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Hernanz-Lobo A, Santos-Sebastián M, Lancharro A, Saavedra-Lozano J, Rincón-López E, Aguilera-Alonso D, García-Santiago M, Bustos-Fonseca MJ, Ruiz-Serrano MJ, Gordillo-Gutiérrez I, Hernández-Sampelayo T, Rodríguez-Baena E, Córdoba-Deorador E, López-Suárez A, Navarro-Gómez ML, Santiago-García B. Use of computed tomography for the diagnosis of TB during a paediatric outbreak. Int J Tuberc Lung Dis 2022; 26:1183-1185. [PMID: 36447313 DOI: 10.5588/ijtld.22.0183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- A Hernanz-Lobo
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain, Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain, Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - M Santos-Sebastián
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain, Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain, Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - A Lancharro
- Pediatric Radiology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - J Saavedra-Lozano
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain, Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain, Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain, Complutense University, Madrid, Spain
| | - E Rincón-López
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain, Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain, Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | - D Aguilera-Alonso
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain, Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain, Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
| | | | | | - M J Ruiz-Serrano
- Microbiology and Infectious Diseases Department, Gregorio Marañón University Hospital, Madrid, Spain, Biomedical Research Centre Network for Respiratory Diseases (CIBERES)
| | - I Gordillo-Gutiérrez
- Pediatric Radiology Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - T Hernández-Sampelayo
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain
| | | | | | - A López-Suárez
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain, Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain
| | - M L Navarro-Gómez
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain, Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain, Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain, Complutense University, Madrid, Spain
| | - B Santiago-García
- Pediatric Infectious Diseases Unit, Department of Pediatrics, Gregorio Marañón University Hospital, Madrid, Spain, Gregorio Marañón Research Health Institute (IiSGM), Madrid, Spain, Biomedical Research Centre Network for Infectious Diseases (CIBERINFEC), Carlos III Health Institute, Madrid, Spain
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2
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Berenguer B, Lorca-García C, Lancharro A, DeTomás E. Pediatric tumors of the buccal fat pad: lipoma and hemangioma. Acta Chir Belg 2020; 120:341-343. [PMID: 30722729 DOI: 10.1080/00015458.2019.1570743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The buccal fat pad (BFP) has prompted numerous publications in anatomy, reconstructive and aesthetic surgery over the years; however, description of surgical treatment of pathologic conditions affecting this space is rare, especially in children. An extensive search of the English literature retrieved only five lipomas and one hemangioma in this age group.Methods: The authors report on two of these exceptional pediatric tumors of the BFP: one lipoma and one hemangioma referred to the outpatient clinic for diagnosis and treatment.Results: Both children had a similar clinical presentation and a characteristic MR image. The two lesions were excised through an intraoral approach, which proved to be a fast, safe and effective technique.Conclusions: Being extremely rare, tumors of the BFP in children have an indicative clinical presentation and radiologic image. A detailed intraoral approach is described and proposed as effective and safe surgical treatment.
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Affiliation(s)
- B. Berenguer
- Section of Pediatric Plastic Surgery, Gregorio Marañón University Hospital, Madrid, Spain
| | - C. Lorca-García
- Section of Pediatric Plastic Surgery, Gregorio Marañón University Hospital, Madrid, Spain
- Complutense University of Madrid, Madrid, Spain
| | - A. Lancharro
- Department of Pediatric Radiology, Gregorio Marañón University Hospital, Madrid, Spain
| | - E. DeTomás
- Section of Pediatric Plastic Surgery, Gregorio Marañón University Hospital, Madrid, Spain
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3
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Berenguer B, Lorca-García C, Agra C, Lancharro A, Tomás E. [Fibrous hamartoma in childhood. A case description of large size and review of the literature]. Cir Pediatr 2018; 31:52-55. [PMID: 29419960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Fibrous hamartoma of infancy is a rare soft tissue tumour that usually appears before 2 years of age, typically in the upper extremities of male infants. CASE REPORT We report the case of a 2 year old boy with a large and rapidly growing tumour in the upper extremity. COMMENTS We describe the case, its differential diagnosis and the immunhistological characteristics, and we discuss the non-aggressive surgical treatment, based on the benign behaviour of this tumour.
