RESUMO
BACKGROUND: Prognostic data on survival of hepatitis B surface antigen-positive (HBsAg+) recipients and of hepatitis B core antibody-positive (HBcAb+) donors are limited in the thoracic transplantation (TT) cohort. Improved understanding of risks could potentially expand the recipient and donor pools. METHODS: Post-hoc analysis of limited-access dataset of the United Network for Organ Sharing database from January 2000-September 2010 was performed. Analyses were performed for all TT, including single and bilateral lung, orthotopic heart, and simultaneous heart-lung transplants. The primary analyzed outcome was overall survival. A Cox proportional multivariate hazards model was used to adjust for significant risk predictors. RESULTS: Of 24,817 patients included, 426 recipients were HBsAg+, of whom 106 (25%) died during a mean follow-up of 3.6 years. On multivariate analysis, recipient HBsAg+ (hazard ratio [HR] = 0.88, 95% confidence interval [CI]: 0.69-1.32; P = 0.80), and donor HBcAb+ (HR = 0.91, 95% CI: 0.68-1.22; P = 0.53) were not associated with increased overall mortality in the entire TT cohort, with similar results for each individual transplant cohort. Unadjusted survival analysis using Kaplan-Meier curves in individual transplant cohorts did not show significant differences between HBsAg+ and HBsAg- recipients. No statistically significant differences were found between causes of mortality in the 2 groups. CONCLUSION: HBsAg+ status of recipients or HBcAb+ status of donors does not significantly affect overall survival of TT recipients. These data add to the scant literature on this subject and could potentially increase the donor and recipient pools.
Assuntos
Transplante de Coração , Transplante de Coração-Pulmão , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/isolamento & purificação , Hepatite B/complicações , Transplante de Pulmão , Adulto , Feminino , Antígenos do Núcleo do Vírus da Hepatite B/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de RiscoAssuntos
Cisteína/genética , Infarto/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Mutação Puntual , Medula Espinal/irrigação sanguínea , Treonina/genética , Análise Mutacional de DNA/métodos , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Medula Espinal/patologiaRESUMO
Angiography of the pelvic vasculature can be quite helpful in assessing bladder tumors, for it provides useful results both when used alone and when used in combination with other methods. It is especially useful when there is doubt about the results of simpler methods, particularly in younger patients.