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1.
Rev Col Bras Cir ; 47: e20202610, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33053064

RESUMO

Brazil, like most countries in the world, experiences the expansion of extended criteria donors, mainly due to the aging of the population and the obesity epidemic. Concerns regarding the quality of these organs along with the vast territorial areas of the country compromise the utilization rate of livers from donors and aggravate the discrepancy between the number of liver transplants performed and the needed. Ex situ liver machine perfusion offers superior preservation for livers from extended criteria donors, limiting cold ischaemia time and offering the possibility of evaluation of their function before transplantation as well as the reconditioning of marginal organs. Objections such as the financial cost, difficulty in transporting the device between hospitals, and demand of trained professionals in the handling of the device must be pondered with the possibility of increasing the number of transplants and the utilisation rate of donor organs. The optimal use of this resource, through the careful selection of donors and the appropriate technical and scientific knowledge, can ensure an effective and successful implementation of this technology.


Assuntos
Transplante de Fígado , Fígado Artificial , Preservação de Órgãos , Perfusão , Doadores de Tecidos , Brasil , Humanos , Fígado
3.
Einstein (Sao Paulo) ; 18: eAO5448, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32965298

RESUMO

OBJECTIVE: To characterize the processes of brain death diagnosis and organ donation in a reference trauma center. METHODS: Observational and cross-sectional study with patients notified with brain death at a reference trauma center. Data were obtained through the collection of medical records and brain death declaration forms. RESULTS: One hundred fity-nine patients were notified with brain death, mostly male (82.6%), young adults (97.61%) and victims of brain traumatic injury (93.7%). Median of the total time interval for the diagnosis of brain death was 20.75 hours, with no difference between organ donors and non-donors. We had excessive time intervals on brain death declaration, but without statistical effect on organ donation numbers. CONCLUSION: We had low efficacy in brain death declaration based on longer time intervals, with no impact on organ donation.


Assuntos
Morte Encefálica , Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Estudos Transversais , Humanos , Masculino , Estudos Retrospectivos , Doadores de Tecidos , Centros de Traumatologia , Adulto Jovem
5.
Medicine (Baltimore) ; 99(39): e22298, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991434

RESUMO

RATIONALE: There are many treatments for chronic hemorrhagic radiation colorectal inflammation, but only a few treatments are supported by high-quality research evidence. Studies have shown that the occurrence and development of radiation proctitis are closely associated with the intestinal flora. Animal studies have indicated that faecal microbiota transplantation (FMT) can improve radiation enteropathy in a mouse model. PATIENT CONCERNS: A 45-year-old female patient suffered from recurrent hematochezia and diarrhea for half a year after radiotherapy and underwent recurrent transfusion treatments. Colonoscopy showed obvious congestion of the sigmoid colon and rectal mucosa, a smooth surface, and bleeding that was easily induced by touch, which are consistent with radiation proctitis. The pathological findings revealed chronic mucosal inflammation. The magnetic resonance imaging examination of the pelvic cavity with a plain scan and enhancement showed changes after radiotherapy and chemotherapy, and no obvious tumor recurrence or metastasis was found. The laboratory examinations excluded pathogen infection. DIAGNOSES: Based on the history and examinations, the final diagnosis of this patient was chronic hemorrhagic radiation proctitis. INTERVENTIONS: The patient was treated with a total of 4 individual courses of FMT. OUTCOMES: After the six-month follow-up, her hematochezia, abdominal pain and diarrhea were relieved. Furthermore, 16S rRNA sequencing of the feces showed that the intestinal bacterial composition of the patient obviously changed after FMT and became similar to that of the donors. LESSONS: This case report shows that FMT can relieve the symptoms of hematochezia and diarrhea by changing the bacterial community structure in patients with chronic hemorrhagic radiation proctitis.