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Affiliation(s)
- B Berenguer
- Servicio de Cirugía Plástica Infantil. Hospital General Universitario Gregorio Marañón. Madrid
| | - C Lorca-García
- Servicio de Cirugía Plástica Infantil. Hospital General Universitario Gregorio Marañón. Madrid
| | - C Agra
- Servicio de Anatomía Patológica. Hospital General Universitario Gregorio Marañón. Madrid
| | - A Lancharro
- Servicio de Radiología Infantil. Hospital General Universitario Gregorio Marañón. Madrid
| | - E Tomás
- Servicio de Cirugía Plástica Infantil. Hospital General Universitario Gregorio Marañón. Madrid
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4
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Montesinos P, Rodríguez-Veiga R, Boluda B, Martínez-Cuadrón D, Cano I, Lancharro A, Sanz J, Arilla MJ, López-Chuliá F, Navarro I, Lorenzo I, Salavert M, Pemán J, Calvillo P, Martínez J, Carpio N, Jarque I, Sanz GF, Sanz MA. Incidence and risk factors of post-engraftment invasive fungal disease in adult allogeneic hematopoietic stem cell transplant recipients receiving oral azoles prophylaxis. Bone Marrow Transplant 2015; 50:1465-72. [PMID: 26281032 DOI: 10.1038/bmt.2015.181] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/01/2015] [Accepted: 07/03/2015] [Indexed: 01/24/2023]
Abstract
Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving >40 days who engrafted and were discharged without prior IFD. All patients who received ⩾20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria. The independent prognostic factors after multivariate analyses were used to construct a post-engraftment IFD risk score. The 1-year CI of IFD was 11%. The non-relapse mortality was 40% in those developing IFD and 16% in those who did not. The intent-to-treat analysis showed that 17% of patients abandoned the assigned prophylaxis. Age >40 years, ⩾1 previous SCT, pre-engraftment neutropenia >15 days, extensive chronic GVHD and CMV reactivation were independent risk factors. The post-engraftment IFD score stratified patients into low risk (0-1 factor, CI 0.7%), intermediate risk (2 factors, CI 9.9%) and high risk (3-5 factors, CI 24.7%) (P<0.0001). The antifungal prophylaxis strategy failed to prevent post-engraftment IFD in 11% of alloSCT. Our risk score could be useful to implement risk-adapted strategies using antifungal prophylaxis after engraftment.
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Affiliation(s)
- P Montesinos
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - R Rodríguez-Veiga
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - B Boluda
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - D Martínez-Cuadrón
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - I Cano
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - A Lancharro
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - J Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - M J Arilla
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - F López-Chuliá
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - I Navarro
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - I Lorenzo
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - M Salavert
- Department of Infectious Diseases, Hospital Universitari i Politècnic La Fe, València, Spain
| | - J Pemán
- Department of Microbiology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - P Calvillo
- Department of Radiology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - J Martínez
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - N Carpio
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - I Jarque
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - G F Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain
| | - M A Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, València, Spain.,Departament de Medicina, Universitat de València, Valencia, Spain
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Chen-Liang TH, Martin-Santos T, Jerez A, Senent L, Orero MT, Remigia MJ, Muiña B, Romera M, Fernandez-Muñoz H, Raya JM, Fernandez-Gonzalez M, Lancharro A, Villegas C, Carlos Herrera J, Frutos L, Luis Navarro J, Uña J, Igua C, Sanchez-Vaño R, Cozar MDP, Contreras J, Sanchez-Blanco JJ, Perez-Ceballos E, Ortuño FJ. The role of bone marrow biopsy and FDG-PET/CT in identifying bone marrow infiltration in the initial diagnosis of high grade non-Hodgkin B-cell lymphoma and Hodgkin lymphoma. Accuracy in a multicenter series of 372 patients. Am J Hematol 2015; 90:686-90. [PMID: 25925613 DOI: 10.1002/ajh.24044] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 12/20/2022]
Abstract
Bone marrow infiltration (BMI), categorized as an extra-nodal site, affects stage and is associated with poor prognosis in newly diagnosed lymphoma patients. We have evaluated the accuracy of PET/CT and bone marrow biopsy (BMB) to assess BMI in 372 lymphoma patients [140 Hodgkin Lymphoma (HL) and 232 High Grade B-cell non-Hodgkin Lymphoma (HG B-NHL), among them 155 Diffuse Large B-Cell Lymphoma (DLCL)]. For HL cases, and taking into account PET/CT, sensitivity, negative predictive value (NPV) and accuracy were 96.7, 99.3, and 99.3% while those of BMB were 32.3, 83.8, and 85%, respectively. For HG B-NHL and considering PET/CT, sensitivity, NPV, and accuracy were 52.7, 81.7, and 84.1%, while those of BMB were 77.6, 90.2, and 90.7%, respectively. In the HG B-NHL group, 25 patients would have been under-staged without BMB. These results lead us to recommend PET/CT and the avoidance of BMB to assess BMI in HL. In the case of HG B-NHL, bone marrow status should be assessed firstly by means of PET/CT; only in either focal or diffuse PET/CT with low borderline SUV max values or in negative cases, should BMB be carried out afterwards. In the HG B-NHL setting and at the present moment, both techniques are complementary.
