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Martín-Sierra C, Martins R, Coucelo M, Abrantes AM, Oliveira RC, Tralhão JG, Botelho MF, Furtado E, Domingues MR, Paiva A, Laranjeira P. Elevated soluble TNFα levels and upregulated TNFα mRNA expression in purified peripheral blood monocyte subsets associated with high-grade hepatocellular carcinoma. J Inflamm (Lond) 2020; 17:14. [PMID: 32256215 PMCID: PMC7106708 DOI: 10.1186/s12950-020-00243-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/13/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Chronic inflammation is involved in the initiation and progression of various cancers, including liver cancer. The current study focuses on the characterization of the peripheral immune response in hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) patients, before and after surgical procedure, in order to assess the effect of tumor resection in the immune system homeostasis and to determine possible prognostic factors associated with high-grade tumors. We developed a whole-blood assay to monitor immune alterations and functional competence of peripheral monocytes in a group of 10 healthy individuals (HG), in 20 HCC patients and 8 CCA patients, by multi-color flow cytometry, qRT-PCR, and ELISA techniques. RESULTS The qRT-PCR analysis showed an upregulation of TNFα expression by classical and intermediate monocytes purified from HCC patients presenting tumors in grade G3-G4 as compared to G1-G2 HCC patients. Moreover, ELISA assay confirmed elevated serum levels of TNFα in G3-G4 compared to G1-G2 HCC patients. A significant decrease of circulating non-classical monocytes was detected in both CCA and HCC patients before and after surgical procedure. In addition, a functional defect in circulating classical and intermediate monocytes was observed in both groups of cancer patients when compared to the HG, with partial recovery after the surgical intervention. CONCLUSIONS This integrated analysis permitted the identification of altered functional competence of monocyte subsets in CCA and HCC patients. In addition, our results point to a potential role of TNFα as a prognostic peripheral biomarker in HCC patients, indicating the presence of high-grade tumors that should be further validated.
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Affiliation(s)
- C. Martín-Sierra
- Flow Cytometry Unit, Clinical Pathology Service, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Ed. S. Jerónimo, 3° piso, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
| | - R. Martins
- Unidade Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra (UTHPA, CHUC), Coimbra, Portugal
- Serviço de Cirurgia Geral, Unidade HBP, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
- Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M. Coucelo
- Unidade de Hematologia Molecular, Serviço de Hematologia Clínica, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - A. M. Abrantes
- Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - R. C. Oliveira
- Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Serviço de Anatomia Patológica, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
| | - J. G. Tralhão
- Unidade Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra (UTHPA, CHUC), Coimbra, Portugal
- Serviço de Cirurgia Geral, Unidade HBP, Centro Hospitalar e Universitário de Coimbra (CHUC), Coimbra, Portugal
- Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M. F. Botelho
- Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - E. Furtado
- Unidade Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra (UTHPA, CHUC), Coimbra, Portugal
| | - M. R. Domingues
- Mass Spectrometry Centre, Department of Chemistry & QOPNA, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - A. Paiva
- Flow Cytometry Unit, Clinical Pathology Service, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Ed. S. Jerónimo, 3° piso, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
- Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Ciências Biomédicas Laboratoriais, Coimbra, Portugal
| | - P. Laranjeira
- Flow Cytometry Unit, Clinical Pathology Service, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Ed. S. Jerónimo, 3° piso, Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Coimbra, Portugal
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Martín-Sierra C, Martins R, Laranjeira P, Coucelo M, Abrantes AM, Oliveira RC, Tralhão JG, Botelho MF, Furtado E, Domingues MR, Paiva A. Functional and Phenotypic Characterization of Tumor-Infiltrating Leukocyte Subsets and Their Contribution to the Pathogenesis of Hepatocellular Carcinoma and Cholangiocarcinoma. Transl Oncol 2019; 12:1468-1479. [PMID: 31425839 PMCID: PMC6712279 DOI: 10.1016/j.tranon.2019.07.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/28/2019] [Accepted: 07/29/2019] [Indexed: 12/12/2022] Open
Abstract
Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) represent the most common primary liver malignancies whose outcome is influenced by the immune response. In the present study, we evaluated the tumor-infiltrating leukocyte (TIL) populations in 21 HCC patients and 8 CCA patients by flow cytometry immediately after the surgical procedure. Moreover, CD4+ T cells, CD8+ T cells, monocytes, and macrophages were purified by cell sorting for further analysis of gene expression by quantitative reverse-transcription polymerase chain reaction. Regarding tumor-infiltrating macrophages, we observed a significantly higher expression of markers associated with M2 phenotype and a higher expression of PD-L1 in patients with HCC in comparison to CCA. In addition, for HCC patients, we found a significant increase in the expression of CD200R in macrophages from tumors that were in grade G3-G4 as compared to tumors in grade G1-G2. Besides, a significantly higher frequency of tumor-infiltrating lymphocytes, CD8+CD56+ T cells, and natural killer cells was detected in HCC biopsies in comparison to CCA. In summary, this study has revealed functional and phenotypic differences in TIL cell subpopulations between CCA and HCC, as well as among different histopathological grades and tumor aggressiveness degrees, and it has provided evidence to better understand the tumor immune microenvironment of CCA and HCC.
