Pardo, F. (Fernando)
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- Plasma levels of leukotriene B4 during hepatic allograft rejection(Elsevier, 1992) Diaz, M.C. (M. C.); Pardo, F. (Fernando); Álvarez-Cienfuegos, J. (Javier); Hernandez-Lizoain, J.L. (Jose Luis); Torramade, J. (J.); Ortigosa, C.R. (C.R.); Pardo-Mindan, F.J. (Francisco Javier); Villa, V. (V.) de; Gonzalez, J. (J.)At the present time, rejection is the most frequent cause of graft dysfunction in liver transplantation. Differential diagnosis between this and other possible causes of dysfunction—preservation injury, vascular, biliary, viral—may well be difficult, as the clinical and analytical findings are often similar; moreover, no markers specific to rejection are available, and histological studies are necessary for a definitive diagnosis. For this reason, markers indicating activity within the immune system need to be established so as to provide a more specific means of distinguishing rejection from other causes of graft dysfunction. The immune response to an allograft is complex, and the intricate mechanisms regulating it are still not entirely understood. Nevertheless, several specialists have drawn connections among changes in the lymphocyte subpopulations, rises in the interleukin-2 levels, expression of the interleukin-2 receptor, and alteration in the expression of antigens belonging to class II in the greater complex of histocompatibility, with rejection of the allograft. Leukotriene B4 (LTB4) is a derivative of the metabolism of arachidonic acid via 5- lipoxygenase, whose in vitro behaviour is to encourage rejection by favoring leukocyte aggregation, proliferation of T lymphocytes, interleukin-1 and -2 secretion, and the development of "natural killer" cell subpopulations. This study examines the role of LTB4 in mediating the immune response to the hepatic allograft in order to assess its usefulness in early diagnosis of rejection.
- Influence of tumor characteristics on the outcome of liver transplantation among(Wiley-Blackwell, 2001) Pardo, F. (Fernando); Herraiz-Bayod, M.J. (Maite J.); Álvarez-Cienfuegos, J. (Javier); Sangro, B. (Bruno); Herrero, J.I. (José Ignacio); Quiroga, J. (Jorge)Hepatocellular carcinoma (HCC) may recur after liver transplantation (LT), mainly in patients with multinodular and large tumors. However, factors predictive of outcome after LT in patients with small tumors remain ill defined. We investigated which factors were related to mortality or tumor recurrence among 47 liver transplant recipients with liver cirrhosis and HCC and compared them with 107 patients with liver cirrhosis without tumor who underwent LT in the same period. Patients with HCC were older (P <.001), more frequently had cirrhosis of a viral origin (P <.001), and had lower Child-Pugh scores (P <.001) than patients without tumor. Survival of patients with and without tumor was not significantly different (P =.20). Among patients with HCC, those with lower recurrence-free survival rates had liver cirrhosis of a viral origin, vascular invasion, bilobar disease, and tumor-node-metastasis (TNM) stage IV. At multivariate analysis, the only factor associated with mortality or recurrence was TNM stage IV (P =.02). Our results suggest that in patients with HCC and TNM stage IV, LT might be contraindicated
- De Novo neoplasia after liver transplantation: an analysis of risk factors and influence on survival(Wiley-Blackwell, 2005) Rotellar, F. (Fernando); Pardo, F. (Fernando); Álvarez-Cienfuegos, J. (Javier); Sangro, B. (Bruno); Lorenzo, M. (María); Prieto, J. (Jesús); Herrero, J.I. (José Ignacio); Quiroga, J. (Jorge)mmunosuppression increases the risk of posttransplant malignancy and it may increase posttransplant mortality. The finding of factors related to the development of posttransplant malignancy may serve as a guide to avoid those risk factors and to develop strategies of posttransplant surveillance. The incidence and risk factors of malignancy were studied in 187 consecutive liver transplant recipients surviving more than 3 months. None of the 12 patients surviving less than 3 months had de novo neoplasia. The impact of malignancy on survival was studied in a case-control study. After a median follow-up of 65 months, 49 patients developed 63 malignancies: 25 patients had 35 cutaneous neoplasias and 27 patients had 28 noncutaneous malignancies. The 5- and 10-year actuarial rates of cutaneous neoplasia were 14 and 24% and the rates of noncutaneous neoplasia were 11 and 22%, respectively. Risk factors for the development of cutaneous malignancy were older age and Child-Turcotte-Pugh A status. Risk factors for the development of noncutaneous malignancy were older age, alcoholism, and smoking. Cutaneous neoplasia had no effect on survival, whereas patients with noncutaneous malignancy had a significant reduction of survival. The overall relative risk of cutaneous and noncutaneous neoplasia, as compared with the general population were 16.91 (95% confidence interval: 11.78-23.51) and 3.23 (95% confidence interval: 2.15-4.67), respectively. The relative risk of cancer-related mortality (after excluding recurrent malignancy) was 2.93 (95% confidence interval: 1.56-5.02). Multivariate analysis showed that noncutaneous malignancy was an independent risk factor for posttransplant mortality. In conclusion, liver transplant recipients have a higher risk of cancer-related mortality than the general population. This increased risk is due to the development of noncutaneous neoplasia. Older age, alcoholism, and smoking increase the risk of de novo noncutaneous neoplasia.
