Browsing by Author "Herzog, C."

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    Chilean experience in liver transplantation for acute liver failure in children
    (2010) Uribe, M.; Alba, A.; Hunter, B.; Valverde, C.; Godoy, J.; Ferrario, M.; Buckel, E.; Cavallieri, S.; Rebolledo Acevedo, Rolando Arturo; Herzog, C.; Calabrán, L.; Flores, L.; Soto, P.
    Background: Acute liver failure (ALF) in children is a life-threatening condition, associated with high mortality, and in almost one third of the cases, with no other therapeutic option than orthotopic liver transplant (OLT). The aim of this study was to present our experience with OLT for ALF in pediatric patients in Chile. Patients fulfilling the criteria for ALF who were transplanted in our centers were prospectively included in an excel Microsoft database. We analyzed demographics, etiology, surgical techniques, complications, and long-term results. Patients and Methods: Between 1994 and 2009, we transplanted 52 pediatric patients with ALF. The most frequent known etiology was acute hepatitis A in 9 cases (18%), but in 26 cases (50%) it was impossible to determine the etiology. Thirty- one patients were males (63%). The overall mean age was 7.5 years and the mean weight, 28.1 kg. Thirty-five (67%) received a cadaveric graft. Among them in 18 cases (34%) the liver had to be reduced but 17 (33%) received whole livers. There were 17 (33%) recipients of living-related livers. Twenty-two patients needed reoperation, including 13 due to surgical complications (59%) and 9 (41%) as planned interventions. Ten patients were retransplanted. Results: Actuarial survival of patients at 1 year was 80% and at 5 and 10 years, 72%. Graft survival at 1 year was 79%, at 5 years 69%, and at 10 years 50%. Conclusion: We have reported a series of pediatric liver transplant patients due to ALF whose results were comparable to other reported series. Living donor transplantation for ALF should be considered and offers a low morbidity rate without mortality.
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    Late Acute Humoral Rejection in Low-Risk Renal Transplant Recipients Induced With an Interleukin-2 Receptor Antagonist and Maintained With Standard Therapy: Preliminary Communication
    (ELSEVIER SCIENCE INC, 2011) Morales, J.; Contreras, L.; Zehnder, C.; Pinto, V.; Elberg, M.; Araneda, S.; Herzog, C.; Calabran, L.; Aguilo, J.; Ferrario, M.; Buckel, E.; Fierro, J. A.
    Low-risk renal transplant recipients treated with standard immunosuppressive therapy including interleukin-2 receptor (IL-2R) antagonist show a low incidence of early rejection episodes but few reports have examined the incidence and severity of late rejection processes. This study evaluated retrospectively cellular and antibody-mediated rejection (AMR) among 42 recipients selected because they showed low panel-reactive-antibodies, short cold ischemia time, no delayed graft function, and therapy including basiliximab (Simulect) induction. The mean observation time was 6.6 years. Sixty-seven percent of donors were deceased. Ten-year patient and death-censored graft survivals were 81% and 78%, respectively. Seven patients lost their kidneys due to nonimmunologic events. The seven recipients who experienced cellular rejection episodes during the first posttransplant year had them reversed with steroids. Five patients displayed late acute AMR causing functional deterioration in four cases including 1 graft loss. De novo sensitization occurred in 48% of recipients including patients without clinical rejection. In conclusion, long-term follow-up of kidney transplant recipients selected by a low immunologic risk showed a persistent risk of de novo sensitization evolving to acute AMR in 11% of cases. Although immunologic events were related to late immunosuppressive reduction, most graft losses were due to nonimmunologic factors.
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    Pediatric liver transplantation experience and outcome in Chile
    (2013) Acuña, C.; Zuleta, R.; Dalmazzo, R.; Valverde, C.; Uribe, M.; Alba, A.; Buckel, E.; Hunter, B.; González, G.; Godoy, J.; Ferrario, M.; Cavallieri, S.; Campos, M.; Pizarro, F.; Wash, A.; Ferrón, S.; Díaz, V.; Macho, L.; Herzog, C.; Calabrán, L.; Flores, L.; Soto, P.; Heine, C.; Rebolledo Acevedo, Rolando Arturo; Auad, H.