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Lima J, Ferreira M, Lopes M, Quaresma V, Azinhais P, Nunes P, Parada B, Ramos M, Figueiredo A. 100 years of history-making urology – the Portuguese urology association. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00170-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Lima J, Sepodes B, Pereira J, Jarimba R, Almeida R, Azinhais P, Nunes P, Parada B, Sousa V, Figueiredo A. Change in prostate cancer staging patterns in the post-COVID-19 era. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02363-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Antunes H, Parada B, Tavares-da-Silva E, Carvalho J, Bastos C, Roseiro A, Nunes P, Figueiredo A. Pediatric Renal Transplantation: Evaluation of Long-Term Outcomes and Comparison to Adult Population. Transplant Proc 2018; 50:1264-1271. [PMID: 29880345 DOI: 10.1016/j.transproceed.2018.02.089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 02/17/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND In Europe, pediatric transplantation accounts for only about 4% of all kidney transplantations performed. The aim of our work is to evaluate the evolution of pediatric renal transplantation in our department over time, but also to compare this special population with the adult one. METHODS We evaluated all pediatric renal transplantations performed in our department between January 1981 and December 2016. We performed the analysis of clinical, analytical, and surgical factors to look for predictive factors of graft loss or decrease of survival. In addition, we performed a comparative study of pediatric and adult populations and an evaluation of the evolution of pediatric renal transplantation in our department over time. RESULTS We evaluated 101 renal transplantations performed in patients younger than 18 years. Pediatric transplantations corresponded to 3.4% of all renal transplantations performed in our department. The rate of living donors was 12%. Donors of grafts for the pediatric population were significantly younger than in the adult population. The increase in donor age was associated with lower renal graft survival rates. Acute rejections were more frequent in the pediatric population. Eleven pediatric recipients (10.9%) died in the follow-up period. Renal graft survival in the pediatric population was 94.8%, 77.4%, and 66.5% at 1, 5, and 10 years, respectively. There was no significant difference in graft survival in the pediatric and adult population. The pediatric overall survival rate at 1, 5 and 10 years was 97.9%, 96.8%, and 91.9%, respectively. CONCLUSION Pediatric renal transplantation presents results identical to those identified in adults.
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Affiliation(s)
- H Antunes
- Department of Urology and Renal Transplantation, Coimbra University Hospital Center, Coimbra, Portugal.
| | - B Parada
- Department of Urology and Renal Transplantation, Coimbra University Hospital Center, Coimbra, Portugal
| | - E Tavares-da-Silva
- Department of Urology and Renal Transplantation, Coimbra University Hospital Center, Coimbra, Portugal
| | - J Carvalho
- Department of Urology and Renal Transplantation, Coimbra University Hospital Center, Coimbra, Portugal
| | - C Bastos
- Department of Urology and Renal Transplantation, Coimbra University Hospital Center, Coimbra, Portugal
| | - A Roseiro
- Department of Urology and Renal Transplantation, Coimbra University Hospital Center, Coimbra, Portugal
| | - P Nunes
- Department of Urology and Renal Transplantation, Coimbra University Hospital Center, Coimbra, Portugal
| | - A Figueiredo
- Department of Urology and Renal Transplantation, Coimbra University Hospital Center, Coimbra, Portugal
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Antunes H, Tavares-da-Silva E, Oliveira R, Carvalho J, Parada B, Bastos C, Figueiredo A. De Novo Urologic Malignancies in Renal Transplant Recipients. Transplant Proc 2018; 50:1348-1354. [DOI: 10.1016/j.transproceed.2018.02.086] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 02/10/2018] [Accepted: 02/23/2018] [Indexed: 01/20/2023]
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Gomes C, Ferreira-Teixeira M, Paiva-Oliveira D, Parada B, Munz C, Rodrigues-Santos P, Reis F. PO-430 Natural killer cell-based adoptive immunotherapy is effective in the eradication of chemoresistant stem-like cells in bladder cancer. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lourenço M, Carvalho J, Eliseu M, Tavares E, Parada B, Figueiredo A, Carvalho J. P-01-056 Circumcision's effect on male sexual function. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.03.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Grenha V, Parada B, Ferreira C, Figueiredo A, Macário F, Alves R, Coelho H, Sepúlveda L, Freire MJ, Retroz E, Mota A. Hepatitis B virus, hepatitis C virus, and kidney transplant acute rejection and survival. Transplant Proc 2016; 47:942-5. [PMID: 26036490 DOI: 10.1016/j.transproceed.2015.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The effect of hepatitis Bs-antigen (AgHBs) and anti-hepatitis C virus (HCV) positivity on renal transplant outcomes is still controversial. Some studies describe higher rates of acute rejection and allograft loss, and greater mortality in transplant recipients with hepatitis. We retrospectively evaluated data from 2284 allograft recipients who underwent transplantation at our hospital between July 1980 and December 2012. Statistical analysis was made using chi-square and Student t tests, Kaplan-Meier curves, and survival analysis. We identified 62 AgHBs+ patients, 99 anti-HCV+ patients, and 14 AgHBs+/anti-HCV+ patients; 2109 patients had "no hepatitis." Mean follow-up time was 7.93 years. No statistical differences were identified on allograft acute rejection rate or patient survival between groups. AgHBs+ patients had, however, an inferior allograft survival, with statistical significance. According to our study, hepatitis B has a harmful impact on allograft survival, although it does not compromise the patient survival.
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Affiliation(s)
- V Grenha
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - B Parada
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - C Ferreira
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Figueiredo
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - F Macário
- Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, Portugal
| | - R Alves
- Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, Coimbra, Portugal
| | - H Coelho
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - L Sepúlveda
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - M J Freire
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - E Retroz
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - A Mota
- Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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Dinis P, Nunes P, Marconi L, Furriel F, Parada B, Moreira P, Figueiredo A, Bastos C, Roseiro A, Dias V, Rolo F, Alves R, Mota A. Small Kidneys for Large Recipients: Does Size Matter in Renal Transplantation? Transplant Proc 2015; 47:920-5. [DOI: 10.1016/j.transproceed.2015.03.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
PURPOSE The need for organs for renal transplantation has encouraged the use of grafts from increasingly older donors. Studies of transplantation results with donors older than 70 years are sparse. The main purpose of this study is to compare the results of transplantation with donors older and younger than 70 years old. METHODS This retrospective study included 1233 consecutive deceased-donor renal transplantations performed between January 1, 2001, and December 31, 2011. We compared outcomes of grafts from donors older than 70 years (group ≥ 70; n = 82) versus donors younger than 70 years (group < 70; n = 1151). RESULTS Univariate analysis of pretransplantation data showed statistically significant differences (P < .05) among the following variables for the group < 70 and group ≥ 70, respectively: recipient age (46 ± 13 versus 61 ± 5 years), donor age (44 ± 16 versus 73 ± 3 years), donor male gender (69.4% versus 47.6%), use of antibody induction immunosuppression (51.7% versus 70.7%), and HLA compatibilities (2.4 versus 2). The group ≥ 70 showed increased postoperative minor complications: bleeding (8.5% versus 3.4%; P = .017), lymphocele formation (3.7% versus 0.5%; P = .011), and incisional hernia (2.4% versus 0.2%; P < .001). Regarding transplantation results, we observed that mean serum creatinine was significantly lower among group < 70, at 1, 3, 6, 12, 24, and 60 months after transplantation (P < .05). Cumulative graft survival at 1, 3, and 4 years was 90%, 85%, and 83% in the group < 70 versus 87%, 79%, and 72% in the group ≥ 70. In the subgroup of recipients younger than 60 years, we did not verify statistically significant differences in allograft survival between group ≥ 70 and group < 70. Using Cox regression for survival analysis, we verified that donor age was not an independent risk factor for graft failure. CONCLUSIONS The group of patients who received kidneys from donors younger than 70 years achieved better transplantation outcomes. Nevertheless, kidneys from older donors represent an excellent alternative for older recipients.