- Risk factors of lung, head and neck, esophageal, and kidney and urinary tract carcinomas after liver transplantation: the effect of smoking withdrawal(Wiley-Blackwell, 2011) D'Avola, D. (Delia); Rotellar, F. (Fernando); Alegre, F. (Félix); Pardo, F. (Fernando); Sangro, B. (Bruno); Iñarrairaegui, M. (Mercedes); Herrero, J.I. (José Ignacio); Marti-Cruchaga, P. (Pablo); Quiroga, J. (Jorge)Liver transplant recipients have an increased risk of malignancy. Smoking is related to some of the most frequent causes of posttransplant malignancy. The incidence and risk factors for the development of neoplasia related to smoking (head and neck, lung, esophageal, and kidney and urinary tract carcinomas) were studied in 339 liver transplant recipients. Risk factors for the development of smoking-related neoplasia were also studied in 135 patients who had a history of smoking so that it could be determined whether smoking withdrawal was associated with a lower risk of malignancy. After a mean follow-up of 7.5 years, 26 patients were diagnosed with 29 smoking-related malignancies. The 5- and 10-year actuarial rates were 5% and 13%, respectively. In multivariate analysis, smoking and older age were independently associated with a higher risk of malignancy. In the smoker subgroup, the variables related to a higher risk of malignancy were active smoking and older age. In conclusion, smoking withdrawal after liver transplantation may have a protective effect against the development of neoplasia.
- Acceso venoso central mediante cápsulas de inyección subcutáneas. Serie de 124 dispositivos(Paz Montalvo, 1991) Pardo, F. (Fernando); Voltas, J. (J.); Álvarez-Cienfuegos, J. (Javier); Hernandez-Lizoain, J.L. (Jose Luis); Benito, C. (C.); Balen, E. (Enrique); Albiach, M. (M.); Gonzalez, J. (J.)Presentamos una serie de 111 pacientes (límites: 9 meses - 78 años) en los que se colocaron 124 dispositivos como modalidad de acceso venoso central. Se analizan las complicaciones aparecidas durante su utilización, que actualmente sobrepasa los 1.100 meses, y se comentan aspectos técnicos de colocación con influencia sobre la morbilidad del sistema. La media actual de funcionamiento se sitúa en 9,9 meses por persona, con una tasa de complicaciones del 19 %.
- Angiomiolipoma epitelioide hepático(Elsevier España, 2002) Rotellar, F. (Fernando); Rodriguez-Spiteri, N. (Natalia); Pardo, F. (Fernando); Olea, J. (J.); Toledo, G. (Gemma); Álvarez-Cienfuegos, J. (Javier); Sola, J. (Josu); Gil, A. (Aurora); Cervera, M. (María)Abstract: We describe the case of a hepatic epithelioid angiomyolipoma in a 50-year-old woman with epigastric pain and well-circumscribed 47 mm hepatic mass detected by ultrasonography. Angiomyolipoma is a rare benign mesenchymal tumor of the liver, composed of variable amounts of smooth muscle cells, abnormal blood vessels and adipose tissue. Preoperative diagnosis is difficult. Immunoreactivity with HMB-45 antibody helps to distinguish this tumor from other benign and malignant tumors of the liver.
