Infecções em pacientes pediátricos submetidos a transplante hepático

Autor: T. Ferreira, Cristina, O. Kieling, Carlos, M. G. Vieira, Sandra, Bischopp, Geraldo, Machado, Adão, Alencastro, Ruy, Müller, Helena, L. Zanottelli, Maria, P. C. Cantisani, Guido, R. da Silveira, Themis
Jazyk: portugalština
Rok vydání: 2022
Předmět:
Zdroj: Clinical & Biomedical Research; Vol. 18 No. 3 (1998): Periodical HCPA
Clinical and Biomedical Research; v. 18 n. 3 (1998): Revista HCPA
Clinical and Biomedical Research
Universidade Federal do Rio Grande do Sul (UFRGS)
instacron:UFRGS
ISSN: 2357-9730
Popis: OBJECTIVE: To identify bacterial, viral, and fungal infections in the first 20 pediatric patients submitted to liver transplant at Hospital de Clínicas de Porto Alegre.PATIENTS AND METHODS: Twenty-one liver transplants were performed in 20 infant and adolescent patients from March 1995 to September 1997, at Hospital deClínicas de Porto Alegre. All transplanted organs were taken from deceased donors with the same ABO blood type as the organ transplant recipient. Nine patientsreceived a whole liver transplant, and 11 patients received a reduced liver transplant. Bacterial infection was diagnosed by the existence of clinical and laboratory evidence;and/or by hemoculture; and/or by positive cultures. For the diagnosis of viral infections, patients were examined for Epstein Barr virus and for cytomegalovirus. For the diagnosis of fungal infection, hemocultures and secretion cultures were taken, and patients were also submitted to draining and sample collections, such as urine samples using a catheter.RESULTS: Of the 20 organ transplant recipient patients, two died within the first 24- 48 hours, and only four of the patients did not present any infections and/or positive cultures that were clinically significant. Fourteen patients had bacterial infection, and nine patients had more than one case of infection. The most frequently found organisms were Staphylococus aureus and epidermidis, and Xanthomonas maltophilia. Five transplant recipients were positive for cytomegalovirus antigenemia, and only one of these recipients was seronegative before the transplant. Fungal infection was diagnosed in two patients, and a third patient presented a positive culture of the biliary drain.CONCLUSIONS: Of the 20 liver transplant recipients, four died due to infection complications. By exerting a careful control, and establishing appropriate prophylacticand therapeutic measures, infection and its consequences may be reduced.
OBJETIVO: Identificar infecções bacterianas, virais e fúngicas nos primeiros 20pacientes pediátricos submetidos a transplante de fígado no HCPA.PACIENTES E MÉTODOS: 21 transplantes foram realizados em 20 crianças eadolescentes, no período de março de 1995 a setembro de 1997, no HCPA. Todosos transplantes foram de doador cadavérico, do mesmo grupo sangüíneo ABO.Nove transplantes foram de fígado inteiro e 11, de fígado reduzido. O diagnósticode infecção bacteriana foi feito quando havia evidências clínico-laboratoriais e/ouhemocultura e/ou outros culturais positivos. Os vírus pesquisados foram citomegaloe Epstein Barr. Fungos eram pesquisados através de hemoculturas e culturas desecreções, drenos e coleções, cateteres e urina.RESULTADOS: Dos 20 pacientes transplantados, dois morreram nas primeiras24-48 horas e apenas quatro não apresentaram infecção e/ou culturais positivos,clinicamente significativos. Quatorze pacientes apresentaram infecção bacteriana,sendo que nove pacientes apresentaram mais do que um episódio infeccioso. Osorganismos mais freqüentes foram Staphylococus aureus e epidermidis eXantomonas maltophilia. Cinco receptores positivaram antigenemia para CMV, sendoque apenas um apresentava sorologia negativa no pré-transplante. Infecção fúngicafoi diagnosticada em dois pacientes e um terceiro paciente apresentou cultura dodreno biliar positiva.CONCLUSÕES: Dos 20 pacientes transplantados, quatro foram ao óbito porcomplicações infecciosas. Um controle cuidadoso e medidas profiláticas eterapêuticas adequadas podem diminuir infecções e suas conseqüências apóstransplante hepático.
Databáze: OpenAIRE
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