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Affiliation(s)
- L Marconi
- Urology and Renal Transplantation Department, Coimbra University Hospital, Coimbra, Portugal
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Teixeira M, Rodrigues-Santos P, Garrido P, Costa E, Parada B, Sereno J, Alves R, Belo L, Teixeira F, Santos-Silva A, Reis F. Cardiac antiapoptotic and proproliferative effect of recombinant human erythropoietin in a moderate stage of chronic renal failure in the rat. J Pharm Bioallied Sci 2013; 4:76-83. [PMID: 22368404 PMCID: PMC3283962 DOI: 10.4103/0975-7406.92743] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 07/08/2011] [Accepted: 07/17/2011] [Indexed: 12/29/2022] Open
Abstract
Objective: Recombinant human erythropoietin (rhEPO) therapy under circumstances of moderate chronic renal failure (CRF), with yet lower kidney and heart lesion, may have a protective cardiac effect beyond the correction of anemia, whose mechanism deserves better elucidation, namely by clarifying the impact on gene expression profile of markers of apoptosis, inflammation, proliferation, angiogenesis, and lesion/stress in the heart. Materials and Methods: Four groups of rats were studied over a period of 15 weeks (n=7 each): control—without surgery and without drug treatment; rhEPO—treated with 50 IU/kg/week of rhEPO—beta; CRF—submitted to partial nephrectomy (3/4); CRF + rhEPO—CRF with rhEPO treatment after the 3rd week of surgery. The heart was collected in order to evaluate the gene expression, by real-time qPCR, of markers of apoptotic machinery, inflammation/immunology, proliferation/angiogenesis, and lesion/stress. Results: The main findings obtained were (a) CRF rats have demonstrated overexpression of EPO-R in the heart without changes on EPO expression, together with overexpression of Bax/Bcl2 ratio, PCNA, and IL-2; (b) rhEPO therapy on the heart of the rats with CRF induced by partial 3/4 nephrectomy promoted nonhematopoietic protection, demonstrated by the apoptosis prevention, viewed by the Bax/Bcl2 balance, by the promotion of proliferation, due to PCNA increment, and by the immunomodulatory action, expressed by a trend to prevent the IL-2 increment. Conclusion: In this model of moderate CRF, rhEPO treatment showed important cardiac nonhematopoietic effects, expressed mainly by the antiapoptotic and the proproliferative action, suggesting that early rhEPO therapy in moderate stages of CRF might have further therapeutic benefits.
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Affiliation(s)
- M Teixeira
- Laboratory of Pharmacology and Experimental Therapeutics, IBILI, Medicine Faculty, Coimbra University
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Hirata M, Tashiro Y, Aizawa K, Endo K, Hirata M, Tashiro Y, Endo K, Aizawa K, Serizawa K, Hirata M, Yogo K, Tashiro Y, Endo K, Cases A, Portoles J, Calls J, Martinez-Castelao A, Munar MA, Segarra A, Samouilidou E, Pantelias K, Petras D, Mpakirtzi T, Pipili C, Chatzivasileiou G, Vasiliou K, Denda E, Grapsa E, Tzanatos H, Shoji S, Inaba M, Tomosugi N, Okuno S, Ichii M, Yamakawa T, Kurihara S, Barsan L, Stanciu A, Stancu S, Capusa C, Bratescu L, Mircescu G, Barsan L, Stanciu A, Stancu S, Capusa C, Mircescu G, Kuo KL, Hung SC, Lee TS, Tarng DC, Nistor I, Covic A, Goldsmith D, Garrido P, Fernandes J, Ribeiro S, Vala H, Parada B, Alves R, Belo L, Costa E, Santos-Silva A, Reis F, Abdulnabi K, Ullah A, Abdulateef A, Howse M, Khalil A, Fouqueray B, Hoffmann M, Addison J, Manamley N, Stamopoulos D, Mpakirtzi N, Afentakis N, Grapsa E, Yu KH, Chou J, Klaus S, Schaddelee M, Kashiwa M, Takada A, Neff T, Galle J, Claes K, Di Giulio S, Guerin A, Herlitz H, Kiss I, Wirnsberger G, Manamley N, Addison J, Fouqueray B, Froissart M, Winearls C, Martinez Castelao A, Cases Amenos A, Torre Carballada A, Torralba Iranzo FJ, Bronsoms Artero JM, Toran Monserrat D, Valles Prats M, Merino JL, Espejo B, Bueno B, Amezquita Y, Paraiso V, Kiss Z, Kerkovits L, Ambrus C, Kulcsar I, Szegedi J, Benke A, Borbas B, Ferenczi S, Hengsperger M, Kazup S, Nagy L, Nemeth J, Rozinka A, Szabo T, Szelestei T, Toth E, Varga G, Wagner G, Zakar G, Gergely L, Kiss I, Exarchou K, Tanahill N, Anthoney A, Khalil A, Ahmed S, Capusa C, Oprican R, Stanciu A, Lipan M, Stancu S, Chirculescu B, Mircescu G, Ferenczi S, Roger S, Malecki R, Farouk M, Dellanna F, Thomas M, Manamley N, Touam M, Chantrel F, Bouiller M, Hurot JM, Raphael T, Testa A, Veillon S, Vendrely B, Masoumi Z, Ahmadpoor P, Ghaderian SMH, Nafar M, Samavat S, Samadian F, Poorrezagholi F, Shahidi M, Riccio E, Visciano B, Capuano I, Memoli A, Mozzillo G, Memoli B, Pisani A. Anaemia in CKD 1-5. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lai CF, Lin SL, Chiang WC, Chen YM, Kuo ML, Tsai TJ, Hwang HS, Choi YA, Park KC, Yang KJ, Choi HS, Kim SH, Lee SJ, Chang YK, Kim SY, Yang CW, Xiujuan Z, Yoshimura R, Matsuyama M, Chargui J, Touraine JL, Yoshimura N, Zulkarnaev AB, Vasilenko IA, Artemov DV, Vatazin AV, Park SK, Kang KP, Lee S, Kim W, Schneider R, Betz B, Moller-Ehrlich K, Wanner C, Sauvant C, Yang KJ, Park KC, Choi HS, Kim SH, Choi YA, Chang YK, Park CW, Kim SY, Lee SJ, Yang CW, Hwang HS, Sohotnik R, Nativ O, Abbasi A, Awad H, Frajewicki V, Armaly Z, Heyman SN, Nativ O, Abassi Z, Chen PY, Chen BL, Yang CC, Chiang CK, Liu SH, Abozahra AE, Abd-Elkhabir AA, Shokeir A, Hussein A, Awadalla A, Barakat N, Abdelaziz A, Yamaguchi J, Tanaka T, Eto N, Nangaku M, Quiros Y, Lopez-Hernandez FJ, Perez de Obanos MP, Ruiz J, Lopez-Novoa JM, Shin HS, Kim MJ, Choi YJ, Ryu ES, Choi HS, Kang DH, Jankauskas SS, Pevzner IB, Zorova LD, Babenko VA, Morosanova MA, Plotnikov EY, Zorov DB, Huang CY, Huang TM, Wu VC, Young GH, Plotnikov EY, Pevzner IB, Zorova