Assuntos
Transplante de Microbiota Fecal/métodos , Hemorragia Gastrointestinal/terapia , Proctite/etiologia , Lesões por Radiação/complicações , Assistência ao Convalescente , Doença Crônica , Colonoscopia/métodos , Diarreia/etiologia , Fezes/microbiologia , Feminino , Humanos , Imagem por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Proctite/diagnóstico , Proctite/patologia , RNA Ribossômico 16S/genética , Lesões por Radiação/diagnóstico por imagem , Lesões por Radiação/patologia , Doadores de Tecidos , Resultado do Tratamento
6.
Caracas; Observatorio Nacional de Ciencia, Tecnología e Innovación; ago. 2020. 53-56 p. ilus.(Observador del Conocimiento. Revista Especializada en Gestión Social del Conocimiento, 5, 2).
Monografia em Espanhol | LILACS, LIVECS | ID: biblio-1118410

RESUMO

El uso de Plasma de Convaleciente de COVID-19 (PC-CoV19) como coadyuvante en el tratamiento de pacientes, tendría impacto socioeconómico importante al disminuir el periodo de estancia hospitalaria y letalidad por la enfermedad. La determinación de anticuerpos en plasma de potenciales donantes es criterio fundamental para su selección. Existe dificultad para disponer de pruebas serológicas certificadas que cuantifiquen anticuerpos específicos contra SARS-CoV-2. Las Pruebas de Diagnóstico Rápido (PDR) se convierten en herramienta útil y al alcance para la selección de pacientes recuperados, potenciales donantes de PC-CoV19. Este estudio evaluó el porcentaje de positividad de diferentes PDR en veintidós (22) muestras de pacientes con COVID-19 confirmada por RT-PCR. Las muestras se analizaron siguiendo el procedimiento descrito por cada fabricante. Se analizó el comportamiento de las PDR en pacientes sintomáticos y asintomáticos en diferentes momentos de la enfermedad. El porcentaje de positividad fue de 100% con dos de las tres pruebas utilizadas, una de las cuales discrimina IgM de IgG. Se concluye que la presencia de IgG se registra a partir de los 15 días del inicio de los síntomas y se mantiene presente a los 59 días de evolución en los pacientes sintomáticos, y que pacientes asintomáticos podrían ser considerados candidatos a donantes de PC-CoV19 pues se evidenció seroconversión para IgG. El porcentaje de positividad a IgG podría disminuir en los pacientes recuperados. Se sugiere que pacientes sintomáticos con criterio de alta médica sean considerados candidatos donantes en momento posterior a 28 días de la fecha de inicio de los síntomas. Se recomienda utilizar PDR que discriminen IgM de IgG como herramienta para la selección de donantes de PC-CoV19(AU)


The use of COVID-19 Convales-cent Plasma (PC-CoV19) as an ad-juvant for the treatment of patients, would have a significant socioeconomic impact by reducing the leng-th of hospital stay and lethality due to the disease. The determination of antibodies in plasma from potential donors is a fundamental criterion for their selection. There is dificulty in obtaining certified serological tests that quantify specific antibodies against SARS-CoV-2. Rapid Diagnostic Tests (PDR) become a useful and accessible tool in the selection of recovered patients, potential PC-CoV19 donors. This study evaluated the positivity rate of different PDRs in twenty two (22) samples from patients with COVID-19 confirmed by RT-PCR. The samples were analyzed following the procedure described by each manufacturer. The performance of PDRs was analyzed in symptomatic and asymptomatic patients at different times of the disease. The positivity rate was 100% with two of the three tests used, one of which discriminates IgM from IgG. It is concluded that the presence of IgG is recorded 15 days after the onset of symptoms and remains present at day 59 of evolution in symptomatic patients, and that asymptomatic patients could be considered candidates for PC-CoV19 donors since IgG se-reconversion was evident. The positivity rate to IgG could decrease in the recovered patients. It is suggested that symptomatic patients with medical discharge criteria be considered donor candidates after 28 days from the date of onset of symptoms. It is recommended to use PDRs that discriminate IgM from IgG as a tool for the selection of PC-CoV19 donors


Assuntos
Humanos , Plasma , Doadores de Tecidos , Imunoglobulina G/uso terapêutico , Imunoglobulina M , Testes Sorológicos , Infecções por Coronavirus , Testes Diagnósticos de Rotina
7.
Curr Opin Ophthalmol ; 31(5): 389-395, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32740064