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Affiliation(s)
- C Martín-Sierra
- Unidade de Gestão Operacional em Citometria, Centro Hospitalar e Universitário de Coimbra (CHUC, Portugal); Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra (Coimbra, Portugal); CNC.IBILI, University of Coimbra, Coimbra, (Portugal); Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Portugal
| | - R Martins
- Unidade Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra (UTHPA, CHUC, Portugal); Serviço de Cirurgia Geral, Unidade HBP, Centro Hospitalar e Universitário de Coimbra (CHUC, Portugal); Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra (Coimbra, Portugal); Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 (Coimbra, Portugal)
| | - P Laranjeira
- Unidade de Gestão Operacional em Citometria, Centro Hospitalar e Universitário de Coimbra (CHUC, Portugal); Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra (Coimbra, Portugal); CNC.IBILI, University of Coimbra, Coimbra, (Portugal); Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Portugal
| | - M Coucelo
- Department of Clinical Haematology, Centro Hospitalar e Universitário de Coimbra (CHUC, Portugal)
| | - A M Abrantes
- Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra (Coimbra, Portugal); Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 (Coimbra, Portugal)
| | - R C Oliveira
- Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra (Coimbra, Portugal); Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 (Coimbra, Portugal); Serviço de Anatomia Patológica, Centro Hospitalar e Universitário de Coimbra (CHUC, Portugal)
| | - J G Tralhão
- Unidade Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra (UTHPA, CHUC, Portugal); Serviço de Cirurgia Geral, Unidade HBP, Centro Hospitalar e Universitário de Coimbra (CHUC, Portugal); Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra (Coimbra, Portugal); Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 (Coimbra, Portugal)
| | - M F Botelho
- Instituto de Biofísica, IBILI, Faculdade de Medicina, Universidade de Coimbra (Coimbra, Portugal); Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 (Coimbra, Portugal)
| | - E Furtado
- Unidade Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra (UTHPA, CHUC, Portugal)
| | - M R Domingues
- Mass Spectrometry Centre, Department of Chemistry & QOPNA, University of Aveiro, Campus Universitário de Santiago (Aveiro, Portugal)
| | - A Paiva
- Unidade de Gestão Operacional em Citometria, Centro Hospitalar e Universitário de Coimbra (CHUC, Portugal); Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra (Coimbra, Portugal); CNC.IBILI, University of Coimbra, Coimbra, (Portugal); Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Portugal; Instituto Politécnico de Coimbra, ESTESC-Coimbra Health School, Ciências Biomédicas Laboratoriais, (Portugal).
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Diogo D, Pacheco C, Oliveira R, Martins R, Oliveira P, Cipriano MA, Tralhão JG, Furtado E. Influence of Ischemia Time in Injury of Deep Peribiliary Glands of the Bile Ducts Graft: A Prospective Study. Transplant Proc 2019; 51:1545-1548. [PMID: 31155189 DOI: 10.1016/j.transproceed.2019.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The deep peribiliary glands (DPBG) are a niche of progenitor cells in the wall of the biliary duct (BD) and are the second line of multiplication when severe lesion of the epithelium occurs. Previous studies have identified DPBG injury as a cause of post-liver transplant (LT) biliary stenosis; this complication is a major cause of post-LT morbidity. The incidence of biliary stenosis in our center is high (38.1%). This study evaluates the lesion of DPBG in response to ischemia. Graft BD was collected in adult LT between August 2016-July 2017, from donation after brain death. Samples of 45 grafts were collected at 2 moments: BD1-during graft preparation and BD2-before biliary anastomosis. Histological analysis of the samples was performed and then classified according to degree of lesion (0, ≤50%, and >50%). A comparison was made between the degree of lesion and graft ischemia, graft histology, donor, and procurement variables. The DPBG lesion was more frequent in BD2 (20.9% vs 7%, P = .079). BD2 lesions with DPBG lesions had higher medians and means at all times of ischemia. The difference was greater in the warm ischemia time (0: 43.3 ± 12.53 minutes vs ≤50%: 52.4 ± 14.38 minutes, P = .068). The group of BD1 with DPBG lesion presented superior median cold ischemia time (CIT). In the analysis of the remaining variables there were also no statistically significant differences. We concluded that during the period of CIT there is already lesion of the DPBG, which increases after reperfusion of the graft, in greater association with longer warm ischemia time.
