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L C Feitosa

Publications and source records attributed to L C Feitosa.

8 recordsLinked to original sources
PubMed2000

Simultaneous pancreas-kidney transplantation: portal versus systemic venous drainage of the pancreas allografts.

Simultaneous pancreas-kidney (SPK) transplantation is considered a valid therapeutic option for patient with type I diabetes mellitus and end-stage diabetic nephropathy. This study was performed to determine whether the technique of pancreas venous drainage affects patient survival as well as graft survival and function. From October 1996 to April 1999 34 uremic patients with type I diabetes mellitus were randomly assigned to two groups: the first group (SV group = 17) received SPK transplantation with systemic venous drainage, and the second group (PV group = 17) received pancreas allograft with portal drainage. A Roux-en-Y loop was performed in all the patients. Patient follow-up included clinical course and metabolic studies. At 1 yr, patient survival rates were 88.2% in the SV group and 94.1% in the PV group while graft survival rate was 76.4% in both groups. Several surgical complications were attributed to the enteric drainage without any graft failure in both groups. One venous thrombosis occurred in each group. No significant differences have been evidenced in kidney and pancreas function. The preliminary results of this randomized trial did not evidence any significant differences between portal and systemic venous drainage of pancreas allograft.

Diabetes Mellitus, Type 1↗
PubMed2000

Severe bleeding after nephrolithotomy: results of hyperselective embolization.

From 1984 to 1998, 808 patients underwent percutaneous nephrolithotomy for removal of renal calculi. Although the technique is safe and effective, complications, including hemorrhages, have been reported. Eight patients (1%) are described in whom severe bleeding following percutaneous nephrolithotomy was uncontrolled by usual methods and treated by hyperselective embolization. Renal arteriography has shown arteriovenous fistula in 3 patients, pseudo aneurysm in 4 and both in1 patient. Embolization allowed definitive treatment of these lesions in 7 of our 8 patients. The failure of embolization in 1 patient imposed a partial nephrectomy. Patients with normal renal function did not suffer significant change in the serum creatinine after treatment (percutaneous nephrolithotomy + embolization), and all but 1 patient have maintained normal blood pressure. In the authors' opinion, hyperselective embolization is the least invasive and best treatment for massive hemorrhage after percutaneous nephrolithotomy.

Adult↗
PubMed2000

Evidence of recurrent type I diabetes following HLA-mismatched pancreas transplantation.

Type 1 diabetes mellitus is considered as an autoimmune disease against beta cells. Diabetes recurrence after pancreas transplantation is well known in HLA-identical twins while it is rarely reported in recipients of cadaveric pancreatic grafts. In the present case report, diabetes recurrence occurred in a recipient who underwent cadaveric combined pancreas kidney transplantation. Seven years after transplantation the patient exhibited progressive hyperglycemia needing insulin therapy while the renal graft was well functioning. The diagnosis of recurrent disease was obtained on the histological features such as selective loss of beta cells without clear signs of insulitis and on the presence of markers (GAD 65 and IA-2) for humoral autoimmunity. It is intriguing that, at the time of recurrence of type 1 diabetes, the patient had stopped steroids and azathioprine, while only cyclosporine was maintained as immunosuppressive treatment. Our case report underlines the relevance of studying the humoral autoimmune response directed to islet autoantigens in cadaveric pancreas allograft recipients. Furthermore, it suggests that an efficient immunosuppressive treatment after transplantation may be able to reduce the autoimmune response against the pancreatic allograft.

Adolescent↗