Browsing by Author "Dib Marambio, Martin Javier"

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    Reduced Immune Response to Inactivated Severe Acute Respiratory Syndrome Coronavirus 2 Vaccine in a Cohort of Immunocompromised Patients in Chile
    (Oxford University Press for the Infectious Diseases Society of America, 2022) Balcells Marty, María Elvira; Le Corre Pérez, Monique Nicole; Durán Santa Cruz, Josefina Gracia; Ceballos Valdivielso, María Elena Andrea; Vizcaya Altamirano, María Cecilia; Mondaca Contreras, Sebastián Patricio; Dib Marambio, Martin Javier; Rabagliati Borie, Ricardo Miguel; Sarmiento Maldonado, Mauricio; Burgos Cañete, Paula Isabel; Espinoza Sepúlveda, Manuel Antonio; Ferres Garrido, Marcela Viviana; Martínez Valdebenito, Constanza Pamela; Ruiz-Tagle Seguel, Cinthya Grace; Ortiz Koh, Catalina Alejandra; Ross Pérez, Patricio Daniel; Budnik Bitran, Sigall; Solari Gajardo, Sandra; Vizcaya Vergara, María De Los Ángeles; Lembach, Hanns; Berríos Rojas, Roslye; Melo González, Felipe; Rios Raggio, Mariana; Kalergis Parra, Alexis Mikes; Bueno Ramírez, Susan Marcela; Nervi Nattero, Bruno
    Background Inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have been widely implemented in low- and middle-income countries. However, immunogenicity in immunocompromised patients has not been established. Herein, we aimed to evaluate immune response to CoronaVac vaccine in these patients. Methods This prospective cohort study included 193 participants with 5 different immunocompromising conditions and 67 controls, receiving 2 doses of CoronaVac 8-12 weeks before enrollment. The study was conducted between May and August 2021, at Red de Salud UC-CHRISTUS, Santiago, Chile. Neutralizing antibody (NAb) positivity, total anti-SARS-CoV-2 immunoglobulin G antibody (TAb) concentrations, and T-cell responses were determined. Results NAb positivity and median neutralizing activity were 83.1% and 51.2% for the control group versus 20.6% and 5.7% (both P < .001) in the solid organ transplant group, 41.5% and 19.2% (both P < .0001) in the autoimmune rheumatic diseases group, 43.3% (P < .001) and 21.4% (PP = .001) in the cancer with solid tumors group, 45.5% and 28.7% (both P < .001) in the human immunodeficiency virus (HIV) infection group, 64.3% and 56.6% (both differences not significant) in the hematopoietic stem cell transplant group, respectively. TAb seropositivity was also lower for the solid organ transplant (20.6%; P < .0001), rheumatic diseases (61%; P < .001), and HIV groups (70.9%; P = .003), compared with the control group (92.3%). On the other hand, the number of interferon gamma spot-forming T cells specific for SARS-CoV-2 tended to be lower in all immunocompromising conditions but did not differ significantly between groups. Conclusions Diverse immunocompromising conditions markedly reduce the humoral response to CoronaVac vaccine. These findings suggest that a boosting vaccination strategy should be considered in these vulnerable patients.
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    Trasplante hepático: Evolución, curva de aprendizaje y resultados después de los primeros 300 casos
    (2019) Quezada González, José Luis; Cancino, Alejandra; Arrese Jimenez, Marco Antonio; Wolff, Rodrigo; Benitez Gajardo, Carlos Esteban; Pattillo Silva, Juan Carlos; Gana Ansaldo, Juan Cristobal; Concha Pinto, Mario Rodrigo; Cortinez Fernandez, Luis Ignacio; Vera Alarcón, María Magdalena; Miranda, Paula; Rubilar, Francisco; Troncoso, Andrés; Briceno Valenzuela, Eduardo Andres; Dib Marambio, Martin Javier; Jarufe Cassis, Nicolas Patricio; Martínez, Jorge; Guerra Castro, Juan Francisco
    Liver transplantation (LT) is an option for people with liverfailure who cannot be cured with other therapies and for some people with liver cancer. Aim: To describe, and analyze the first 300 LT clinical results, andto establish our learning curve. Material and Methods: Retrospective cohortstudy with data obtained from a prospectively collected LT Program database.We included all LT performed at a single center from March 1994 to September2017. The database gathered demographics, diagnosis, indications for LT, surgicalaspects and postoperative courses. We constructed a cumulative summation testfor learning curve (LC-CUSUM) using 30-day post-LT mortality. Mortality at 30days, and actuarial 1-, and 5-year survival rate were analyzed. Results: A total of281 patients aged 54 (0-71) years (129 women) underwent 300 LT. Ten percentof patients were younger than 18 years old. The first, second and third indicationsfor LT were non-alcoholic steatohepatitis, chronic autoimmune hepatitis andalcoholic liver cirrhosis, respectively. Acute liver failure was the LT indication in51 cases (17%). The overall complication rate was 71%. Infectious and biliarycomplications were the most common of them (47 and 31% respectively). TheLC-CUSUM curve shows that the first 30 patients corresponded to the learningcurve. The peri-operative mortality was 8%. Actuarial 1 and 5-year survival rateswere 82 and 71.4%, respectively. Conclusions: Outcome improvement of a LTprogram depends on the accumulation of experience after the first 30 transplantsand the peri-operative mortality directly impacted long-term survival.