128 results on '"Varo, Evaristo"'
Search Results
2. Abdominal normothermic regional perfusion in controlled donation after circulatory determination of death liver transplantation: Outcomes and risk factors for graft loss
- Author
-
Hessheimer, Amelia J., de la Rosa, Gloria, Gastaca, Mikel, Ruíz, Patricia, Otero, Alejandra, Gómez, Manuel, Alconchel, Felipe, Ramírez, Pablo, Bosca, Andrea, López-Andújar, Rafael, Atutxa, Lánder, Royo-Villanova, Mario, Sánchez, Belinda, Santoyo, Julio, Marín, Luís M., Gómez-Bravo, Miguel Á., Mosteiro, Fernando, Villegas Herrera, María T., Villar del Moral, Jesús, González-Abos, Carolina, Vidal, Bárbara, López-Domínguez, Josefina, Lladó, Laura, Roldán, José, Justo, Iago, Jiménez, Carlos, López-Monclús, Javier, Sánchez-Turrión, Víctor, Rodríguez-Laíz, Gonzalo, Velasco Sánchez, Enrique, López-Baena, Jose Á., Caralt, Mireia, Charco, Ramón, Tomé, Santiago, Varo, Evaristo, Martí-Cruchaga, Pablo, Rotellar, Fernando, Varona, María A., Barrera, Manuel, Rodríguez-Sanjuan, Juan C., Briceño, Javier, López, Diego, Blanco, Gerardo, Nuño, Javier, Pacheco, David, Coll, Elisabeth, Domínguez-Gil, Beatriz, and Fondevila, Constantino
- Published
- 2022
- Full Text
- View/download PDF
3. A Survey of Heads of Surgery and Residents on Accessibility and Employment in Liver Transplant Teams in Spain
- Author
-
Blanco Fernández, Gerardo, Gómez Bravo, Miguel Ángel, Briceño Delgado, Javier, Valdivieso López, Andrés, López-Guerra, Diego, Rodríguez-Laiz, Gonzalo, Villar-del-Moral, Jesús, Pardo Sánchez, Fernando, Santoyo, Julio, López Andújar, Rafael, Nuño, Javier, Sánchez Turrión, Víctor, González Pinto, Ignacio, Jiménez, Carlos, López Baena, José Ángel, Gómez Gutierrez, Manuel, Fabregat Prous, Joan, Pacheco Sánchez, David, Barrera, Manuel, García-Gil, Agustín, Ramírez, Pablo, Varo, Evaristo, Bilbao, Itxarone, Fondevila, Constantino, and Rodríguez-Sanjuan, Juan Carlos
- Published
- 2019
- Full Text
- View/download PDF
4. Encuesta a los jefes de Unidad y residentes de Cirugía sobre la accesibilidad y el trabajo en los equipos de trasplante hepático en España
- Author
-
López-Guerra, Diego, Rodríguez-Laiz, Gonzalo, Villar-del-Moral, Jesús, Pardo Sánchez, Fernando, Santoyo, Julio, López Andújar, Rafael, Nuño, Javier, Sánchez Turrión, Víctor, González Pinto, Ignacio, Jiménez, Carlos, López Baena, José Ángel, Gómez Gutierrez, Manuel, Fabregat Prous, Joan, Pacheco Sánchez, David, Barrera, Manuel, García-Gil, Agustín, Ramírez, Pablo, Varo, Evaristo, Bilbao, Itxarone, Fondevila, Constantino, Rodríguez-Sanjuan, Juan Carlos, Blanco Fernández, Gerardo, Gómez Bravo, Miguel Ángel, Briceño Delgado, Javier, and Valdivieso López, Andrés
- Published
- 2019
- Full Text
- View/download PDF
5. Multicentric Study on Total Pancreatectomies
- Author
-
Fabregat Prous, Joan, Secanella, Lluis, Larrea, Javier, Olea, Sanchez Bueno, Francisco, Botello Martinez, Francisco, Briceño, Javier, Miyar-de León, Alberto, Serradilla, Mario, Serrablo, Alejandro, Ferrer Fabrega, Joana, Sanchez Cabús, S., Angel Gómez Bravo, Miguel, Padillo, Javier, Blanco, Laia, Balcells, J., Cugat, Esteban, García Domingo, Maribel, Muñoz Bellvis, Luis, Dolores Perez Diaz, Maria, Santoyo Santoyo, Julio, Sanchez, Belinda, Villegas, Trinidad, Pacho, Silvino, Díez Valladares, Luis, Rebollar, Jose, Ángel Suárez Muñoz, Miguel, Domínguez, Elías, Martín Perez, Elena, Falgueras, Laia, Poves, Ignasi, Artigas, Vicenç, Sabater, Luis, Garcia Gil, Agustin, Ignacio Miota de Llama, Jose, Manzanet, Gerardo, Carlos Pino, Jose, Carlos Rodríguez Sanjuán, Juan, Lluis, F., Ausania, Fabio, Alkorta Zuloaga, Maialen, Escartín, Jorge, Salas, Manel, Domingo, Carlos, Artigues Sánchez de Rojas, Enrique, Antonio Barreras Mateos, José, María Fernández Cebrián, José, Pérez Cabrera, Beatriz, Padilla Valverde, D., Sanjuanbenito, Alfonso, Iturburu Belmonte, Ignacio, Bejarano, Natalia, García Borobia, F., Toral Guinea, Pablo, Lopez Marcano, Aylhin, Asencio Arana, Francisco, Varo, Evaristo, Esteban, Rafael, Blas, Juan L., Jover Navalón, José M., Fernández Martínez, Cristina, Daban Collado, Enrique, Calvo Duran, Antonio, Vicens, J.C., Romero, J., Badía, J.M., Sánchez, Raquel, de Miguel Ibáñez, Ricardo, Pardoc, Fernando, Francos von Hunefeld, Carlos, Pereira, Fernando, Garcia Molina, Francisco, Rodríguez Prieto, Ignacio, Alonso Poza, Alfredo, Gilsanz, Carlos, Miguel Martínez Albert, Jose, Angel Morcillo, Miguel, Martínez Cortijo, Sagrario, Martín Fernández, José, Baquedano, Jesús, Castell, José, Aguiló, Javier, Carlos Bernal, Juan, Ramia, Jose M., Martin-Perez, Elena, Fabregat-Prous, Joan, Larrea y Olea, Javier, Sanchez-Bueno, Francisco, Botello-Martinez, Francisco, and Moya-Herraiz, Angel
- Published
- 2019
- Full Text
- View/download PDF
6. Estudio multicéntrico nacional sobre pancreatectomías totales
- Author
-
Fabregat Prous, Joan, Secanella, Lluis, Larrea y Olea, Javier, Sanchez Bueno, Francisco, Botello Martinez, Francisco, Briceño, Javier, Miyar-de León, Alberto, Serradilla, Mario, Serrablo, Alejandro, Ferrer Fabrega, Joana, Sanchez Cabús, S., Angel Gómez Bravo, Miguel, Padillo, Javier, Blanco, Laia, Balcells, J., Cugat, Esteban, García Domingo, Maribel, Muñoz Bellvis, Luis, Dolores Perez Diaz, Maria, Santoyo Santoyo, Julio, Sanchez, Belinda, Villegas, Trinidad, Pacho, Silvino, Díez Valladares, Luis, Rebollar, Jose, Ángel Suárez Muñoz, Miguel, Domínguez, Elías, Martín Perez, Elena, Falgueras, Laia, Poves, Ignasi, Artigas, Vicenç, Sabater, Luis, Garcia Gil, Agustin, Ignacio Miota de Llama, Jose, Manzanet, Gerardo, Carlos Pino, Jose, Carlos Rodríguez Sanjuán, Juan, Lluis, F., Ausania, Fabio, Alkorta Zuloaga, Maialen, Escartín, Jorge, Salas, Manel, Domingo, Carlos, Artigues Sánchez de Rojas, Enrique, Antonio Barreras Mateos, José, María Fernández Cebrián, José, Pérez Cabrera, Beatriz, Padilla Valverde, D., Sanjuanbenito, Alfonso, Iturburu Belmonte, Ignacio, Bejarano, Natalia, García Borobia, F., Toral Guinea, Pablo, Lopez Marcano, Aylhin, Asencio Arana, Francisco, Varo, Evaristo, Esteban, Rafael, Blas, Juan Laaa, Jover Navalón, José M., Fernández Martínez, Cristina, Daban Collado, Enrique, Calvo Duran, Antonio, Vicens, J.C., Romero, J., Badía, J.M., Sánchez, Raquel, de Miguel Ibáñez, Ricardo, Pardoc, Fernando, Francos von Hunefeld, Carlos, Pereira, Fernando, Garcia Molina, Francisco, Rodríguez Prieto, Ignacio, Alonso Poza, Alfredo, Gilsanz, Carlos, Miguel Martínez Albert, Jose, Angel Morcillo, Miguel, Martínez Cortijo, Sagrario, Martín Fernández, José, Baquedano, Jesús, Castell, José, Aguiló, Javier, Carlos Bernal, Juan, Ramia, Jose M., Martin-Perez, Elena, Fabregat-Prous, Joan, Sanchez-Bueno, Francisco, Botello-Martinez, Francisco, and Moya-Herraiz, Angel
