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Tejedor-Tejada J, García-Pajares F, Madrigal Rubiales B. Hepatobiliary and Pancreatic: Sertraline-induced vanishing bile duct syndrome treated with plasmapheresis. J Gastroenterol Hepatol 2019; 34:488. [PMID: 30536927 DOI: 10.1111/jgh.14503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 09/30/2018] [Indexed: 12/09/2022]
Affiliation(s)
- J Tejedor-Tejada
- Department of Gastroenterology and Hepatology, Río Hortega Universitary Hospital, Valladolid, Spain
| | - F García-Pajares
- Department of Gastroenterology and Hepatology, Río Hortega Universitary Hospital, Valladolid, Spain
| | - B Madrigal Rubiales
- Department of Pathology, Río Hortega Universitary Hospital, Valladolid, Spain
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García-Pajares F, Peñas-Herrero I, Sánchez-Ocaña R, Torrres-Yuste R, Cimavilla-Román M, Carbajo-López A, Almohalla-Alvarez C, Pérez-Saborido B, Muñoz-Conejero E, Gonzalez-Sagrado M, Caro-Patón A, Sánchez-Antolín G. Metabolic Syndrome After Liver Transplantation: Five-Year Prevalence and Risk Factors. Transplant Proc 2017; 48:3010-3012. [PMID: 27932133 DOI: 10.1016/j.transproceed.2016.07.038] [Citation(s) in RCA: 13] [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] [Received: 06/14/2016] [Accepted: 07/27/2016] [Indexed: 12/11/2022]
Abstract
Survival after orthotopic liver transplantation (OLT) has increased over the last decades, focusing on the metabolic complications that contribute to patient morbidity and mortality. The aim of our study was to describe the prevalence of metabolic syndrome (MS), its components, and its associated factors in patients who underwent OLT in a hospital in Spain. From November 2001 to January 2014, we performed 415 transplantations in 386 patients. We analyzed 204 patients with a minimum follow-up of 1 year (77.6% were male and the mean age was 54.2+/-9.5 years). The most frequent etiology was alcohol (41%), followed by hepatitis C virus (29.1%). The indication was decompensated cirrhosis in 51.8% and hepatocellular carcinoma in 34%. According to modified National Cholesterol Education Program-Adult Treatment Panel-III (NCEP-ATP III) criteria, 5 years post-transplantation MS was diagnosed in 38.2% of patients. Significant independent predictors of post-transplantation MS on logistic regression analysis were as follows: pretransplantation obesity (odds ratio [OR], 3.09; P = .056), 1-year post-transplantation obesity (OR, 3.95; P = .009), pretransplantation diabetes (OR, 4.63; P = .001), 1-year post-transplantation diabetes (OR, 3.01; P = .015), 1-year post-transplantation hypertension (OR, 1.85; P = .176), and hypertriglyceridemia at the first year after transplantation (OR, 2.32; P = .063). In our center the prevalence of MS at 5 years after OLT is slightly lower than published. The most important risk factors were obesity and diabetes (both pretransplantation and the first year post-transplantation).
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Affiliation(s)
- F García-Pajares
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain.
| | - I Peñas-Herrero
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain
| | - R Sánchez-Ocaña
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain
| | - R Torrres-Yuste
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain
| | - M Cimavilla-Román
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain
| | - A Carbajo-López
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain
| | | | - B Pérez-Saborido
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain; Surgery Service, Liver Transplantation Unit, Valladolid, Spain
| | - E Muñoz-Conejero
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain
| | - M Gonzalez-Sagrado
- Investigation Unit, Hospital Universitario Río Hortega, Valladolid, Spain
| | - A Caro-Patón
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain
| | - G Sánchez-Antolín
- Gastroenterology Service, Liver Transplantation Unit, Valladolid, Spain
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García-Pajares F, Santos-Santamarta F, Fernández-Fontecha E, Sánchez-Ocaña R, Amo-Alonso R, Loza-Vargas A, Madrigal B, Pérez-Saborido B, Almohalla C, Sánchez-Antolín G. Severe anemia, gastric ulcer, pneumonitis and cholangitis in a liver transplant patient: multiple organic dysfunction and one etiology: a case report. Transplant Proc 2015; 47:136-8. [PMID: 25645792 DOI: 10.1016/j.transproceed.2014.11.019] [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: 11/17/2022]
Abstract
Cytomegalovirus (CMV) is the most common viral pathogen that negatively affects the outcome of liver transplantation. CMV causes febrile illness often accompanied by bone marrow suppression, and in some cases it invades tissues, including the transplanted allograft. In addition, CMV has been significantly associated with an increased predisposition to allograft rejection, accelerated hepatitis C recurrence, and other opportunistic infections, as well as reduced overall patient and allograft survivals. We carried out a study on a Spanish adult liver transplant recipient who rapidly presented anemia and was diagnosed as having Coomb negative (nonimmune) hemolytic anemia, gastric ulcer, pneumonitis, and cholangitis associated with a CMV infection.
