Browsing by Author "Dib, Martin"

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    ADULT-TO-PEDIATRIC LIVING DONOR LIVER TRANSPLANT IN RECIPIENTS >20 KG: A CASE SERIES OF FULL LEFT LOBE GRAFTS
    (2024) Ortiz, Catalina; Meira-Jr, Jose Donizeti; Pattillo, Juan Carlos; Vinuela, Eduardo; Jarufe, Nicholas; Martinez, Jorge; Briceno, Eduardo; Dib, Martin
    BACKGROUND: Chile presents one of the lowest organ donation rates, resulting in pediatric Walter de Biase 1 , Claudemiro 1 , Eduardo Gu liver waitlist mortality rates up to 38.1%. Live donor liver transplantation is one of the main alternatives Fabricio Ferreira 3 ,Paulo 3 to decrease waitlist mortality, mostly utilized in our country for small children up to 20 kg. AIMS: The aim of this study was to report a three-case series of adult-to-pediatric living donor liver transplantation using a full left lobe graft. METHODS: We report three cases of children with more than 20 kg who received complete left hemi-grafts in different clinical scenarios. The indications and techniques- Racional: O tratamento de escolha para pacientes com hipertens & atilde;o portal adopted are discussed. RESULTS: Three children, two girls and one boy, aged 11, 7, and 3 years, esquistossom & oacute;tica com sangramento de varizes h a desconex & atilde;o & aacute;zigo-portal mais were transplanted. The indications for transplant were fulminant hepatitis of autoimmune etiology, esplenectomia (DAPE) associada & agrave; terapia endosc & oacute;pica. Porhm, estudos mostram aumento hepatoblastoma, and chronic liver failure due to autoimmune hepatitis, respectively. The evolution was satisfactory in all three children, and to date, all are well, approximately 12-24 months after the do calibre das varizes em alguns pacientes durante o seguimento em longo prazo. Objetivo: transplant. CONCLUSIONS: The use of a living donor left lateral segment (segments 2 and 3) has been Avaliar oimpactodaDAPE e tratamento endosc & oacute;picop & oacute;s-operat & oacute;rionocomportamento successfully employed in pediatric liver transplantation. However, it is only suitable for infants and lowdas varizes esof & aacute;gicas e recidiva hemorr & aacute;gica, de pacientes esquistossom & oacute;ticos. Mhtodos: weight children. This approach using the whole left hemi-liver graft contributes to the reduction of Foram estudados 36 com a cinco distribu & iacute;dos em small-for-size syndrome, mortality rate, and waiting times associated with deceased donors.
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    Portosystemic shunt surgery for severe portal hypertension due to portal thrombosis after bariatric surgery
    (2024) Reyes, Natalia; Jarufe, Alessandra; Briceno, Eduardo; Vinuela, Eduardo; Martinez, Jorge; Dib, Martin; Jarufe, Nicolas
    Portal vein thrombosis is a rare complication after laparoscopic sleeve gastrectomy, a widely performed bariatric surgery procedure. Occasionally, the development of portal vein thrombosis can progress to more severe conditions, including portal hypertension and cavernomatosis, thereby presenting a complex and challenging clinical scenario. The management of such complications often requires careful consideration; however, surgical intervention in the form of a splenorenal shunt is an exceptional indication. We present the case of a 33-year-old female patient who had previously undergone laparoscopic sleeve gastrectomy in 2014 and subsequently developed portal thrombosis, followed by cavernomatosis and associated complications of portal hypertension. A proximal splenorenal shunt procedure and splenectomy were successfully performed to manage portal hypertension. The presentation of this clinical case aims to contribute to the available evidence and knowledge surrounding this rare and challenging pathology.