- Published
- 2019
- Full Text
- View/download PDF
7. Post-operative stress hyperglycemia is a predictor of mortality in liver transplantation
- Author
-
Giráldez, Elena, Varo, Evaristo, Guler, Ipek, Cadarso-Suarez, Carmen, Tomé, Santiago, Barral, Patricia, Garrote, Antonio, and Gude, Francisco
- Published
- 2018
- Full Text
- View/download PDF
8. Profilaxis de la infección por citomegalovirus en el trasplante hepático
- Author
-
Cisneros, José Miguel and Varo, Evaristo
- Published
- 2011
- Full Text
- View/download PDF
9. Severe, non-bacteremic infections in ICU patients
- Author
-
Aguado, José M., Torres, Antonio, Muñoz, Patricia, Soriano, Álex, Carratalá, Jordi, Guirao, Xavier, and Varo, Evaristo
- Published
- 2011
- Full Text
- View/download PDF
10. GESITRA-SEIMC/REIPI recommendations for the management of cytomegalovirus infection in solid-organ transplant patients
- Author
-
Torre-Cisneros, Julian, Fariñas, M. Carmen, Castón, Juan José, Aguado, José María, Cantisán, Sara, Carratalá, Jordi, Cervera, Carlos, Cisneros, José Miguel, Cordero, Elisa, Crespo-Leiro, Maria G., Fortún, Jesús, Frauca, Esteban, Gavaldá, Joan, Gil-Vernet, Salvador, Gurguí, Mercé, Len, Oscar, Lumbreras, Carlos, Marcos, María Ángeles, Martín-Dávila, Pilar, Monforte, Victor, Montejo, Miguel, Moreno, Asunción, Muñoz, Patricia, Navarro, David, Pahissa, Albert, Pérez, José Luis, Rodriguez-Bernot, Alberto, Rumbao, José, San Juan, Rafael, Santos, Francisco, Varo, Evaristo, and Zurbano, Felipe
- Published
- 2011
- Full Text
- View/download PDF
11. Impact of tacrolimus and mycophenolate mofetil regimen vs. a conventional therapy with steroids on cardiovascular risk in liver transplant patients
- Author
-
Cuervas-Mons, Valentín, Herrero, Ignacio J., Gomez, Miguel A., González-Pinto, Ignacio, Serrano, Trinidad, de la Mata, Manuel, Fabregat, Joan, Gastaca, Mikel, Bilbao, Itxarone, Varo, Evaristo, Sánchez-Antolín, Gloria, Rodrigo, Juan, and Espinosa, María Dolores
- Published
- 2015
- Full Text
- View/download PDF
12. Acute cellular rejection versus recurrent hepatitis C after liver transplantation: Clinical and pathological features driving a rational diagnostic approach
- Author
-
de la Peña-Moral, Jesús M., Pons, Jose A., Tome, Santiago, Gude, Francisco, Miras, Manuel, Bermejo, Juan, Ramirez, Pablo, Berenguer, Marina, Varo, Evaristo, Forteza, Jeronimo, and Parrilla, Pascual
- Published
- 2015
- Full Text
- View/download PDF
13. Tratamiento de pacientes con lesiones graves de la vía biliar
- Author
-
González Rodríguez, Francisco Javier, Bustamante Montalvo, Manuel, Conde Freire, Rogelio, Martínez, Jorge, Rodríguez Segade, Faustino, and Varo, Evaristo
- Published
- 2008
- Full Text
- View/download PDF
14. Donation after circulatory death liver transplantation: consensus statements from the Spanish Liver Transplantation Society
- Author
-
Hessheimer, Amelia J., Gastaca, Mikel, Miñambres, Eduardo, Colmenero, Jordi, Fondevila, Constantino, Briceño, Javier, Caralt, Mireia, de la Rosa, Gloria, Fernández Aguilar, José Luis, Fundora, Yiliam, García‐Gil, F. Agustín, González‐Pinto, Ignacio, Lladó, Laura, López‐Andújar, Rafael, López Guerra, Diego, López Santamaría, Manuel, Manrique, Alejandro, Marín Gómez, Luis Miguel, Moneva, Enrique, Nuño, Javier, Pardo, Fernando, Pérez Saborido, Baltasar, Ramírez, Pablo, Rivas, José Ignacio, Rodríguez Laíz, Gonzalo P., Rodríguez Sanjuan, Juan Carlos, Ruíz, Patricia, Sánchez Turrión, Víctor, Varo, Evaristo, Velasco, Enrique Antonio, and Universidad de Cantabria
- Subjects
medicine.medical_specialty ,Consensus ,Tissue and Organ Procurement ,Standard of Good Practice ,medicine.medical_treatment ,Regional perfusion ,cardiac arrest ,030230 surgery ,Liver transplantation ,Postoperative management ,03 medical and health sciences ,0302 clinical medicine ,Clinical Research ,medicine ,Humans ,Intensive care medicine ,Liver diseases ,Marginal donor ,warm ischemia ,Transplantation ,Warm ischemia ,Transplantation of organs ,business.industry ,Malalties del fetge ,Graft Survival ,Organ Preservation ,Cardiac arrest ,Circulatory death ,Tissue Donors ,Liver Transplantation ,Death ,Perfusion ,Trasplantament d'òrgans ,Clinical Practice ,Spain ,Donation ,marginal donor ,Original Article ,030211 gastroenterology & hepatology ,business ,regional perfusion - Abstract
Summary Livers from donation after circulatory death (DCD) donors are an increasingly more common source of organs for transplantation. While there are few high‐level studies in the field of DCD liver transplantation, clinical practice has undergone progressive changes during the past decade, in particular due to mounting use of postmortem normothermic regional perfusion (NRP). In Spain, uncontrolled DCD has been performed since the late 1980s/early 1990s, while controlled DCD was implemented nationally in 2012. Since 2012, the rise in DCD liver transplant activity in Spain has been considerable, and the great majority of DCD livers transplanted in Spain today are recovered with NRP. A panel of the Spanish Liver Transplantation Society was convened in 2018 to evaluate current evidence and accumulated experience in DCD liver transplantation, in particular addressing issues related to DCD liver evaluation, acceptance criteria, and recovery as well as recipient selection and postoperative management. This panel has created a series of consensus statements for the standard of practice in Spain and has published these statements with the hope they might help guide other groups interested in implementing new forms of DCD liver transplantation and/or introducing NRP into their clinical practices.