LD, Chupyrkina AA, Zorov SD, Zorov DB, Grande JP, Hartono SP, Knudsen BE, Mederle K, Castrop H, Hocherl K, Iwakura T, Fujikura T, Ohashi N, Yasuda H, Fujigaki Y, Matsui I, Hamano T, Inoue K, Obi Y, Nakano C, Kusunoki Y, Tsubakihara Y, Rakugi H, Isaka Y, Shimomura A, Wallentin Guron C, Nguy L, Lundgren J, Grimberg E, Kashioulis P, Guron G, Guron G, DiBona GF, Nguy L, Grimberg E, Lundgren J, Nedergaard Mikkelsen M, Marcussen N, Saeed A, Edvardsson K, Lindberg K, Larsson T, Ito K, Nakashima H, Watanabe M, Abe Y, Ogahara S, Saito T, Albertoni G, Borges F, Schor N, Beresneva ON, Parastayeva MM, Kucher AG, Ivanova GT, Shved N, Rybakova MG, Kayukov IG, Smirnov AV, Chen JF, Ni HF, Pan MM, Liu H, Xu M, Zhang MH, Liu BC, Kim Y, Choi BS, Kim YS, Han JS, Reis LA, Christo JS, Simoes MDJ, Schor N, Mulay SR, Santhosh Kumar VR, Kulkarni OP, Darisipudi M, Lech M, Anders HJ, Zorov DB, Plotnikov EY, Silachev DN, Jankauskas SS, Pevzner IB, Zorova LD, Zorov SD, Morosanova MA, Sola A, Jung M, Ventayol M, Mastora C, Buenestado S, Hotter G, Rong S, Shushakova N, Wensvoort G, Haller H, Gueler F, Pan MM, Zhang MH, Ni HF, Chen JF, Xu M, Liu BC, Morais C, Vesey DA, Johnson DW, Gobe GC, Godo M, Kaucsar T, Revesz C, Hamar P, Cheng Q, Wen J, Ma Q, Zhao J, Castellano G, Stasi A, Di Palma AM, Gigante M, Netti GS, Curci C, Intini A, Divella C, Prattichizzo C, Fiaccadori E, Pertosa G, Grandaliano G, Gesualdo L, Wei QW, Jing QQ, Ying NJ, Dong QZ, Yong G, Choi YJ, Kim MJ, Shin HS, Ryu ES, Choi HS, Kang DH, Pevzner IB, Pulkova NV, Plotnikov EY, Zorova LD, Silachev DN, Morosanova MA, Sukhikh GT, Zorov DB, Kim S, Lee J, Nam NJ, Na KY, Han JS, Ma SK, Joo SY, Kim CS, Choi JS, Bae EH, Lee J, Kim SW, Cernaro V, Medici MA, Donato V, Trimboli D, Lorenzano G, Santoro D, Montalto G, Buemi M, Longo V, Segreto HRC, Almeida W, Schor N, Ramos MF, Gomes L, Razvickas C, Schor N, Gueler F, Rong S, Gutberlet M, Meier M, Mengel M, Wacker D, Haller H, Hueper K, Uzum A, Ersoy R, Cakalagaoglu F, Karaman M, Kolatan E, Sahin O, Yilmaz O, Cirit M, Inal S, Koc E, Okyay GU, Pasaoglu O, Gonul I, Oyar E, Pasaoglu H, Guz G, Sabbatini M, Rossano R, Andreucci M, Pisani A, Riccio E, Choi DE, Jeong JY, Kim SS, Chang YK, Na KR, Lee KW, Shin YT, Silva AF, Teixeira VC, Schor N, Meszaros K, Koleganova-Gut N, Schaefer F, Ritz E, Walacides D, Ruskamp N, Rong S, Hueper K, Meier M, Haller H, Schiffer M, Gueler F, Marom O, Haick H, Nakhoul F, Chen JF, Liu H, Ni HF, Lv LL, Zhang MH, Tang RN, Zhang JD, Ma KL, Chen PS, Liu BC, Wu VC, Young GH, Chen YM, Ko WJ, Misiara GP, Coimbra TM, Silva GEB, Costa RS, Francescato HDC, Neto MM, Dantas M, Lindberg K, Olauson H, Amin R, Ponnusamy A, Goetz R, Mohammadi M, Canfield A, Kublickiene K, Larsson T, Rodriguez J, Reyes EP, Cortes PP, Fernandez R, Yoon HE, Koh ES, Chung S, Shin SJ, Pazzano D, Montalto G, Cernaro V, Lupica R, Torre F, Costantino G, Buemi M, Prieto M, Gonzalez-Buitrago JM, Lopez-Hernandez F, Lopez-Novoa JM, Morales AI, Vicente-Vicente L, Ferreira L, Christo JS, Reis LA, Simoes MJ, Passos CD, Schor NS, Shimizu MHM, Canale D, de Braganca AC, Andrade L, Luchi WM, Seguro AC, Canale D, de Braganca AC, Goncalves J, Shimizu MHM, Volpini RA, Andrade L, Seguro AC, Garrido P, Fernandes J, Ribeiro S, Vala H, Parada B, Alves R, Belo L, Costa E, Santos-Silva A, Reis F. AKI - experimental models. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Castelo D, Campos L, Moreira P, Furriel F, Parada B, Nunes P, Figueiredo A, Mota A. Does multiorgan versus kidney-only cadaveric organ procurement affect graft outcomes? Transplant Proc 2013; 45:1248-50. [PMID: 23622670 DOI: 10.1016/j.transproceed.2013.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The majority of kidney grafts in most European countries still come from deceased donors who provide other organs. We analyzed whether multiorgan procurement portends a worse functional outcome compared with kidney-only harvesting. METHODS We performed a retrospective analysis of 1043 consecutive brain-dead donor kidney transplantations performed at a single academic institution from September 2002 to June 2011. The graft outcomes using kidney-only donors (n = 243) were compared with multiorgan donor grafts (n = 800) analyzing donor age, gender, cause of death, duration of mechanical ventilation, renal function, and cold ischemic interval. We compared delayed graft function and serum creatinine values at 1, 3, 6, and 12 months posttransplantation as well as graft survivals. This methodology was also applied to the subset of expanded criteria donors: 179 kidney-only versus 474 multiorgan. The influence of donor variables on graft survival was also analyzed in a Cox regression model. Immunosuppressive regimens and preservation solutions were similar in both groups. RESULTS Kidney-only donors were older than their multiorgan counterparts (53.1 versus 44.8, P < .0005) and predominantly male (76.5% versus 62.6% male donors, P < .0005). Other donor variables were comparable. Kidney-only donor grafts showed a slightly higher incidence of delayed function (27.2 versus 21.1%, P = .049), but the mean serum creatinine values were similar at all intervals. No differences were observed in 7-year graft survival: 80.7% versus 79.9%. Expanded criteria donor grafts showed overlapping results, except for a higher rate of donor oligoanuria and a lower 1-month mean creatinine among kidney-only donors. Multivariate analysis revealed that the number of harvested organs did not influence graft survival. DISCUSSION Immediate and long-term outcomes of kidney grafts did not correlate with the number of organs harvested from the donor. The longer explantation time associated with multiorgan procurement did not seem to affect graft function.