RESUMO

PURPOSE OF REVIEW: Coronavirus disease 2019, caused by novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is highly infectious; however, the different routes of transmission are not well understood. Transmission through tissue transplantation is possible and must be considered. This review will evaluate the current literature regarding routes of transmission, the likelihood of transmission through ocular tissue transplantation, and the guidelines in place to mitigate this risk. RECENT FINDINGS: Although respiratory droplets have been the primary route of SARS-CoV-2 transmission, there is evidence that transmission through blood donation and organ or tissue transplantation is possible. This includes corneal transplantation, as SARS-CoV-2 has been detected in conjunctival swabs of infected patients, and the ocular surface may play an important role in viral entry. Several tissue transplantation organizations have guidelines in place regarding the screening of donors and tissue procurement procedures, including clinical and/or PCR screening of donors. The Eye Bank Association of America (EBAA) is currently not recommending asymptomatic PCR screening. However, their antiseptic protocols may play an important role in viral inactivation. SUMMARY: Based on the current literature and guidelines, the risk of SARS-CoV-2 transmission through corneal transplantation is likely low. However, tissue screening guidelines need to be re-evaluated regularly as knowledge regarding the SARS-CoV-2 virus evolves.


Assuntos
Betacoronavirus , Transplante de Córnea , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Bancos de Olhos/normas , Pneumonia Viral/transmissão , Bancos de Olhos/organização & administração , Humanos , Pandemias , Guias de Prática Clínica como Assunto , Doadores de Tecidos , Coleta de Tecidos e Órgãos , Obtenção de Tecidos e Órgãos
8.
BMC Infect Dis ; 20(1): 613, 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32811453

RESUMO

BACKGROUND: Strongyloidiasis is caused by the helminth Strongyloides stercoralis and is well-recognised amongst transplant recipients. Serious complications, including Strongyloides hyperinfection which is a syndrome of accelerated autoinfection, or disseminated disease, can occur post-transplantation, resulting in significant morbidity and mortality. Here we present the first published case we are aware of, describing post-transplant Strongyloides hyperinfection in an HIV-positive kidney transplant patient. We discuss the diagnostic challenges and the role of pre-transplant screening. CASE PRESENTATION: A 58-year-old African-American male, originally from the Caribbean, received a deceased donor kidney transplant for presumed focal segmental glomerulosclerosis. He was known to be HIV-positive, with a stable CD4 count, and an undetectable viral load. Five months post-transplant, he developed gastrointestinal symptoms and weight loss. He had a normal eosinophil count (0.1-0.2 × 109/L), negative serum cytomegalovirus DNA, and negative blood and stool cultures. His Strongyloides serology remained negative throughout. A diagnosis of Strongyloides hyperinfection was made by the histological examination of his duodenum and lung, which identified the parasites. He completed his course of treatment with Ivermectin but exhibited profound deconditioning and required a period of total parenteral nutrition. He was subsequently discharged after a prolonged hospital admission of 54 days. CONCLUSIONS: This case highlights the challenges in diagnosing Strongyloides infection and the need to maintain a high index of clinical suspicion. Non-invasive techniques for the diagnosis of Strongyloides may be insufficient. Routine pre-transplant serological strongyloidiasis screening is now performed at our centre.


Assuntos
Soropositividade para HIV/fisiopatologia , HIV/imunologia , Transplante de Rim/efeitos adversos , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Estrongiloidíase/etiologia , Transplantados , Afro-Americanos , Animais , Antiparasitários/uso terapêutico , Soropositividade para HIV/virologia , Humanos , Ivermectina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/parasitologia , Doadores de Tecidos , Resultado do Tratamento
9.
PLoS One ; 15(8): e0234396, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756556

