Combined liver-kidney transplant in polycystic diseases: a case report.

Polycystic liver disease, a hereditary pathology, usually manifests as autosomal dominant polycystic kidney disease. The many cysts in the liver cause massive hepatomegaly, majorly affecting the patient's quality of life. In cases of refractory symptoms, liver transplantation is the only treatment choice.

A real-life study on the impact of direct-acting antivirals in the treatment of chronic hepatitis C in liver transplant recipients at two university centers in Northeastern Brazil.

The efficacy of direct-acting antivirals (DAAs) in the treatment of chronic hepatitis C (CHC) in liver transplant recipients is poorly understood, and several factors, including immunosuppression, drug interactions, elevated viraemia, and intolerance to ribavirin (RBV), can reduce cure rates. We conducted a real-life study on liver transplant recipients with CHC treated with a combination of sofosbuvir (SOF) and daclatasvir (DCV) or simeprevir (SIM), with or without RBV, followed-up for 12 to 24 weeks. The treatment effectiveness was assessed by determining the sustained virological response (SVR) rates at 12 or 24 weeks after the treatment cessation.

Frequency of Anatomic Variations on Hepatic Arteries and Types of Reconstruction Employed: Study on Livers Prepared for Transplantation.

Background: Recognition of anatomic variations in the hepatic artery is important at the time of organ uptake and at the back table for transplantation.

Purpose: To know the frequency of these variations, in a 5-year series of liver transplantation and the various types of arterial reconstruction used in back table surgery.

Methods: We analyzed 340 donor files and calculated the frequencies of the various anatomic variations of the hepatic artery, according to Hiatt, and the types of vascular reconstruction employed.

Use of Liver Grafts From Deceased Organ Donors With Infectious Diseases.

Introduction: Liver transplant is the only option in reversing liver insufficiency and its complications. It is very important to realize the quality control of organs and tissues used in transplant, as well as to develop diagnostic, treatment, and prophylaxis techniques to prevent other comorbidities and to increase the survival of transplanted patients.

Objectives: The study describes the characteristics of liver transplant using organs with infectious diseases realized by Liver Transplantation Unit (LTU) of the University Hospital Oswaldo Cruz (UHOC).

Improved glycaemic variability and time in range with dapagliflozin versus gliclazide modified release among adults with type 2 diabetes, evaluated by continuous glucose monitoring: A 12-week randomized controlled trial.

Aims: To evaluate whether there is a difference between the effects of dapagliflozin and gliclazide modified release (MR) on glycaemic variability (GV) and glycaemic control, as assessed by continuous glucose monitoring (CGM), in individuals with uncontrolled type 2 diabetes.

Materials And Methods: This randomized, open-label, active-controlled study was conducted in individuals with uncontrolled type 2 diabetes who were drug-naïve or on steady-dose metformin monotherapy. Participants were treated once daily with 10 mg dapagliflozin or 120 mg gliclazide MR.

Dissection of the Hepatic Artery: A Rare Cause of Late Ischemia After Liver Transplant.

Hepatic artery dissection is an infrequent vascular complication that can arise after orthotopic liver transplant. Most patients with this complication are diagnosed during the intraoperative period or the first days after liver transplant, with an association shown with living-donor liver transplant. In this study, we discuss a rare case of an extrahepatic artery dissection that was successfully managed through surgical excision and arterial revascularization that was diagnosed 4 years after orthotopic liver transplant.

UPPER MIDLINE INCISION IN RECIPIENTS OF DECEASED-DONORS LIVER TRANSPLANTATION.

Background: Liver transplant (LT) is the only effective and long-lasting option for patients with end-stage liver disease. Innovations and refinements in surgical techniques occurred with the advent of transplants with partial grafts and laparoscopy. Despite these modifications, the abdominal incision remains with only few changes.

Schistosomal liver fibrosis and hepatocellular carcinoma - case series of patients submitted to liver transplantation.

Schistosomiasis affects approximately 207 million people in 76 countries. The association between hepatocellular carcinoma and Schistosoma mansoni infection has been investigated. Studies using animal models suggest that the parasite may accelerate the oncogenic process when combined with other factors, such as hepatitis C virus infection or exposure to a carcinogen.