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Affiliation(s)
- D Castelo
- Department of Urology and Renal Transplantation, Coimbra University Hospital Centre, Coimbra, Portugal
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Campos L, Parada B, Furriel F, Castelo D, Moreira P, Mota A. Do intraoperative hemodynamic factors of the recipient influence renal graft function? Transplant Proc 2013; 44:1800-3. [PMID: 22841277 DOI: 10.1016/j.transproceed.2012.05.042] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE To assess the importance of intraoperative management of recipient hemodynamics for immediate versus delayed graft function. METHODS The retrospective study of 1966 consecutive renal transplants performed in our department between June 1980 and December 2009 analyzed several perioperative hemodynamic factors: central venous pressure (CVP), mean arterial pressure (MAP) as well as volumes of fluids, fresh frozen plasma (FFP), albumin, and whole blood transfusions. We examined their influence on renal graft function parameters: immediate diuresis, serum creatinine levels, acute rejection, chronic transplant dysfunction, and graft survival. RESULTS Mean CVP was 9.23 ± 2.65 mm Hg and its variations showed no impact on graft function. We verified a twofold greater risk of chronic allograft dysfunction among patients with CVP ≥ 11 mm Hg (P < .001). Mean MAP was 93.74 ± 13.6 mm Hg; graft survivals among subjects with MAP ≥ 93 mm Hg were greater than those of patients with MAP < 93 mm Hg (P = .04). On average, 2303.6 ± 957.4 mL of saline solutions were infused during surgery. Patients who received whole blood transfusions (48%) showed a greater incidence of acute rejection episodes (ARE) (P = .049) and chronic graft dysfunction (P < .001). Patients who received FFP (55.7%), showed a higher incidence of ARE (P < .001). Only 4.6% of patients (n = 91) received human albumin with a lower incidence of ARE (P = .045) and chronic graft dysfunction (P = .024). Logistic binary regression analysis revealed that plasma administration was an independent risk factor for ARE (P < .001) and chronic dysfunction (P = .028). Volume administration (≥ 2500 mL) was also an independent risk factor for chronic allograft dysfunction (P = .016). Using Cox regression, we verified volume administration ≥ 2500 mL to be the only independent risk factor for graft failure (P < .001). CONCLUSION MAP ≥ 93 mm Hg and perioperative fluid administration <2500 mL were associated with greater graft survival. Albumin infusion seemed to be a protective factor, while CVP ≥ 11 mm Hg, whole blood, and FFP transfusions were associated with higher rates of ARE and chronic graft dysfunction.
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Affiliation(s)
- L Campos
- Department of Urology and Renal Transplantation, Coimbra University Hospital, Coimbra, Portugal.
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Fliser D, Shilo V, Covic A, Besarab A, Provenzano R, Duliege AM, Chen M, Tong S, Francisco C, Gao HY, Polu K, De Francisco AL, Macdougall I, Macdougall I, Schiller B, Locatelli F, Wiecek A, Francisco C, Tang H, Tong S, Chen M, Duliege AM, Polu K, Mayo M, Covic A, Macdougall I, Macdougall I, Casadevall N, Stead R, Taal M, Faller B, Karras A, Chen M, Tong S, Duliege AM, Rowell R, Polu K, Eckardt KU, Locatelli F, Dusilova Sulkova S, Arnaud S, Bruno P, Arnaud G, Dorina V, Eric A, Gerard M, Cases A, Portoles JM, Calls J, Martinez Castelao A, Sanchez-Guisande D, Segarra A, Tsubakihara Y, Tsubakihara Y, Saito A, Saito A, Saito A, Tsubakihara Y, Martinez-Castelao A, Martinez-Castelao A, Cases A, Fort J, Bonal J, Fulladosa X, Galceran JM, Torregrosa V, Coll E, Minutolo R, Cozzolino M, DI Iorio B, Polito P, Santoro D, Manenti F, Nappi F, Feriozzi S, Conte G, De Nicola L, Mikhail A, Provenzano R, Schiller B, Besarab A, Francisco C, Gao HY, Daley R, Tong S, Mayo M, Yang A, Polu K, Macdougall I, Wiecek A, Schiller B, Canaud B, Locatelli F, Yang A, Chen M, Polu K, Francisco C, Gao HY, Tong S, Duliege AM, Provenzano R, Locatelli F, Locatelli F, Provenzano R, Besarab A, Rath T, Yang A, Mayo M, Francisco C, Macdougall I, Bartnicki P, Baj Z, Majewska E, Rysz J, Fievet P, Assem M, Brazier F, Xu X, Soltani ON, Demontis R, Barsan L, Stancu S, Stancu S, Stanciu A, Capusa C, Petrescu L, Zugravu A, Mircescu G, Malyszko JM, Levin-Iaina N, Malyszko J, Glowinska I, Koc-Zorawska E, Slotki I, Mysliwiec M, Mircescu G, Mircescu G, Capusa C, Stancu S, Barsan L, Grabowski D, Blaga V, Dumitru D, Pchelin I, Shishkin A, Kus T, Usalan C, Tiryaki O, Chin HJ, Chae DW, Kim S, Bertram H, Keller F, Rumjon A, Wood C, Wilson P, Khakoo S, Chai MO, Macdougall IC, Nuria GF, Maria Asuncion F, Jose Maria MG, Carmen C, Paloma Leticia MM, Francisco Javier L, Moniek DG, De Goeij M, Yvette M, Diana G, Friedo D, Nynke H, Lezaic V, Miljkovic B, Petkovic N, Maric I, Vucicevic K, Simic Ogrizovic S, Djukanovic L, Cases A, Martinez-Castelao A, Fort A, Bonal J, Fulladosa X, Galceran JM, Torregrosa V, Coll E, DI Giulio S, DI Giulio S, Galle J, Kiss I, Herlitz H, Wirnsberger G, Claes K, Suranyi M, Guerin A, Winearls C, Addison J, D'souza M, Froissart M, Garrido P, Garrido P, Teixeira M, Costa E, Rodrigues-Santos P, Parada B, Belo L, Alves R, Teixeira F, Santos-Silva A, Reis F, Winearls C, Winearls C, DI Giulio S, Galle J, Kiss I, Herlitz H, Wirnsberger G, Claes K, Suranyi M, Guerin A, Addison J, D'souza M, Fouqueray B, Floris M, Conti M, Cao R, Pili G, Melis P, Matta V, Murgia E, Atzeni A, Binda V, Angioi A, Peri M, Pani A, Besarab A, Belo D, Diamond S, Martin E, Sun C, Lee T, Saikali K, Franco M, Leong R, Neff T, Yu KHP, Tiranathanagul K, Praditpornsilpa K, Katavetin P, Kanjanabuch T, Avihingsanon Y, Tungsanga K, Eiam-Ong S, Macdougall IC, Casadevall N, Percheson P, Potamianou A, Foucher A, Fife D, Vercammen E. Renal anaemia - CKD 1-5. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Eufrásio P, Parada B, Nunes P, Moreira P, Mota A. UP-01.133 Surgery or Embolization for Varicocele in Subfertile Men? Urology 2011. [DOI: 10.1016/j.urology.2011.07.685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
BACKGROUND AND PURPOSE Older patients on hemodialysis have become candidates for renal transplantation, particularly in the period of increasing numbers of marginal donors. The purpose of this study was to evaluate short-term and long-term results of renal transplantation among recipients ≥65 years old for comparison with these in younger patients. PATIENTS AND METHODS We retrospectively studied 1,796 renal transplantations performed between June 1991 and May 2010, dividing the sample into 2 groups: ≥65 years old (n = 89) versus <65 years old (n = 1,707). RESULTS The mean ages were 42.17 and 67.45 years for the younger and older groups, respectively. Time of pretransplantation dialysis was significantly greater among the older group (52.76 vs 47.69 mo). There were no differences between the 2 groups regarding donor age, donor renal function, or cold ischemia times. After a mean follow-up of 73.37 versus 39.73 months for the younger versus older groups, respectively, we observed differences in initial graft function, with a greater rate of delayed graft function in the ≥65 group (28.1% vs 17.8%), and in acute rejection rate, which was higher among the younger group (19.4% vs 10.1%). Initial creatinine was better for the older group (1.71 vs 2.10 mg/dL), but similar between the groups at 10 years. Graft and patient survivals at 1, 5, and 10 years were lower among the older group. When analyzing graft survival censored for death with a functioning kidney, there were no differences between the younger and older groups: It was at 1, 5, and 10 years, namely 93.6% versus 90.6%, 87% versus 80.8%, and 76.7% versus 70.1%, respectively. CONCLUSIONS Selected recipients ≥65 years of age show good outcomes of transplantation.