- Published
- 2020
15. Resultados de una encuesta sobre el soporte nutricional perioperatorio en la cirugía pancreática y biliar en España
- Author
-
Loinaz, Carmelo, Ochando, Federico, Vicente, Emilio, Serrablo, Alejandro, López Cillero, Pablo, Gómez, Miguel Ángel, Fabregat Prous, Joan, Varo, Evaristo, Miyar de Leon, Albert, Fondevila, Constantino, Valdivieso, Andrés, Blanco, Gerardo, Sánchez, Belinda, López Andújar, Rafael, Fundora, Yilian, Cugat Andorrà, Esteban, Díez Valladares, Luis, Herrera, Javier, García Gil, Agustín, Morales, Rafael, Pardo, Fernando, Sabater, Luis, Baena, José Ángel, Muñoz Bellvis, Luis, Martín Pérez, Elena, Pérez Saborido, Baltasar, Suárez, Miguel Ángel, Meneu, Juan Carlos, Albiol, Maite, Sanjuanbenito, Alfonso, Ramia, José Miguel, Pereira, Fernando, Paseiro, Gloria, Palomo, Juan Carlos, Leon, Miguel, GENPOCIRP (Grupo Encuesta Nutrición PeriOperatoria en CIRugia Pancreatobiliar), UAM. Departamento de Cirugía, and Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-IP)
- Subjects
medicine.medical_specialty ,Medicina ,Medicine (miscellaneous) ,Páncreas. Biliar. Cirugía. Nutrición ,Nutritional Status ,Critical Care and Intensive Care Medicine ,Pancreatic head ,Biliary surgery ,Pancreatic surgery ,Pancreatectomy ,Surveys and Questionnaires ,medicine ,Humans ,Malalties del pàncrees ,Pancreas ,Nutrició ,Nutrition ,Nutrition and Dietetics ,Nutritional Support ,business.industry ,General surgery ,Biliary ,Guideline ,Perioperative ,Middle Aged ,Biliar ,Pancréas diseases ,Biliary Tract Surgical Procedures ,Páncreas ,Solid food ,Spain ,Nutrición ,Surgery ,Preoperative fasting ,business ,Oral feeding - Abstract
Introduction: a survey on peri-operative nutritional support in pancreatic and biliary surgery among Spanish hospitals in 2007 showed that few surgical groups followed the 2006 ESPEN guidelines. Ten years later we sent a questionnaire to check the current situation. Methods: a questionnaire with 21 items sent to 38 centers, related to fasting time before and after surgery, nutritional screening use and type, time and type of peri-operative nutritional support, and number of procedures. Results: thirty-four institutions responded. The median number of pancreatic resections (head/total) was 29.5 (95% CI: 23.0-35; range, 5-68) (total, 1002); of surgeries for biliary malignancies (non-pancreatic), 9.8 (95% CI: 7.3-12.4; range, 2-30); and of main biliary resections for benign conditions, 10.4 (95% CI: 7.6-13.3; range, 2-33). Before surgery, only 41.2% of the sites used nutritional support (< 50% used any nutritional screening procedure). The mean duration of preoperative fasting for solid foods was 9.3 h (range, 6-24 h); it was 6.6 h for liquids (range, 2-12). Following pancreatic surgery, 29.4% tried to use early oral feeding, but 88.2% of the surveyed teams used some nutritional support; 26.5% of respondents used TPN in 100% of cases. Different percentages of TPN and EN were used in the other centers. In malignant biliary surgery, 22.6% used TPN always, and EN in 19.3% of cases. Conclusions: TPN is the commonest nutrition approach after pancreatic head surgery. Only 29.4% of the units used early oral feeding, and 32.3% used EN; 22.6% used TPN regularly after surgery for malignant biliary tumours. The 2006 ESPEN guideline recommendations are not regularly followed 12 years after their publication in our country., Introducción: realizamos una encuesta sobre soporte nutricional perioperatorio en cirugía pancreática y biliar en hospitales españoles en 2007, que mostró que pocos grupos quirúrgicos seguían las guías de ESPEN 2006. Diez años después enviamos un cuestionario para comprobar la situación actual. Métodos: treinta y ocho centros recibieron un cuestionario con 21 preguntas sobre tiempo de ayunas antes y después de la cirugía, cribado nutricional, duración y tipo de soporte nutricional perioperatorio, y número de procedimientos. Resultados: respondieron 34 grupos. La mediana de pancreatectomías (cabeza/total) fue de 29,5 (IC 95 %: 23,0-35; rango, 5-68) (total, 1002), la de cirugías biliares malignas de 9,8 (IC 95 %: 7,3-12,4; rango, 2-30) y la de resecciones biliares por patología benigna de 10,4 (IC 95 %: 7,6-13,3; rango, 2-33). Solo el 41,2 % de los grupos utilizaban soporte nutricional antes de la cirugía (< 50 % habian efectuado un cribado nutricional). El tiempo medio de ayuno preoperatorio para sólidos fue de 9,3 h (rango, 6-24 h), y de 6,6 h para líquidos (rango, 2-12). Tras la pancreatectomía, el 29,4 % habían intentado administrar una dieta oral precoz, pero el 88,2 % de los grupos usaron algún tipo de soporte nutricional y el 26,5 % usaron NP en el 100 % de los casos. Los demás grupos usaron diferentes porcentajes de NP y NE en sus casos. En la cirugía biliar maligna, el 22,6 % utilizaron NP siempre y NE en el 19,3 % de los casos. Conclusiones: la NP es el soporte nutricional más utilizado tras la cirugía de cabeza pancreática. Solo el 29,4 % de las unidades usan nutrición oral precoz y el 32,3 % emplean la NE tras este tipo de cirugía. El 22,6 % de las instituciones usan NP habitualmente tras la cirugía de tumores biliares malignos. Las guías ESPEN 2006 no se siguen de forma habitual en nuestro país tras más de 10 años desde su publicación.
- Published
- 2020
16. Análisis farmacoeconómico del tratamiento hemostático en cirugía con una esponja medicamentosa de fibrinógeno y trombina
- Author
-
Borro, José María, Domínguez-Gil, Alfonso, Lisart, Rafael Ferriols, Maestre, José Antonio, de Urbina, Jorge Ortiz, Rubio-Terrés, Carlos, Santoyo, Julio, and Varo, Evaristo
- Published
- 2006
- Full Text
- View/download PDF
17. Immunosuppressant treatment adherence, barriers to adherence and quality of life in renal and liver transplant recipients in Spain
- Author
-
Morales, José M., Varo, Evaristo, and Lázaro, Pablo
- Published
- 2012
- Full Text
- View/download PDF
18. DONOR-RECIPIENT MATCHING IN LIVER TRANSPLANTATION BASED ON A RULE-SYSTEM BUILT ON A MULTIOBJECTIVE ARTIFICIAL NEURAL NETWORK: MO-018
- Author
-
Briceño, Javier, Cruz, Manuel, Prieto, Martín, Navasa, Miquel, Ortiz, Jorge, Orti, Rafael, Gómez, Miguel A., Otero, Alejandra, Tomé, Santiago, Varo, Evaristo, Clémente, Gerardo, Bañares, Rafel, Bárcena, Rafael, Cuervas, Valentín, Solórzano, Guillermo, Hervás, César, and de la Mata, Manuel
- Published
- 2011
19. Pharmacokinetics for once-daily versus twice-daily tacrolimus formulations in de novo liver transplantation: A randomized, open-label trial
- Author
-
Fischer, Lutz, Trunečka, Pavel, Gridelli, Bruno, Roy, Andre, Vitale, Alessandro, Valdivieso, Andrés, Varo, Evaristo, Seehofer, Daniel, Lynch, Stephen, Samuel, Didier, Ericzon, Bo-Goran, Boudjema, Karim, Karpf, Carmen, and Undre, Nasrullah
- Published
- 2011
- Full Text
- View/download PDF
20. Improvement of Renal Function After the Switch from a Calcineurin Inhibitor to Everolimus in Liver Transplant Recipients with Chronic Renal Dysfunction
- Author
-
Castroagudín, Javier F., Molina, Esther, Romero, Rafael, Otero, Esteban, Tomé, Santiago, and Varo, Evaristo
- Published
- 2009
- Full Text
- View/download PDF
21. A prospective randomized open study in liver transplant recipients: Daclizumab, mycophenolate mofetil, and tacrolimus versus tacrolimus and steroids
- Author
-
Otero, Alejandra, Varo, Evaristo, de Urbina, Jorge Ortiz, Martín-Vivaldi, Rafael, Cuervas-Mons, Valentin, González-Pinto, Ignacio, Rimola, Antoni, Bernardos, Angel, Otero, Santiago, Maldonado, Jorge, Herrero, Jose I., Barrao, Elena, and Domínguez-Granados, Rosa
- Published
- 2009
- Full Text
- View/download PDF
22. Malaria infection through multiorgan donation: An update from Spain
- Author
-
Rodriguez, Monserrat, Tome, Santiago, Vizcaino, Luis, Fernandez-Castroagudin, Javier, Otero-Anton, Esteban, Molina, Esther, Martinez, Jorge, DeRosa, Gloria, Lovo, Jose, and Varo, Evaristo
- Published
- 2007
- Full Text
- View/download PDF
23. Time-course changes of serum immunoglobulins (IgA, IgG, IgM) after liver transplantation for alcoholic cirrhosis
- Author
-
González-Quintela, Arturo, López-Ben, Santiago, Pérez, Luis-Fernando, Graña, Begoña, Varela, Marı́a, Tomé, Santiago, and Varo, Evaristo
- Published
- 2003
- Full Text
- View/download PDF
24. Post-operative stress hyperglycemia is a predictor of mortality in liver transplantation
- Author
-
Universidade de Santiago de Compostela. Departamento de Estatística, Análise Matemática e Optimización, Giráldez, Elena, Varo, Evaristo, Guler, Ipek, Cadarso Suárez, Carmen María, Tomé Martínez de Rituerto, Santiago, Barral, Patricia, Garrote, Antonio, Gude Sampedro, Francisco, Universidade de Santiago de Compostela. Departamento de Estatística, Análise Matemática e Optimización, Giráldez, Elena, Varo, Evaristo, Guler, Ipek, Cadarso Suárez, Carmen María, Tomé Martínez de Rituerto, Santiago, Barral, Patricia, Garrote, Antonio, and Gude Sampedro, Francisco
- Abstract
A significant association is known between increased glycaemic variability and mortality in critical patients. To ascertain whether glycaemic profiles during the first week after liver transplantation might be associated with long-term mortality in these patients, by analysing whether diabetic status modified this relationship.
