[Liver transplantation in children: initial experience of the Instituto da Criança of the Hospital das Clínicas of Universidade de São Paulo]. / Transplante de fígado em criança: experiência inicial do Instituto da Criança do Hospital das Clínicas da Universidade de São Paulo.

The initial experience at the Instituto da Criança do Hospital das Clínicas--School of Medicine of São Paulo University with liver transplantation in children is presented. A staff experienced in the management of children, including pediatric surgeons, hepatologists, critical care specialists, anesthesiologists, and other has been joined to draw therapeutic protocols. Afterward, more than 100 experimental liver transplant were performed in animals of medium size (dogs and pigs). From September, 1989 to July 1991, 12 liver transplants were performed on 9 children (3 retransplants) ranging in age from 2.5 to 17 years, being 5 boys and 4 girls. The donors had been selected according to the ABO blood group and body weight. Just once a blood A+ recipient received a liver from a blood O+ donor. The regular postoperative immunosuppression consisted of triple therapy with cyclosporin, prednisone and azathioprine. The postoperative stay in the Intensive Care Unit ranged from 3 to 24 days, according to the necessity of ventilatory support. These was no intraoperative mortality, arterial or venous thromboses, or early biliary complications. The overall survival is 78% (7/9). Primary non-function of the graft was the cause of death in two of our children. Although the number of cases is still small our results are comparable to those of the best liver transplant centers in the world.

[Acute abdomen in childhood caused by intestinal angiostrongylus infection: a case report]. / Abdome agudo na infância por angiostrongilíase intestinal: relato de um caso.

A case of acute abdomen in a one-year-old infant with abdominal angiostrongyliasis is reported. The main clinical and pathologic features of this disease are discussed. The diagnosis is made only through a biopsy that shows maturing stages of the worm within the intestinal wall and/or mesentery. Neither eggs nor larvae have been found in human feces. Treatment has been by surgical resection of the inflammatory mass. The prevalence of this illness is underestimated because of the difficult diagnosis. The main purpose of the present article is to attract attention to this diagnostic possibility as a cause of abdominal pain and acute abdomen in childhood.