A randomized controlled trial to compare the effects of sulphonylurea gliclazide MR (modified release) and the DPP-4 inhibitor vildagliptin on glycemic variability and control measured by continuous glucose monitoring (CGM) in Brazilian women with type 2 diabetes.

Aims: This study aims to evaluate whether there is a difference between the effects of vildagliptin and gliclazide MR (modified release) on glycemic variability (GV) in women with type 2 diabetes (T2DM) as evaluated by continuous glucose monitoring (CGM).

Methods: An open-label, randomized study was conducted in T2DM women on steady-dose metformin monotherapy which were treated with 50 mg vildagliptin twice daily or 60-120 mg of gliclazide MR once daily. CGM and GV indices calculation were performed at baseline and after 24 weeks.

Measurements between the hepatic veins and portal venous system, in human cirrhotic liver: a cast study.

Purpose: To measure the distance between the right and middle hepatic veins and portal vein branches, in human cirrhotic liver casts. Was this measure actually smaller in the cirrhotic liver than in normal one?

Materials And Methods: This study was authorized by an area Research Ethics Committee, and each study subject or legal representative granted signed informed consent. Acrylic corrosion casts of 21 resected cirrhotic livers were generated.

Vildagliptin has the same safety profile as a sulfonylurea on bone metabolism and bone mineral density in post-menopausal women with type 2 diabetes: a randomized controlled trial.

Background: Several antidiabetic therapies affect bone metabolism. Sulfonylureas have the lowest impact on bone among oral antidiabetics. The objective of this study is to compare the effects of vildagliptin and gliclazide modified release (MR) on bone turnover markers (BTMs) and bone mineral density (BMD) in postmenopausal women with uncontrolled type 2 diabetes (T2D).

ANATOMIC VARIATIONS OF HEPATIC ARTERY: A STUDY IN 479 LIVER TRANSPLANTATIONS.

Background:: The incidence of anatomic variations of hepatic artery ranges from 20-50% in different series. Variations are especially important in the context of liver orthotopic transplantation, since, besides being an ideal opportunity for surgical anatomical study, their precise identification is crucial to the success of the procedure.

Aim:: To identify the anatomical variations in the hepatic arterial system in hepatic transplantation.

Modified technique for preparation of venous circulation resin casts in the cirrhotic liver.

This study describes two major adaptations for the preparation of resin casts in human cirrhotic liver, harvested at the time of transplantation. The first is the way of fixing the catheter in the ostia of the hepatic and portal veins through a cerclage, so as to prevent displacement of the catheter and / or leakage of the resin during its injection. The second is the extension of corrosion time in the NaOH solution, averaging 6.

ACUTE APENDICITIS IN LIVER TRANSPLANT RECIPIENTS.

Background: Appendicitis is a common cause of emergency surgery that in the population undergoing organ transplantation presents a rare incidence due to late diagnosis and treatment.

Aim: To report the occurrence of acute appendicitis in a cohort of liver transplant recipients.

Methods: Retrospective analysis in a period of 12 years among 925 liver transplants, in witch five cases of acute appendicitis were encountered.

Angiografic and pressoric changes determined by splenectomy with left gastric vein ligature in mansoni schistosomiasis.

Background: In hepatosplenic schistosomiasis occurs diffuse hepatic fibrosis associated with venous congestion of the portal system resulting in hepatosplenomegaly. It can produce digestive hemorrhage caused by rupture of esophageal and stomach varices or peptic gastroduodenal mucosal lesions.

Aim: To study the effects of splenectomy and ligature of the left gastric vein on portohepatic hemodynamics.

Reappraisal of serum insulin-like growth factor-I (IGF-1) measurement in the detection of isolated and combined growth hormone deficiency (GHD) during the transition period.

Objective: To evaluate the accuracy of serum IGF-1 in the detection of isolated (IGHD) or combined growth hormone deficiency (CGHD) at the transition phase.

Subjects And Methods: Forty nine patients with GHD during childhood [16 with IGHD (10 men) and 33 with CGHD (24 men); age 23.2 ± 3.