- Published
- 2018
25. Time-Course Changes of Serum Keratin Concentrations after Liver Transplantation: Contrasting Results of Keratin-18 and Keratin-19 Fragments.
- Author
-
Macía, Cristina, Loureiro, Jose, Campos-Varela, Isabel, Abdulkader, Ihab, Otero, Esteban, Varo, Evaristo, Tomé, Santiago, and Gonzalez-Quintela, Arturo
- Subjects
LIVER transplantation ,SERUM ,KERATIN ,AMINOTRANSFERASES ,POLYPEPTIDES - Abstract
Objective. Under normal conditions, adult hepatocytes express only keratin-8 (K8) and keratin-18 (K18), whereas cholangiocytes also express K19. In this study, we delineate the pattern of normal time-course changes in serum K19 and K18 levels after liver transplantation. Patients and Methods. Serum levels of the K19 fragment CYFRA 21-1 and the K18 fragments tissue polypeptide specific antigen (TPS) and M30 (a neoepitope that is generated after caspase cleavage during apoptosis) were measured at baseline and at regular intervals (up to 6 months) after liver transplantation in 11 adult patients. Results. There was a gradual decrease in serum K19 concentrations from baseline values after transplantation, following a time-course pattern similar to that of serum bilirubin. In contrast, serum concentrations of K18 fragments increased markedly shortly after transplantation and gradually decreased thereafter, following a time-course pattern similar to that of serum transaminases. The increase in TPS tended to occur earlier than that in M30, suggesting an initial predominance of hepatocyte necrosis followed by a predominance of apoptosis in the first days after transplantation. Five patients presented posttransplant complications (acute rejection in three cases and HCV recurrence in two cases). An early increase in serum K19 concentrations was observed in all cases. An increase in serum concentrations of K18 fragments (M30 and TPS) was observed in the two cases with HCV recurrence and was more variable in the three cases with acute rejection. Conclusions. Serum concentrations of K19 and K18 fragments follow a dissimilar pattern of time-course changes after liver transplantation. The diagnostic value of variations in these normal patterns should be addressed in future studies. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
26. Randomized trial of micafungin for the prevention of invasive fungal infection in high-risk liver transplant recipients
- Author
-
Saliba, Faouzi, Pascher, Andreas, Cointault, Olivier, Laterre, Pierre-François, Cervera, Carlos, De Waele, Jan J., Cillo, Umberto, Langer, Róbert M., Lugano, Manuela, Göran-Ericzon, Bo, Phillips, Stephen, Tweddle, Lorraine, Karas, Andreas, Brown, Malcolm, Fischer, Lutz, Pratschke, Johann, Decruyenaere, Johan, Moreno, Christophe, Michielsen, Peter, Neuhaus, Peter, Schemmer, Peter, Varo, Evaristo, Montejo, Miguel, Bouza, Emilio, Blanes, Marino, De La Torre, Julián, Fortun, Jesus, Rostaing, Lionel, Paugam-Burtz, Catherine, Eyraud, Daniel, Shah, Tahir, Heaton, Nigel, McCormick, Aiden, Salizzoni, Mauro, De Gasperi, Andrea, Tomé, Luís, Daniel, Jorge, Popescu, Irinel, Moysyuk, Yan G., Chzhao, Alexey V., Zagaynov, Vladimir E., and Ericzon, Bo-Göran
- Subjects
Male ,Antifungal Agents ,ECHINOCANDIN RESISTANCE ,medicine.medical_treatment ,Liver transplantation ,Kidney Function Tests ,PROPHYLAXIS ,FEBRILE NEUTROPENIA ,Liver disease ,chemistry.chemical_compound ,Echinocandins ,Liver Function Tests ,Medicine and Health Sciences ,80 and over ,EPIDEMIOLOGY ,Articles and Commentaries ,AMPHOTERICIN-B ,medicine.diagnostic_test ,biology ,Middle Aged ,Treatment Outcome ,Infectious Diseases ,Administration ,lipids (amino acids, peptides, and proteins) ,Female ,prophylaxis ,Intravenous ,medicine.drug ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Echinocandin ,Adolescent ,Drug-Related Side Effects and Adverse Reactions ,Chemoprevention ,Lipopeptides ,Young Adult ,Internal medicine ,MANAGEMENT ,medicine ,Humans ,Aged ,CANDIDA ,Candida glabrata ,business.industry ,micafungin ,Micafungin ,STEM-CELL TRANSPLANTATION ,FLUCONAZOLE ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,infection ,Transplant Recipients ,Liver Transplantation ,antifungal therapy ,liver transplant ,chemistry ,Mycoses ,Immunology ,Administration, Intravenous ,Aged, 80 and over ,Caspofungin ,Liver function tests ,business ,Fluconazole ,HEALTHY-VOLUNTEERS - Abstract
In this randomized clinical trial comparing micafungin 100 mg with standard-care antifungal prophylaxis (fluconazole, liposomal amphotericin B, or caspofungin) in high-risk liver transplant patients, micafungin 100 mg was noninferior and had a better kidney safety profile., Background. Invasive fungal infection (IFI) following liver transplant is associated with significant morbidity and mortality. Antifungal prophylaxis is rational for liver transplant patients at high IFI risk. Methods. In this open-label, noninferiority study, patients were randomized 1:1 to receive intravenous micafungin 100 mg or center-specific standard care (fluconazole, liposomal amphotericin B, or caspofungin) posttransplant. The primary endpoint was clinical success (absence of a proven/probable IFI and no need for additional antifungals) at end of prophylaxis (EOP). Noninferiority (10% margin) of micafungin vs standard care was assessed in the per protocol and full analysis sets. Safety assessments included adverse events and liver and kidney function tests. Results. The full analysis set comprised 344 patients (172 micafungin; 172 standard care). Mean age was 51.2 years; 48.0% had a Model for End-Stage Liver Disease score ≥20. At EOP (mean treatment duration, 17 days), clinical success was 98.6% for micafungin and 99.3% for standard care (Δ standard care – micafungin [95% confidence interval], 0.7% [−2.7% to 4.4%]) in the per protocol set and 96.5% and 93.6%, respectively (−2.9% [−8.0% to 1.9%]), in the full analysis set. Incidences of drug-related adverse events for micafungin and standard care were 11.6% and 16.3%, leading to discontinuation in 6.4% and 11.6% of cases, respectively. At EOP, liver function tests were similar but creatinine clearance was higher in micafungin- vs standard care–treated patients. Conclusions. Micafungin was noninferior to standard care as antifungal prophylaxis in liver transplant patients at high risk for IFI. Adverse event profiles and liver function at EOP were similar, although kidney function was better with micafungin. Clinical Trials Registration. NCT01058174.
