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Inter- and intraobserver agreement in computed tomography enterography in inflammatory bowel disease

World journal of Gastroenterology 2016年第45期22卷 10002-10008页

作者： Natally Horvat Camila Carlos Tavares Adriana Ribas Andrade Julia Campos Sim?es Cabral Hilton Muniz Le?o Filho Angela Hissae Motoyama Caiado Serli Kiyomi Nakao Ueda André Zonetti de Arruda Leite Aytan Miranda Sipahi Manoel de Souza rocha Radiology Department Hospital das Clínicas da Faculdade de Medicina da Universidade de S?o Paulo Gastroenterology Department Lim 07 Hospital da Clínicas da Faculdade de Medicina da Universidade de S?o Paulo

AIM To evaluate intra- and interobserver agreement in imaging features in inflammatory bowel disease and comparison with fecal calprotectin(FC) *** Our institutional computed tomography enterography(CTE) database was retrospectively queried to identify patients who underwent CTE from January 2014 to June 2015. Patient inclusion criteria were confirmed inflammatory bowel disease(IBD) and FC collected 1 pattern, or normal); and signs of active disease(present or absent). In 42 of 44 patients evaluated, routine CTE reports were made by one of the readers who reevaluated the CTEs ≥ 6 mo later, to determine the intraobserver agreement. FC was considered a sign of disease activity when it was higher than 250 μg/*** Forty-four patients with IBD(38 with Crohn's disease and 6 with ulcerative colitis) were included. There was a moderate interobserver agreement regarding localization of IBD(k = 0.540), type of disease(k = 0.410) and the presence of active signs in CTE(k = 0.419). There was almost perfect intraobserver agreement regarding localization, type and signs of active disease in IBD. The k values were 0.902, 0.937 and 0.830, respectively. After a consensus between both radiologists regarding inflammatory activity in CTE, we found that 24(85.7%) of 28 patients who were classified with active disease had elevated FC, and six(37.5%) of 16 patients without inflammatory activity in CTE had elevated FC(P = 0.003). The correlation between elevated FC and the presence of active disease in CTE was significant(k = 0.495, P = 0.001).CONCLUSION We found almost perfect intraobserver and moderate interobserve

关键词： Crohn’s disease Ulcerative colitis Computed tomography Fecal calprotectin Inflammatory bowel disease activity

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Living-donor liver transplantation in Budd-Chiari syndrome with inferior vena cava complete thrombosis:A case report and review of the literature

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World journal of Hepatology 2021年第1期13卷 151-161页

作者： Vinicius rocha-Santos Daniel Reis Waisberg Rafael Soares Pinheiro Lucas Souto Nacif Rubens Macedo arantes Liliana Ducatti Rodrigo Bronze Martino Luciana Bertocco Haddad Flavio Henrique Galvao Wellington Andraus Luiz Augusto Carneiro-D'Alburquerque Department of Gastroenterology Abdominal Organs Transplantation DivisionHospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo(HC-FMUSP)Sao Paulo 05403900SPBrazil Department of Gastroenterology Laboratory of Medical Investigation 37(LIM-37)Faculdade de Medicina da Universidade de Sao Paulo(FMUSP)Sao Paulo 01246903Brazil

BACKGROUND Budd-Chiari syndrome(BCS)is a challenging indication for liver transplantation(LT)due to a combination of massive liver,increased bleeding,retroperitoneal fibrosis and frequently presents with stenosis of the inferior vena cava(IVC).Occasionally,it may be totally thrombosed,increasing the complexity of the procedure,as it should also be *** challenge is even greater when performing living-donor LT as the graft does not contain the retrohepatic IVC;thus,it may be necessary to reconstruct *** SUMMARY A 35-year-old male patient with liver cirrhosis due to BCS and hepatocellular carcinoma beyond the Milan criteria underwent living-donor LT with IVC *** was necessary to remove the IVC as its retrohepatic portion was completely thrombosed,up to almost the right atrium.A right-lobe graft was retrieved from his sister,with outflow reconstruction including the right hepatic vein and the branches of segment V and VIII to the middle hepatic *** to massive subcutaneous collaterals in the abdominal wall,venovenous bypass was implemented before incising the *** right atrium was reached via a transdiaphragramatic *** was performed en bloc with the retrohepatic vena *** was reconstructed with an infra-hepatic vena cava graft obtained from a deceased *** patient remains well on outpatient clinic follow-up 25 mo after the procedure,under an anticoagulation protocol with *** Living-donor LT in BCS with IVC thrombosis is feasible using a meticulous surgical technique and tailored strategies.

