca, mau estado geral à época do transplante e doador com 56 anos ou mais. Gênero feminino evidenciou efeito apenas no modelo bruto, perdendo o efeito no modelo multivariado. Apoio social, com complementação de renda e pronto diagnóstico com ingresso na lista em boas condições clínicas, pode favorecer o sucesso do transplante hepático.

MELD and other predictors of survival after liver transplantation

“…This negative effect of platelets is in agreement with a recent study by de Boer et al (26). There is increasing evidence that transfusion of blood products is associated with side effects (27,28). The statistical analysis was adjusted for age of the recipient and era of transplant surgery, thus controlling for variables that could have otherwise acted as confounding factors.…”

“…(26). There is increasing evidence that transfusion of blood products is associated with side effects (27, 28).…”

Immediate graft histological assay, post pig's liver transplantation

“…Brazil has been offering the procedure free by Health Public System (SUS), being the second country in the world in realized transplantations a year by the public system, making possible to investigate the effect of socio-economical inequalities on the transplantation result 3 . Ophir Loyola Hospital, in Belem, has had the service of collecting livers since 2007 and is awaiting permission to hold the graft 4 .…”

Proposition of technique modification of liver harvesting in orthotopic transplantation in pigs

“…Liver transplantation and immunosuppressants have significantly increased survival of patients with terminal chronic and irreversible liver diseases; however, the failure of transplantation is still a constant concern. 1 Technical development has represented a major challenge in clinical-surgical practice, not only for its complexity but also by the shortage of available organs. 2 At the University Hospital of Recife, Brazil, it was found to be possible to perform liver transplantations with good results in public hospitals of underserved regions in terms of health care, provided that there are trained multidisciplinary teams and minimum physical structure.…”