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1.
Transplant Proc ; 38(8): 2382-4, 2006 Oct.
Article in English | MEDLINE | ID: mdl-17097941

ABSTRACT

UNLABELLED: Our objective was establish a scoring system that allows a donor to be evaluated quickly and easily using a set of variables that are evaluated prior to the donation and another set that are evaluated during surgery. MATERIALS AND METHODS: Prior to the donation we analyzed age, medication requirements, natremia, hepatic biochemistry, gas levels, days in ICU, history of hypertension, and weight. A value of 40% was allocated to this group of factors. During the transplant we assessed the characteristics of the organ-shine, consistency, surface, edge, color, presence of steatosis, and atheromatosis. A value of 60% was allocated to this set. We established a scale of 1 to 10, only accepting organs scoring 5 or more points. Those grafts that received a score between 5 and 7.5 points were called suboptimal and those with over 7.5 points, optimal. We prospectively analyzed 133 donors whose organs were implanted. RESULTS: The survival rate at 1 year was 85%, and the rejection rate was 12%. The incidence of primary graft dysfunction was 8.2% (n = 11) and that of primary graft nonfunction 2.2% (n = 3). The incidence of primary graft dysfunction was greater within the group with fewer points (suboptimal). There were no differences between the optimal and suboptimal groups in terms of primary malfunction, survival, or rejection rate. CONCLUSIONS: The score provided a guide to decide whether to accept viable organs for implantation, given that the point system was obtained quickly and easily. When greater than 5, it correlated with low rates of primary nonfunction (<3%) and of primary graft dysfunction (<15%), with acceptable survival at 1 year (>80%) and acute rejections rate (<15%).


Subject(s)
Liver Transplantation/statistics & numerical data , Liver , Follow-Up Studies , Graft Rejection/epidemiology , Graft Survival , Humans , Liver Transplantation/physiology , Medical History Taking , Patient Selection
2.
Transplant Proc ; 37(9): 3926-9, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16386587

ABSTRACT

AIMS: To report our experience with mycophenolate mofetil (MMF) for induction and maintenance therapy to prevent acute liver transplant rejection. METHODS: A retrospective analysis of 66 elective, noncombined liver transplant patients treated beginning de novo MMF and follow for a minimum of 2 years. Thirty-nine of the 66 cases received MMF, calcineurin inhibitors, and steroids. In 11 cases daclizumab was added; in 16 daclizumab was added without steroids. RESULTS: The global survival rate was 91% at 6 months, 89.4% at 1 year, and 87.9% after 2 years. Acute rejection episodes were observed in six patients (9.1%). All episodes responded to corticoids. Toxicity possibly, probably, or partially related to MMF was observed in 35 patients (53%) with definitive suspension required in 13 cases (20%), with dose reduction or temporary suspension in 22 (33%). Hematological toxicity associated with MMF was observed in 12 patients (18%), leading to definitive suspension in two patients (3.03%), temporary suspension in two cases (3.03%), and dose reduction in eight cases (12%). Opportunistic infection was observed in seven cases (10%). Gastrointestinal toxicity was mild and infrequent (five cases, 7.5%). CONCLUSION: Regimens containing MMF reduce rejection episodes with high survival rates and low toxicity.


Subject(s)
Liver Diseases/surgery , Liver Transplantation/immunology , Mycophenolic Acid/analogs & derivatives , Adult , Aged , Follow-Up Studies , Humans , Immunosuppression Therapy/methods , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Liver Diseases/classification , Middle Aged , Mycophenolic Acid/adverse effects , Mycophenolic Acid/therapeutic use , Retrospective Studies , Safety , Survival Analysis , Time Factors
4.
Med Clin (Barc) ; 98(14): 540-2, 1992 Apr 11.
Article in Spanish | MEDLINE | ID: mdl-1602854