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Affiliation(s)
- Tzu-Hua Chen-Liang
- S. de Hematología Y Oncología Médica. H.J.M. Morales Meseguer; Murcia Spain
| | | | - Andres Jerez
- S. de Hematología Y Oncología Médica. H.J.M. Morales Meseguer; Murcia Spain
| | | | | | | | - Begoña Muiña
- S. de Hematología. H. R. Méndez; Lorca Murcia Spain
| | | | | | - Jose M. Raya
- S. de Hematología. H, Universitario de Canarias; La Laguna Tenerife Spain
| | | | | | | | | | - Laura Frutos
- S. de Medicina Nuclear. H, Virgen de La Arrixaca; Murcia Spain
| | | | - Jon Uña
- S. de Medicina Nuclear H, Universitario N.S. de La Candelaria; Tenerife Spain
| | | | | | | | - Jose Contreras
- S. de Medcina Nuclear. H, Sta Lucia; Cartagena Murcia Spain
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6
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Montesinos P, Rodríguez-Veiga R, Martínez-Cuadrón D, Boluda B, Navarro I, Vera B, Alonso CM, Sanz J, López-Chulia F, Martín G, Jannone R, Sanz G, Lancharro A, Cano I, Palau J, Lorenzo I, Jarque I, Salavert M, Ramírez P, Sanz MÁ. Treatment of invasive fungal disease using anidulafungin alone or in combination for hematologic patients with concomitant hepatic or renal impairment. Rev Iberoam Micol 2015; 32:185-9. [PMID: 25858598 DOI: 10.1016/j.riam.2014.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/16/2014] [Accepted: 10/21/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Invasive fungal disease (IFD) treatment is challenging in hematologic patients due to drug interactions and toxicities that limit the use of the antifungal agents. AIMS To analyze retrospectively in terms of safety and potential efficacy anidulafungin therapy, alone or in combination. METHODS Our institutional guidelines recommended anidulafungin treatment in hematologic patients with suspected IFD and concomitant renal or liver impairment (to avoid drug interactions and preserve organ function). RESULTS From 2008 to 2013, 24 episodes of IFD occurring in 21 patients were classified as proven (4 cases), probable (15 cases) and possible (5 cases). Anidulafungin was administered alone (13%) or in combination (88%). Eight (33%) episodes were resolved, using monotherapy (1 out of 3, 33%) or a combined therapy (7 out of 21, 33%). Twelve cases (50%) were registered as failure (death due to IFD progression in 4 patients, and treatment change due to lack of efficacy in 8), and 4 cases (17%) were not evaluable (death unrelated to the IFD). Anidulafungin was not withdrawn in any case due to toxicity. CONCLUSIONS Anidulafungin therapy, alone or in combination, could be considered in hematologic patients with IFD and concomitant liver or renal impairment. Due to the low number of patients, we cannot draw any conclusion about efficacy.
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Affiliation(s)
- Pau Montesinos
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain.
