array:22 [ "pii" => "S0025775300716149" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71614-9" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71614" "copyright" => "Elsevier España, S.L.. Todos los derechos reservados" "copyrightAnyo" => "2000" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:521-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2743 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 2570 "PDF" => 167 ] ] "itemSiguiente" => array:18 [ "pii" => "S0025775300716150" "issn" => "00257753" "doi" => "10.1016/S0025-7753(00)71615-0" "estado" => "S300" "fechaPublicacion" => "2000-01-01" "aid" => "71615" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2000;115:530-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 4201 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 4012 "PDF" => 184 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Intoxicación por paraquat. Estudio de 29 casos y evaluación del tratamiento con la «pauta caribeña»" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "530" "paginaFinal" => "533" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Paraquat intoxication. A study of 29 cases with an evaluation of the effectivity of the «Caribbean scheme»" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Javier Botella de Maglia, José Enrique Belenguer Tarín" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Javier" "apellidos" => "Botella de Maglia" ] 1 => array:2 [ "nombre" => "José" "apellidos" => "Enrique Belenguer Tarín" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775300716150?idApp=UINPBA00004N" "url" => "/00257753/0000011500000014/v1_201307291650/S0025775300716150/v1_201307291650/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Análisis de 500 trasplantes hepáticos en el Hospital de Bellvitge" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "521" "paginaFinal" => "529" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Eduardo Jaurrieta, Luis Casais, Juan Figueras, Emilio Ramos, Carmen Lama, Antonio Rafecas, Teresa Casanovas Taltavull, Juan Fabregat, Xavier Xiol, Jaume Torras, Carmen Baliellas, Antonio Sabaté, Gabriel Rufí, Carmen Benasco, Teodoro Casanovas, Teresa Serrano, Salvador Gil-Vernet, Isabel Sabaté, Juli Busquets" "autores" => array:19 [ 0 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Jaurrieta" ] 1 => array:2 [ "nombre" => "Luis" "apellidos" => "Casais" ] 2 => array:4 [ "nombre" => "Juan" "apellidos" => "Figueras" "email" => array:1 [ 0 => "jfigueras@csub.scs.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 3 => array:2 [ "nombre" => "Emilio" "apellidos" => "Ramos" ] 4 => array:2 [ "nombre" => "Carmen" "apellidos" => "Lama" ] 5 => array:2 [ "nombre" => "Antonio" "apellidos" => "Rafecas" ] 6 => array:2 [ "nombre" => "Teresa" "apellidos" => "Casanovas Taltavull" ] 7 => array:2 [ "nombre" => "Juan" "apellidos" => "Fabregat" ] 8 => array:2 [ "nombre" => "Xavier" "apellidos" => "Xiol" ] 9 => array:2 [ "nombre" => "Jaume" "apellidos" => "Torras" ] 10 => array:2 [ "nombre" => "Carmen" "apellidos" => "Baliellas" ] 11 => array:2 [ "nombre" => "Antonio" "apellidos" => "Sabaté" ] 12 => array:2 [ "nombre" => "Gabriel" "apellidos" => "Rufí" ] 13 => array:2 [ "nombre" => "Carmen" "apellidos" => "Benasco" ] 14 => array:2 [ "nombre" => "Teodoro" "apellidos" => "Casanovas" ] 15 => array:2 [ "nombre" => "Teresa" "apellidos" => "Serrano" ] 16 => array:2 [ "nombre" => "Salvador" "apellidos" => "Gil-Vernet" ] 17 => array:2 [ "nombre" => "Isabel" "apellidos" => "Sabaté" ] 18 => array:2 [ "nombre" => "Juli" "apellidos" => "Busquets" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Trasplante Hepático Ciudad Sanitaria y Universitaria de Bellvitge L'Hospitalet de Llobregat Barcelona." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Dr. J. Figueras. Unidad de Trasplante Hepático. Ciudad Sanitaria y Universitaria de Bellvitge. Avda. Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Analysis of 500 liver transplantations in the Bellvitge Hospital, Spain" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-02-17" "fechaAceptado" => "2000-06-22" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec222531" "palabras" => array:3 [ 0 => "Trasplante hepático" 1 => "Complicaciones postoperatorias" 2 => "Supervivencia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se presenta la experiencia del programa de trasplante hepático del Hospital de Bellvitge en 500 trasplantes realizados durante 15 años, con el objetivo de poner de manifiesto los cambios que se han producido y exponer los resultados a largo plazo de esta terapéutica.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se consideraron y compararon 5 grupos de 100 trasplantes consecutivos (I-V).