Navegando por Palavras-chave "Organ preservation"
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- ItemAcesso aberto (Open Access)Características dos doadores de córneas do Banco de Olhos de Cascavel: impacto do exame anti-HBc para hepatite B(Conselho Brasileiro de Oftalmologia, 2011-02-01) Shiratori, Cesar Nobuo; Hirai, Flávio Eduardo [UNIFESP]; Sato, Elcio Hideo [UNIFESP]; Banco de Olhos de Cascavel; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To describe the characteristics of human ocular tissue donors from the Cascavel Eye Bank in the State of Paraná (PR) and investigate the impact of hepatitis B serologic test positivity on discarded ocular tissues. METHODS: Cross-sectional study of data collected between March 2006 and April 2007 at the Cascavel Eye Bank. Information such as age, gender, cause of death, time between death and enucleation, and serologic tests results was collected. Data were used to characterize the study population and stratified according to hepatitis B (anti-HBc) status. RESULTS: Mean age of donors was 54.2 ± 20.6 years and a greater proportion of men (64,7%) was observed. Mean time between death and enucleation was 3.8 ± 2.4 hours, cardiovascular diseases were the main cause of death (34.5%). Positivity of anti-HBc and HBsAg tests was 47.4% and 1.5%, respectively. Hepatitis B was the main reason for discarding corneas. Donors whose serologic tests were positive for anti-HBc had higher mean age compared to those with negative tests (p<0.001). Only 0.8% of all donations tested positive for hepatitis C and donors with positive HIV test were not seen in our study. CONCLUSIONS: Activities of the Cascavel Eye Bank significantly increased the availability of corneas for transplant in the State of Paraná. The main contraindication for availability of ocular tissues was positivity of serologic tests for anti-HBc. Biosafety studies should be performed in order to investigate the potential transmission of hepatitis B virus for donors with positive tests for anti-HBc. The inclusion of these donors would increase the number of corneas available for transplant.
- ItemAcesso aberto (Open Access)Contaminação de halos doadores córneo-esclerais em ceratoplastia penetrante no Hospital de Clínicas de Porto Alegre(Conselho Brasileiro de Oftalmologia, 2008-02-01) Borowsky, Cláudia Martins; Wallau, Anelise Dutra [UNIFESP]; Reetz, Aline; Kwitko, Sérgio [UNIFESP]; Rymer, Samuel; Locatelli, Claudete Inês; Universidade Federal do Rio Grande do Sul Hospital de Clínicas de Porto Alegre; Universidade Federal de São Paulo (UNIFESP); Universidade de Passo Fundo; Hospital de Clínicas de Porto Alegre; UFRGS Faculdade de Medicina; UFRGS Hospital de Clínicas de Porto Alegre; UFRGSPURPOSE: To determine the incidence of positive corneoscleral rim cultures preserved in Optisol GS medium, to identify pathogens involved and possible recipient eye infection. METHODS: A hundred sixty-three corneoscleral rim cultures penetrating keratoplasties performed from January 2001 to January 2003 in the Hospital de Clínicas de Porto Alegre were reviewed. Enucleations and corneal storage were done as aseptic as possible and gentamicin 0.3% was instilled. Corneoscleral rim was divided into two segments, half was inoculated into Sabouraud broth and the other half into thioglycolate broth; inoculation into blood agar, chocolate agar and MacConkey agar was done later if necessary for pathogen identification. The receiver's eye data were reviewed. RESULTS: There were eleven positive cultures (6.7%) out of 163 evaluated corneoscleral rim cultures. Of these, four were Staphylococcus epidermidis, one was Staphylococcus aureus, one was Serratia sp., one was Pseudomonas aeruginosa and the other four were different subtypes of Candida (two Candida sp., one Candida albicans and one Candida parapapilosis). All pathogens were resistant to gentamicin. None of the eleven cases of positive corneoscleral rim cultures resulted in ocular infection at the receiver's eyes (six months follow-up). CONCLUSIONS: We found low rates of positive corneoscleral rim cultures after penetrating keratoplasty at the Porto Alegre Clinical Hospital. The most frequent involved pathogens were Staphylococcus sp and Candida sp. Although we did not identify any postoperative infection at the receiver's eyes, we recommend corneoscleral rim culture for guidance of postoperative infection, a rare but possible devastating ocular event.
