Navegando por Palavras-chave "fígado gorduroso"

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    Avaliação da influência da esteatose do enxerto no resultado do transplante de fígado
    (Universidade Federal de São Paulo (UNIFESP), 2014-12-17) Cezar, Leandro Dias [UNIFESP]; Linhares, Marcelo Moura Linhares [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Steatosis is frequently present in liver grafts, and it is usually admitted that small grade (<30%) of macrosteatosis is safe to transplant and is not advisable to use graft with severe (>=60%) macrosteatosis. However there is no consensus about the real cut off for extent of macrosteatosis and on the risk of microsteatosis. The aim of this study is to evaluate the steatosis influence on transplant outcome in a large unicentric cohort. Methods: We performed a retrospective analysis of a prospectively maintained database in a single center. Two thousand seven hundred and six patients (2.706) were transplanted from December 3, 1984 to December 31, 2010. Among these grafts, 1132 had steatosis (924 macro, 782 micro, 458 macro and micro). Graft biopsies were available in 98% of the cases. Donor and recipient data and surgical factors were analyzed. The end-points were primary dysfunction, delayed graft function (aspartate aminotransferase level >2.000 and TP<30%), 3-month, 1-year and 5-year survival. A multivariable analysis and logistic regression were performed to indentify the risk factors associated with the outcome. Results: The presence of microsteatosis or macrosteatosis at any percentage is a risk factor for graft dysfunction or primary nonfunction (OR: 1.41 and 1.39; P= 0.01 and 0.02 respectively). The 3-month and 1-year graft survival is only affected by macrosteatosis more than 30% (OR: 1,94, P= 0.002 and OR: 1.41, p= 0.02 respectively). According to the grade of macrosteatosis, the 1 year graft survival was 81% for <30% macrosteatosis, 73% for 30-50% macrosteatosis, 67% for 50-60% macrosteatosis, 58% for >=60% macrosteatosis; the 5 year graft survival was 67% for <30% macrosteatosis, 66% for 30-50% macrosteatosis, 44% for 50-60% macrosteatosis, 38% for >=60% macrosteatosis. Conclusion: The presence of graft steatosis, (macro or micro) does affect the initial graft function. Only Macrosteatosis more than 30% does affect graft survival. With more than 50% macrosteatosis risk of graft loss overexceeds 50% and becomes prohibitive.
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    Doença hepática gordurosa não alcoólica em escolares obesos
    (Sociedade de Pediatria de São Paulo, 2008-06-01) Souza, Fabíola Isabel S.; Amancio, Olga Maria Silverio [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; Pitta, Tassiana Sacchi; Fernandes, Ana Paula; Fonseca, Fernando Luiz Affonso [UNIFESP]; Hix, Sonia; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina do ABC
    OBJECTIVE: To evaluate the prevalence of altered hepatic ultrasound and elevated serum alanine aminotransferase (ALT) in overweight and obese children, as well as to relate them to lipid peroxidation, lipid profile and insulin resistance. METHODS: A prospective, controlled, cross-sectional study was performed with 67 overweight and obese children (38 female, mean age of 8,6 years) paired by gender and age with 65 eutrophic controls. The following parameters were evaluated: lipid profile (LDL-c, HDL-c, triglycerides), ALT, lipid peroxidation measured by thiobarbituric acid reaction substance (TBARS), serum glucose and insulin resistance (Homeostasis Model Assessment). Hepatic steatosis was evaluated by ultrasound by a single professional and classified as diffuse mild, moderate or severe. RESULTS: Elevated ALT (>40 U/L) was observed in 3% and altered ultrasound in 57.4% of the overweight/obese children. Obese/overweight children showed a higher percentage of ALT >18 U/L (OR 4.2, p=0.0006) and hypertriglyceridemia (OR 4.2, p<0.001). ALT was associated with elevated triglycerides (OR 3,2; p=0,010). There was not association between TBARS (oxidative stress) or HOMA-IR with the presence of overweight/obesity or ALT >18 U/L. CONCLUSIONS: The frequency of altered ALT (>40U/L) was low and of altered hepatic ultrasound was high. There was no association between fatty liver at ultrasound with nutritional status or ALT levels. Elevated triglycerides were associated with higher levels of ALT.