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Affiliation(s)
- P Eufrásio
- Department of Urology and Renal Transplantation, Coimbra University Hospital, Coimbra, Portugal.
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Furriel F, Parada B, Campos L, Moreira P, Castelo D, Dias V, Mota A. Pretransplantation overweight and obesity: does it really affect kidney transplantation outcomes? Transplant Proc 2011; 43:95-9. [PMID: 21335163 DOI: 10.1016/j.transproceed.2010.12.027] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The objective of this study was to compare kidney transplant outcomes among pretransplantation overweight and obese patients with those with normal weight. METHODS We performed a retrospective analysis of a sample of 448 kidney transplantations performed between 1984 and 2008 in our institution. We compared of initial graft function, postoperative length of stay, surgical complications, acute and chronic rejection rates, creatinine serum levels, and patient and graft survival, between normal weight, overweight, and obesity groups. RESULTS Overweight was detected on 28.3% of the patients, and obesity on 5.8%. A male predominance was noted among the normal and overweight groups, and the opposite in the obesity group: namely, male:female ratios of 2.17:1, 3.37:1, and 0.37:1, respectively. Mean age was lower in the normal weight group (41.51 years) versus 48.36 and 46.08 years in the overweight and obesity groups, respectively. Compared with the normal weight group, recipient creatinine serum levels between 1 and 6 months were higher among the obese group, but not the overweight one. Both overweight and obese groups showed significantly higher incidences of delayed graft function (26.8% and 26.9%, respectively) versus 16.9% in the normal weight group (P = .028) and longer surgery times, ie, greater than 3 hours in 22.8% and 42.3%, respectively, versus 20.7% of the normal weight patients. Surgical complication rates were higher in both non-normal weight groups (17.3% and 26.9% vs 15.9% in the normal weight group), especially lymphocele formation and wound dehiscence (P = .031 and P < .0005, respectively). However, no differences were detected concerning postoperative length of stay, graft loss, acute or chronic rejection, and graft or patient survival. CONCLUSION Pretransplantation overweight and obesity did not seem to significantly affect kidney transplantation in the medium and long terms. The early posttransplantation period can however be disturbed by an increased incidence of surgical complications and reversible degradation of some graft functional parameters.
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Affiliation(s)
- F Furriel
- Department of Urology and Renal Transplantation, Coimbra University Hospital, Coimbra, Portugal.
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Abstract
PURPOSE Our aim was to evaluate the influence of donor cause of brain death on the results of kidney transplantation. METHODS This retrospective study included 896 consecutive deceased-donor renal transplantations performed between January 1, 2000, and December 31, 2009. We compared outcomes of grafts from donors after cerebrovascular accident (CVA; n = 371) versus head trauma (HT; n = 525). RESULTS Univariate analysis of pretransplantation data showed statistically significant differences (P < .05): among the following variables for the HT versus CVA groups respectively: recipient age (43.63 ± 13.2 y vs 49.80 ± 12.5 y); donor age (36.06 ± 16.6 y vs 52.57 ± 13.2 y) and time on dialysis (50.67 ± 45.034 mo vs 59.39 ± 46.3 mo). Regarding transplantation results, we observed that mean serum creatinine was significantly lower among HT recipient, at 1, 3, 6, 12, and 24 months after transplantation (P < .05). Chronic allograft nephropathy (CAN) and delayed graft function were higher among the CVA group. HT group kidneys showed significantly longer mean survival times than CVA group kidneys (102.7 ± 3.9 mo vs 94.8 ± 5.6 mo; log rank: P = .04). Upon multivariate analysis donor cause of death was not identified as an independent risk factor for graft survival or occurrence of chronic allograft nephropathy. CONCLUSIONS Transplantation results were better among the HT group. However multivariate regression analysis indicated that donor cause of death was not an independent risk factor for graft survival or occurrence of chronic allograft nephropathy.
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Affiliation(s)
- L Marconi
- Urology and Renal Transplantation Department, Coimbra University Hospital, Coimbra, Portugal.
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Figueiredo S, Sousa AP, Parada B, Carvalheiro V, Almeida Santos T, Obejero EY, De Caro R, Marconi G, Lombardi E, Young E, Tiveron M, Valcarcel A, Colonna Worrilow K, Eid S, Matthews J, Pelts E, Khoury C, Liebermann J, Queiroz P, Figueira RCS, Braga DPAF, Angelozzi de Oliveira M, Dresch Martinhago C, Pasqualotto FF, Iaconelli A, Borges E, Romany L, Meseguer M, Garcia-Herrero S, Romero JL, Pellicer A, Garrido N, Ramos L, de Vries M, Hulsbergen-van deer Kaa C, D'Hauwers K, de Boer P. Session 04: Novel Techniques for Sperm Selection. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Garrido P, Reis F, Costa E, Teixeira-Lemos E, Parada B, Alves R, Piloto N, Sereno J, Figueiredo A, Pinto R, Carvalho L, Rocha-Pereira P, Belo L, Santos-Silva A, Teixeira F. Characterization of a rat model of moderate chronic renal failure--focus on hematological, biochemical, and cardio-renal profiles. Ren Fail 2010; 31:833-42. [PMID: 19925293 DOI: 10.3109/08860220903151435] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The pathophysiological modifications underlying chronic renal failure seems to be dependent on the insufficiency degree, which will determine the moment to start therapy. As there is yet limited information about animal models of moderate chronic renal failure, we intended to perform a complete characterization of the hematological and cardio-renal alterations induced by partial nephrectomy. Blood samples from control and chronic renal failure rats were collected at 0, 3, 9, and 15 weeks in order to evaluate renal function, hematological parameters, iron metabolism, blood lipids, peripheral sympathetic nervous system, and inflammatory and redox status markers. BP, tissues trophy indexes, and kidney histomorphology were also assessed. Our data are consistent with a sustained moderate degree of chronic renal failure with a quickly compensated modest anaemia, though presenting iron metabolism disturbances. Despite the reasonable degree of functionality of the remnant kidney, as suggested by the anaemia correction and by the kidney hypertrophy and moderate lesions, several important cardiovascular modifications were developed. Our model presented hypertension, dyslipidemia, erythropoietic disturbances, sympathetic activation, and oxidative stress. This model might be a good tool to study the cellular/molecular mechanisms underlying moderate stages of chronic renal failure and to evaluate the therapeutic efficacy for prevention and treatment/correction of cardio-renal anaemia syndromes and complications in early stages.