- ItemAcesso aberto (Open Access)Estudo da fração inspirada de oxigênio na isquemia-reperfusão pulmonar em ratos(Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2004-10-01) Silveira, Rafael José; Silva, Fábio May Da [UNIFESP]; Wilhelm Filho, Danilo [UNIFESP]; Cardoso, José De Deus; Leao, Luiz Eduardo Villaca [UNIFESP]; Secretaria Estadual de Saúde de Santa Catarina; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Santa Catarina Departamento de Clínica CirúrgicaPURPOSE: To evaluate the FiO2 effect at 0,21, 0,40 and 1,00 on the lung ischaemia-reperfusion injury. METHODS: Forty Wistar rats were randomly allocated in 4 groups. The group I was the control one, and in groups II, III, IV rats were ventilated during the ischaemia-reperfusion at 0,21, 0,40 and 1.00 FiO2 respectively. The ischaemia time was 30 minutes and the reperfusion time was 10 minutes. The model used was normothermic ischaemia-reperfusion, in situ. As assessment parameters, the systemic average arterial pressure (PAM), the oxygen arterial partial pressure/ inspired oxygen fraction relation (PO2/FiO2), the level of reduced glutathione (GSH) and barbituric acid substances reactive measure (TBARS) in the lung tissue and the lung wet/dry weight ratio were used. RESULTS: The results showed that the ventilation with FiO2 at 0,21, when compared with the ventilation at 0,40 and 1,00 FiO2 during the ischaemia-reperfusion period, presented lower PAM, better PO2/FiO2 relation, higher values in the reduced glutathione measures, lower production of the TBARS and lower formation of lung edema. CONCLUSION: The ventilation with low FiO2 (0.21) showed better results when compared to those performed with higher FiO2 (0,40 and 1,00) on the lung ischaemia-reperfusion injury.
- ItemAcesso aberto (Open Access)Fatores associados à qualidade da córnea doada pelo Banco de Olhos do Hospital São Paulo(Conselho Brasileiro de Oftalmologia, 2009-02-01) Hirai, Flávio Eduardo [UNIFESP]; Adán, Consuelo Bueno Diniz [UNIFESP]; Sato, Elcio Hideo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To investigate factors associated with the morphological quality of corneal tissue at the Hospital São Paulo Eye Bank (BOHSP) - UNIFESP. METHODS: Retrospective study of records from the BOHSP between 2001 and 2006. Information about donors such as age, gender, and cause of death were collected as well as time between death and enucleation (time-to-enucleation), time between enucleation and tissue preservation (time-to-preservation), preservation media, and source of corneal tissue. Biomicroscopic examination was performed in preserved corneas which were classified as Excellent or Good (group A) or Regular, Bad, or Unacceptable (group B). Multivariate logistic regression models were used to assess factors that were independently associated with corneal quality. RESULTS: Data from 870 cornea donors were analyzed. The mean ± standard error age in groups A and B was 40.7 ± 16.1 and 56.3 ± 17.5 years, respectively (p<0.01). Time-to-preservation was significantly lower in group A (5.2 vs. 6.6 hours, p<0.01). There was no statistically significant difference between the two groups regarding gender (p=0.82) and time-to-enucleation (p=0.17). A higher proportion of traumas was observed in group A compared to group B (p<0.01). Overall, Optisol was the most commonly used preservation medium and approximately half of the corneas were harvested by BOHSP. Factors that were independently associated with corneal quality were: age (Odds ratio 95% CI, 1.05 (1.04 - 1.06), for 1 year), time-to-preservation (1.05 (1.02 - 1.08), for 1 hour), source (1.53 (1.12 2.09), for Others vs. BOHSP) and cause of death (2.06 (1.43 -2.96), for Chronic diseases vs. External causes). CONCLUSIONS: This study showed some factors that were independently associated with morphological quality of donated corneas in the BOHSP such as age, time-to-preservation, source, and cause of death. Similar studies are necessary in order to determine factors that might influence the quality of corneas delivered to ophthalmic surgeons.
- ItemAcesso aberto (Open Access)Motivos do descarte de córneas captadas pelo banco de olhos do Hospital São Paulo em dois anos(Sociedade Brasileira de Oftalmologia, 2010-02-01) Santos, Carla Galluzzi dos [UNIFESP]; Pacini, Keila Mattos [UNIFESP]; Adán, Consuelo Bueno Diniz [UNIFESP]; Sato, Elcio Hideo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyze causes of discarded donor corneas which were collected and preserved by São Paulo Hospital Eye Bank in a period of two years. METHODS: Retrospective study based in the investigation of donor's medical records, for clinical and ocular factors, age, death cause, serology results, body conditions, slit lamp corneal examination and endothelial cells counting. RESULTS: 1,116 corneas were donated and included in the study, 518 (46.41%) were discarded before preservation, 168 (15.05%) were not transplanted for optical purpose, but used for tectonic indication. The main reason of cornea discard was the cause of death in 288 (25.80%) corneas, second the slit lamp analysis of tissues in 174 (15.59%) corneas. CONCLUSION: The analysis of the medical records and the donor's clinical history was an important factor of cornea discard of the not preserved tissues, showing the importance of this stage to guarantee the quality of the tissue and to ensure proper safety for the recipient. Also, the biomicroscopy evaluation realized in the slit lamp is a fundamental stage for qualification and classification of the tissue to guarantee a good surgical result.