Seudoxantoma elástico y cardiopatía isquémica / Pseudoxanthoma elasticum and ischemic heart disease

No disponible

Absceso vulvar de origen odontógeno / Odontogenic vulvar abscess

No disponible

[Liver transplantation: influence of donor-related factors]. / Trasplante hepático: influencia de los factores dependientes del donante.

OBJECTIVE: To detect donor characteristics related to graft function after orthotopic liver transplantation (OLT). DESIGN: Retrospective cohort study. CONTEXT: Polyvalent intensive care unit. PATIENTS: 145 liver transplant recipients and their respective donors. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: In donors: age, hypernatremia, and infection. In recipients: reperfusion syndrome, coagulopathy, infection, ARDS, shock, kidney failure, primary graft dysfunction, and mortality. RESULTS: 71.7% of recipients were male. Mean recipient age was 54.5 +/- 9.9 years; 66.2% of patients were classified as Child B and and 19.3% as Child C. The mean model for end-stage liver disease (MELD) score was 14.6 +/- 4.8 and the mean APACHE II score was 17.3 +/- 4.9. A total of 64.1% of the donors were male. Mean donor age was 42.3 +/- 16.3 years, and mean APACHE II score was 22.3 +/- 5.8. Donor age > 65 years was associated to higher recipient aspartate aminotransferase (AST) levels but not to increased complications or mortality. No other donor factors (including age, sex, serum sodium, severity level, transfusions, hemodynamic alterations, renal dysfunction, or infection) were associated to evolution or prognosis. Infection was diagnosed in 18 recipients (12.4%) in the postoperative period; the incidence of infection in recipients that received an organ from infected donors was not different from those that received an organ from an uninfected donor (14.6% versus 11.5%; p > 0.05). CONCLUSIONS: We detected no donor characteristics related to graft function or the appearance of complications in recipients during the immediate postoperative period. Donor age > 65 years and documented but appropriately treated bacteremia posed no risk for the viability of the liver after transplantation.

Trasplante hepático: influencia de los factores dependientes del donante / Liver transplantation: influence of donor-related factors

Objetivo. Detectar características del donante relacionadas con la funcionalidad del injerto tras el trasplante ortotópico hepático (TOH). Diseño. Estudio de cohortes retrospectivo. Ámbito. Unidad de cuidados intensivos polivalente. Pacientes. Se incluyó a 145 pacientes trasplantados y sus correspondientes donantes. Intervenciones. Ninguna. Variables principales de interés. En el donante se analizan predictores de gravedad como la edad, la hipernatremia y la infección; las principales variables dependientes del receptor fueron infección, síndrome de disnea del adulto, shock, insuficiencia renal, disfunción primaria del injerto y mortalidad. Resultados. El 71,7% de los receptores eran varones, con una media de edad de 54,5 ± 9,9 años; en Child B el 66,2% y en Child C el 19,3%; Meld, 14,6 ± 4,8; APACHE II, 17,3 ± 4,9. El 64,1% de los donantes eran varones, con una media de edad de 42,3 ± 16,3 años; APACHE II, 22,3 ± 5,8. La edad del donante > 65 años se relaciona con un máximo de aspartato aminotransferasa (AST) más elevado en el receptor, pero no con un aumento de complicaciones o mortalidad. Ningún otro factor se relacionó con la evolución o el pronóstico. En 18 (12,4%) receptores se diagnosticó infección en el postoperatorio; la incidencia en los que recibieron un órgano de donante con infección no fue diferente de la de aquellos cuyo donante no estaba infectado (el 14,6 frente al 11,5%; p > 0,05). Conclusiones. No se ha detectado ninguna característica del donante relacionada con la funcionalidad del injerto ni con la aparición de complicaciones en el receptor durante el postoperatorio inmediato. La edad > 65 años y la bacteriemia documentada y adecuadamente tratada en el donante no suponen un riesgo para la viabilidad hepática postrasplante

Objective. To detect donor characteristics related to graft function after orthotopic liver transplantation (OLT). Design. Retrospective cohort study. Context. Polyvalent intensive care unit. Patients. 145 liver transplant recipients and their respective donors. Interventions. None.Main variables of interest. In donors: age, hypernatremia, and infection. In recipients: reperfusion syndrome, coagulopathy, infection, ARDS, shock, kidney failure, primary graft dysfunction, and mortality. Results. 71.7% of recipients were male. Mean recipient age was 54.5 ± 9.9 years; 66.2% of patientswere classified as Child B and and 19.3% as Child C. The mean model for end-stage liver disease (MELD) score was 14.6 ± 4.8 and the mean APACHE II score was 17.3 ± 4.9. A total of 64.1% of the donors were male. Mean donor age was 42.3 ± 16.3 years, and mean APACHE II score was 22.3 ± 5.8. Donor age > 65 years was associated to higher recipient aspartate aminotransferase(AST) levels but not to increased complications or mortality. No other donor factors (including age, sex, serum sodium, severity level, transfusions, hemodynamic alterations, renal dysfunction, or infection) were associated to evolution or prognosis. Infection was diagnosed in 18 recipients (12.4%) in the postoperative period; the incidenceof infection in recipients that received an organ from infected donors was not different from those that received an organ from an uninfected donor(14.6% versus 11.5%; p > 0.05). Conclusions. We detected no donor characteristics related to graft function or the appearance of complications in recipients during the immediate postoperative period. Donor age > 65 years and documented but appropriately treated bacteremia posed no risk for the viability of the liverafter transplantation