- Published
- 2015
27. Encuesta a los jefes de Unidad y residentes de Cirugía sobre la accesibilidad y el trabajo en los equipos de trasplante hepático en España
- Author
-
Blanco Fernández, Gerardo, Gómez Bravo, Miguel Ángel, Briceño Delgado, Javier, Valdivieso López, Andrés, López-Guerra, Diego, Rodríguez-Laiz, Gonzalo, Villar-del-Moral, Jesús, Pardo Sánchez, Fernando, Santoyo, Julio, López Andújar, Rafael, Nuño, Javier, Sánchez Turrión, Víctor, González Pinto, Ignacio, Jiménez, Carlos, López Baena, José Ángel, Gómez Gutierrez, Manuel, Fabregat Prous, Joan, Pacheco Sánchez, David, Barrera, Manuel, García-Gil, Agustín, Ramírez, Pablo, Varo, Evaristo, Bilbao, Itxarone, Fondevila, Constantino, and Rodríguez-Sanjuan, Juan Carlos
- Published
- 2019
- Full Text
- View/download PDF
28. Estudio multicéntrico nacional sobre pancreatectomías totales
- Author
-
Ramia, Jose M., Martin-Perez, Elena, Poves, Ignasi, Fabregat-Prous, Joan, Larrea y Olea, Javier, Sanchez-Bueno, Francisco, Botello-Martinez, Francisco, Briceño, Javier, Miyar-de León, Alberto, Serradilla, Mario, Moya-Herraiz, Angel, Fabregat Prous, Joan, Secanella, Lluis, Larrea y Olea, Javier, Sanchez Bueno, Francisco, Botello Martinez, Francisco, Briceño, Javier, Miyar-de León, Alberto, Serradilla, Mario, Serrablo, Alejandro, Ferrer Fabrega, Joana, Sanchez Cabús, S., Angel Gómez Bravo, Miguel, Padillo, Javier, Blanco, Laia, Balcells, J., Cugat, Esteban, García Domingo, Maribel, Muñoz Bellvis, Luis, Dolores Perez Diaz, Maria, Santoyo Santoyo, Julio, Sanchez, Belinda, Villegas, Trinidad, Pacho, Silvino, Díez Valladares, Luis, Rebollar, Jose, Ángel Suárez Muñoz, Miguel, Domínguez, Elías, Martín Perez, Elena, Falgueras, Laia, Poves, Ignasi, Artigas, Vicenç, Sabater, Luis, Garcia Gil, Agustin, Ignacio Miota de Llama, Jose, Manzanet, Gerardo, Carlos Pino, Jose, Carlos Rodríguez Sanjuán, Juan, Lluis, F., Ausania, Fabio, Alkorta Zuloaga, Maialen, Escartín, Jorge, Salas, Manel, Domingo, Carlos, Artigues Sánchez de Rojas, Enrique, Antonio Barreras Mateos, José, María Fernández Cebrián, José, Pérez Cabrera, Beatriz, Padilla Valverde, D., Sanjuanbenito, Alfonso, Iturburu Belmonte, Ignacio, Bejarano, Natalia, García Borobia, F., Toral Guinea, Pablo, Lopez Marcano, Aylhin, Asencio Arana, Francisco, Varo, Evaristo, Esteban, Rafael, Blas, Juan Laaa, Jover Navalón, José M., Fernández Martínez, Cristina, Daban Collado, Enrique, Calvo Duran, Antonio, Vicens, J.C., Romero, J., Badía, J.M., Sánchez, Raquel, de Miguel Ibáñez, Ricardo, Pardoc, Fernando, Francos von Hunefeld, Carlos, Pereira, Fernando, Garcia Molina, Francisco, Rodríguez Prieto, Ignacio, Alonso Poza, Alfredo, Gilsanz, Carlos, Miguel Martínez Albert, Jose, Angel Morcillo, Miguel, Martínez Cortijo, Sagrario, Martín Fernández, José, Baquedano, Jesús, Castell, José, Aguiló, Javier, and Carlos Bernal, Juan
- Published
- 2019
- Full Text
- View/download PDF
29. Pharmacokinetics of prolonged-release tacrolimus versus immediate-release tacrolimus in de novo liver transplantation: A randomized phase III substudy.
- Author
-
Ericzon, Bo‐Göran, Varo, Evaristo, Trunečka, Pavel, Fischer, Lutz, Colledan, Michele, Gridelli, Bruno, Valdivieso, Andrés, O'Grady, John, Dickinson, James, and Undre, Nasrullah
- Subjects
- *
LIVER transplantation , *PHARMACOKINETICS , *TACROLIMUS , *CLINICAL trials , *DRUG dosage - Abstract
Background With the same dose of tacrolimus, lower systemic exposure on the first day of dosing has been reported for prolonged-release tacrolimus compared with immediate-release tacrolimus, prompting investigation of differing initial doses. Methods This substudy of a double-blind, randomized, phase III trial in de novo liver transplant recipients compared the pharmacokinetics of once-daily prolonged-release tacrolimus (initial dose: 0.2 mg/kg/day) versus twice-daily immediate-release tacrolimus (initial dose: 0.1 mg/kg/day) during the first 2 weeks post-transplant. Results Pharmacokinetic data were analyzed from patients receiving prolonged-release tacrolimus (n=13) and immediate-release tacrolimus (n=12). Mean systemic exposure ( AUC0-24) was higher with prolonged-release versus immediate-release tacrolimus. Dose-normalized AUC0-24 (normalized to 0.1 mg/kg/day) showed generally lower exposure with prolonged-release tacrolimus versus immediate-release tacrolimus. There was good correlation between AUC0-24 and concentration at 24 hours after the morning dose ( r=.96 and r=.86, respectively), and the slope of the line of best fit was similar for both formulations. Conclusions Doubling the initial starting dose of prolonged-release tacrolimus compared with immediate-release tacrolimus overcompensated for lower exposure on Day 1. A 50% higher starting dose of prolonged-release tacrolimus than immediate-release tacrolimus may be required for similar systemic exposure. However, doses of both formulations can be optimized using the same trough-level monitoring system. (ClinicalTrials.gov number: NCT00189826). [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
30. Impact of Cytomegalovirus Infection on Severe Hepatitis C Recurrence in Patients Undergoing Liver Transplantation.
- Author
-
Caston, Juan Jose, Castells, Luis, Varo, Evaristo, Gomez, Miguel Angel, de la Mata, Manuel, Campos-Varela, Isabel, Lumbreras, Carlos, Gonzalez-Dieguez, Luisa, Fabregat, Joan, Herrero, Ignacio, Salcedo, Magdalena, Sanchez-Antolín, Gloria, and Torre-Cisneros, Julian
- Published
- 2016
- Full Text
- View/download PDF
31. Acute cellular rejection versus recurrent hepatitis C after liver transplantation: Clinical and pathological features driving a rational diagnostic approach.
- Author
-
Peña‐Moral, Jesús M., Pons, Jose A., Tome, Santiago, Gude, Francisco, Miras, Manuel, Bermejo, Juan, Ramirez, Pablo, Berenguer, Marina, Varo, Evaristo, Forteza, Jeronimo, and Parrilla, Pascual
- Subjects
HEPATITIS C diagnosis ,DISEASE relapse ,LIVER transplantation ,HEPATITIS C virus ,BIOPSY ,HEPATITIS C ,PHYSIOLOGY ,PATIENTS - Abstract
Aim The aim of our study was develop and validate an algorithm system based on morphological features for finding the differences between recurrent hepatitis C virus ( HCV) and acute cellular rejection ( ACR) in liver biopsies of HCV-transplanted patients. Methods Two hundred and eighty-eight liver biopsies were analyzed from 121 patients transplanted for HCV. A diagnostic consensus was reached between clinicians and pathologists in 214 biopsies for the diagnosis of recurrent HCV or ACR. A random sample of 114 liver biopsies (derivation cohort) was taken to generate the diagnostic tree and was subsequently evaluated using the validation cohort in 100 liver biopsies by recursive partitioning analysis of morphological variables and time since transplantation. Results The presence of endotheliitis together with a time of less than 6 weeks since LT definitely excluded recurrent HCV. After obtaining the regression tree, diagnostic accuracy was 96% and 93% in the derivation and validation cohort, respectively. Both cases surpassed the pathologist's original diagnosis, which had a diagnostic accuracy of 91% ( P < 0.05, for both comparisons). Conclusion A recursive partitioning analysis of the morphological features in liver biopsies from HCV-transplanted patients may be useful for easily distinguishing between recurrent HCV and ACR. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
32. Nefropatía crónica en trasplante no renal: prevención, diagnóstico precoz y manejo.
- Author
-
Guirado, Lluís, Almenar, Luis, Alonso, Ángel, Castroagudín, Javier F., Hernández, Domingo, Morales, José María, Usetti, Piedad, and Varo, Evaristo
- Abstract
Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2009
33. 56 Endoscopic Ultrasound (EUS) vs Helical CT Scan for TN Staging and Evaluation of Resectability of Pancreatic Cancer: A Prospective, Comparative Study Using Histology of Surgical Specimens as Gold-Standard
- Author
-
Iglesias-Garcia, Julio, Alvarez-Castro, Ana, Iglesias-Canle, Jose, Larino-Noia, Jose, Pazos, Gerardo, Forteza, Jeronimo, Varo, Evaristo, and Dominguez-Munoz, Enrique
- Published
- 2010
- Full Text
- View/download PDF
34. ANALYSIS OF THE COMPLICATIONS OF THE PIGGY-BACK TECHNIQUE IN 1,112 LIVER TRANSPLANTS.
- Author
-
Parrilla, Pascual, Sánchez-Bueno, Francisco, Figueras, Juan, Jaurrieta, Eduardo, Mir, Jose, Margarit, Carlos, Lázaro, José, Herrera, Luis, Gómez-Fleitas, Manolo, Varo, Evaristo, Vicente, Emilio, Robles, Ricardo, and Ramirez, Pablo
