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SM ISO690:2012 TARAN, Natalia, HOTINEANU, Adrian, BURGOCI, Serghei, LUPAŞCO, Iulianna, PELTEC, Angela. Transplantul – o speranță la viață. Caz clinic. In: Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, 21-23 octombrie 2020, Chişinău. Chişinău: USMF, 2020, p. 454. |
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Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” 2020 | |||||||
Congresul "Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”" Chişinău, Moldova, 21-23 octombrie 2020 | |||||||
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Pag. 454-454 | |||||||
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Rezumat | |||||||
Background. Malnutrition increases mortality on the waiting list. Hydrothorax, renal dysfunction, MELD score >17 affect prognosis. Objective of the study. The case is 56 years old patient, cirrhosis, on the waiting list since 2017. Material and Methods. Investigated according to the LT protocol: biochemical analyzes, nasopharynx cultures, uroculture, hemoculture, pleural fluid, ascites; tumor markers, viral, autoimmune. Examined vital functions. Pulmonary CT: bilateral hydrothorax (D>S). Abdominal CT: ascites, splenomegaly, v. portae thrombosis, EDS- esophageal varices dgr II-III; HBV DNA 1 552 UI / ml, HDV RNA – 2 458 570 UI / ml. Results. Confirmed HBV /VHD HC, Child Pugh C (11 p). Hypersplenism dgr. II-III., MELD Na 20.7. Esophageal varices dgr II-III. Portal gastropathy. Recurrent hydrothorax. Thrombosis v. portae. Severe malnutrition BMI <18.5 portal enteropathy. Hyponatremia. LT from brain-dead donor, age <30 years, comorbidities abs. Rehabilitation period: Na+diminished, renal dysfunction, ascites, pseudomembranous colitis Cl. Difficile. Post-LT abdominal CT: stenosis v. portae, at anastomosis level, surgically resolved. Administered etiopathogenetic, immunosuppressive treatment adapted to disease features. 12 months post LT: absence of ascites, normal biochemical parameters, except creatinine 125 umoll, BMI –Conclusion. LT is the only treatment in the terminal stage. Postoperative evolution involves: age, nutritional status, renal dysfunction, viral infection, MELD score – receiver; age, quality of liver transplant – donor. |
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Cuvinte-cheie liver cirrhosis (LC), liver transplantation (LT), ciroza hepatica (CH), transplant hepatic (TH) |
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Cerif XML Export
<?xml version='1.0' encoding='utf-8'?> <CERIF xmlns='urn:xmlns:org:eurocris:cerif-1.5-1' xsi:schemaLocation='urn:xmlns:org:eurocris:cerif-1.5-1 http://www.eurocris.org/Uploads/Web%20pages/CERIF-1.5/CERIF_1.5_1.xsd' xmlns:xsi='http://www.w3.org/2001/XMLSchema-instance' release='1.5' date='2012-10-07' sourceDatabase='Output Profile'> <cfResPubl> <cfResPublId>ibn-ResPubl-126264</cfResPublId> <cfResPublDate>2020</cfResPublDate> <cfStartPage>454</cfStartPage> <cfISBN></cfISBN> <cfURI>https://ibn.idsi.md/ro/vizualizare_articol/126264</cfURI> <cfTitle cfLangCode='RO' cfTrans='o'>Transplantul – o speranță la viață. Caz clinic</cfTitle> <cfKeyw cfLangCode='RO' cfTrans='o'>liver cirrhosis (LC); liver transplantation (LT); ciroza hepatica (CH); transplant hepatic (TH)</cfKeyw> <cfAbstr cfLangCode='EN' cfTrans='o'><p>Background. Malnutrition increases mortality on the waiting list. Hydrothorax, renal dysfunction, MELD score >17 affect prognosis. Objective of the study. The case is 56 years old patient, cirrhosis, on the waiting list since 2017. Material and Methods. Investigated according to the LT protocol: biochemical analyzes, nasopharynx cultures, uroculture, hemoculture, pleural fluid, ascites; tumor markers, viral, autoimmune. Examined vital functions. Pulmonary CT: bilateral hydrothorax (D>S). Abdominal CT: ascites, splenomegaly, v. portae thrombosis, EDS- esophageal varices dgr II-III; HBV DNA 1 552 UI / ml, HDV RNA – 2 458 570 UI / ml. Results. Confirmed HBV /VHD HC, Child Pugh C (11 p). Hypersplenism dgr. II-III., MELD Na 20.7. Esophageal varices dgr II-III. Portal gastropathy. Recurrent hydrothorax. Thrombosis v. portae. Severe malnutrition BMI <18.5 portal enteropathy. Hyponatremia. LT from brain-dead donor, age <30 years, comorbidities abs. Rehabilitation period: Na+diminished, renal dysfunction, ascites, pseudomembranous colitis Cl. Difficile. Post-LT abdominal CT: stenosis v. portae, at anastomosis level, surgically resolved. Administered etiopathogenetic, immunosuppressive treatment adapted to disease features. 12 months post LT: absence of ascites, normal biochemical parameters, except creatinine 125 umoll, BMI –Conclusion. LT is the only treatment in the terminal stage. Postoperative evolution involves: age, nutritional status, renal dysfunction, viral infection, MELD score – receiver; age, quality of liver transplant – donor.