Browsing by Author "Dominguez, Pilar"
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- ItemOperational tolerance after liver transplantation, more common than we think: A case report(MEXICAN ASSOC HEPATOLOGY, 2011) Benitez, Carlos; Pablo Arancibia, Juan; Arrese, Marco; Soza, Alejandro; Dominguez, Pilar; Jarufe, Nicolas; Martinez, Jorge; Maria Perez Ayuso, RosaOperational tolerance after liver transplantation has been described in around 20% of the recipients. These patients are able to maintain a normal graft function in the absence of immunosuppressive drugs, thus being free of adverse effects that are common and frequently severe. Here we present a well-documented case of operational tolerance after liver transplantation and discuss current concepts on this topic with emphasis on recent findings that will potentially allow for identifying graft-tolerant patients.
- ItemSteatotic livers. Can we use them in OLTX? Outcome data from a prospective baseline liver biopsy study(MEXICAN ASSOC HEPATOLOGY, 2012) Gabriel, Mauricio; Moisan, Fabrizio; Vidal, Marcela; Duarte, Ignacio; Jimenez, Macarena; Izquierdo, Guillermo; Dominguez, Pilar; Mendez, Javier; Soza, Alejandro; Benitez, Carlos; Perez, Rosa; Arrese, Marco; Guerra, Juan; Jarufe, Nicolas; Martinez, JorgeIntroduction. Steatotic livers have been associated with greater risk of allograft dysfunction in liver transplantation. Our aim was to determinate the prevalence of steatosis in grafts from deceased donors in Chile and to assess the utility of a protocol-bench biopsy as an outcome predictor of steatotic grafts in our transplant program. Material and methods. We prospectively performed protocol-bench graft biopsies from March 2004 to January 2009. Biopsies were analyzed and classified by two independent pathologists. Steatosis severity was graded as normal from absent to < 6%; grade 1: 6-33%; grade 2: > 33-66% and grade 3: > 66%. Results. We analyzed 58 liver grafts from deceased donors. Twenty-nine grafts (50%) were steatotic; 9 of them (16%) with grade 3. Donor age (p < 0.001) and BMI over 25 kg/m(2) (p = 0.012) were significantly associated with the presence of steatosis. There were two primary non-functions (PNF); both in a grade 3 steatotic graft. The 3-year overall survival was lower among recipients with macrovesicular steatotic graft (57%) than recipients with microvesicular (85%) or non-steatotic grafts (95%) (p = 0.026). Conclusion. Macrovesicular steatosis was associated with a poor outcome in this series. A protocol bench-biopsy would be useful to identify these grafts.