- Published
- 1999
- Full Text
- View/download PDF
35. Recurrent fulminant liver failure caused by hepatitis B virus after liver transplantation.
- Author
-
de la Mata, Manuel, Rufián, Sebastián, Gómez, Federico, Varo, Evaristo, López-Cillero, P, Costán, Guadalupe, Solórzano, Guillermo, González, Rafael, Mifio, Gonzalo, Pera, Carlos, de la Mata, M, Rufián, S, Gómez, F, Varo, E, Costán, G, Solórzano, G, González, R, Miño, G, and Pera, C
- Published
- 1994
- Full Text
- View/download PDF
36. INTRAHEPATIC CHOLANGIOCARCINOMA OR MIXED HEPATOCELLULAR- CHOLANGIOCARCINOMA IN PATIENTS UNDERGOING LIVER TRANSPLANTATION. A SPANISH MATCHED COHORT MULTICENTER STUDY
- Author
-
Sapisochin, Gonzalo, Lope, Carlos Rodriguez, Gastaca, Mikel, Urbina, Jorge Ortiz, Rafael López Andujar, Palacios, Francisco, Ramos, Emilio, Fabregat, Joan, Castroagudin, Javier, Varo, Evaristo, Pons, Jose Antonio, Parilla, Pascual, Gonzalez-Dieguez, Maria Luisa, Rodriguez, M., Otero, Alejandra, Vazquez, M. A., Zozaya, Gabriel, Herrero, Jose Ignacio, Sanchez, Gloria, Perez, Baltasar, Ciria, Ruben, Rufian, Sebastian, Suarez, Yiliam Fundora, Orijuela, Jose Antonio Ferron, Guiberteau, Ana, Blanco, Gerardo, Varona, M. A., Barrera, M. A., Suarez, Miguel Angel, and Santoyo, Julio
37. The 20th Congress of the Spanish Liver Transplantation Society (SETH)
- Author
-
Varo, Evaristo
- Published
- 2009
- Full Text
- View/download PDF
38. The 21st Congress of the Spanish Liver Transplantation Society (SETH)
- Author
-
Varo, Evaristo
- Published
- 2010
- Full Text
- View/download PDF
39. M2035 Ductal Adenocarcinoma of the Pancreas: Expression of Growth Factor Receptors, Oncogenes and Suppressor Genes and Its Relationship to Pathological Features, Staging and Survival.
- Author
-
Lozano-Leon, Antonio, Vieites, Begoña, Larino-Noia, Jose, Iglesias-Garcia, Julio, Varo, Evaristo, Forteza, Jeronimo, and Dominguez-Munoz, Enrique
- Published
- 2008
- Full Text
- View/download PDF
40. Use of artificial intelligence as an innovative donor-recipient matching model for liver transplantation: Results from a multicenter Spanish study.
- Author
-
Briceño, Javier, Cruz-Ramírez, Manuel, Prieto, Martín, Navasa, Miguel, Ortiz de Urbina, Jorge, Orti, Rafael, Gómez-Bravo, Miguel-Ángel, Otero, Alejandra, Varo, Evaristo, Tomé, Santiago, Clemente, Gerardo, Bañares, Rafael, Bárcena, Rafael, Cuervas-Mons, Valentín, Solórzano, Guillermo, Vinaixa, Carmen, Rubín, Ángel, Colmenero, Jordi, Valdivieso, Andrés, and Ciria, Rubén
- Subjects
- *
ARTIFICIAL intelligence , *LIVER transplantation , *MULTIPLE regression analysis , *ALLOCATION of organs, tissues, etc. , *DECISION making - Abstract
Background & Aims There is an increasing discrepancy between the number of potential liver graft recipients and the number of organs available. Organ allocation should follow the concept of benefit of survival, avoiding human-innate subjectivity. The aim of this study is to use artificial-neural-networks (ANNs) for donor-recipient (D-R) matching in liver transplantation (LT) and to compare its accuracy with validated scores (MELD, D-MELD, DRI, P-SOFT, SOFT, and BAR) of graft survival. Methods 64 donor and recipient variables from a set of 1003 LTs from a multicenter study including 11 Spanish centres were included. For each D-R pair, common statistics (simple and multiple regression models) and ANN formulae for two non-complementary probability-models of 3-month graft-survival and -loss were calculated: a positive-survival (NN-CCR) and a negative-loss (NN-MS) model. The NN models were obtained by using the Neural Net Evolutionary Programming (NNEP) algorithm. Additionally, receiver-operating-curves (ROC) were performed to validate ANNs against other scores. Results Optimal results for NN-CCR and NN-MS models were obtained, with the best performance in predicting the probability of graft-survival (90.79%) and -loss (71.42%) for each D-R pair, significantly improving results from multiple regressions. ROC curves for 3-months graft-survival and –loss predictions were significantly more accurate for ANN than for other scores in both NN-CCR (AUROC-ANN = 0.80 vs. –MELD = 0.50; -D-MELD = 0.54; -P-SOFT = 0.54; -SOFT = 0.55; –BAR = 0.67 and -DRI = 0.42) and NN-MS (AUROC-ANN = 0.82 vs. –MELD = 0.41; -D-MELD = 0.47; -P-SOFT = 0.43; -SOFT = 0.57, -BAR = 0.61 and -DRI = 0.48). Conclusions ANNs may be considered a powerful decision-making technology for this dataset, optimizing the principles of justice, efficiency and equity. This may be a useful tool for predicting the 3-month outcome and a potential research area for future D-R matching models. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
41. Influence of superimposed alcoholic hepatitis on the outcome of liver transplantation for end-stage alcoholic liver disease
- Author
-
Tomé, Santiago, Martinez-Rey, Carmen, González-Quintela, Arturo, Gude, Francisco, Brage, Antonio, Otero, Esteban, Abdulkader, Ihab, Forteza, Jerónimo, Bustamante, Manuel, and Varo, Evaristo
- Subjects
- *
ALCOHOL , *CIRRHOSIS of the liver , *TRANSPLANTATION of organs, tissues, etc. - Abstract
Background/Aims: Alcoholic cirrhosis is a common indication for liver transplantation. The present study was aimed to assess the influence of superimposed alcoholic hepatitis on the outcome of liver transplantation in patients with alcoholic cirrhosis.Methods: Survival rates of 68 patients transplanted for alcoholic cirrhosis were compared with those of 101 patients transplanted for miscellaneous causes. Within the alcoholic group, explanted livers were searched for data of acute alcoholic hepatitis. The survival rate of patients with alcoholic hepatitis superimposed on liver cirrhosis was compared to that of patients with liver cirrhosis alone. Clinical severity of alcoholic hepatitis was assessed with Maddrey''s score.Results: Survival was similar in alcoholics and patients with other causes of liver disease. Among patients transplanted for alcoholic cirrhosis, survival was similar in patients with superimposed alcoholic hepatitis (n=36) and in cases with liver cirrhosis alone (n=32). There was no difference in survival between patients with mild (n=26) and severe (n=10) alcoholic hepatitis. Seven alcoholics (10%) returned to ethanol consumption. Recidivism was not associated with either alcoholic hepatitis in the explanted liver or graft loss.Conclusions: Survival after liver transplantation in patients with alcoholic cirrhosis plus alcoholic hepatitis detected in the explanted liver is similar to that of patients transplanted for other reasons. Even the presence of severe alcoholic hepatitis does not worsen the outcome of liver transplantation for end-stage alcoholic liver disease. [Copyright &y& Elsevier]
- Published
- 2002
- Full Text
- View/download PDF
42. First consensus document of waiting list prioritization for liver transplantation by the Spanish Society of Liver Transplantation (SETH).
- Author
-
Bilbao I, Lladó L, Cachero A, Campos-Varela I, Colmenero J, Del Hoyo J, Fábrega García E, García-Pajares F, González Diéguez L, González Grande R, Guiberteau Sánchez A, Hernández Oliveros F, Herrero Santos JI, Lorente S, Martín Mateos R, Mesa López MJ, Montero Álvarez JL, Muñoz Codoceo C, Otero Ferreiro A, Otón Nieto E, Rodríguez Soler M, Romero Cristóbal M, Sastre Oliver L, Senosiain Labiano M, Sousa Martín JM, Trapero-Marugán M, Varo E, de la Rosa G, and Rodríguez-Perálvarez M
- Abstract
Spain is worldwide leader in deceased donation rates per million habitants and count on a strong network of twenty-five liver transplant institutions. Although the access to liver transplantation is higher than in other countries, approximately 10% of patients qualifying for liver transplantation in Spain will die in the waiting list or would be excluded due to clinical deterioration. A robust waiting list prioritization system is paramount to grant the sickest patients with the first positions in the waiting list for an earlier access to transplant. In addition, the allocation policy may not create or perpetuate inequities, particularly in a public and universal healthcare system. Hitherto, Spain lacks a unique national allocation system for elective liver transplantation. Most institutions establish their own rules for liver allocation and only two autonomous regions, namely Andalucía and Cataluña, share part of their waiting list within their territory to provide regional priority to patients requiring more urgent transplantation. This heterogeneity is further aggravated by the recently described sex-based disparities for accessing liver transplantation in Spain, and by the expansion of liver transplant indications, mainly for oncological indications, in absence of clear guidance on the optimal prioritization policy. The present document contains the recommendations from the first consensus of waiting list prioritization for liver transplantation issued by the Spanish Society of Liver Transplantation (SETH). The document was supported by all liver transplant institutions in Spain and by the Organización Nacional de Trasplantes (ONT). Its implementation will allow to homogenize practices and to improve equity and outcomes among patients with end-stage liver disease.