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Affiliation(s)
- P Garrido
- Institute of Pharmacology & Experimental Therapeutics, IBILI, Medicine Faculty, Coimbra University, Coimbra, Portugal.
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Parada B, Figueiredo A, Reis F, Nunes P, Sereno J, Eufrásio P, Garrido P, Xavier Cunha M, Mota A, Teixeira F. MP-13.05: Antitumoral Properties of a Cyclooxigenase-2 Inhibitor and Immunosuppression Agents on Rat Urinary Bladder Carcinogenesis. Urology 2009. [DOI: 10.1016/j.urology.2009.07.874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ferrer F, Mota A, Alves R, Bastos C, Macário F, Figueiredo A, Santos L, Roseiro A, Parada B, Pratas J, Nunes P, Campos M. Renal transplantation with expanded criteria donors: the experience of one Portuguese center. Transplant Proc 2009; 41:791-3. [PMID: 19376353 DOI: 10.1016/j.transproceed.2009.02.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The shortage of kidneys available for transplantation has led to enlarged criteria donors (ECD): namely, donors older than 60 years or aged between 50 and 59 years with 2 of the following characteristics-hypertension, predonation serum creatinine level higher than 1.5 mg/dL or cerebrovascular disease as the cause of death. The aim of this study was to analyze renal transplants using ECD compared with standard criteria donors (SCD) concerning the incidences of delayed graft function (DGF), acute rejection episodes (ARE), and patient and graft survivals. MATERIALS AND METHODS This retrospective study of 409 cadaveric renal transplants over the last 4 years identified ECD in contrast with SCD. RESULTS Of the transplants, 24.4% used ECD. The baseline characteristics of recipients of ECD versus SCD kidneys were similar, except for age and cold ischemia time. Comparing ECD and SCD, we observed an higher incidence of DGF (35% vs 18%), occurrence of ARE (34.4% vs 16.6%), average serum creatinine levels at 6 (1.87 vs 1.4 mg/dL), and 12 months (1.88 vs 1.43 mg/dL) as well as lower graft survival at 1 (82% vs 91%) and 3 years (75% vs 84%) after transplantation. Recipient survival at 1 year was not different. Multivariate analysis identified recipient age, cold ischemia time, ARE, and DGF as risk factors for graft failure. CONCLUSIONS Renal transplantation with grafts from ECD shows significantly worse outcomes with higher rates of DGF and ARE, worse graft function, and lower graft survival.
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Affiliation(s)
- F Ferrer
- Renal Transplantation Unit, Department of Urology and Renal Transplantation, Hospitais da Universidade de Coimbra, Portugal.
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Santos L, Alves R, Macario F, Parada B, Campos M, Mota A. Impact of hepatitis B and C virus infections on kidney transplantation: a single center experience. Transplant Proc 2009; 41:880-2. [PMID: 19376378 DOI: 10.1016/j.transproceed.2009.01.074] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The impacts of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections on patient and renal graft survivals are controversial. This study sought to evaluate the effects of pretransplantation HCV and HBV infections on renal transplant patients and their grafts at our center. PATIENTS AND METHODS We retrospectively examined 1224 renal transplantations performed between 1992 and 2006, including 28 HBsAg positive; 64, anti-HCV; 9, anti-HCV plus HBsAg positive; and 1123, negative for anti-HCV and HBsAg. The mean posttransplantation follow-up was 5.6 +/- 4.1 years. RESULTS The prevalences of HBV infection were 6.2% in 1994 and 2.3% in 2006 and those of HCV infection were 6.8% in 1998 and 5.2% in 2006. The rejection rate was higher among HBV+ (46.4%) and HCV+ (40.6%) groups than the negative groups (31.5%), but it was not significant. There were no significant differences in patient and graft survivals among the groups. The major cause of patient death was liver failure among patients with concomitant HBV+ and HCV+ infections and cardiovascular disease among HCV+ and negative patients. CONCLUSIONS There has been a decrease in the prevalence of recipients with hepatitis virus infections over the last 15 years. Patient and graft survivals were not affected by HCV or HBV infection.
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Affiliation(s)
- L Santos
- Department of Nephrology, Rainha Santa Isabel Hospital, Torres Novas, Portugal.
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Filipe R, Mota A, Alves R, Bastos C, Macário F, Figueiredo A, Roseiro A, Parada B, Sá H, Nunes P, Bastos M. Kidney transplantation with corticosteroid-free maintenance immunosuppression: a single center analysis of graft and patient survivals. Transplant Proc 2009; 41:843-5. [PMID: 19376367 DOI: 10.1016/j.transproceed.2009.02.001] [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: 10/20/2022]
Abstract
The purpose of this study was to assess the impact of a corticosteroid-free maintenance immunosuppression on graft survival in kidney transplantation. We analyzed 79 patients who were transplanted between June 1, 2006 and May 31, 2007. We excluded hyperimmunized patients, second transplantations, living donors, and black recipients. Patients underwent induction with thymoglobulin or basiliximab, followed by treatment with mycophenolate mofetil (MMF), tacrolimus, and methylprednisolone. On the 5th day, the patients were divided into 2 groups: group A (n = 45) discontinued steroid therapy; group B (n = 34) continued prednisone therapy. We performed a comparative analysis of incidence of delayed graft function (DGF), acute rejection episodes (ARE), renal function at 6 and 12 months, graft and patient survivals, causes of graft loss, and mortality. The 2 groups were similar for donor, recipient, and graft characteristics. The incidences of DGF were 8.9% in group A and 14.7% in group B; those for ARE were 2.3% in group A and 13.8% in group B (P = .077). The mean serum creatinine levels at 6 and 12 months were similar. There were 8 graft losses: 3 in group A (3 deaths with functioning grafts) and 5 in group B (1 death, 3 vascular causes, 1 kidney nonfunction). The 4 deaths were due to infection (n = 3) or neoplasia (n = 1). Graft survivals at 1 year were 98% in group A and 85% in group B, and patient survivals were 98% and 97%, respectively. An immunosuppressive regimen using antibody induction and steroid-free treatment proved to be effective in low-risk patients.
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Affiliation(s)
- R Filipe
- Renal Transplantation Unit, Departments of Urology and Kidney Transplantation, Coimbra University Hospital, Coimbra, Portugal.