RESUMO

INTRODUCTION: Early conversion to a CNI-free immunosuppression with SRL was associated with an improved 1- and 3- yr renal function as compared with a CsA-based regimen in the SMART-Trial. Mixed results were reported on the occurrence of donor specific antibodies under mTOR-Is. Here, we present long-term results of the SMART-Trial. METHODS AND MATERIALS: N = 71 from 6 centers (n = 38 SRL and n = 33 CsA) of the original SMART-Trial (ITT n = 140) were enrolled in this observational, non-interventional extension study to collect retrospectively and prospectively follow-up data for the interval since baseline. Primary objective was the development of dnDSA. Blood samples were collected on average 8.7 years after transplantation. RESULTS: Development of dnDSA was not different (SRL 5/38, 13.2% vs. CsA 9/33, 27.3%; P = 0.097). GFR remained improved under SRL with 64.37 ml/min/1.73m2 vs. 53.19 ml/min/1.73m2 (p = 0.044). Patient survival did not differ between groups at 10 years. There was a trend towards a reduced graft failure rate (11.6% SRL vs. 23.9% CsA, p = 0.064) and less tumors under SRL (2.6% SRL vs. 15.2% CsA, p = 0.09). CONCLUSIONS: An early conversion to SRL did not result in an increased incidence of dnDSA nor increased long-term risk for the recipient. Transplant function remains improved with benefits for the graft survival.


Assuntos
Inibidores de Calcineurina/administração & dosagem , Imunossupressão/métodos , Imunossupressores/administração & dosagem , Transplante de Rim , Sirolimo/administração & dosagem , Adulto , Especificidade de Anticorpos , Esquema de Medicação , Feminino , Seguimentos , Taxa de Filtração Glomerular , Rejeição de Enxerto/etiologia , Rejeição de Enxerto/imunologia , Sobrevivência de Enxerto/imunologia , Humanos , Estimativa de Kaplan-Meier , Transplante de Rim/efeitos adversos , Transplante de Rim/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Serina-Treonina Quinases TOR/antagonistas & inibidores , Fatores de Tempo , Doadores de Tecidos
10.
Artigo em Alemão | MEDLINE | ID: mdl-32736386

RESUMO

In recent years, the diagnosis of irreversible brain function loss in severely brain-damaged patients has gained in importance. Brain death, defined as an irreversible loss of the overall function of the cerebrum, cerebellum and brain stem, is a prerequisite for organ removal in the context of organ donation. The article presents the legal and organizational framework.Brain death is determined on the basis of the latest update of the guidelines of the German Medical Chamber (Bundesärztekammer) using a three-step scheme and consists of clinical and instrumental examinations. After the final diagnosis of brain death, the phase of organ-preserving treatment for the potential organ donor begins. In the case of patients who themselves or their relatives have not agreed to organ donation, the intensive care therapy must be terminated promptly. The legal framework for the determination of brain death and for the removal of organs from potential organ donors is provided by the Transplantation Act. The German Foundation for Organ Transplantation (DSO) is responsible for the coordination of organ donations in Germany. The DSO supports hospitals in many ways during the organ donation process, but also in training courses for medical staff on organ donation. The main contact person of the DSO is the transplant officer in the hospitals. The care of the relatives of a potential organ donor is of great importance.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Morte Encefálica , Alemanha , Humanos , Doadores de Tecidos
11.
Artigo em Alemão | MEDLINE | ID: mdl-32736387

RESUMO

According to the Transplantation Act (TPG), clinics and transplant commissaries (TxB) are obliged to ensure quality in donor evaluation. They are supervised. TxBs exist in every hospital that carries out organ harvesting and are always available. They are responsible for the conception of the organ donation process and should manage each individual case from the evaluation to the implementation of the patient's wishes.The evaluation for potential organ donors should be routine and supported by IT technology. The intensive care team must inform the TxB about living patients who "come into consideration" as organ donors. Reasons for exclusion can be known rejection, absolute medical contraindications and loss of function of all transplant organs. ICBF (irreversible cessation of brain function) deceased without reasons for exclusion must be reported to the DSO immediately. Talks with relatives about the neurological outcome, the ICBF diagnostics and organ donation are of fundamental importance for the implementation of the (presumed) wish of the potential organ donor and the relatives. The aim of the talks should be a sound decision with which the relatives can conclude. The TxBs support the ICU team to achieve this.Organ donation should be handled like an emergency. Typical bottlenecks are the instrument-based examinations and the availability of the operating room. The TxBs should draw up a schedule, communicate this to the interfaces and be available at all times during the entire organ donation process. Documentation of all details is important, as the TxBs must prepare detailed individual case analyses for quality assurance purposes and forward them to the clinic management and the DSO. Quality circles and especially peer review procedures are used and recommended as further QM tools.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Cuidados Críticos , Hospitais , Humanos , Doadores de Tecidos
12.
Nat Commun ; 11(1): 4333, 2020 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-32859933