ABSTRACT

The aim of the present was to study the possible clinical histological correlations in the cases of lymphomatoid granulomatosis (LG) diagnosed in the last 10 years. Clinic evolutive data were collected in 7 patients diagnosed LG. The histological samples related to the same were revised and an immunohistochemical study was carried out with the oxidase/antiperoxidase technique. Seven patients (5 females and 2 men) with a mean age of 47 years (limit 23-47) were studied. The form of presentation was alteration of the general state in 5 cases accompanied by respiratory symptoms in 4. In 2 cases lung involvement was not found. In 7 biopsies performed at the initiation of the disease, 3 presented characteristics of lymphoma. Three patients are presently alive with a mean follow up time of 31 months and 4 have died (mean survival 17 months). Immunohistochemistry demonstrated T lymphocyte predominance in most of the cases (5 out of 6). The first case of LG in a patient simultaneously infected with the HIV and HTLV-1 is presented. Lymphomatoid granulomatosis possesses a symptomatology which is very inspecific and has histological features which may be superposed to other lymphoproliferative disorders, specially those of the T strain. Given the known relation between HTLV-1 and T lymphomas the role of HTLV-1 in the genesis of LG should be studied in these patients specially in those with the HIV.


Subject(s)
Lymphomatoid Granulomatosis/diagnosis , Adult , Aged , Female , Humans , Male , Middle Aged
5.
An Esp Pediatr ; 30(4): 296-8, 1989 Apr.
Article in Spanish | MEDLINE | ID: mdl-2500879

ABSTRACT

Two cases of Ewing's sarcoma primary found in the skull are presented. Both started with neurologic symptoms, the first case with intracraneal hypertension syndrome, and the second case with Jackson-like crisis. We emphasize the rareness of the initial localization, as well as the favorable evolution of both cases after surgery and radiotherapy and chemotherapy treatment.


Subject(s)
Epilepsies, Partial/etiology , Sarcoma, Ewing/diagnosis , Skull Neoplasms/diagnosis , Brain/pathology , Child , Combined Modality Therapy , Humans , Male , Pseudotumor Cerebri/etiology , Sarcoma, Ewing/complications , Sarcoma, Ewing/pathology , Skull Neoplasms/complications , Skull Neoplasms/pathology , Tomography, X-Ray Computed
6.
Med Pediatr Oncol ; 17(2): 131-3, 1989.
Article in English | MEDLINE | ID: mdl-2539546

ABSTRACT

In 4 of 35 childhood Wilms' tumors on record in the Hospital Infantil Virgen de Rocio de Sevilla, it was possible to identify diffuse anaplasia despite the fact these children had received cytoreductive chemotherapy preoperatively.


Subject(s)
Dactinomycin/administration & dosage , Vincristine/administration & dosage , Wilms Tumor/pathology , Anaplasia , Child , Dactinomycin/therapeutic use , Humans , Necrosis , Preoperative Care , Vincristine/therapeutic use , Wilms Tumor/drug therapy
11.
An Esp Pediatr ; 9(4): 438-46, 1976.
Article in Spanish | MEDLINE | ID: mdl-988768

ABSTRACT

A case of idiopathic intestinal lymphangiectasis is reported in a three month old child. Clinical course and laboratory findings are given in relation to administration of three diets containing different concentrations and types of fat. Short term improvement was only noticed with diets containing low concentrations of long chain triglycerides supplement with medium chain triglycerides. Clinical manifestations related to fat malabsortion improved greatly but there was no relationship with serum protein level. No effect on low level of gamma-globulins and lymphatic displasia was found as sawn in an intestinal biopsy performed after three months of treatment. Nevertheless, long-term results were poor and only were evident in a diminution of steatorrhea and normalization of stools.


Subject(s)
Infant, Newborn, Diseases/diet therapy , Lymphangiectasis, Intestinal/diet therapy , Protein-Losing Enteropathies/diet therapy , Dietary Fats/therapeutic use , Humans , Infant , Infant, Newborn , Male , Methods , Triglycerides/therapeutic use
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