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    Right Lobe Liver Donation After Bariatric Surgery. A Case Series of 4 Living Donors
    (2022) Garcia, Daniel; Riveros, Sergio; Ochoa, Gabriela; Rebolledo, Patricia; Achurra, Pablo; Briceno, Eduardo; Vinuela, Eduardo; Arab, Juan Pablo; Jarufe, Nicolas; Fernandes, Eduardo; Martinez, Jorge; Dib, Martin
    Background. The increasing prevalence of obesity and need for bariatric surgery as well as the expanding use of living donors for liver transplantation means that potential donors could present with this surgical history. We present 4 cases of liver donors with previous bariatric surgery in our living donor liver transplant program. Methods. A retrospective descriptive analysis of patients with a bariatric surgery history who underwent right hepatectomy in our living donor liver transplant program is presented. Results. Case 1: A 53-year-old man with body mass index (BMI) of 33 who underwent lapa-roscopic sleeve gastrectomy (LSG). Pretransplant BMI was 21.5. Case 2: A 46-year-old woman with a BMI maximum of 40.8 who underwent LSG and required conversion to Roux-en-Y gas-tric bypass. Pretransplant BMI was 35.1. Case 3: A 53-year-old woman with a BMI maximum of 31.6 who underwent LSG. Pretransplant BMI was 24.2. Case 4: A 38-year-old man with a BMI maximum of 41.5 who underwent Roux-en-Y gastric bypass 6 years before the hepatectomy. Pretransplant BMI was 29.4. No complications were observed. Average operative time was 367.5 minutes, with a hospital stay of 5.8 days and 100% graft survival to date. Discussion. Utilization of selected donors with previous bariatric surgery appears to be a safe option and increases the donor pool.
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    Risk factors for readmission after a cholecystectomy: a case-control study
    (2024) Garcia, Daniel; Pastore, Antonia; Rodriguez, Javier; Crovari, Fernando; Cerda, Jaime; Rebolledo, Patricia; Achurra, Pablo; Vinuela, Eduardo; Martinez, Jorge; Dib, Martin; Briceno, Eduardo
    Objective: The aim of this study was to assess the risk factors associated with 30 -day hospital readmissions after a cholecystectomy. Methods: We conducted a case-control study, with data obtained from UC-Christus from Santiago, Chile. All patients who underwent a cholecystectomy between January 2015 and December 2019 were included in the study. We identified all patients readmitted after a cholecystectomy and compared them with a randomized control group. Univariate and multivariate analyses were conducted to identify risk factors. Results: Of the 4866 cholecystectomies performed between 2015 and 2019, 79 patients presented 30 -day hospital readmission after the surgical procedure (1.6%). We identified as risk factors for readmission in the univariate analysis the presence of a solid tumor at the moment of cholecystectomy (OR = 7.58), high pre -operative direct bilirubin (OR = 2.52), high pre -operative alkaline phosphatase (OR = 3.25), emergency admission (OR = 2.04), choledocholithiasis on admission (OR = 4.34), additional surgical procedure during the cholecystectomy (OR = 4.12), and post -operative complications. In the multivariate analysis, the performance of an additional surgical procedure during cholecystectomy was statistically significant (OR = 4.24). Conclusion: Performing an additional surgical procedure during cholecystectomy was identified as a risk factor associated with 30 -day hospital readmission.
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    Trasplante hepático: Evolución, curva de aprendizaje y resultados después de los primeros 300 casos
    (2019) Francisco Guerra, Juan; Luis Quezada, Jose; Cancino, Alejandra; Arrese, Marco; Wolff, Rodrigo; Benitez, Carlos; Carlos Pattillo, Juan; Cristobal Gana, Juan; Concha, Mario; Cortinez, Luis; Vera, Magdalena; Miranda, Paula; Rubilar, Francisco; Troncoso, Andres; Briceno, Eduardo; Dib, Martin; Jarufe, Nicolas; Martinez, Jorge
    Background: Liver transplantation (LT) is an option for people with liver failure who cannot be cured with other therapies and for some people with liver cancer. Aim: To describe, and analyze the first 300 LT clinical results, and to establish our learning curve. Material and Methods: Retrospective cohort study with data obtained from a prospectively collected LT Program database. We included all LT performed at a single center from March 1994 to September 2017. The database gathered demographics, diagnosis, indications for LT, surgical aspects and postoperative courses. We constructed a cumulative summation test for learning curve (LC-CUSUM) using 30-day post-LT mortality. Mortality at 30 days, and actuarial 1-, and 5-year survival rate were analyzed. Results: A total of 281 patients aged 54 (0-71) years (129 women) underwent 300 LT. Ten percent of patients were younger than 18 years old. The first, second and third indications for LT were non-alcoholic steatohepatitis, chronic autoimmune hepatitis and alcoholic liver cirrhosis, respectively. Acute liver failure was the LT indication in 51 cases (17%). The overall complication rate was 71%. Infectious and biliary complications were the most common of them (47 and 31% respectively). The LC-CUSUM curve shows that the first 30 patients corresponded to the learning curve. The peri-operative mortality was 8%. Actuarial 1 and 5-year survival rates were 82 and 71.4%, respectively. Conclusions: Outcome improvement of a LT program depends on the accumulation of experience after the first 30 transplants and the peri-operative mortality directly impacted long-term survival.