Antineoplasic effect of aqueous extract of plectranthus amboinicus in ehrlich ascites carcinoma.

There are 46,000 new cases of peritoneal carcinomatosis per year in the USA and 17,700 in Brazil. New media, including plant derivatives, are being tested in its treatment. Plectranthus amboinicus is a medicinal plant widely used in Brazil, especially in the northeast region, for the treatment of various diseases, including cancer.

Postoperative kidney injury does not decrease survival after liver transplantation.

Purpose: To explore the effect of acute kidney injury (AKI) on long-term survival after conventional orthotopic liver transplantation (OLT) without venovenous bypass (VVB).

Methods: A retrospective cohort study was carried out on 153 patients with end-stage liver diseases transplanted by the Department of General Surgery and Liver Transplantation of the University of Pernambuco, from August, 1999 to December, 2009. The Kaplan-Meier survival estimates and log-rank test were applied to explore the association between AKI and long-term patient survival, and multivariate analyses were applied to control the effect of other variables.

Non-cancerous prognostic factors of hepatocellular carcinoma after liver transplantation.

Purpose: To explore non-cancerous factors that may be related with medium-term survival (24 months) after liver transplantation (LT) in this data from northeast Brazil.

Methods: A cross-sectional study was carried out in patients who underwent deceased-donor orthotopic LT because hepatocellular carcinoma (HCC) at the University of Pernambuco, Brazil. Non-cancerous factors (i.

Employment of MELD score for the prediction of survival after liver transplantation.

Objective: To assess the overall accuracy of the preoperative MELD score for predicting survival after liver transplantation (LT) and appraise medium-term (24 months) predictors of survival.

Methods: We conducted a cross-sectional study including patients transplanted by the Department of General Surgery and Liver Transplantation of the Oswaldo Cruz University Hospital, University of Pernambuco, between July 15th, 2003 and July 14th, 2009. We used analysis of area under ROC (receiver operating characteristic) as a summary measure of the performance of the MELD score and assessed predictors of medium-term survival using univariate and multivariate analysis.

Splenectomy and gastric vein ligature in hepatosplenic schistosomiais: effects upon esophageal variceal pressure and endoscopic risk factors of esophageal variceal bleeding.

Background: A significant number of patients with schistosomiasis develop the hepatosplenic form, with portal hypertension, in which bleeding caused by rupture of esophagogastric varices emerged as the leading cause of morbidity and mortality.

Aim: To investigate the effects of splenectomy and ligature of the left gastric vein on risk factors for bleeding of esophagogastric varices in patients with schistosomiasis mansoni, hepatosplenic form, with a history of upper gastrointestinal bleeding.

Methods: The main risk factors of bleeding from esophagogastric varices were studied in 34 patients.

Impact of MELD allocation policy on survival outcomes after liver transplantation: a single-center study in northeast Brazil.

Objective: To analyze the impact of model for end-stage liver disease (MELD) allocation policy on survival outcomes after liver transplantation (LT).

Introduction: Considering that an ideal system of grafts allocation should also ensure improved survival after transplantation, changes in allocation policies need to be evaluated in different contexts as an evolutionary process.

Methods: A retrospective cohort study was carried out among patients who underwent LT at the University of Pernambuco.

Donor age as a predictor of risk for short-term outcomes after liver transplant.

Objectives: To investigate an association between short-term mortality and donor age-associated worst outcomes in liver transplant.

Materials And Methods: A total of 178 consecutive patients underwent a liver transplant between 1999 and 2007. Among these patients, there were 172 liver transplants (donor age, 32.

Needlescopic clipless cholecystectomy as an efficient, safe, and cost-effective alternative with diminutive scars: the first 1000 cases.

Background: The advent of natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS), surgery without skin scarring, is now challenging every surgeon to improve the esthetic results for patients. Minilaparoscopic cholecystectomy (MLC) represents a refinement in laparoscopic surgery, potentially as cosmetically effective as NOTES. Nevertheless, because of the increased cost and difficulty in managing the equipment, it has not been widely accepted among surgeons.