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Affiliation(s)
- F García-Pajares
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain.
| | - F Santos-Santamarta
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
| | - E Fernández-Fontecha
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
| | - R Sánchez-Ocaña
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
| | - R Amo-Alonso
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
| | - A Loza-Vargas
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
| | - B Madrigal
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
| | - B Pérez-Saborido
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
| | - C Almohalla
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
| | - G Sánchez-Antolín
- Gastroenterology Service, Hematology Service, Pathology Service, Surgery Service, Hospital Río Hortega, Valladolid, Spain
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García-Pajares F, Sánchez-Antolín G, Almohalla Alvárez C, Madrigal Rubiales B, Núñez-Rodríguez H, Sancho del Val L, Ruiz-Zorrilla R, Barrera A, Gómez-Nieto A, Peñas Herrero I, Vargas García A, Caro-Patón A. Cutaneous mucormycosis infection by Absidia in two consecutive liver transplant patients. Transplant Proc 2013; 44:1562-4. [PMID: 22841214 DOI: 10.1016/j.transproceed.2012.05.022] [Citation(s) in RCA: 4] [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: 11/29/2022]
Abstract
Mucormycosis, although an infrequent fungal infection, has a high mortality in patients undergoing orthotopic liver transplantation. We present two cases of cutaneous Absidia mucormycosis in two successive patients undergoing liver transplantation in our hospital. In our literature search, we encountered only one published case of Absidia infection in liver transplantation.
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Affiliation(s)
- F García-Pajares
- Liver Transplantation Unit, Hospital Universitario Río Hortega, Valladolid, Spain.
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García-Pajares F, Almohalla C, Lorenzo Pelayo S, Ruiz Zorrilla R, Pinto P, Ramos C, Sanchez Antolin G, Paton A. Early and Extended Therapy for Recurrent Hepatitis C after Liver Transplantation. Transplant Proc 2012; 44:1571-3. [DOI: 10.1016/j.transproceed.2012.05.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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García-Pajares F, Sánchez-Antolín G, Pelayo S, Gómez de la Cuesta S, Herranz Bachiller M, Pérez-Miranda M, de La Serna C, Vallecillo Sande M, Alcaide N, Llames R, Pacheco D, Caro-Patón A. Covered Metal Stents for the Treatment of Biliary Complications after Orthotopic Liver Transplantation. Transplant Proc 2010; 42:2966-9. [DOI: 10.1016/j.transproceed.2010.07.084] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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García-Pajares F, Caro-Patón Gómez A. Hepatocyte growth factor (HGF): a predictor of outcome and response to therapy in hepatitis C? Rev Esp Enferm Dig 2010; 102:349-351. [PMID: 20575593 DOI: 10.4321/s1130-01082010000600001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Martín MA, Saracíbar E, Santamaría A, Arranz E, Garrote JA, Almaraz A, del Olmo ML, García-Pajares F, Fernández-Orcajo P, Velicia R, Blanco-Quirós A, Caro-Patón A. [Interleukin 18 (IL-18) and other immunological parameters as markers of severity in acute pancreatitis]. Rev Esp Enferm Dig 2009; 100:768-73. [PMID: 19222336 DOI: 10.4321/s1130-01082008001200006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Our aim was to prospectively compare the behavior of interleukin 18 (IL-18) levels and other immunological parameters during the first week of hospitalization between acute pancreatitis patients with and without severity criteria, as well as between patients with and without late pseudocyst development. PATIENTS AND METHODS In 36 patients with acute pancreatis we compared sTNF-RI, IL-1Ra, IL-6, and IL-18 levels at days 1, 2, 3 and 7 after hospitalization between mild pancreatitis, severe pancreatitis, and a "control" group (13 patients) with uncomplicated biliary colic, as well as between patients with and without pseudocyst. RESULTS On comparing mild to severe pancreatitis, IL-18 was significantly higher only the first day in severe pancreatitis, while the other parameters were steadily higher after the second day. In patients developing pseudocyst, IL-18 was also noticeably higher the first day. CONCLUSIONS IL-18 appears to be the earliest marker of complications and severity in acute pancreatitis at both the systemic and local level (pseudocyst).
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Affiliation(s)
- M A Martín
- Servicio de Aparato Digestivo, Hospital Universitario del Río Hortega, Departamento de Medicina, Facultad de Medicina
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Núñez-Rodríguez MH, Calero H, Velicia-Llames R, García-Pajares F, Sánchez-Antolín G, Caro-Patón A. Fístula arterioportal sintomática resuelta mediante tratamiento conservador. Gastroenterología y Hepatología 2006; 29:237-9. [PMID: 16584694 DOI: 10.1157/13085977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Arterioportal shunt in the liver is a rare vascular disorder that may be due to congenital vascular malformation (hereditary hemorrhagic telangiectasia), trauma, iatrogenic causes (after a hepatic biopsy) or neoplasm. Initial treatment consists of transcatheter arterial embolization with different kinds of materials. We present the case of a 64-year-old woman with signs of portal hypertension and severe diarrhea. Doppler ultrasonography, computed tomography and angiography revealed arterioportal fistulae between the hepatic artery and right portal vein. Transcatheter arterial embolization with n-butyl-2-cyanoacrylate surgical glue (Glubran) was successfully performed. After 2 years of follow-up, the patient remains asymptomatic. Transcatheter arterial embolization with Glubran should be considered as a therapeutic option in arterioportal shunts and could be a definitive therapy.
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Affiliation(s)
- M H Núñez-Rodríguez
- Servicio de Digestivo, Hospital Universitario Río Hortega, Valladolid, Spain.
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Cantalapiedra A, Peñarrubia MJ, Gutiérrez O, García-Pajares F, Núñez H, García-Frade J, Caro-Patón A. Cirrosis biliar primaria, síndrome "sicca" y anemia hemolítica autoinmune. Rev esp enferm dig 2005; 97:678-9. [PMID: 16266245 DOI: 10.4321/s1130-01082005000900014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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