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Reis F, Parada B, Teixeira de Lemos E, Garrido P, Dias A, Piloto N, Baptista S, Sereno J, Eufrásio P, Costa E, Rocha-Pereira P, Santos-Silva A, Figueiredo A, Mota A, Teixeira F. Hypertension Induced by Immunosuppressive Drugs: A Comparative Analysis Between Sirolimus and Cyclosporine. Transplant Proc 2009; 41:868-73. [DOI: 10.1016/j.transproceed.2009.02.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Reis F, Teixeira-de-Lemos E, Espinhaço L, Parada B, Pinto R, Baptista S, Dias A, Rocha-Pereira P, Teixeira F. PARAOXONASE ACTIVITY, OXIDATIVE STRESS AND HDL-C AND LDL-C LEVELS IN A PORTUGUESE POPULATION SAMPLE. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70333-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Teixeira F, Teixeira de Lemos E, Reis F, Espinhaço L, Baptista S, Pinto R, Parada B, Dias A. ASSOCIATION BETWEEN ADIPONECTIN, CRP LEVELS AND THE LIPIDIC PROFILE IN A PORTUGUESE POPULATION.A PRELIMINARY STUDY. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70855-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Reis F, Teixeira de Lemos E, Almeida L, Parada B, Garrido AP, Rocha-Pereira P, Santos-Silva A, Santos-Dias J, Dinis A, Figueiredo A, Costa-Almeida C, Mota A, Teixeira F. Dual effect of nitrate therapy for cyclosporine-induced hypertension on vascular and platelet morphofunctional markers; an animal model. Transplant Proc 2007; 39:2501-6. [PMID: 17954158 DOI: 10.1016/j.transproceed.2007.07.029] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study sought to evaluate the prevention and reversion effects of isosorbide-5-mononitrate (Is-5-Mn) on the development of hypertension (HT) and on the underlying vascular and platelet morphofunctional disturbances, using an animal model of cyclosporine (CsA)-induced HT. The following rat groups (n = 8) were tested: (1) a control group (orange juice, for 7 weeks); (2) the CsA group (5 mg/kg/d for 7 weeks); (3) the Is-5-Mn group (150 mg/kg/d, twice a day for 7 weeks); (4) the prevention group (Is-5-Mn + CsA) treated for 2 weeks with Is-5-Mn only and thereafter with both drugs for 7 weeks; (5) the curative group (CsA + Is-5-Mn) beginning 7 weeks after CsA and following thereafter with both drugs for 5 weeks. Blood pressure, lipid profile, vascular lesion, platelet aggregation and morphology, and platelet thromboxane A(2)/vascular prostacyclin equilibrium were evaluated. Is-5-Mn + CsA therapy prevented (systolic blood pressure [SBP]: 114.3 +/- 1.9 mm Hg, P < .001; diastolic blood pressure [DBP]: 97.0 +/- 3.3 mm Hg, P < .001) the CsA-induced HT (SBP: 146.2 +/- 4.5 mm Hg, P < .001; DBP: 124.9 +/- 4.5 mm Hg, P < .001 vs control: SBP: 111.6 +/- 0.7 mm Hg; DBP: 94.6 +/- 1.0 mm Hg), as well as the vascular lesion and the platelet morphofunctional disturbances. The curative group did not show attenuated CsA-induced BP increase; it showed further enhancement of the HT effect (SBP: 159.7 +/- 5.5 mm Hg, P < .05; DBP: 132.8 +/- 2.8 mm Hg), as well as worsened vascular lesions and platelet function, namely a disruption in the TXA(2)/PGI(2) equilibrium. Our data suggested that Is-5-Mn therapy may be a valid choice to prevent the morphofunctional changes associated with CsA-induced HT, when used as a preventive therapy. A careful evaluation of the impact of nitrate therapy should be considered, particularly the negative effect on cardiovascular hemodynamics, when considering its use after previous CsA disturbances have been established.
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Affiliation(s)
- F Reis
- Institute of Pharmacology and Experimental Therapeutics, Faculty of Medicine, Coimbra University, 3004-504 Coimbra, Portugal
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Nunes P, Mota A, Alves R, Figueiredo A, Parada B, Macário F, Rolo F. Simultaneous renal transplantation and native nephrectomy in patients with autosomal-dominant polycystic kidney disease. Transplant Proc 2007; 39:2483-5. [PMID: 17954154 DOI: 10.1016/j.transproceed.2007.07.035] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
UNLABELLED Our objective was to study the influence on transplant outcome of unilateral native nephrectomy of massively enlarged kidneys at the time of renal transplantation among patients with end-stage renal disease owing to autosomal-dominant polycystic kidney disease (ADPKD). PATIENTS AND METHODS We studied 159 renal transplants in patients with ADPKD divided into two groups according to the need to perform a unilateral native nephrectomy owing to enlarged kidneys (N+; n = 143) versus those not (N0; n = 16) needing this procedure. Parameters related to the donors, grafts, recipients, and operative data were correlated with short- and long-term outcomes. The groups were homogeneous in terms of recipient and donor ages, genders, HLA compatibilities, and length of pretransplant dialysis. RESULTS When no nephrectomy was needed surgery length was shorter (N0, 3.01 vs. N+, 4.23 hours; P < .001), less intraoperative crystalloids were infused (N0, 1.84 vs. N+, 2.76 L; P < .001), and less plasma (N0, 2.07 vs. N+, 2.93 U; P < .05), or blood (N0, 1.05 vs. N+, 1.81 U; P < .05) transfusions were required. Hospital stay was similar (N0, 12.70 vs N+, 16.50 days; P not significant [NS]). There was only one urologic complication in the nephrectomy group. There were no differences (P = NS) in rates of delayed graft function (N0, 19.9%; N+, 12.5%), acute rejections (N0, 25.5%; N0, 33.3%), chronic allograft dysfunction (N0, 15.8%; N+, 28.6%). Graft function at 1 month as well as 1 and 5 years were comparable. Patient and graft survivals were similar at 1 and 5 years. There were no differences in the causes of graft loss or patient death. CONCLUSION In patients with ADPKD native nephrectomy of massively enlarged kidneys may be safely performed during the transplant procedure with no repercussions on the length of hospital stay, graft short- and long-term function and patient survival. However the procedure eads to a longer operative time and greater need for fluids and blood products.
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Affiliation(s)
- P Nunes
- Department of Urology and Renal Transplantation, Hospitais da Universidade de Coimbra, 3000 Coimbra, Portugal.
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Nunes P, Mota A, Figueiredo A, Macário F, Rolo F, Dias V, Parada B. Efficacy of Renal Preservation: Comparative Study of Celsior and University of Wisconsin Solutions. Transplant Proc 2007; 39:2478-9. [DOI: 10.1016/j.transproceed.2007.07.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Figueiredo A, Moreira P, Parada B, Nunes P, Macário F, Bastos C, Mota A. Risk Factors for Delayed Renal Graft Function and Their Impact on Renal Transplantation Outcome. Transplant Proc 2007; 39:2473-5. [DOI: 10.1016/j.transproceed.2007.07.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Figueiredo A, Moreira P, Parada B, Nunes P, Macario F, Bastos C, Mota A. UP-01.72. Urology 2006. [DOI: 10.1016/j.urology.2006.08.716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Parada B, Figueiredo A, Nunes P, Bastos C, Rolo F, Mota A. UP-01.67. Urology 2006. [DOI: 10.1016/j.urology.2006.08.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nunes P, Parada B, Figueiredo A, Roseiro A, Dias V, Bastos C, Rolo F, Mota A. PD-09.03. Urology 2006. [DOI: 10.1016/j.urology.2006.08.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Parada B, Figueiredo A, Nunes P, Macário F, Mota A. UP-01.68. Urology 2006. [DOI: 10.1016/j.urology.2006.08.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Parada B, Figueiredo A, Nunes P, Moreira P, Rolo F, Mota A. PD-09.08. Urology 2006. [DOI: 10.1016/j.urology.2006.08.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nunes P, Parada B, Pratas J, Roseiro A, Figueiredo A, Macário F, Rolo F, Mota A. Cadaveric Donor Factor Variations During a 12-Year Period: Influence on Kidney Transplant Outcomes. Transplant Proc 2006; 38:1867-9. [PMID: 16908308 DOI: 10.1016/j.transproceed.2006.06.058] [Citation(s) in RCA: 4] [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: 11/21/2022]
Abstract
UNLABELLED Our purpose was to evaluate changes in cadaveric donor factors between 1993 and 2004 and their impact on the short- and long-term outcomes of renal transplants in a single center. PATIENTS AND METHODS Cadaveric renal transplants performed in our unit between 1993 and 2004 were divided in two groups of identical length: A (n = 455; 1993-1998) and B (n = 465; 1999-2004). Major differences related to donor, graft, and recipient factors were analyzed between groups and correlated with main outcome parameters. Recipient age, gender, weight, etiology of end-stage renal disease, average length of dialysis, and cold ischemia were not different in the two periods. RESULTS Grafts harvested in our hospital were more frequent in group A (92.3 vs 78.2%; P < .005). Traumatic causes of death were more frequent before 1999: 90.9 vs 70.9% (P < .001). Mean donor age was higher after 1999: 31.37 vs 35.94 years (P < .005). Female donors were more frequent in the second period: 20.5 vs 26.6% (P < .05). Mean donor weight was also higher: 52.36 vs 67.86 kg (P < .05). All of these differences were unfavourable characteristics regarding graft outcomes. Delayed graft function (A = 13%, B = 24.2%), acute rejection episodes (A = 41.2%, B = 28%), and chronic allograft dysfunction (A = 23.5%, B = 14.4%) were also significantly different between the two cohorts (P < .005). Graft function (serum creatinine at 1 and 2 years), patient and graft survivals, causes of graft loss, and of patient death were similar across time. CONCLUSION The unfavorable tendency in the quality of cadaveric donors during the last 12 years had no negative impact on graft function and patient outcome.