- Published
- 2024
- Full Text
- View/download PDF
43. Underestimation of chronic renal dysfunction after liver transplantation: ICEBERG study.
- Author
-
Varo E, Bañares R, and Guilera M
- Abstract
Aim: To compare prevalence of chronic renal dysfunction (CRD) according to serum creatinine (sCr) vs estimated glomerular filtration rate (eGFR) among maintenance liver transplant patients., Methods: The ICEBERG study was an observational, retrospective, cross-sectional, and multicenter study. Consecutive adult patients (aged 18 years or older) with liver transplantation (LT) performed at least two years previously were recruited. Multi-organ transplant recipients were excluded. Chronic renal dysfunction was defined according to sCr based criteria in routine clinical practice (≥ 2 mg/dL) and eGFR using MDRD-4 equation (< 60 mL/min per 1.73 m(2)). Agreement between sCr definition and eGFR assessment was evaluated using the Kappa index. Cox regression analysis was applied to identify predictive factors for developing CRD after LT., Results: A total of 402 patients were analyzed (71.6% males). Mean ± SD age at transplant was 52.4 ± 9.8 years. Alcoholic cirrhosis without hepatocellular carcinoma was the most common reason for LT (32.8%). Mean time since LT was 6.9 ± 3.9 years. Based on sCr assessment, 35.3% of patients (95%CI: 30.6-40.0) had CRD; 50.2% (95%CI: 45.3-55.1) according to eGFR. In 32.2% of cases, sCr assessment had underestimated CRD. Multivariate analysis showed the following factors associated with developing CRD: eGFR < 60 mL/min per 1.73 m(2) at three months post-transplant [hazard ratio (HR) = 4.76; 95%CI: 2.78-8.33; P < 0.0001]; calcineurin inhibitor use (HR = 2.31; 95%CI: 1.05-5.07; P = 0.0371); male gender (HR = 1.98; 95%CI: 1.09-3.60; P = 0.0260); and ≥ 10 years post-transplantation (HR = 1.95; 95%CI: 1.08-3.54; P = 0.0279)., Conclusion: Seven years after LT, CRD affected half our patients, which was underestimated by sCr. An eGFR < 60 mL/min per 1.73 m(2) three months post-LT was predictive of subsequent CRD.
- Published
- 2015
- Full Text
- View/download PDF
44. GESITRA-SEIMC/REIPI recommendations for the management of cytomegalovirus infection in solid-organ transplant patients.
- Author
-
de la Torre-Cisneros J, Fariñas MC, Castón JJ, Aguado JM, Cantisán S, Carratalá J, Cervera C, Cisneros JM, Cordero E, Crespo-Leiro MG, Fortún J, Frauca E, Gavaldá J, Gil-Vernet S, Gurguí M, Len O, Lumbreras C, Marcos MÁ, Martín-Dávila P, Monforte V, Montejo M, Moreno A, Muñoz P, Navarro D, Pahissa A, Pérez JL, Rodriguez-Bernot A, Rumbao J, San Juan R, Santos F, Varo E, and Zurbano F
- Subjects
- Antiviral Agents administration & dosage, Antiviral Agents adverse effects, Cytomegalovirus drug effects, Cytomegalovirus physiology, Cytomegalovirus Infections diagnosis, Cytomegalovirus Infections etiology, Cytomegalovirus Infections prevention & control, Cytomegalovirus Infections transmission, Disease Management, Donor Selection, Drug Administration Schedule, Drug Resistance, Viral, Evidence-Based Medicine, Humans, Immunity, Cellular, Immunocompromised Host, Risk Factors, T-Lymphocyte Subsets immunology, Tissue Donors, Viremia diagnosis, Virus Activation drug effects, Antiviral Agents therapeutic use, Cytomegalovirus Infections drug therapy, Transplantation adverse effects
- Abstract
Cytomegalovirus infection remains a major complication of solid organ transplantation. In 2005 the Spanish Transplantation Infection Study Group (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) developed consensus guidelines for the prevention and treatment of CMV infection in solid organ transplant recipients. Since then, numerous publications have clarified or questioned the aspects covered in the previous document. These aspects include the situations and populations who must receive prophylaxis and its duration, the selection of the best diagnosis and monitoring technique and the best therapeutic strategy. For these reasons, we have developed new consensus guidelines to include the latest recommendations on post-transplant CMV management based on new evidence available., (Copyright © 2011 Elsevier España, S.L. All rights reserved.)
- Published
- 2011
- Full Text
- View/download PDF
45. Clinical relevance of epidermal growth factor receptor (EGFR) alterations in human pancreatic tumors.
- Author
-
Lozano-Leon A, Perez-Quintela BV, Iglesias-García J, Urisarri-Ruiz A, Lariño-Noia J, Abdulkader I, Varo E, Forteza J, and Domínguez-Muñoz JE
- Subjects
- Adult, Aged, Base Sequence, ErbB Receptors biosynthesis, ErbB Receptors genetics, Female, Genetic Variation, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence, Male, Middle Aged, Molecular Sequence Data, Neoplasm Invasiveness, Neoplasm Staging, Pancreatic Neoplasms genetics, Polymerase Chain Reaction, Prognosis, Sequence Analysis, DNA, ErbB Receptors metabolism, Pancreatic Neoplasms metabolism, Pancreatic Neoplasms pathology
- Abstract
Pancreatic cancer is a malignant neoplasm with an extremely poor prognosis. The mechanisms of aggressive growth and metastasis are currently not well understood. Expression of epidermal growth factor receptor (EGFR) has been suggested to be associated with the malignant transformation of pancreatic cancer. In this study, we examined the EGFR status of 52 pancreatic tumors by PCR-sequencing (exons 19 and 21), immunohistochemistry and FISH probes. We subsequently investigated the relationship between EGFR status and clinicopathological factors. Somatic alterations in EGFR (R841R, T571T and R831C) were observed only in ductal adenocarcinoma (3/34). In 4 (8%) of the 52 tumors analyzed EGFR was overexpressed, 6 (12%) of the tumors showed moderate expression while 19 (32%) were weakly stained. EGFR overexpression (3+ score) was frequently found in endocrine tumors (29%) followed of ampullary tumors (13%; p < 0.01). No significant correlation was observed between the presence of a somatic EGFR mutation and clinicopathological variables. Fluorescence in situ hybridization (FISH) analysis did not demonstrate amplification in any tumors. Only three somatic mutations in the EGFR gene were detected in pancreatic ductal adenocarcinoma and no association was observed with the clinical variables. Our results suggest that EGFR mutations are rare in pancreatic tumors and not associated with clinical prognosis, and treatment response.
- Published
- 2011
- Full Text
- View/download PDF
46. Ductal adenocarcinoma of the pancreas: Expression of growth factor receptors, oncogenes and suppressor genes, and their relationship to pathological features, staging and survival.
- Author
-
Lozano-Leon A, Perez-Quintela BV, Iglesias-García J, Lariño-Noia J, Varo E, Forteza J, and Domínguez-Muñoz JE
- Abstract
Pancreatic ductal adenocarcinoma results in high short-term mortality despite recent advances in diagnostics, surgery and chemotherapy. Modern chemotherapeutic agents directed to specific tumor receptors have higher therapeutic efficacy and lower adverse effects. However, few studies exist that evaluate the clinical impact in pancreatic cancer. The expression of tumor growth factor receptors, oncogenes and tumor suppressor oncogenes in surgical pancreatic cancer specimens as related to pathological characteristics, staging and prognosis was evaluated. Data were recorded for 50 patients who underwent a pancreatic cancer resection and were suitable for immunohistochemical evaluation (32 male, mean age 61 years, range 44-78) with regard to pTN, tumor size and location, histological differentiation grade, vascular and perineural invasion, adjuvant chemotherapy and survival time. Tumor specimens and normal pancreatic tissue were deparaffinized and the expression of vascular epidermal growth factor (VEGF) receptors (R)-1 and -2, epidermal growth factor receptor (EGFR), Her-2/neu, COX-2, p16, p21 and p53 was immunohistochemically evaluated using tissue microarrays. Associations between molecular marker expression and clinicopathological tumor characteristics were evaluated using the Chi-square test (SPSS) and the survival time was defined. The Kaplan-Meier method was utilized to analyze survival curves, verified by the log-rank test. No molecular markers evaluated were expressed in normal tissue. Tumor expression data included VEGF-R1 (74%), EGFR (52%), Her-2/neu (7.84%), COX-2 (21.5%), p16 (29.4%), p21 (21.7%) and p53 (50%). Tumors expressing VEGF-R1, EGFR and/or p53 were larger (p<0.02), frequently poorly differentiated (p<0.05) and more frequently associated with perineural and lymph node invasion (p<0.05). Marker expression did not correlate with pathological tumor characteristics. The median post-surgery survival was 15 months; 60 and 27% patients survived to 12 and 24 months, respectively, with a longer survival time in patients receiving adjuvant chemotherapy (n=20) (median 36 vs. 15 months, p<0.02). Growth factor receptors, oncogenes and tumor suppressor genes were frequently expressed in pancreatic cancer tissue. VEGF-R1, EGFR and p53 expression were associated with poor tissue differentiation and perineural and lymph node infiltration. Only VEGF-R1 expression was associated with a longer survival time and a more favorable response to adjuvant chemotherapy.
