ABSTRACT
A reversed-phase high performance liquid chromatography (RP-HPLC) method with ultraviolet detection was developed and validated for the simultaneous quantification of antiretroviral drugs lamivudine (3TC), stavudine (d4T), and zidovudine (AZT) in perfusate samples obtained from the Single-Pass Intestinal Perfusion studies. The chromatographic analysis was performed using a Gemini C18 column and didanosine as internal standard (IS). The following parameters were considered for the validation procedure: system suitability, accuracy, precision, linearity and selectivity. The limits of detection were 0.32 µg/mL for 3TC, 0.11 µg/mL for d4T and 0.45 µg/mL for AZT and the limits of quantification were 1.06 µg/mL for 3TC, 0.38 µg/mL for d4T and 1.51 µg/mL for AZT. Repeatability and intermediate precision ranged from 1.05 to 1.31 and 1.50 to 1.87, respectively, and are expressed as percent of relative standard deviation (RSD). Based on these results, the developed and validated RP-HPLC method can be used for simultaneous determination of 3TC, d4T, and AZT in perfusate samples. Furthermore, this method is simple and adequate for measurements of the antiretroviral drugs in the same sample, since those compounds are mostly co-administered. Besides, this work can be used as an initial base for the development of similar methods in the same conditions presented in our study.
Subject(s)
Zidovudine/pharmacology , Chromatography, High Pressure Liquid/methods , Lamivudine/pharmacology , Validation Study , Anti-Retroviral Agents/pharmacology , Perfusion/instrumentation , Permeability , Pharmaceutical Preparations/administration & dosage , Limit of DetectionABSTRACT
RESUMO Com a utilização crescente da máquina de perfusão no transplante renal, tem sido constatado que a isquemia dinâmica correlaciona-se à melhora da preservação orgânica. Nesse contexto, realizamos uma revisão sistemática que procurou avaliar a eficácia do uso de máquina de perfusão portátil (LifePort Kidney Transporter Machine®), utilizada no Brasil, comparada ao armazenamento estático, no que tange à função retardada do transplante renal de doadores com morte encefálica. Foi efetuada pesquisa bibliográfica, nas bases LILACS, MEDLINE via PubMed, Scopus, Clarivate Analytics, Cochrane Library, Embase, SciELO, além de busca manual no Google acadêmico. A revisão sistemática, finalizada em abril 2017, foi constituída somente por ensaios clínicos randomizados. Para metanálise, foram avaliadas Razão de Risco e Razão de Chance. Foram identificados 86 documentos e selecionados, ao final, dois artigos com critérios de elegibilidade para metanálise, de grupos europeus e brasileiros. Nestes, 374 rins foram alocados para a máquina de perfusão, e igual número para o armazenamento estático. A função retardada do enxerto foi constatada em 84 e 110 pacientes, respectivamente. Na metanálise, foram obtidas uma Razão de Risco de 0,7568 (p=0,0151) e uma Razão de Chance de 0,6665 (p=0,0225), ambas com intervalo de confiança de 95%. A máquina de perfusão reduziu a incidência de função retardada do enxerto de doadores com morte encefálica.
ABSTRACT With the increasing use of machine perfusion in kidney transplantation, it has been observed that dynamic ischemia correlates with the improvement of organ preservation. In this context, we performed a systematic review that aimed to evaluate the efficacy of the portable machine perfusion (LifePort Kidney Transporter Machine®), used in Brazil, compared to cold storage, regarding the delayed graft function of deceased donors with brain death. Literature search was carried out in LILACS, MEDLINE via PubMed, Scopus, Clarivate Analytics, Cochrane Library, Embase, and SciELO, as well as in Google Scholar manually. The systematic review consisted only of randomized clinical trials. For meta-analysis, relative risk and odds ratio were evaluated. Eighty-six documents were identified and two papers from European and Brazilian groups were selected at the end, with eligibility criteria for meta-analysis. In these, 374 kidneys were assigned to machine perfusion and 374 kidneys were assigned to cold storage. Delayed graft function was observed in 84 and 110 patients, respectively. In meta-analysis, a risk ratio of 0.7568 (p=0.0151) and an odds ratio of 0.6665 (p=0.0225) were obtained, both with a 95% confidence interval. Machine perfusion reduced the incidence of delayed graft function of deceased donors with brain death.
