Treatment of persistent rejection with methotrexate in stable patients submitted to heart transplantation

Bacal, Fernando; Veiga, Viviane Cordeiro; Fiorelli, Alfredo Inácio; Bellotti, Giovanni; Bocchi, Edimar Alcides; Stolf, Noedir Antônio Groppo; Ramires, José Antônio Franchini

doi:10.1590/s0066-782x2000000200004

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…The findings of this study are consistent with previous publications in respect to the effectiveness of transplantation to treat symptoms of end-stage heart failure [2,3,9.11] and in respect to rejection and episodes of infection, which still constitute the greatest cause of morbidity and mortality in the immediate postoperative period [17]. Results of patients operated in Brazil show a 5-year survival of 50% for transplanted patients, 10% lower than the corresponding rates from the USA [18,19].…”

Section: Discussionsupporting

confidence: 92%

Os significados de ter o coração transplantado: a experiência dos pacientes

Sadala²

2006

Rev Bras Cir Cardiovasc

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Os significados de ter o coração transplantado: a experiência dos pacientes Experiencing heart transplantation: the patients' perspective Abstract Objective: For patients with heart failure, heart transplantation represents the possibility of survival and improvement in their quality of life. Thus, the awareness and participation of patients in the follow-up work by the healthcare team after transplantation are important. This study aimed at understanding the experience of heart transplantation based on the descriptions of patients. Method: Twenty male and six female patients, whose ages ranged from 13 to 71 years old, were interviewed. The similarities of their accounts illustrated shared feelings which described their experiences. Results: The patients re-experienced the transplantation phases and compared heart failure symptoms with the improvement achieved after transplantation. Some felt healthy whereas others reported the persistence of rejection and complications as well as the onset of other pathologies. However, all of them noted the improvement in their quality of life. Each one brought his own views concerning the experience itself, their relatives and the professionals who participated in their experience. They expressed their expectations regarding work and family achievements. Conclusion: The contribution of this descriptive study lies in unveiling new perspectives of understanding such patients' needs, thus helping professionals who assist them to respond more effectively to their individual necessities. Descriptors: Heart transplantation. Quality of life. Adaptation, psychological. Resumo Introdução: O transplante cardíaco representa, para pacientes com falência cardíaca, a possibilidade de sobrevivência e melhorias na qualidade de vida. Para tanto, faz-se necessária a conscientização e a participação do paciente no trabalho de acompanhamento da equipe de saúde, póstransplante. O objetivo do estudo foi compreender a experiência do transplante cardíaco, partindo da descrição dos pacientes. Método: Foram entrevistados 26 pacientes, 20 homens e seis mulheres, entre 13 e 71 anos. As convergências dos depoimentos levaram às verdades gerais, que descrevem a experiência vivida. Resultados: Os participantes revivem as fases do transplante. Comparam sintomas da falência cardíaca com os progressos que conseguiram após transplante. Alguns se sentem saudáveis. Outros relatam persistência da rejeição e complicações; e surgimento de outras afecções. Porém, todos STOLF, NAG ET AL-Experiencing heart transplantation: the patients' perspective

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Section: Discussionsupporting

confidence: 92%

Os significados de ter o coração transplantado: a experiência dos pacientes

Sadala²

2006

Rev Bras Cir Cardiovasc

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“…There are studies comparing the various immunosuppression regimens; however, more reactivations have been diagnosed with the use of mycophenolate mofetil 280 . Experience with the use of tacrolimus, rapamycin, methotrexate and everolimus has not been published, despite their potential benefit 281 . The following can be used to induce tolerance or to treat a rejection episode: corticosteroids; cyclophosphamide; methotrexate 282,283 ; interleukin-2 receptor antagonists; polyclonal antibodies; monoclonal antibodies; and apheresis.…”

Section: Immunosuppressionmentioning

confidence: 99%

I Diretriz Latino-Americana para o Diagnóstico e Tratamento da Cardiopatia Chagásica

Castro¹,

Andrade²,

Vilas-Boas³

et al. 2011

Arq. Bras. Cardiol.

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“…In our institution endomyocardial biopsy and Gallium-scintigraphy are the main methods to rejection control and Chagas' disease reactivation after heart transplantation, and research too [31][32][33][34][35][36][37][38][39] . The two-dimensional echocardiography has been used in last 25 years to guide endomyocardial biopsy examination with emphasis in critical patients with cardiomyopathy or after heart transplantation; to help in the visualization of the intracardiac tumors' position and in patients that cannot go at catheterization room 40,41 .…”

Section: Disadvantagesmentioning

confidence: 99%