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Affiliation(s)
- D Diogo
- Adult and Paediatric Liver Transplantation Unit, Coimbra Hospital and University Centre, Coimbra, Portugal.
| | - C Pacheco
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - R Oliveira
- Department of Pathologic Anatomy, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - R Martins
- Adult and Paediatric Liver Transplantation Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - P Oliveira
- Adult and Paediatric Liver Transplantation Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - M A Cipriano
- Department of Pathologic Anatomy, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - J G Tralhão
- Department of Surgery, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - E Furtado
- Adult and Paediatric Liver Transplantation Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
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Vieira H, Rodrigues C, Pereira L, Jesus J, Bento C, Seco C, Pinto F, Eufrásio A, Calretas S, Silva N, Ferrão J, Tomé L, Barros A, Diogo D, Furtado E. Liver retransplantation in patients with acquired familial amyloid polyneuropathy: a Portuguese center experience. Transplant Proc 2016; 47:1012-5. [PMID: 26036507 DOI: 10.1016/j.transproceed.2015.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In 1995 Furtado et al performed the first domino transplantation using a donor liver with familial amyloid polyneuropathy (FAP), thereby increasing the pool of donors. Our experience showed that the onset of FAP symptoms occurs earlier in some patients. Patients with FAP acquired by transplantation are candidates for liver retransplantation to minimize the progression of symptoms. Liver retransplantation is considered to be a high-risk procedure and has lower survival compared with the first transplantation. We evaluated the risk of liver retransplantation in patients with acquired FAP. We did a retrospective analysis of these patients based on the records of perioperative data. From 1995 to 2004 we carried out 81 domino transplantations, of which 10 were submitted to liver retransplantation because of acquired FAP. The better outcomes in this group lead us to think that the liver retransplantation in patients with acquired FAP is not associated with the same risks of liver retransplantation in candidates with graft failure.
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Affiliation(s)
- H Vieira
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - C Rodrigues
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Pereira
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Jesus
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Bento
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Seco
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F Pinto
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Eufrásio
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - S Calretas
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - N Silva
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Ferrão
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Tomé
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Barros
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - D Diogo
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Furtado
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Carvalheiro F, Rodrigues C, Adrego T, Viana J, Vieira H, Seco C, Pereira L, Pinto F, Eufrásio A, Bento C, Furtado E. Diastolic Dysfunction in Liver Cirrhosis: Prognostic Predictor in Liver Transplantation? Transplant Proc 2016; 48:128-31. [DOI: 10.1016/j.transproceed.2016.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 12/31/2015] [Accepted: 01/06/2016] [Indexed: 02/06/2023]
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Rodrigues C, Vieira H, Jesus J, Pereira L, Bento C, Seco C, Pinto F, Eufrásio A, Calretas S, Silva N, Ferrão J, Tomé L, Barros A, Diogo D, Furtado E. Evaluation of operative risk in de novo familial amyloid polyneuropathy retransplantation. Transplant Proc 2015; 47:1016-8. [PMID: 26036508 DOI: 10.1016/j.transproceed.2015.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Familial amyloid polyneuropathy (FAP) is the most common hereditary amyloidosis, characterized by progressive peripheral sensory and motor neuropathy. The livers of patients with FAP are used in domino liver transplantation in selected cases to increase the number of grafts available. In our department 10 patients underwent liver retransplantation (ReLTx) in the absence of liver dysfunction by de novo FAP after domino liver transplantation. Our aim was to compare the differences in the consumption of blood products and intraoperative hemodynamic support among patients with FAP undergoing liver transplantation (LTx) and patients with de novo FAP undergoing ReLTx in the same time frame. The anesthetic records of all patients who underwent LTx for FAP and ReLTx for de novo FAP were analyzed, from January 2009 to May 2014. Patients were divided into 2 groups: group 1 patients with FAP, and group 2 patients with de novo FAP. Statistical differences in the value of preoperative creatinine were found. Hemoglobin levels, preoperative international normalized ratio (INR), use of blood products, aminergic support, and surgical time showed no statistical difference. Major bleeding rates would be expected in patients undergoing ReLTx. Changes in renal function, chronic immunosuppressive therapy, and age may contribute to the increase in intraoperative complications. We did not find statistically significant differences, leading us to the conclusion that de novo FAP does not seem to be a predictor of perioperative risk.