Subject(s)
Humans , Organ Preservation/methods , Perfusion/methods , Brain Death , Cold Ischemia/methods , Kidney , Organ Preservation/instrumentation , Perfusion/instrumentation , Time Factors , Pulsatile Flow , Reproducibility of Results , Risk Factors , Kidney Transplantation/methods , Delayed Graft FunctionABSTRACT
A strategy employing moderate hypothermia for the replacement of the aortic arch is proposed to avoid the complications of profound hypothermic circulatory arrest. Two patients underwent the complete replacement of the aortic arch using three pumps - for the brain, thoracoabdominal aorta, and heart, respectively. There were no complications and the patients were extubated uneventfully. The method preserved the auto-regulation of the cerebral blood flow without high vascular resistance
Subject(s)
Humans , Male , Perfusion/instrumentation , Hypothermia, Induced , Brain/blood supply , Circulatory Arrest, Deep Hypothermia Induced , Thoracic Surgery , Cardiopulmonary Bypass/instrumentation , Equipment Design , Perfusion/instrumentationABSTRACT
Nos últimos 20 anos, o transplante pulmonar tornou-se o tratamento padrão para algumas pneumopatias graves em estágio terminal. Menos de 20 por cento dos pulmões doados para transplante são realmente utilizados. Essa desproporção entre o crescente número de candidatos ao transplante pulmonar e o reduzido número de doadores resulta em aumento da mortalidade nas filas de espera. Estratégias, como o uso de órgãos de doadores marginais, não se mostraram efetivas em aumentar o número de transplantes. Em 2000, na Suécia, foi desenvolvido um método novo para recondicionar pulmões humanos rejeitados para transplante. Descrevemos nossa experiência inicial com a perfusão pulmonar ex vivo.
In the last 20 years, lung transplantation has become the standard treatment for patients with end-stage lung disease. However, less than 20 percent of the donor lungs available for transplant are actually usable. This disparity between the growing number of recipients and the small number of donors has resulted in increased mortality among lung transplant candidates on waiting lists. Strategies such as the utilization of organs from marginal donors have proven ineffective in increasing the number of transplants. In 2000, a new method for reconditioning human lungs that had been previously rejected for transplantation was developed in Sweden. We describe our initial experience with ex vivo lung perfusion.
Subject(s)
Aged , Humans , Middle Aged , Lung , Lung Transplantation , Organ Preservation/methods , Perfusion/methods , Brazil , Donor Selection , Perfusion/instrumentationABSTRACT
Acompanhamos para eventos cardíacos tardios (EC) 487 pts submetidos à ecocardiografia de contraste miocárdico ECM por 36+17 meses. Defeito reversível de perfusão foi positivo (POS) e normal ou defeito fixo isolado foi negativo (NEG). Os pts foram considerados de baixo(87), intermediário(94) e alto risco(141), ou com doença arterial coronária (DAC) confirmada(165). Foram documentados 85 EC: morte cardíaca (15), infarto do miocárdio (7) e revascularização miocárdica (63). POS foi preditor independente para EC. A sobrevida acumulada livre de eventos foi 96 por cento e 77 por cento para pts com ECM NEG e POS respectivamente (p<0,001). ECM é útil preditor para EC em pts com suspeita ou DAC confirmada / Long-term predictive value for late cardiac events (CE) was determined in 487 patients who underwent myocardial contrast echocardiography (MCE) and were followed up for 36+17 months. Reversible perfusion defects were positive (POS) and normal or isolated fixed defects were negative (NEG). Patients were at low (87), intermediate (94), high-risk (141), or with confirmed coronary disease (165). CE were: cardiac death (15), non-fatal myocardial infarction (7), and revascularization (63) patients. POS test was an independent predictor of CE. The cumulative event free survival was 96 per cent (NEG-MCE) and 77 per cent (POS-MCE), p<0.001. MCE was a useful predictor of CE...
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Coronary Disease/diagnosis , Echocardiography , Perfusion/instrumentation , Adenosine/adverse effects , Adenosine , Follow-Up Studies , Prognosis , Perfusion/statistics & numerical dataABSTRACT
An improvised device for coronary perfusion of isolated rat heart consisted of a reservoir of buffer pressurised with continuous bubbling of O2 connected to two double condensors in series. The outer jacket of each condenser was connected to a temperature controlled motorised water bath to ensure steady temperature of buffer. Isolated hearts could be tested with known agents directly through a syringe connected to the aortic cannula.
Subject(s)
Animals , Buffers , Heart/physiology , Oxygen , Perfusion/instrumentation , Rats , TemperatureABSTRACT
Bombas peristálicas eletromecânicas e máquinas de perfusäo eletrônicas (tipo Harvard) säo recomendadas comumente pela literatura para uso na perfusäo de alças isoladas de ratos e hamsters, "in vivo". Tais aparelhos säo de custo elevado e de manutençäo que exige mäo de obra especializada, o que torna seu uso problemático em nosso meio. Idealizamos uma bomba de perfusäo, que pode ser montada com peças de fácil aquisiçäo e de manutençäo simples, que permite fluxos variáveis com precisäo e segurança, podendo substituir a similar importada