Value of hepatic volume preoperative weight of the graft right hemi-liver, with and without inclusion of middle hepatic vein, in the donor transplantation

Objetivo: Analisar a relacao da volumetria medida por tomografia do hemi-figado direito no pre-operatorio com o peso do enxerto intraoperatorio com ou sem a veia hepatica media. Metodos: Neste estudo, os 63 pacientes submetidos a doacao mediram o volume por tomografia no pre-operatorio do hemi-figado esquerdo e direito, tambem foram medidos os pesos intraoperatorios do hemi-figado direito com (grupo 1, n=29) e sem (grupo 2 n=34) a presenca da veia hepatica media e compararam-se os resultados quanto a : sexo, idade, peso corporal, altura, indice de massa corporea (IMC), peso do hemi-figado direito e esquerdo medido por tomografia computadorizada e peso do hemi-figado direito medido no intraoperatorio. Resultados: Verificou-se que existe uma diferenca de 21,64% entre o peso do hemi-figado direito medido por tomografia e o peso do hemi-figado direito medido no intraoperatorio (grupo 2). Tambem se verificou uma diferenca 12,83% entre o peso do hemi-figado direito medido por tomografia e o peso do hemi-figado direito com a inclusao da veia hepatica media (grupo 1). Conclusao: O peso do enxerto do hemi-figado direito no transplante intervivos e menor que o calculado pela tomografia computadorizada pre-operatoria e a inclusao da veia hepatica media no enxerto do hemi-figado direito diminui estatisticamente esta diferencaPurpose: To analyze the relationship between the volume measured by CT scan of the right hemi-liver preoperatively with the weight of intraoperative graft with or without the middle hepatic vein. Methods: The hepatic volume by computed tomography is already provided for preoperative evaluation of donor liver donors, with measures of hemi-liver right and left. The measure of the weight of the right hemi-liver with the inclusion of middle hepatic vein is not routine. In this study, all patients measured the volume tomography in the preoperative hemi-liver right and left. Subsequently, the weights were also measured intraoperative right hemi-liver with (group 1) and without (group 2) the presence of middle hepatic vein and compared the results. Results: We found that there is a difference of 21.64% between the weight of the right hemi-liver measured by CT and weight of the right hemi-liver measured intraoperatively (group 2). Also there was a 12.83% difference between the weight of the right hemi-liver measured by CT and weight of the right hemi-liver with the inclusion of middle hepatic vein (group 1). Conclusion: The weight of the graft in the right hemi-liver transplants is lower than that determined by preoperative computed tomography and the inclusion of middle hepatic vein graft in the right hemi-liver reduces this difference statisticallyBV UNIFESP: Teses e dissertaçõe

Transplante hepático em sarcoma embrionário indiferenciado de fígado em adultos: relato de caso

Undifferentiated embryonal sarcoma of the liver (UESL) consists of a rare malignant neoplasm with a still poorly known etiopathogenesis, affecting mostly children between the ages of 6 and 10 years. It corresponds to 7% of primary liver tumors, and is the fourth most common liver cancer in pediatrics. The diagnosis of UESL is based on a set of imaging findings, age and level of alpha-fetoprotein (AFP), which is usually normal, as well as liver function tests. Early diagnosis is hampered by non-specific symptoms, such as abdominal pain, a rapidly growing palpable abdominal mass, fever, weight loss, and gastrointestinal symptoms. The most characteristic image finding is that of a large, unique, and well-defined mass. Ultrasonography shows a predominantly solid and echogenic mass. Computed tomography, on the other hand, shows a mass that takes on a mainly cystic characteristic. Histologically, myxoid tissue with spindle-shaped neoplastic cells is evidenced. Some immunohistochemical studies indicate UESL mesenchymal origin. The macroscopic aspect of the tumor appears as a large hepatic mass, with a predominantly solid component, with some cystic areas, hemorrhage, and necrosis in up to 80% of its surface. The best approach for the treatment of primary liver sarcoma is not yet well defined. Therapeutic options include surgical resection, chemotherapy, radiotherapy, and liver transplantation (LT). However, in cases of unresectable tumors, LT is an option that must be considered, since in this histological type both chemotherapy and radiotherapy have questionable benefits. This article aims to report a case of giant UESL, with vascular invasion, submitted to LT with good postoperative evolution and without signs of recurrence after nine months of LT.O sarcoma embrionário indiferenciado de fígado (SEIF) consiste em uma neoplasia maligna rara com etiopatogenia ainda pouco conhecida, acometendo em sua maioria crianças na faixa etária entre 6 e 10 anos. Corresponde a 7% dos tumores primários de fígado, e é a quarta neoplasia hepática mais frequente na pediatria. O diagnóstico do SEIF se dá em um conjunto de achados de imagem, idade e nível de alfa-fetoproteína (AF), que geralmente está normal, assim como as provas de função hepática. O diagnóstico precoce é prejudicado pelos sintomas inespecíficos, como dor abdominal, massa abdominal palpável de rápido crescimento, febre, perda de peso e sintomas gastrintestinais. O achado de imagem mais característico é o de massa grande, única e bem-delimitada. A ultrassonografia mostra massa predominantemente sólida e ecogênica. Já a tomografia computadorizada evidencia uma massa que assume característica principalmente cística. Histologicamente é evidenciado tecido mixoide com células neoplásicas fusiformes. Alguns estudos imuno-histoquímicos indicam origem mesenquimal do SEIF. O aspecto macroscópico do tumor se apresenta como grande massa hepática, de componente sólido predominantemente, com algumas áreas císticas, hemorragia e necrose em até 80% de sua superfície. Ainda não é bem-definida a melhor abordagem para o tratamento do sarcoma primário de fígado. As opções terapêuticas incluem ressecção cirúrgica, quimioterapia, radioterapia e transplante hepático (TH). Porém, nos casos de tumores irressecáveis, o TH é uma opção que deve ser considerada, uma vez que nesse tipo histológico tanto quimioterapia como radioterapia têm benefício questionável. Este artigo tem por objetivo relatar um caso de SEIF gigante, com invasão vascular, submetido a TH com boa evolução pós-operatória e sem sinais de recidiva após nove meses de TH

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data