Impact of renal failure on liver transplantation survival.

Renal failure after orthotopic liver transplantation (OLT) is a common complication (ranging from 12% to 70%) associated with worse outcomes, particularly when it requires renal replacement therapy (RRT). Renal dysfunction is a common scenario among waiting list patients. It can lead to a worse prognosis after OLT, due to an increased incidence of postoperative renal failure.

Donor liver dysfunction: application of a new scoring system to identify the marginal donor.

Livers from marginal donors are increasingly used for transplantation due to the shortage of donor organs. The definition of a marginal donor remains unclear; prediction of organ function is a challenge. In the literature the use of steatotic livers has been associated with poor liver function or even primary dysfunction of the allograft.

Correlation between graft arterial anatomy and biliary complications after liver transplantation.

Knowledge of the arterial vascular anatomy of the liver is important for orthotopic liver transplantation (OLT) because the lack of an adequate arterial blood supply results in biliary and parenchymal complications or graft loss. A number of reports have shown a relationship between aberrations of graft arteries and an increased incidence of early or late complications. Recent studies suggest no differences unless multiple anastomoses are required.

Analysis of Model for End-Stage Liver Disease (MELD) score in a liver transplantation waiting list.

Background: The Model for End-Stage Liver Disease (MELD) was introduced in 1999 to quantify the 3-month prognosis of cirrhotic patients after a transjugular intrahepatic portosystemic shunt (TIPS). Because of the imbalance between organ donors and patients on the waiting list, the MELD was adopted by the United States in 2002 to allocate liver grafts for transplantation. Preliminary results have indicated a reduction in waiting list deaths and an increase in transplantation rates for candidates.

Video endoscopic inguinal lymphadenectomy: a new minimally invasive procedure for radical management of inguinal nodes in patients with penile squamous cell carcinoma.

Purpose: Video endoscopic inguinal lymphadenectomy is a recently described lymphadenectomy with the same template of the open technique but performed with laparoscopic instruments under video guidance. It was developed to decrease procedure related morbidity while maintaining good oncological results. We report our initial results in a trial comparing video endoscopic inguinal lymphadenectomy with standard inguinal lymphadenectomy.

Reconstruction of upper digestive tract: reducing morbidity by laparoscopic pull-up.

Background: Gastric pull-up is a useful method for reconstruction of the upper digestive tract, with considerable morbidity/mortality, especially in esophageal cancers (EC).

Objective: To analyze the experience of a multidisciplinary team with a laparoscopic gastric pull-up (LGPU) method, with or without thoracoscopy, in a series of 120 patients with EC.

Study Design: Retrospective.

Testicular histopathological diagnosis as a predictive factor for retrieving spermatozoa for ICSI in non-obstructive azoospermic patients.

Objective: Histological testicular pattern has a predictive role in the possibility of finding spermatozoa for ICSI in cases of non-obstructive azoospermia because some individuals could show residual spermatogenic sites in the testis. The aim of this study was to evaluate the sperm retrieval rate in each of the histopathological groups (hypospermatogenesis--Hypo, spermatogenic maturation arrest--MA, Sertoli cell only--SCO and testicular hyalinization) in patients assisted in our clinic.

Materials And Methods: Retrospective study from March 1997 to October 2002.

Rigid ureteroscopy for diagnosis and treatment of ureteral calculi during pregnancy.

Objective: To evaluate ureteroscopy as a treatment option for women presenting ureteral calculi during pregnancy.

Materials And Methods: Eighteen pregnant patients presenting renal colic and indication of surgical treatment for ureteral calculi were analyzed. Patients were 20 to 34 years old (medium = 28), and the gestation period ranged from 12 to 34 weeks (medium = 18).

Percutaneous epididymal sperm aspiration (PESA) in men with obstructive azoospermia.

Objectives: Assessing the efficiency of repeated percutaneous epididymal sperm aspiration (PESA) in men with obstructive azoospermia, and also the possibility of cryopreservation of remaining material for future use in intracytoplasmic sperm injection (ICSI).

Method: Retrospective study, in which 79 procedures of PESA were assessed in 58 patients (mean age = 45 years), whose partners had mean age of 34 years. Vasectomy was the most frequent cause of obstructive azoospermia (n = 46).

Leiomyosarcoma of the renal vein.

Leiomyosarcoma of the renal vein is a rare tumor of complex diagnosis. We presented a case of renal vein leiomyosarcoma detected in a routine study. The primary treatment was complete surgical removal of the mass.

Acinar cell carcinoma of the pancreas.

Acinar cell carcinoma of the pancreas is a rare tumor for which the best chemotherapy regimen has not been clearly established. Here, we report on a female patient with an unusually long survival and a remarkable response to weekly paclitaxel. To our knowledge, this is the first time that paclitaxel has been associated with an objective response in this disease.

Glycemic control during pancreas transplantation: continous infusion versus bolus.

Pancreas transplantation is a method to restore endogenous insulin secretion in insulin-dependent diabetic patients. Because glycemia >150 mg/dL may harm pancreatic graft beta cells, early glucose control using insulin administration is recommended during transplantation. The aim of this study was to evaluate the benefits of strict glycemic control during pancreas transplantation by comparing two types of insulin and glucose administration: continuous infusion and bolus.

Anesthetic management of liver transplantation in patients with fulminant hepatic failure: case reports.

Fulminant hepatic failure (FHF), although not frequent, produces a high mortality rate of 70% to 90%. This study describes the management of FHF patients without the use of any intracranial pressure monitoring device.

Serial beta-2 microglobulin measurement as an auxilliary method in the early diagnosis of cytomegalovirus infection in renal transplant patients.

Infection by cytomegalovirus is one of the most important causes of morbidity and mortality after renal transplant. During episodes of acute rejection serum levels of beta-2 microglobulin (B2M) are elevated due to decreased excretion and/or increased production from T-cell proliferation. Sequential measurement of B2M in the first months after transplantation may detect patients at increased risk of rejection.

Pediatric oncology in Brazil.

Brazil is a country with many contrasts. This can help the understanding of environmental factors influencing the incidence of different cancers. The standard treatment and results achieved in certain areas of the country are not encountered in others.