Background The incidence of abdominal wall hernias in cirrhotic patients is as high as 20 % and in cases of major ascites this number may increase up to 40 % [1, 2]. Several factors such as increased abdominal tension due to the presence of tense ascites, malnutrition, and worsening muscle wasting are major risk factors for the development of abdominal hernias in these patients [3]. Moreover, due to the presence of increased surgical risk
Background Abernethy malformation (AM) is a rare congenital abnormality described by John Abernethy in 1793. It is characterized by a shunt between the portal vein and systemic circulation [1, 2]. It is frequently associated with other congenital abnormalities, including the absence of a portal vein and/or congenital mesenterico-caval shunt, cardiac and/or pulmonary malformation and liver nodules [3, 4]. Complications of Abernethy malformation include hepatic encephalopathy, hepatopulmonary syndrome, portopulmonary syndrome
Introduction The Small-for-Size Syndrome (SSS) is seen more often if the transplanted segment of the donor is <30% liver or <0.8% of body weight of the recipient1. The SSS is a complex process resulting primarily from ischemia-reperfusion injury (IRI) and portal hypertension associated with mismatch between the graft and recipient size. In the initial period, the molecular events associated with subsequent apoptosis, necrosis, proliferation and regeneration appeared in specific patterns of protein expression2-4. The diagnosis of SSS graft is generally
INTRODUCTION The hepatopulmonary syndrome (HPS) has been acknowledged as an important vascular complication in lungs due to systemic hypoxemia in patients with cirrhosis and portal hypertension. Is formed by a clinical triad of arterial oxygenation abnormalities induced by intrapulmonary vascular dilatations with liver disease. It is present in 4-32% of patients with cirrhosis14 , 19. It was also seen in both genders in middle-aged patients17. HPS pathogenesis is not well defined, but it is
Introduction Hepatopulmonary syndrome (HPS) is formed by the clinical triad of chronic liver disease, intrapulmonary vascular dilatation, and hypoxemia. This condition is present in 4% to 32% of patients with cirrhosis. The pathogenesis of this condition is not well defined, but it is speculated that a combination of factors, such as an imbalance in the response of vascular endothelin receptors, pulmonary microvascular remodeling, and genetic predisposition, leads to intrapulmonary vascular dilatation and bacterial translocation1 – 4. The pathophysiology of
INTRODUCTION Obesity is a major public health problem worldwide; a quarter of the world’s population is in the range of overweight and 10% are considered obese. In Brazil, half the population is overweight (BMI>25 kg/m2) and 17.5% is obese (BMI>30 kg/m2)1. Bariatric surgery is the most effective method of treatment of severe or morbid obesity (BMI>40 kg/m2 or BMI>35 kg/m2 with comorbidities), presenting superior results with respect to weight loss, control of comorbidities, improved quality of life and survival compared
Background Pancreas transplantation is a treatment for advanced type 1 diabetes and offers significant improvement in quality of life. Recent advances in surgical techniques and immunosuppression regimes lead to good outcomes. However, despite significant higher rates of multiorgan donors in Brazil, pancreas transplantation seems to have remained stable. This study aimed to investigate the acceptance rate of potential pancreas donors in the past 10 years in São Paulo State. Methods We retrospectively evaluated potential pancreas donors characteristics and its acceptance rate in São
INTRODUCTION Orthotopic liver transplantation (OLT) is a well-accepted treatment of end-stage liver disease. Biliary fistula, anastomotic biliary strictures (ABS)(5, 17) and ischemic biliary lesions(18) figure among the most common complications after OLT. Considering specifically ABS there are some treatment options including balloon dilation, the placement of multiple plastic stents (MPS) and the placement of self-expandable metal stents(6, 9, 10, 15, 18). These modalities can be employed individually or in association. Furthermore the biliary access
INTRODUCTION Hepatopulmonary syndrome (HPS) is defined as clinical triad of liver disease, intrapulmonary vascular dilatation and hypoxemia. It is present in 4-32% of patients with cirrhosis. Its pathogenesis is not well defined, but it is speculated that a combination of factors, such as an imbalance in the response of vascular endothelin receptors, pulmonary microvascular remodeling and genetic predisposition, leads to intrapulmonary vascular dilatation and bacterial translocation1 – 4 Initially the hypoxemia in these patients responds to low-flow supplemental
INTRODUÇÃO Síndrome hepatopulmonar (SHP) é formada pela entidade clínica composta por uma tríade: doença hepática crônica, dilatação vascular intrapulmonar e alteração nos gases arteriais. Esta condição está presente em 4% a 32% dos pacientes com cirrose. A sua fisiopatogênese não está bem definida, mas especula-se uma combinação de fatores, tais como o desequilíbrio na resposta dos receptores de endotelina, a remodelação microvascular pulmonar e predisposição genética, levando à dilatação vascular intrapulmonar e translocação
