Implantação do transplante ortotópico de fígado humano no Estado do Ceará

Detalhes bibliográficos
Autor(a) principal: Garcia, José Huygens Parente
Data de Publicação: 2002
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
Texto Completo: http://www.repositorio.ufc.br/handle/riufc/2738
Resumo: The orthotopic liver transplantation is the only effective treatment for the end-stage liver diseases. The state of Ceará, with a population of about seven million inhabitants did not offer, until recently, this therapeutic modality. In 1999 an experimental liver transplantation program in pigs was initiated in the University Hospital of the Federal University of Ceará with the objective to group and train a multidisciplinary team in this procedure. On May 17th 2002, all these efforts were rewarded with the successful fulfillment of the first liver transplantation. Since then were realized six liver transplants with inferior caval vein preservation, a technical variant called piggyback. The patients average age was 39.5 years and five of the recipients were men. The etiology of the liver failure was virus C cirrhosis in five patients and Wilson´s disease in one. This patient had a clinical presentation of acute hepatic failure and priority for transplantation. There were an average of 2.6 packed red blood cells per patient, the graft cold ischemia time was in average 7.5 hours and the mean hospitalization time 17 days. All patients were weaned from ventilation until six hours of post transplant. Five patients presented normalization of the hepatic transaminases and bilirrubins as well as the prothrombin time and left the hospital between the 10th and 16th day. One patient had an acute increased in hepatic enzymes, characterizing a primary graft dysfunction, and presented variceal and diffused bleeding, dying at the 8th post operative day. Concluding, there was a 100% technical success, and an initial survival (more than 30 days) of 83,3%. After these successful results, the liver transplant program was consolidated as a therapeutic option in the State of Ceará.
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spelling Implantação do transplante ortotópico de fígado humano no Estado do CearáOrthotopic liver transplantation in the State of CearáTransplante de FígadoHepatopatiasCirrose HepáticaThe orthotopic liver transplantation is the only effective treatment for the end-stage liver diseases. The state of Ceará, with a population of about seven million inhabitants did not offer, until recently, this therapeutic modality. In 1999 an experimental liver transplantation program in pigs was initiated in the University Hospital of the Federal University of Ceará with the objective to group and train a multidisciplinary team in this procedure. On May 17th 2002, all these efforts were rewarded with the successful fulfillment of the first liver transplantation. Since then were realized six liver transplants with inferior caval vein preservation, a technical variant called piggyback. The patients average age was 39.5 years and five of the recipients were men. The etiology of the liver failure was virus C cirrhosis in five patients and Wilson´s disease in one. This patient had a clinical presentation of acute hepatic failure and priority for transplantation. There were an average of 2.6 packed red blood cells per patient, the graft cold ischemia time was in average 7.5 hours and the mean hospitalization time 17 days. All patients were weaned from ventilation until six hours of post transplant. Five patients presented normalization of the hepatic transaminases and bilirrubins as well as the prothrombin time and left the hospital between the 10th and 16th day. One patient had an acute increased in hepatic enzymes, characterizing a primary graft dysfunction, and presented variceal and diffused bleeding, dying at the 8th post operative day. Concluding, there was a 100% technical success, and an initial survival (more than 30 days) of 83,3%. After these successful results, the liver transplant program was consolidated as a therapeutic option in the State of Ceará.O transplante ortotópico de fígado é o único tratamento eficaz para as doenças hepáticas terminais. Até recentemente, o Estado do Ceará, com uma população estimada de 7 milhões de habitantes, não oferecia esta opção terapêutica. Há três anos foi iniciado um programa de transplante hepático experimental em suínos no Hospital Universitário da Universidade Federal do Ceará com a finalidade de reunir e treinar uma equipe multidisciplinar em torno de um projeto comum. Em 17 de maio de 2002, todo esse esforço foi coroado pela realização com sucesso do primeiro transplante de fígado do Ceará. Desde então, foram realizados 6 transplantes de fígado com preservação da veia cava, técnica conhecida pelo nome de piggyback. A idade média foi de 39,5 anos. Cinco pacientes eram do sexo masculino e um do sexo feminino. A etiologia da doença hepática foi cirrose pelo virus C em 5 pacientes e doença de Wilson em uma paciente, que foi transplantada de urgência por falência hepática aguda. A média de transfusão foi de 2,6 concentrados de hemácias por paciente. O tempo de isquemia fria do enxerto foi em média de 7,5 horas e a permanência hospitalar média foi