Immunodiagnostic tests' predictive values for progression to tuberculosis in transplant recipients. A prospective cohort study

Background: Little is known about the predictive value for progression to tuberculosis (TB) of interferon-γ release assays and how they compare with the tuberculin skin test (TST) in assessing the risk of TB infection in transplant recipients. Methods: We screened 50 liver transplant (LT) and 26 hematopoietic stem cell transplant (HSCT) recipients with both QuantiFERON-TB Gold In-tube (QFT-GT) and TST and prospectively followed them for a median of 47 months without preventive chemoprophylaxis. Results: In the LT cohort, 1 in 22 (4.5%) QFT-GT-positive patients developed posttransplant TB, compared with none of the QFT-GT-negative patients. In the HSCT cohort, none of the 7 QFT-GT-positive patients developed TB, whereas 1 case (5.3%) progressed to active TB among the 19 QFT-GT-negative patients. Comparable results were obtained with the TST: in the LT group, 1 of 23 TST-positive and none of the 27 TST-negative patients developed TB; and in the HSCT group, none of the 8 TST-positive and one of the 18 TST-negative patients progressed to active TB. Conclusions: In this cohort of transplant recipients, the positive predictive value of QFT-GT for progression to active TB was low and comparable to that of TST. Although the risk of developing TB in patients with negative results at baseline is very low, some cases may still occur

Immunodiagnostic tests' predictive values for progression to tuberculosis in transplant recipients. A prospective cohort study

Background: Little is known about the predictive value for progression to tuberculosis (TB) of interferon-γ release assays and how they compare with the tuberculin skin test (TST) in assessing the risk of TB infection in transplant recipients. Methods: We screened 50 liver transplant (LT) and 26 hematopoietic stem cell transplant (HSCT) recipients with both QuantiFERON-TB Gold In-tube (QFT-GT) and TST and prospectively followed them for a median of 47 months without preventive chemoprophylaxis. Results: In the LT cohort, 1 in 22 (4.5%) QFT-GT-positive patients developed posttransplant TB, compared with none of the QFT-GT-negative patients. In the HSCT cohort, none of the 7 QFT-GT-positive patients developed TB, whereas 1 case (5.3%) progressed to active TB among the 19 QFT-GT-negative patients. Comparable results were obtained with the TST: in the LT group, 1 of 23 TST-positive and none of the 27 TST-negative patients developed TB; and in the HSCT group, none of the 8 TST-positive and one of the 18 TST-negative patients progressed to active TB. Conclusions: In this cohort of transplant recipients, the positive predictive value of QFT-GT for progression to active TB was low and comparable to that of TST. Although the risk of developing TB in patients with negative results at baseline is very low, some cases may still occur

Estudio comparativo de la colestasis hepática entre la infusión de triglicéridos de cadena larga y mezcla de triglicéridos de cadena media y larga

Se realiza un estudio prospectivo, randomizado, doble ciego en pacientes quirúrgicos que requieren nutrición parenteral durante un período de diez días y estén en ayuno completo. Los pacientes deben tener una función hepática normal medida por gamma-GT, fosfatasa alcalina (FA), bilirrubina y ALT normales. Se estudia la evolución de los parámetros de colestasis los días O, 1, 3, 8 y 1 O. Se observa un aumento de la gammaGT en las de grupos, pero mucho más marcado en el grupo con LCT (p < 0,005) al décimo día que en el grupo MCT/LCT. La FA aumenta sólo en el grupo LCT, siendo estadísticamente significativo (p < 0,001) al décimo día respecto al grupo MCT/LC

Estudio comparativo de la colestasis hepática entre la infusión de triglicéridos de cadena larga y mezcla de triglicéridos de cadena media y larga

Se realiza un estudio prospectivo, randomizado, doble ciego en pacientes quirúrgicos que requieren nutrición parenteral durante un período de diez días y estén en ayuno completo. Los pacientes deben tener una función hepática normal medida por gamma-GT, fosfatasa alcalina (FA), bilirrubina y ALT normales. Se estudia la evolución de los parámetros de colestasis los días O, 1, 3, 8 y 1 O. Se observa un aumento de la gammaGT en las de grupos, pero mucho más marcado en el grupo con LCT (p < 0,005) al décimo día que en el grupo MCT/LCT. La FA aumenta sólo en el grupo LCT, siendo estadísticamente significativo (p < 0,001) al décimo día respecto al grupo MCT/LC

Changes in peripheral blood levels of platelet-activating factor after orthotopic liver transplantation

Platelet-Activating factor (PAF) is a phospholipid mediator structurally characterized as 1-alkyl-2-acetyl-sn-glycero-3-phosphocholine with a broad range of biological activities. PAF has been implicated as a mediator of the acute allergic and inflammatory response as well as in the pathogenesis of hyperacute rejection in organ transplantation, which is mediated..

La quimioembolización en el tratamiento del hepatocarcinoma

Presentamos una serie de 46 pacientes, a los cuales se les aplicó quimioterapia intraarterial con lipiodol y adriamicina, 27 de ellos con embolización arterial mediante partículas de fibrina, dentro de un tratamiento pluridisciplinario del hepatocarcinoma (HCC). Cinco pacientes posteriormente fueron resecados y a 13 se les practicó un trasplante de hígado ortotópico (THO). El objetivo de este trabajo es analizar la supervivencia y el grado de necrosis tumoral