- Tumor neuroectodérmico renal primitivo. A propósito de un caso(2011) Romero, L.M. (L.M.); Rosell, D. (David); Pardo, F. (Fernando); Barba, J. (Joaquín); Queipo, F.J. (Francisco Javier); Algarra, R. (Rubén)
- Comparison Between Two Warm Ischemic Models in Experimental Liver Transplantation in Pigs(Elsevier, 2003) Rotellar, F. (Fernando); Espi, A. (A.); Martinez-Regueira, F. (Fernando); Baixauli-Fons, J. (Jorge); Pardo, F. (Fernando); Olea, J. (J.); Álvarez-Cienfuegos, J. (Javier); Hernandez-Lizoain, J.L. (Jose Luis); Diez-Caballero, A. (Alberto); Nwose, P. (P.)Experimental models of warm ischemia in liver transplantation have been employed to study the mechanisms and treatment of ischemia reperfusion injury. METHODS: We compared a control group without (group A, n = 10) versus two models of warm ischemia of liver transplants in pigs: namely, occlusion of the hepatic artery and portal vein for 30 minutes (group B, n = 23) and extraction of the liver 60 minutes after cardiac arrest (group C, n = 5). Liver function tests, coagulation studies, and liver biopsies were performed during the first 24 hours post-liver transplant. RESULTS: Clamping of the hepatic vasculature in group B produced a significant liver injury compared with the control group: elevation of the ALT and an abnormal 1-hour post-revascularization biopsy similar to that observed in the cardiac arrest group C. The transaminase levels were lower among group A animals (P <.05). But the hepatic synthetic functions as reflected in the protrombin time (PT) were not affected in group B versus group A. The alteration in PT with respect to the initial value was similar among group A and group B animals, which were significantly less than that in group C (P <.05). CONCLUSIONS: Occlusion of the hepatic artery and portal vein, a simple surgical maneuver, causes moderate damage to a liver graft but less alteration of hepatic synthetic function. Clamping of the hepatic vasculture obtains more long-term survivors after OLT than cardiac arrest.
- Cirugía laparoscópica hepática y pancreática(Gobierno de Navarra. Departamento de Salud, 2005) Valenti, V. (Víctor); Pastor, C. (Carlos); Rotellar, F. (Fernando); Poveda, I. (Ignacio); Pardo, F. (Fernando); Zozaya-Larequi, G. (Gabriel); Marti-Cruchaga, P. (Pablo)The development of laparoscopic surgery also includes the more complex procedures of abdominal surgery such as those that affect the liver and the pancreas. From diagnostic laparoscopy, accompanied by laparoscopic echography, to major hepatic or pancreatic resections, the laparoscopic approach has spread and today encompasses practically all of the surgical procedures in hepatopancreatic pathology. Without forgetting that the aim of minimally invasive surgery is not a better aesthetic result but the reduction of postoperative complications, it is undeniable that the laparoscopic approach has brought great benefits for the patient in every type of surgery except, for the time being, in the case of big resections such as left or right hepatectomy or resections of segments VII and VIII. Pancreatic surgery has undergone a great development with laparoscopy, especially in the field of distal pancreatectomy due to cystic and neuroendocrine tumours where the approach of choice is laparoscopic. Laparoscopy similarly plays an important role, together with echolaparoscopy, in staging pancreatic tumours, prior to open surgery or for indicating suitable treatment. In coming years, it is to be hoped that it will continue to undergo an exponential development and, together with the advances in robotics, it will be possible to witness a greater impact of the laparoscopic approach on the field of hepatic and pancreatic surgery.
- Effectiveness of aprotinin in orthotopic liver transplantation(Georg Thieme, 1993) Paramo, J.A. (José Antonio); Picardi, A. (Antonio); Suarez, M. (Manuel); Pardo, F. (Fernando); Rocha, E. (Eduardo); Carrera, J. (José); Álvarez-Cienfuegos, J. (Javier); Hidalgo, F. (Francisco); Sangro, B. (Bruno); Prieto, J. (Jesús); Herrero, J.I. (José Ignacio); Quiroga, J. (Jorge); Carrascosa, F. (Francisco)