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Affiliation(s)
- P Nunes
- Department of Urology and Renal Transplantation, Hospitais da Universidade de Coimbra, 3000 Coimbra, Portugal.
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Parada B, Figueiredo A, Nunes P, Bastos C, Macário F, Roseiro A, Dias V, Rolo F, Mota A. Pediatric renal transplantation: comparative study with renal transplantation in the adult population. Transplant Proc 2006; 37:2771-4. [PMID: 16182806 DOI: 10.1016/j.transproceed.2005.05.046] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [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: 11/26/2022]
Abstract
PURPOSE To retrospectively review our experience with pediatric renal transplantation and to compare the results with the adult population. PATIENTS AND METHODS Between January 1981 and August 2003, 74 renal transplants were performed in patients < or =18 years at the time of the transplant--the pediatric group versus 1153 patients in the adult group. We analyzed various risk factors for actuarial kidney graft and patient survivals using the Kaplan-Meier method. RESULTS Median ages were 13.8 +/- 3.5 and 42.6 +/- 2.4 years, respectively. There was no statistically significant difference in the human leukocyte antigen matching or immunosuppression. There was, however, a younger donor age and shorter ischemia time in the pediatric group. Overall, kidney transplant survival rates for patients < or =18 years at 1, 2, 5, and 10 years were 94.4%, 91.3%, 70.6%, and 58.2%, respectively, with no significant difference for patients older than 18 (91.2%, 89.3%, 78.8%, 60.5%, P = .4325). There was a significantly decreased graft survival in the adult group at 10 years when the donor age was over 60 years and when the ischemia time was > or =20 hours. The incidence of delayed graft function and the creatinine levels of functioning grafts did not differ between the two groups. During the follow-up, acute rejections were more frequent in the younger group. Patient survival in the pediatric group at 1, 2, 5, and 10 years was 98.6%, 98.8%, 98.6%, and 90.3%, respectively, significantly lower in the adult group (95.3%, 94.0%, 87.9%, 76.8%, P < .02). CONCLUSIONS Renal transplantation may be successfully performed in the pediatric patients with end-stage renal disease. Overall graft survival at 10 years did not differ significantly between the two groups. There is a higher incidence of acute rejections but longer patient survival in the pediatric population.
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Affiliation(s)
- B Parada
- Department of Urology and Renal Transplantation, University Hospital of Coimbra, Coimbra, Portugal.
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Abstract
PURPOSE Compare renal transplant long-term outcomes among recipients aged 60 years or older with those in younger patients. PATIENTS AND METHODS We analyzed 103 transplants in recipients above 60 years of age for the influence of key factors related to the graft and patient. The results were compared with 1060 transplant recipients aged 18 to 59 years. RESULTS The mean ages were 62.93 and 40.35 years for the older and younger group. The older group showed a higher prevalence of obesity and unknown etiologies for the end-stage renal disease. Important comorbidity was significantly more frequent among recipients aged more than 60 years, mainly of a cardiovascular nature (56% vs 18.5%). Donor age (39.75 vs 31.59 years), cold ischemia time (22.43 vs 20.49 hours) and human leukocyte antigen compatibilities (2.59 vs 2.36) were significantly greater in the older subset. After a mean follow-up of 4.72 and 6.07 years for the older versus younger group, we found no differences in initial graft function, acute rejection rate, and serum creatinine/clearance. Patient and graft survivals at 1, 5, and 10 years were lower among the 60+ group. There were no differences in graft survival censored for death with a functioning graft, namely, 95.1%, 89.4%, and 81.2% for the 60+ cohort. The main cause of graft loss in the older group was death with a functioning graft. CONCLUSION Renal transplantation should be considered for selected patients older than 60 years. Despite a shorter life expectancy, they benefit from it similar to younger recipients.
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Affiliation(s)
- P Nunes
- Department of Urology and Renal Transplantation, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
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Abstract
PURPOSE To describe our initial results using a calcineurin inhibitor-free immunosuppression protocol in renal transplants. PATIENTS AND METHODS Between October 2001 and June 2003, 56 recipients of a renal allografts were started on an immunosuppression protocol without calcineurin inhibitors, consisting of basiliximab, sirolimus, mycophenolate mofetil, and steroids. We analyzed patient and graft survival, acute rejection episodes, and renal function. RESULTS The mean follow-up was 19.6 months. Actuarial patient survival at 1 and 2 years was 98.1% and 95.3%, respectively. Actuarial graft survival at 1 and 2 years was 92.9% and 87.6%, respectively. Acute rejection occurred in 27.8% of the patients, usually Banff 1 (73.3%). There was stable renal function with mean serum creatinine of 1.3, 1.4, 1.3, and 1.3 mg/dL at 1, 6, 12, and 24 months after transplant. CONCLUSIONS The use of immunosuppression free of calcineurin inhibitors is effective and safe. Further follow-up is needed to evaluate the impact on long-term results.
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Affiliation(s)
- B Parada
- Department of Urology and Renal Transplantation, University Hospital of Coimbra, Coimbra, Portugal.
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Mota A, Figueiredo A, Macário F, Cunha FX, Freitas L, Parada B, Bastos C, Furtado L. Risk factors for chronic graft dysfunction in 918 renal transplants. Transplant Proc 2003; 35:1064-5. [PMID: 12947857 DOI: 10.1016/s0041-1345(03)00307-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- A Mota
- Department of Urology and Transplantation, Coimbra University Hospital, 3049 Coimbra, Portugal
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Affiliation(s)
- B Parada
- Department of Urology and Transplantation, Coimbra University Hospital, 3049 Coimbra, Portugal.
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Affiliation(s)
- B Parada
- Department of Urology and Transplantation, Coimbra University Hospital, 3049 Coimbra, Portugal
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