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Las indicaciones más frecuentes fueron el hepatocarcinoma (23%), la cirrosis alcohólica (22,8%) y la hepatopatía crónica por virus C (18,8%). En 59 pacientes se llevaron a cabo 65 retrasplantes (13%), cuyas indicaciones más frecuentes fueron la trombosis arterial (13 pacientes) y el fallo primario del injerto (10 pacientes). En 19 enfermos se realizó un trasplante combinado hepatorrenal. La causa más frecuente de muerte del donante en el grupo I fueron los traumatismos craneales (80%), mientras que en el grupo V fue la enfermedad vascular (52%). Otras diferencias significativas entre estos grupos se observan en la proporción de pacientes en estadio 2 y 3 de la clasificación UNOS (el 45 frente al 19%), en el consumo de hemoderivados (29,6 [26] frente a 4,6 [5,3] concentrados de hematíes), en la frecuencia de reintervenciones por hemoperitoneo (el 22 frente al 5%), en la estancia en UCI (13 [13] frente a 7,4 [11] días) y en el hospital 40 [52] frente a 23,7 [17] días), y en la incidencia de rechazo (el 46 frente al 20%) y de fallo primario del injerto (el 9 frente al 3%). Sin embargo, la prevalencia de infección (el 48 frente al 54,5%) y la incidencia de complicaciones biliares (el 26 frente al 20%) no han presentado variaciones significativas. La supervivencia actuarial de los pacientes trasplantados desde 1990 es del 83 y del 70% al año y a los 5 años, respectivamente.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se observa una mejoría notable y progresiva de los resultados del trasplante hepático. Sin embargo, los tumores de novo, la recidiva de la hepatitis por virus C y el rechazo crónico pueden limitar los resultados a largo plazo.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We present the experience of the liver transplantation program at the Hospital of Bellvitge with 500 transplantations performed during 15 years, to describe changes in liver transplantation observed throughout the time and to analyze the long term results.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Five groups each one including 100 consecutive transplantations are studied.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The main indications were hepatocellular carcinoma (23%), alcoholic cirrhosis (22.8%), and post-hepatitis C cirrhosis (18.8%). Sixty-five retransplantations were performed in 59 patients (13%), being the more frequent indications arterial thrombosis (13 patients) and primary nonfunction of graft (10 patients). In 10 patients a hepatorenal transplantation was performed. In group I, the most frequent donor cause of death was cranial traumatism (80%), while in group V it was the vascular pathology (52%). There were other significative dif-ferences between these groups of patients (I vs V): patients with stage 2 or 3 from UNOS status (45 vs 19%), blood use (29.6 [26] vs 4.6 [5.3] PRBC), ICU stay (13 [13] vs 7.4 [11] days), hospital stay (40 [52] vs 23.7 [17] days), rejection rate (46 vs 20%) and primary graft non-function (9 vs 3%). However, the infection rates (48 vs 54.5%) and biliary tract complications (26 vs 20%) have not shown statistically significant differences. Actuarial one and 5-year survival are 83 and 70% respectively.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">An important and progressive improvement of liver transplantation results has been observed. However, de novo tumours, hepatitis C virus recurrence and chronic rejection can limit long term results.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Homotransplantation of the liver in humans Surg Gynecol Obstet" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.E. Starzl" 1 => "T.L. Marchioro" 2 => "K.N. 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Análisis de 500 trasplantes hepáticos en el Hospital de Bellvitge
Analysis of 500 liver transplantations in the Bellvitge Hospital, Spain
Eduardo Jaurrieta, Luis Casais, Juan Figueras
, Emilio Ramos, Carmen Lama, Antonio Rafecas, Teresa Casanovas Taltavull, Juan Fabregat, Xavier Xiol, Jaume Torras, Carmen Baliellas, Antonio Sabaté, Gabriel Rufí, Carmen Benasco, Teodoro Casanovas, Teresa Serrano, Salvador Gil-Vernet, Isabel Sabaté, Juli Busquets
Autor para correspondencia
jfigueras@csub.scs.es
Correspondencia: Dr. J. Figueras. Unidad de Trasplante Hepático. Ciudad Sanitaria y Universitaria de Bellvitge. Avda. Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona.
Correspondencia: Dr. J. Figueras. Unidad de Trasplante Hepático. Ciudad Sanitaria y Universitaria de Bellvitge. Avda. Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat. Barcelona.
Unidad de Trasplante Hepático Ciudad Sanitaria y Universitaria de Bellvitge L'Hospitalet de Llobregat Barcelona.