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Affiliation(s)
- C Rodrigues
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - H Vieira
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Jesus
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Pereira
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Bento
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Seco
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F Pinto
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Eufrásio
- Serviço de Anestesiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - S Calretas
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - N Silva
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - J Ferrão
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Tomé
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Barros
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - D Diogo
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Furtado
- Unidade de Transplantação Hepática Pediátrica e de Adultos, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Vieira V, Alexandrino H, Furtado E, Martinho F. Peritoneal and hepatic hydatid disease causing major bile duct destruction. J Surg Case Rep 2012; 2012:6. [PMID: 24960823 PMCID: PMC3649529 DOI: 10.1093/jscr/2012.4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Echinococcosis is endemic in Mediterranean regions and is found primarily in the liver. Biliary fistula is a common complication, but major biliary duct involvement is very rare, and occurs in 0.47% of patients with hepatic hydatid disease. Cyst rupture causing secondary peritoneal hydatidosis is a rare but serious complication. We report the case of a 27-year-old man with multiple peritoneal and hepatic hydatid cysts. The patient came to our attention with cholestatic jaundice. Imaging exams showed numerous peritoneal cysts and massive hydatid disease of the liver, which involved the hepatic confluence, with destruction of the right hepatic duct and fistula formation to the left hepatic duct. The patient was treated with pre-operative albendazole therapy and radical surgery, which consisted of resection of all peritoneal cysts and extended right hepatectomy with biliary reconstruction. No recurrence was seen on CT investigations on the 12th month following surgery. Radical surgical approach remains the treatment of choice.
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Affiliation(s)
- V Vieira
- Hospitais da Universidade de Coimbra, Portugal
| | | | - E Furtado
- Hospitais da Universidade de Coimbra, Portugal
| | - F Martinho
- Hospitais da Universidade de Coimbra, Portugal
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Silva M, Santos A, Furtado E, Villela N, Bouskela E. Microcirculatory, leukocyte/endothelium interaction and survival time effects of recombinant C-reactive protein in nonhypotensive endotoxemia in hamsters. Crit Care 2009. [PMCID: PMC4084129 DOI: 10.1186/cc7407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Santos A, Furtado E, Villela N, Bouskela E. Microcirculatory, leucocyte/endothelium interaction and survival time effects of dobutamine in nonhypotensive endotoxemia. Crit Care 2009. [PMCID: PMC4084128 DOI: 10.1186/cc7406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Perdigoto R, Sequeira C, Tomé L, Ferrão J, Silva N, Geraldes J, Furtado E, Oliveira FJ. Sirolimus: efficacy in liver transplant patients with nephrotoxicity and renal insufficiency. Transplant Proc 2007; 39:2519-21. [PMID: 17954163 DOI: 10.1016/j.transproceed.2007.07.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Nephrotoxicity is a complication of patients undergoing orthotopic liver transplantation. Herein we present several factors that play an important role in this complication.
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Affiliation(s)
- R Perdigoto
- Liver Transplantation Unit, Coimbra University Hospital, 3000-075 Coimbra, Portugal.
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11
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Perdigoto R, Furtado AL, Furtado E, Oliveira FJ, Geraldes B, Mota O, Ferrāo J, Tome L, Viana J. The Coimbra University Hospital experience in liver transplantation in patients with familial amyloidotic polyneuropathy. Transplant Proc 2003; 35:1125. [PMID: 12947884 DOI: 10.1016/s0041-1345(03)00334-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Viana JS, Furtado E, Romero A, Furtado AL. Air embolism as a complication of venovenous bypass during liver transplant for diffuse hemangiomatosis. Transplant Proc 2003; 35:1128-30. [PMID: 12947886 DOI: 10.1016/s0041-1345(03)00336-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J S Viana
- Departments of Transplantation and Anaesthesiology, Coimbra University Hospitals, Coimbra, Portugal.