| | | | | | - Blanca Boluda
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Inés Navarro
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Belen Vera
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Carmen M Alonso
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Jaime Sanz
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | | | - Guillermo Martín
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Rosa Jannone
- Intensive Care Unit Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Guillermo Sanz
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Aima Lancharro
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Isabel Cano
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Javier Palau
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Ignacio Lorenzo
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Isidro Jarque
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Miguel Salavert
- Infectious Diseases Unit of the Hospital Universitario La Fe, Valencia, Spain
| | - Paula Ramírez
- Intensive Care Unit Department of the Hospital Universitario La Fe, Valencia, Spain
| | - Miguel Ángel Sanz
- Hematology Department of the Hospital Universitario La Fe, Valencia, Spain
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Sanz J, Cano I, González-Barberá EM, Arango M, Reyes J, Montesinos P, Lorenzo I, Jarque I, Martínez J, López F, Arilla MJ, Lancharro A, Moscardó F, López-Hontangas JL, Salavert M, Sanz MA, Sanz GF. Bloodstream infections in adult patients undergoing cord blood transplantation from unrelated donors after myeloablative conditioning regimen. Biol Blood Marrow Transplant 2015; 21:755-60. [PMID: 25585274 DOI: 10.1016/j.bbmt.2014.12.038] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 12/31/2014] [Indexed: 12/29/2022]
Abstract
The incidence, epidemiology, and risk factors of bloodstream infection (BSI) and their impact on transplant outcomes after umbilical cord blood transplantation (UCBT) are not well defined. Between May 1997 and December 2012, 202 isolates in 189 episodes of BSI were registered in 134 of 241 patients who underwent single-unit myeloablative UCBT. Cumulative incidence (CI) of developing at least 1 episode of BSI was 21%, 29%, 34%, 42%, and 52% at days +7, +14, +30, +100, and +365, respectively. The median time of onset for the first BSI episode was day +10 (range, day -7 to +1217). Early BSI before day 7 was associated with increased nonrelapse mortality (relative risk [RR], 1.5; 95% confidence interval [CI], 1.1 to 2.3; P = .04), whereas BSI before day 14 was an independent adverse risk factor for neutrophil recovery (RR, .6; 95% CI, .5 to .9; P = .002). A higher CD8(+) cell dose of the graft was the only variable independently associated with reduced risk of BSI (RR, .1; 95% CI, .02 to .7; P = .02). The gram-negative rod (GNR) to gram-positive bacteria ratio was .9 before day +30 and 1.6 thereafter (P = .03). Escherichia coli (31%) and Pseudomonas sp. (28%) were the most frequently isolated among GNR. The overall crude mortality rate was 12% at day 7 and was higher for GNR (18%) compared with gram-positive bacteria (7%) (P = .03). These findings emphasize the importance of preventing bacterial infections during conditioning and the very early post-UCBT period.
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Affiliation(s)
- Jaime Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
| | - Isabel Cano
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Marcos Arango
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jheremy Reyes
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Pau Montesinos
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ignacio Lorenzo
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Isidro Jarque
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jesús Martínez
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Francisca López
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - María J Arilla
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Aima Lancharro
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Federico Moscardó
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Miguel Salavert
- Department of Infectious Diseases, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Miguel A Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Guillermo F Sanz
- Department of Hematology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Solves P, Carpio N, Moscardo F, Lancharro A, Cano I, Moya A, López-Andujar R, Sanz MÁ. Transfusion management and immunohematologic complications in liver transplantation: experience of a single institution. Transfus Med Hemother 2014; 42:8-14. [PMID: 25960710 DOI: 10.1159/000370260] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/05/2014] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Liver transplantation (LT) has traditionally been associated with major blood loss and consequently high blood transfusion requirements. Our objective was to analyze transfusion management and incidence of immunohematologic complications in patients undergoing LT at our institution. METHODS A retrospective analysis of immunohematologic events and transfusion outcomes was carried out at La Fe University Hospital in Valencia. Data from 654 patients were reviewed: 654 underwent only one LT while 36 underwent second LT. RESULTS Patients received a median of 3 red blood cell (RBC) concentrates, 2 platelets concentrates (PCs) and 2 fresh frozen plasma units (FFPs). Variables significantly influencing RBC transfusions were: the MELD score, hemoglobin levels, and the platelet counts before LT. 27 patients (4.1%) had a positive antibody screening before transplant. Immunohematologic events occurred in 8% of the patients, mostly in the first month after LT, and involved hemolysis in 13 cases. Mortality was significantly higher in patients developing immunohematologic disorders (42.8 vs. 18.3%; p < 0.001). In the multivariable analysis, only ABO minor incompatibility between donor and recipient significantly increased the appearance of immunohematologic incidences (OR 4.92, 95% CI 2.31-10.50; p < 0.001). CONCLUSION Transfusion management of patients that underwent LT can be complicated by immunohematologic problems. Blood banks should implement the DAT test in each transfusion to detect them.
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Affiliation(s)
- Pilar Solves
- Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
| | - Nelly Carpio
- Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
| | - Federico Moscardo
- Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
| | - Aima Lancharro
- Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
| | - Isabel Cano
- Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
| | - Angel Moya
- Liver Transplant Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Rafael López-Andujar
- Liver Transplant Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Miguel Ángel Sanz
- Blood Bank, Hematology Department, Hospital Universitari I Politècnic La Fe. Valencia, Spain
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Cañigral C, Moscardó F, Castro C, Pajares A, Lancharro A, Solves P, de la Rubia J, Carpio N, Sanz MA. Eculizumab for the treatment of pregnancy-related atypical hemolytic uremic syndrome. Ann Hematol 2013; 93:1421-2. [PMID: 24306089 DOI: 10.1007/s00277-013-1970-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 11/20/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Carolina Cañigral
- Hematology Department, Hospital Universitari i Politècnic La Fe, Bulevard Sur s/n, Valencia, 46026, Spain
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