关键词： Liver transplantation Living donors Budd-Chiari syndrome Hepatic venoocclusive disease Inferior vena cava Case report

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Perioperative blood transfusion decreases long-term survival in pediatric living donor liver transplantation

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World journal of Gastroenterology 2021年第12期27卷 1161-1181页

作者： Karina Gordon Estela Regina Ramos Figueira joel Avancini rocha-Filho Luiz Antonio Mondadori Eduardo Henrique Giroud joaquim joao Seda-Neto Eduardo Antunes da Fonseca Renata Pereira Sustovitch Pugliese Agustin Moscoso Vintimilla jose Otavio Costa Auler Jr Maria jose Carvalho Carmona Luiz Augusto Carneiro D'Alburquerque Division of Anesthesiology Hospital das ClínicasUniversity of São Paulo School of MedicineSão Paulo 05403-000Brazil Department of Anesthesiology AC Camargo Cancer CenterSão Paulo 01509-010Brazil Department of Gastroenterology Discipline of Liver and Gastrointestinal TransplantationLaboratory of Medical Investigations LIM37 Hospital das ClinicasUniversity of São Paulo School of MedicineSão Paulo 05402-000Brazil Department of Liver Transplantation AC Camargo Cancer CenterSão Paulo 01525-901Brazil Department of Gastroenterology Division of Liver and Gastrointestinal TransplantHospital das ClinicasUniversity of São Paulo School of MedicineSão Paulo 05402-000Brazil

BACKGROUND The impact of perioperative blood transfusion on short-and long-term outcomes in pediatric living donor liver transplantation(PLDLT)must still be ascertained,mainly among young *** and surgical postoperative complications related to perioperative blood transfusion are well described up to three months after adult liver *** To determine whether transfusion is associated with early and late postoperative complications and mortality in small patients undergoing *** We evaluated the effects of perioperative transfusion on postoperative complications in recipients up to 20 kg of body weight,submitted to PLDLT.A total of 240 patients were retrospectively allocated into two groups according to postoperative complications:Minor complications(n=109)and major complications(n=131).Multiple logistic regression analysis identified the volume of perioperative packed red blood cells(RBC)transfusion as the only independent risk factor for major postoperative *** receiver operating characteristic curve was drawn to identify the optimal volume of the perioperative RBC transfusion related to the presence of major postoperative complications,defining a cutoff point of 27.5 mL/***,patients were reallocated to a low-volume transfusion group(LTr;n=103,RBC≤27.5 mL/kg)and a high-volume transfusion group(HTr;n=137,RBC>27.5 mL/kg)so that the outcome could be *** High-volume transfusion was associated with an increased number of major complications and mortality during hospitalization up to a 10-year follow-up *** a short-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and bleeding complications,with a decrease in rejection complications compared to the *** a long-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and minor neoplastic complications,with a decrease in rejection ***,Cox hazard regr

关键词： Liver transplantation Child Blood transfusion Outcome Liver cirrhosis Mortality

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A mathematical model for shortening waiting time in pancreas-kidney transplantation

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World journal of Gastrointestinal Surgery 2011年第8期3卷 119-122页

作者： Eleazar Chaib Marcelo Augusto F Ribeiro Jr Vinicius rocha Santos Roberto Ferreira Meirelles Jr Luiz Augusto Carneiro D'Albuquerque Eduardo Massad Liver and Pancreas Transplantation Surgery Unit LIM 37 and LIM 01 Department of Gastroenterology University of Sao Paulo School of Medicine

AIM: To simulate a hypothetical increase of 50% in the number of pancreas-kidney (PK) transplantations using less-than-ideal donors by a mathematical model. METHODS: We projected the size of the waiting list by taking into account the incidence of new patients per year, the number of PK transplantations carried out in the year and the number of patients who died on the waiting list or were removed from the list for other reasons. These variables were treated using a model developed elsewhere. RESULTS: We found that the waiting list demand will meet the number of PK transplantation by the year 2022. CONCLUSION: In future years, it is perfectly possible to minimize the waiting list time for pancreas transplantation through expansion of the donor pool using less-than-ideal donors.

关键词： Pancreas-Kidney transplantation Waiting list Mathematical model

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