</p></cfAbstr> <cfAbstr cfLangCode='RO' cfTrans='o'><p>Introducere. Malnutriția este una dintre cauzele mortalității pacienților din lista de așteptare. Hidrotoracele, disfuncția renală, scorul MELD >17 afectează prognosticul. Scopul lucrării. Se prezintă cazul pacientului cirotic, 56 de ani, pe lista de așteptare din 2017. Material și Metode. Investigat conform protocolului TH: analize biochimice, culturile nasofaringe, urocultura, hemocultura, lichidul pleural, ascitic; markerii tumorali, virali, autoimuni. Examinate funcțiile vitale. CT pulmonară: Hidrotorace bilateral (D>S). CT abdominală: ascită, splenomegalie, tromboza v. portae, EDS- varice esofagiene gr II-III; ADN VHB – 1 552 UI / ml, ARN VHD – 2 458 570 UI / ml. Rezultate. Diagnosticat CH VHB/VHD, st Child Pugh C (11 p). Hipersplenism gr. II-III., MELD Na 20.7. Varice esofagiene gr II-III. Gastropatie portală. Hidrotorace recidivant. Tromboza v. portae. Malnutriție severă IMC<18.5. Enteropatie portală. Hiponatriemie. TH donator în moarte cerebrală, <30 ani, comorbidități abs. Evoluția postoperatorie: Na+diminuat, disfuncție renală, ascită, colită pseudomembranoasă Cl. Difficile. CT abdominală post TH: stenoza v. portae, nivelul anastomozei, rezolvată chirurgical. Administrat tratament etiopatogenetic/ imunosupresiv, adaptat particularităților bolii. 12 luni post TH: absența ascitei, parametrii biochimici normali, IMC – 24.5, excepție creatinina – 125. Concluzii. TH este unicul tratament în stadiul terminal. Prognosticul și evoluția bolii implică: vârsta, statutul nutrițional, disfuncția renală, infecția virală, scorul MELD – recipient; vârsta, calitatea grefei hepatice – donator.</p></cfAbstr> <cfResPubl_Class> <cfClassId>eda2d9e9-34c5-11e1-b86c-0800200c9a66</cfClassId> <cfClassSchemeId>759af938-34ae-11e1-b86c-0800200c9a66</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> </cfResPubl_Class> <cfResPubl_Class> <cfClassId>e601872f-4b7e-4d88-929f-7df027b226c9</cfClassId> <cfClassSchemeId>40e90e2f-446d-460a-98e5-5dce57550c48</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> </cfResPubl_Class> <cfPers_ResPubl> <cfPersId>ibn-person-13440</cfPersId> <cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId> <cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> </cfPers_ResPubl> <cfPers_ResPubl> <cfPersId>ibn-person-11176</cfPersId> <cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId> <cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> </cfPers_ResPubl> <cfPers_ResPubl> <cfPersId>ibn-person-42616</cfPersId> <cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId> <cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> </cfPers_ResPubl> <cfPers_ResPubl> <cfPersId>ibn-person-13436</cfPersId> <cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId> <cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> </cfPers_ResPubl> <cfPers_ResPubl> <cfPersId>ibn-person-11473</cfPersId> <cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId> <cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> </cfPers_ResPubl> </cfResPubl> <cfPers> <cfPersId>ibn-Pers-13440</cfPersId> <cfPersName_Pers> <cfPersNameId>ibn-PersName-13440-2</cfPersNameId> <cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId> <cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> <cfFamilyNames>Таран</cfFamilyNames> <cfFirstNames>Наталья</cfFirstNames> </cfPersName_Pers> </cfPers> <cfPers> <cfPersId>ibn-Pers-11176</cfPersId> <cfPersName_Pers> <cfPersNameId>ibn-PersName-11176-2</cfPersNameId> <cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId> <cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> <cfFamilyNames>Hotineanu</cfFamilyNames> <cfFirstNames>Adrian</cfFirstNames> </cfPersName_Pers> </cfPers> <cfPers> <cfPersId>ibn-Pers-42616</cfPersId> <cfPersName_Pers> <cfPersNameId>ibn-PersName-42616-2</cfPersNameId> <cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId> <cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> <cfFamilyNames>Burgoci</cfFamilyNames> <cfFirstNames>Serghei</cfFirstNames> </cfPersName_Pers> </cfPers> <cfPers> <cfPersId>ibn-Pers-13436</cfPersId> <cfPersName_Pers> <cfPersNameId>ibn-PersName-13436-2</cfPersNameId> <cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId> <cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> <cfFamilyNames>Лупашко</cfFamilyNames> <cfFirstNames>Юлианна</cfFirstNames> </cfPersName_Pers> </cfPers> <cfPers> <cfPersId>ibn-Pers-11473</cfPersId> <cfPersName_Pers> <cfPersNameId>ibn-PersName-11473-2</cfPersNameId> <cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId> <cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId> <cfStartDate>2020T24:00:00</cfStartDate> <cfFamilyNames>Peltec</cfFamilyNames> <cfFirstNames>Angela</cfFirstNames> </cfPersName_Pers> </cfPers> </CERIF>