RESUMO

Diarrhoea is one of the most burdensome and common adverse events of chemotherapeutics, and has no standardised therapy to date. Increasing evidence suggests that the gut microbiome can influence the development of chemotherapy-induced diarrhoea. Here we report findings from a randomised clinical trial of faecal microbiota transplantation (FMT) to treat diarrhoea induced by tyrosine kinase inhibitors (TKI) in patients with metastatic renal cell carcinoma (ClinicalTrials.gov number: NCT04040712). The primary outcome is the resolution of diarrhoea four weeks after the end of treatments. Twenty patients are randomised to receive FMT from healthy donors or placebo FMT (vehicle only). Donor FMT is more effective than placebo FMT in treating TKI-induced diarrhoea, and a successful engraftment is observed in subjects receiving donor faeces. No serious adverse events are observed in both treatment arms. The trial meets pre-specified endpoints. Our findings suggest that the therapeutic manipulation of gut microbiota may become a promising treatment option to manage TKI-dependent diarrhoea.


Assuntos
Carcinoma de Células Renais/complicações , Diarreia/terapia , Inibidores Enzimáticos/metabolismo , Transplante de Microbiota Fecal/métodos , Neoplasias Renais/complicações , Tirosina/metabolismo , Idoso , Método Duplo-Cego , Tratamento Farmacológico , Disbiose , Fezes , Feminino , Microbioma Gastrointestinal , Humanos , Masculino , Pessoa de Meia-Idade , Doadores de Tecidos
13.
Transplantation ; 104(8): 1529-1530, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32732824
16.
Transplantation ; 104(9): 1929-1942, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32769628

RESUMO

BACKGROUND: Liver graft viability assessment has long been considered a limit of hypothermic oxygenated machine perfusion (HOPE). Aim of this study was assessing correlations of easily available perfusate parameters (PP) (aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, glucose, lactate, and pH) with graft features and outcome. METHODS: In the period October 2018-February 2020, perfusate samples were obtained every 30 minutes during 50 dual-HOPE (D-HOPE) procedures. Correlations of PP with graft factors, 90-day graft loss, early allograft dysfunction (EAD), L-GrAFT score, acute kidney injury, and comprehensive complication index were analyzed using Pearson coefficient, receiver-operating characteristics analysis and by univariable and multivariable regression. RESULTS: Median D-HOPE time was 122 minutes. All parameters were normalized to liver weight. Only macrovesicular steatosis (MaS) significantly impacted PP levels and slope. Grafts with ≥30% MaS exhibited significantly different PP values and slope. Graft loss and EAD rate were 2% (n = 1) and 26% (n = 13). All PP except lactate correlated with EAD, 90-minute alanine aminotransferase showing the highest area under the receiver-operating characteristics curve (0.84). However, at multivariable analysis, the only factor independently associated with EAD was MaS (odds ratio, 5.44; confidence interval, 1.05-28.21; P = 0.04). Ninety minutes lactate dehydrogenase had the strongest correlation with L-GrAFT (R = 0.70; P < 0.001). PP correlated poorly with comprehensive complication index and grades 2-3 acute kidney injury rate. CONCLUSIONS: PP were predictive of graft function after transplant, but their association with graft survival and clinical outcomes requires further evaluation. MaS influenced levels of PP and was the only independent predictor of EAD.