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13
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Tomé L, Ferrão J, Furtado E, Geraldes J, Mota O, Oliveira F, Perdigoto R, Viana J, Cipriano A, Furtado L. Sequential liver transplantation: 27 cases in 25 patients. Transplant Proc 2001; 33:1430-2. [PMID: 11267359 DOI: 10.1016/s0041-1345(00)02540-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- L Tomé
- Transplantation Department, University Hospital, Coimbra, Portugal
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14
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Paiva A, Pereira SV, Ballesteros R, Freitas A, Perdigoto R, Mota O, Ferrão J, Tomé L, Furtado E, Cipriano MA, Geraldes B, Oliveira FJ, Furtado AL, Regateiro FJ. Cytokine-producing T lymphocytes as a marker of prognosis and rejection episodes in orthotopic liver transplantation. Transplant Proc 2001; 33:1528-30. [PMID: 11267409 DOI: 10.1016/s0041-1345(00)02584-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- A Paiva
- Histocompatibility Centre, Coimbra University Hospital, Coimbra, Portugal
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15
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Furtado A, Perdigoto R, Oliveira F, Geraldes B, Furtado E, Tomé L, Mota O, Ferrão J, Viana J, Bento C, Vieira H, Neves S. Local immunosuppression in clinical small bowel transplantation (report of two cases). Transplant Proc 2000; 32:1206-8. [PMID: 10995910 DOI: 10.1016/s0041-1345(00)01187-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- A Furtado
- Department of Transplantation, HUC, Coimbra, Portugal
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16
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Perdigoto R, Paiva A, Freitas A, Coimbra HB, Mota O, Ferrão J, Tomé L, Furtado E, Cipriano MA, Geraldes B, Oliveira FJ, Furtado AL. Peripheral blood lymphocyte phenotype can predict rejection episodes after orthotopic liver transplantation. Transplant Proc 1999; 31:2418-20. [PMID: 10500650 DOI: 10.1016/s0041-1345(99)00457-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- R Perdigoto
- Liver Transplant Unit, Coimbra University Hospital, Portugal
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17
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Oliveira FJ, Ferrao H, Furtado E, Batista H, Santos MS. Total gastrectomy for gastric adenocarcinoma. Analysis of 115 consecutive patients. Hepatogastroenterology 1999; 46:2044-7. [PMID: 10430395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND/AIMS There was a tendency to use more extensive operations for the treatment of gastric cancer during the last decade particularly in Europe. This retrospective study was carried out to review our recent experience with total gastrectomy for gastric adenocarcinoma. METHODOLOGY One hundred and fifteen patients treated for gastric cancer by total gastrectomy from 1987 to 1996 were analyzed. At the time of surgery 22.3% of patients were older than 70 years of age. RESULTS Fifty eight cancers (50.4%) were located in the distal third of the stomach, forty-seven (41%) were smaller than 6 cm and seventy-one (61.7%) were of the diffuse type. In 74.9% the tumor had penetrated through the serosa. The mortality and morbidity rates were 6.1% and 35.1% respectively. Age was a major determining factor with respect to hospital mortality and post-operative complications. CONCLUSIONS Irrespective of personal attitudes, gastrectomy does not have to be total to be curative, and many total gastrectomies performed in Western countries with "curative intent" are noncurative procedures. Nevertheless, to achieve a curative oncologic resection, total gastrectomy is required with growing frequency.
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Affiliation(s)
- F J Oliveira
- IInd Department of Surgery, University Hospital of Coimbra, Portugal
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18
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Furtado L, Oliveira F, Furtado E, Geraldes B, Reis A, Viana J, Bento C, Vieira H, Neves S. Maximum sharing of cadaver liver grafts composite split and domino liver transplants. Liver Transpl Surg 1999; 5:157-8. [PMID: 10071357 DOI: 10.1002/lt.500050204] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- L Furtado
- Transplant Unit, Hospital of the University of Coimbra, Portugal
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Oliveira FJ, Furtado E, Ferrao H, Conceicao L, Baptista H. Total gastrectomy for gastric cancer in elderly patients. Hepatogastroenterology 1999; 46:616-9. [PMID: 10228870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND/AIMS The increased average life expectancy and the changing patterns in gastric carcinoma have resulted in a considerable rise in the number of older patients requiring total gastrectomy. Results of total gastrectomy for gastric cancer in elderly patients are presented. METHODOLOGY Between January 1987 and December 1996, 115 patients underwent total gastrectomy for gastric adenocarcinoma. At the time of surgery, 25 (21.8%) patients were older than 70 years. The results achieved in these patients were compared with those observed in 90 younger ones. RESULTS The hospital mortality and morbidity rates for the elderly patients were 16% and 56%, respectively; for the younger ones they were 3.3% and 30%, respectively. No difference was seen between the two age groups concerning the average post-operative hospital stay. CONCLUSIONS In our series, age was a major determinant with respect to post-operative morbidity and mortality. However, age alone could not be clearly defined as a determining risk factor considering that the accompanying illness and preexisting factors predispose for poor prognosis.
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Affiliation(s)
- F J Oliveira
- Second Department of Surgery, University Hospital of Coimbra, Portugal
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Affiliation(s)
- A Furtado
- Servico Urologia e Transplantacao, Hospitais da Universidade de Coimbra, Portugal
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