- Published
- 2011
- Full Text
- View/download PDF
47. [Chronic nephropathy in non-kidney transplantation: [prevention, early diagnosis and management].
- Author
-
Guirado L, Almenar L, Alonso A, Castroagudín JF, Hernández D, Morales JM, Usetti P, and Varo E
- Subjects
- Biopsy, Early Diagnosis, Female, Humans, Immunosuppressive Agents adverse effects, Immunosuppressive Agents classification, Incidence, Kidney Function Tests, Male, Prevalence, Renal Replacement Therapy, Risk Factors, Vasoconstriction, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic economics, Kidney Failure, Chronic epidemiology, Kidney Failure, Chronic etiology, Kidney Failure, Chronic physiopathology, Kidney Failure, Chronic prevention & control, Kidney Failure, Chronic therapy, Postoperative Complications diagnosis, Postoperative Complications economics, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications physiopathology, Postoperative Complications prevention & control, Postoperative Complications therapy, Transplantation
- Abstract
Transplant from solid nonrenal organ has experienced an important increase in the last decades. It is due to the increasing improvement of the results obtained with the above mentioned transplants. Parallel, many nonrenal transplanted patients have developed a chronic renal failure that has determined, in some cases, the need of beginning the substitution of renal function by means of dialysis and/or transplant. The origin of the same one is multifactorial and the consequences derived from it are very important so much in morbimortality as of economic nature for the set of the system. The present review tries to help to the identification of risk factors of renal insufficiency in the nonrenal transplanted patient and to determine which might be the basic concepts of prevention, early diagnosis and of derivation to the nephrologist expert in transplants and renal dysfunction. Finally, we check the possibilities of managing of the immunosuppressive treatment and substitution of renal function by means of dialysis and/or simple or double transplant.
- Published
- 2009
- Full Text
- View/download PDF
48. [Management of patients with iatrogenic bile duct injury].
- Author
-
González Rodríguez FJ, Bustamante Montalvo M, Conde Freire R, Martínez J, Rodríguez Segade F, and Varo E
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prospective Studies, Bile Ducts injuries, Bile Ducts surgery, Intraoperative Complications surgery
- Abstract
Objectives: The aim of this study is to present an analysis of 30 patients with major bile duct injuries in a single hospital centre., Material and Method: From January 2001 to December 2006, a prospective database was kept of all patients with a bile duct injury (BDI) following laparoscopic cholecystectomy (LC). Patients' charts were reviewed to analyse perioperative surgical management., Results: Over 6 years, 30 patients were treated for a major BDI. Patient demographics were not notable for 16 women (53%) and 14 men (47%) with a mean age of 58.9 years. Twenty of them sustained their BDI at another hospital. The mean interval from the time of BDI to referral was 17.4 days. A total of 30 patients underwent definitive biliary reconstruction, including 17 hepaticojejunostomies (56.7%), 8 end-to-end repairs (20%), 2 choledochoduodenostomies (6.7%), 3 liver transplantations (10%), 1 hepatectomy and 1 Whipple (3.3%). There were 2 deaths in the postoperative period (6.7%). Thirteen (43.3%) sustained at least 1 postoperative complication. The most common complications were cholangitis (20%), and intra-abdominal abscess/biloma (23.3%). The mean postoperative length of stay was 17.46 days., Conclusions: Bile duct injury is a serious complication that affects mostly individuals with benign disease. Various subsequent procedures (surgical and/or endoscopic) are almost always necessary for its correction, with a high socioeconomic cost that imposes great suffering on the patients and their relatives. Clearly, all efforts should be made to prevent such accidents.
- Published
- 2008
- Full Text
- View/download PDF
49. Spanish experience in liver transplantation for hilar and peripheral cholangiocarcinoma.
- Author
-
Robles R, Figueras J, Turrión VS, Margarit C, Moya A, Varo E, Calleja J, Valdivieso A, Valdecasas JC, López P, Gómez M, de Vicente E, Loinaz C, Santoyo J, Fleitas M, Bernardos A, Lladó L, Ramírez P, Bueno FS, Jaurrieta E, and Parrilla P
- Subjects
- Adult, Bile Duct Neoplasms mortality, Bile Duct Neoplasms pathology, Cholangiocarcinoma mortality, Cholangiocarcinoma secondary, Female, Humans, Liver Neoplasms mortality, Liver Neoplasms pathology, Male, Middle Aged, Neoplasm Recurrence, Local, Prognosis, Retrospective Studies, Survival Rate, Bile Duct Neoplasms surgery, Bile Ducts, Intrahepatic, Cholangiocarcinoma surgery, Liver Neoplasms surgery, Liver Transplantation
- Abstract
Objective: To assess the real utility of orthotopic liver transplantation (OLT) in patients with cholangiocarcinoma, we need series with large numbers of cases and long follow-ups. The aim of this paper is to review the Spanish experience in OLT for hilar and peripheral cholangiocarcinoma and to try to identify the prognostic factors that could influence survival., Summary Background Data: Palliative treatment of nondisseminated irresectable cholangiocarcinoma carries a zero 5-year survival rate. The role of OLT in these patients is controversial, due to the fact that the survival rate is lower than with other indications for transplantation and due to the lack of organs., Methods: We retrospectively reviewed 59 patients undergoing OLT in Spain for cholangiocarcinoma (36 hilar and 23 peripheral) over a period of 13 years. We present the results and prognostic factors that influence survival., Results: The actuarial survival rate for hilar cholangiocarcinoma at 1, 3, and 5 years was 82%, 53%, and 30%, and for peripheral cholangiocarcinoma 77%, 65%, and 42%. The main cause of death, with both types of cholangiocarcinoma, was tumor recurrence (present in 53% and 35% of patients, respectively). Poor prognosis factors were vascular invasion (P < 0.01) and IUAC classification stages III-IVA (P < 0.01) for hilar cholangiocarcinoma and perineural invasion (P < 0.05) and stages III-IVA (P < 0.05) for peripheral cholangiocarcinoma., Conclusions: OLT for nondisseminated irresectable cholangiocarcinoma has higher survival rates at 3 and 5 years than palliative treatments, especially with tumors in their initial stages, which means that more information is needed to help better select cholangiocarcinoma patients for transplantation.
- Published
- 2004
- Full Text
- View/download PDF
50. Bilateral adrenal metastases from hepatocellular carcinoma after liver transplantation.
- Author
-
Castroagudín JF, González-Quintela A, Martínez J, Tomé S, Forteza J, and Varo E
- Subjects
- Adrenalectomy methods, Carcinoma, Hepatocellular surgery, Humans, Liver Neoplasms surgery, Male, Middle Aged, Treatment Outcome, Adrenal Gland Neoplasms secondary, Carcinoma, Hepatocellular pathology, Liver Neoplasms pathology, Liver Transplantation
- Abstract
Therapeutic management of hepatocellular carcinoma is a controversial issue. Orthotopic liver transplantation is an alternative for the treatment of hepatocellular carcinoma in a selected group of patients, but recurrence is possible. A 51-year-old patient with liver transplantation due to hepatocellular carcinoma presented bilateral adrenal metastases in a successive manner. A left adrenal gland metastasis was diagnosed five months after liver transplantation, and a left adrenalectomy was carried out. Eight months later, a right adrenal gland metastasis was diagnosed, and a right adrenalectomy was performed. Pathological examination confirmed the diagnosis of a well-differentiated hepatocellular carcinoma. At present, there is no evidence of recurrence 35 months after the second adrenalectomy. Bilateral adrenal gland metastases from hepatocellular carcinoma after liver transplantation have not been previously reported in English literature. Surgical resection of metastases may be indicated in similar patients with successful treatment of the primary tumor, absence of additional metastasic disease, and good performance status.
- Published
- 2002
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.