de 17 dias. Todos os pacientes foram extubados dentro das 6 primeiras horas pós-transplante. Cinco pacientes evoluíram com normalização das enzimas hepáticas e das bilirrubinas, bem como do tempo de protrombina representada pelo INR e receberam alta entre o 10o e o 16o dia de pós-operatório. Um paciente apresentou grande elevação de AST e ALT, caracterizando uma disfunção primária do enxerto, seguida por hemorragia digestiva alta e óbito no 8o dia. Concluíndo, o sucesso técnico dos transplantes de fìgado realizados foi de 100%, sendo que a sobrevida inicial maior que 30 dias foi de 83,3%. Assim, pode-se considerar consolidada a etapa de implantação do programa de transplante de fìgado no Estado do Ceará.Moraes Filho, Manoel Odorico deGarcia, José Huygens Parente2012-06-13T16:51:30Z2012-06-13T16:51:30Z2002info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisapplication/pdfGARCIA, J. H. P. Implantação do transplante ortotópico de fígado humano no Estado do Ceará. 2002. 100 f. Tese (Doutorado em Farmacologia) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2002.http://www.repositorio.ufc.br/handle/riufc/2738porreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2019-11-10T21:07:43Zoai:repositorio.ufc.br:riufc/2738Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:26:23.929165Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.none.fl_str_mv Implantação do transplante ortotópico de fígado humano no Estado do Ceará
Orthotopic liver transplantation in the State of Ceará
title Implantação do transplante ortotópico de fígado humano no Estado do Ceará
spellingShingle Implantação do transplante ortotópico de fígado humano no Estado do Ceará
Garcia, José Huygens Parente
Transplante de Fígado
Hepatopatias
Cirrose Hepática
title_short Implantação do transplante ortotópico de fígado humano no Estado do Ceará
title_full Implantação do transplante ortotópico de fígado humano no Estado do Ceará
title_fullStr Implantação do transplante ortotópico de fígado humano no Estado do Ceará
title_full_unstemmed Implantação do transplante ortotópico de fígado humano no Estado do Ceará
title_sort Implantação do transplante ortotópico de fígado humano no Estado do Ceará
author Garcia, José Huygens Parente
author_facet Garcia, José Huygens Parente
author_role author
dc.contributor.none.fl_str_mv Moraes Filho, Manoel Odorico de
dc.contributor.author.fl_str_mv Garcia, José Huygens Parente
dc.subject.por.fl_str_mv Transplante de Fígado
Hepatopatias
Cirrose Hepática
topic Transplante de Fígado
Hepatopatias
Cirrose Hepática
description The orthotopic liver transplantation is the only effective treatment for the end-stage liver diseases. The state of Ceará, with a population of about seven million inhabitants did not offer, until recently, this therapeutic modality. In 1999 an experimental liver transplantation program in pigs was initiated in the University Hospital of the Federal University of Ceará with the objective to group and train a multidisciplinary team in this procedure. On May 17th 2002, all these efforts were rewarded with the successful fulfillment of the first liver transplantation. Since then were realized six liver transplants with inferior caval vein preservation, a technical variant called piggyback. The patients average age was 39.5 years and five of the recipients were men. The etiology of the liver failure was virus C cirrhosis in five patients and Wilson´s disease in one. This patient had a clinical presentation of acute hepatic failure and priority for transplantation. There were an average of 2.6 packed red blood cells per patient, the graft cold ischemia time was in average 7.5 hours and the mean hospitalization time 17 days. All patients were weaned from ventilation until six hours of post transplant. Five patients presented normalization of the hepatic transaminases and bilirrubins as well as the prothrombin time and left the hospital between the 10th and 16th day. One patient had an acute increased in hepatic enzymes, characterizing a primary graft dysfunction, and presented variceal and diffused bleeding, dying at the 8th post operative day. Concluding, there was a 100% technical success, and an initial survival (more than 30 days) of 83,3%. After these successful results, the liver transplant program was consolidated as a therapeutic option in the State of Ceará.
publishDate 2002
dc.date.none.fl_str_mv 2002
2012-06-13T16:51:30Z
2012-06-13T16:51:30Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
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dc.identifier.uri.fl_str_mv GARCIA, J. H. P. Implantação do transplante ortotópico de fígado humano no Estado do Ceará. 2002. 100 f. Tese (Doutorado em Farmacologia) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2002.
http://www.repositorio.ufc.br/handle/riufc/2738
identifier_str_mv GARCIA, J. H. P. Implantação do transplante ortotópico de fígado humano no Estado do Ceará. 2002. 100 f. Tese (Doutorado em Farmacologia) - Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, 2002.
url http://www.repositorio.ufc.br/handle/riufc/2738
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reponame_str Repositório Institucional da Universidade Federal do Ceará (UFC)
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