RESUMO
INTRODUCTION: Orthotopic liver transplantation (OLT) is today the gold standard treatment of the end-stage liver disease. Different solutions are used for graft preservation. Our objective was to compare the results of cadaveric donor OLT, preserved with the University of Wisconsin (UW) or Celsior solutions in the portal vein and Euro-Collins in the aorta. METHODS: We evaluated retrospectively 72 OLT recipients, including 36 with UW solution (group UW) and 36 with Celsior (group CS). Donors were perfused in situ with 1000 mL UW or Celsior in the portal vein of and 3000 mL of Euro-Collins in the aortia and on the back table managed with 500 mL UW or Celsior in the portal vein, 250 mL in the hepatic artery, and 250 mL in the biliary duct. We evaluated the following variables: donor characteristics, recipient features, intraoperative details, reperfusion injury, and steatosis via a biopsy after reperfusion. We noted grafts with primary nonfunction (PNF), initial poor function (IPF), rejection episodes, biliary duct complications, hepatic artery complications, re-OLT, and recipient death in the first year after OLT. RESULTS: The average age was 33.6 years in the UW group versus 41 years in the CS group (P = .048). There was a longer duration of surgery in the UW group (P = .001). The other recipient characteristics, ischemia-reperfusion injury, steatosis, PNF, IPF, rejection, re-OLT, and recipient survival were not different. Stenosis of the biliary duct occured in 3 (8.3%) cases in the UW group and 8 (22.2%) in the CS (P = .19) with hepatic artery thrombosis in 4 (11.1%) CS versus none in the UW group (P = .11). CONCLUSION: Cadaveric donor OLT showed similar results with organs preserved with UW or Celsior in the portal vein and Euro-Collins in the aorta.
Assuntos
Aorta Abdominal/fisiologia , Soluções Hipertônicas/uso terapêutico , Falência Hepática/cirurgia , Transplante de Fígado/métodos , Soluções para Preservação de Órgãos/uso terapêutico , Veia Porta/fisiologia , Adenosina/uso terapêutico , Adolescente , Adulto , Idoso , Alopurinol/uso terapêutico , Aorta Abdominal/efeitos dos fármacos , Cadáver , Criança , Pré-Escolar , Dissacarídeos/uso terapêutico , Eletrólitos/uso terapêutico , Feminino , Glutamatos/uso terapêutico , Glutationa/uso terapêutico , Histidina/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Insulina/uso terapêutico , Transplante de Fígado/imunologia , Masculino , Manitol/uso terapêutico , Pessoa de Meia-Idade , Preservação de Órgãos/métodos , Veia Porta/efeitos dos fármacos , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Rafinose/uso terapêutico , Traumatismo por Reperfusão/epidemiologia , Estudos Retrospectivos , Doadores de TecidosRESUMO
Beads trapped by an optical tweezers can be used as a force transducer for measuring forces of the same order of magnitude as typical forces induced by flagellar motion. We used an optical tweezers to study chemotaxis by observing the force response of a flagellated microorganism when placed in a gradient of attractive chemical substances. This report shows such observations for Leishmania amazonensis, responsible for leishmaniasis, a serious disease. We quantified the movement of this protozoan for different gradients of glucose. We were able to observe both the strength and the directionality of the force. The characterization of the chemotaxis of these parasites can help to understand the mechanics of infection and improve the treatments employed for this disease. This methodology can be used to quantitatively study the taxis of any kind of flagellated microorganisms under concentration gradients of different chemical substances, or even other types of variable gradients such as temperature and pressure.
Assuntos
Quimiotaxia , Leishmania mexicana/fisiologia , Locomoção , Microscopia de Vídeo/métodos , Pinças Ópticas , Animais , Fatores Quimiotáticos/farmacologia , Glucose/farmacologiaRESUMO
This article reports the case of a patient who underwent transjugular intrahepatic portosystemic shunt, which migrated to the right atrium. During liver transplantation, the extracardiac portion was sectioned and the portion adherent inside the atrium was managed expectantly.
Assuntos
Átrios do Coração/cirurgia , Complicações Intraoperatórias/fisiopatologia , Transplante de Fígado/efeitos adversos , Derivação Portossistêmica Transjugular Intra-Hepática/efeitos adversos , Transfusão de Sangue , Transfusão de Eritrócitos , Feminino , Humanos , Período Intraoperatório , Transfusão de Plaquetas , Veia Porta/cirurgiaRESUMO
Recently, our group demonstrated that mouse lesions infected with Leishmania amazonensis are hypoxic. Evidence indicates the negative impact of hypoxia on the efficacy of a variety of chemotherapeutic agents against tumors, fungi, bacteria, and malaria parasites. In the present study, comparison of the effect of antileishmanial drugs on L. amazonensis-infected macrophages under normoxic and hypoxic conditions was performed. We compared the effect of 5% oxygen tension with a tension of 21% oxygen on peritoneal murine macrophage cultures infected with the parasite and treated with glucantime, amphotericin B, or miltefosine. Analysis of the infection index (percentage of infected macrophages x number of amastigotes per macrophage), dose-dependent efficacy of drugs, and IC(50) values demonstrated that hypoxia conferred a small, but significant, resistance to all 3 antileishmanial drugs. The present finding suggests that in vitro assays under hypoxia should not be neglected in drug studies.