Assuntos
Transplante de Fígado/métodos , Preservação de Órgãos/métodos , Perfusão/métodos , Doadores de Tecidos , Alanina Transaminase/análise , Aspartato Aminotransferases/análise , Temperatura Baixa , Feminino , Sobrevivência de Enxerto , Humanos , Concentração de Íons de Hidrogênio , L-Lactato Desidrogenase/análise , Transplante de Fígado/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
18.
Transplantation ; 104(9): 1890-1898, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32826843

RESUMO

BACKGROUND: Ex situ heart perfusion (ESHP) limits ischemic periods and enables continuous monitoring of donated hearts; however, a validated assessment method to predict cardiac performance has yet to be established. We compare biventricular contractile and metabolic parameters measured during ESHP to determine the best evaluation strategy to estimate cardiac function following transplantation. METHODS: Donor pigs were assigned to undergo beating-heart donation (n = 9) or donation after circulatory death (n = 8) induced by hypoxia. Hearts were preserved for 4 hours with ESHP while invasive and noninvasive (NI) biventricular contractile, and metabolic assessments were performed. Following transplantation, hearts were evaluated at 3 hours of reperfusion. Spearman correlation was used to determine the relationship between ESHP parameters and posttransplant function. RESULTS: We performed 17 transplants; 14 successfully weaned from bypass (beating-heart donation versus donation after circulatory death; P = 0.580). Left ventricular invasive preload recruitable stroke work (PRSW) (r = 0.770; P = 0.009), NI PRSW (r = 0.730; P = 0.001), and NI maximum elastance (r = 0.706; P = 0.002) strongly correlated with cardiac index (CI) following transplantation. Right ventricular NI PRSW moderately correlated to CI following transplantation (r = 0.688; P = 0.003). Lactate levels were weakly correlated with CI following transplantation (r = -0.495; P = 0.043). None of the echocardiography measurements correlated with cardiac function following transplantation. CONCLUSIONS: Left ventricular functional parameters, especially ventricular work and reserve, provided the best estimation of myocardial performance following transplantation. Furthermore, simple NI estimates of ventricular function proved useful in this setting. Right ventricular and metabolic measurements were limited in their ability to correlate with myocardial recovery. This emphasizes the need for an ESHP platform capable of assessing myocardial contractility and suggests that metabolic parameters alone do not provide a reliable evaluation.


Assuntos
Transplante de Coração/métodos , Preservação de Órgãos/métodos , Perfusão , Doadores de Tecidos , Função Ventricular Esquerda/fisiologia , Animais , Ecocardiografia , Masculino , Contração Miocárdica , Miocárdio/metabolismo , Suínos
20.
Nat Commun ; 11(1): 4289, 2020 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-32855397

RESUMO

Older organs represent an untapped potential to close the gap between demand and supply in organ transplantation but are associated with age-specific responses to injury and increased immunogenicity, thereby aggravating transplant outcomes. Here we show that cell-free mitochondrial DNA (cf-mt-DNA) released by senescent cells accumulates with aging and augments immunogenicity. Ischemia reperfusion injury induces a systemic increase of cf-mt-DNA that promotes dendritic cell-mediated, age-specific inflammatory responses. Comparable events are observed clinically, with the levels of cf-mt-DNA elevated in older deceased organ donors, and with the isolated cf-mt-DNA capable of activating human dendritic cells. In experimental models, treatment of old donor animals with senolytics clear senescent cells and diminish cf-mt-DNA release, thereby dampening age-specific immune responses and prolonging the survival of old cardiac allografts comparable to young donor organs. Collectively, we identify accumulating cf-mt-DNA as a key factor in inflamm-aging and present senolytics as a potential approach to improve transplant outcomes and availability.


Assuntos
DNA Mitocondrial/efeitos adversos , Dasatinibe/farmacologia , Inflamação/prevenção & controle , Transplante de Órgãos/métodos , Quercetina/farmacologia , Adulto , Envelhecimento/fisiologia , Animais , Diferenciação Celular , Ácidos Nucleicos Livres , Senescência Celular/efeitos dos fármacos , Senescência Celular/fisiologia , Citocinas/metabolismo , DNA Mitocondrial/metabolismo , Células Dendríticas/imunologia , Células Dendríticas/fisiologia , Transplante de Coração/efeitos adversos , Transplante de Coração/métodos , Humanos , Inflamação/etiologia , Masculino , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Pessoa de Meia-Idade , Transplante de Órgãos/efeitos adversos , Traumatismo por Reperfusão/genética , Traumatismo por Reperfusão/imunologia , Doadores de Tecidos
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