Person: Loinaz Segurola, Carmelo
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First Name
Carmelo
Last Name
Loinaz Segurola
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Cirugía
Area
Cirugía
Identifiers
6 results
Search Results
Now showing 1 - 6 of 6
Item Trasplante hepático como tratamiento de la polineuropatía amiloidótica familiar en pacientes mayores de 60 años.(Medicina Clínica, 2015) Marcacuzco Quinto, Alberto Alejandro; Manrique Municio, Alejandro; Jiménez Romero, Luis Carlos; Loinaz Segurola, Carmelo; Calvo Pulido, Jorge; Justo Alonso, Iago; García-Sesma Pérez-Fuentes, Álvaro; Abradelo De Usera, Manuel; Cambra Molero, Félix; Caso Maestro, Óscar; Moreno González, EnriqueFundamento y objetivo La polineuropatía amiloidótica familiar (PAF) constituye el tipo más prevalente de amiloidosis sistémica hereditaria. Es una enfermedad autosómica dominante que se caracteriza por el depósito de una variante anómala de la transtiretina. Tiene una distribución mundial, con zonas endémicas localizadas en Portugal, Suecia y Japón. En España hay un foco endémico, localizado en Mallorca. El trasplante hepático es la única opción curativa para los pacientes con PAF. El objetivo de este estudio fue describir las características clínicas y demográficas de los pacientes trasplantados con diagnóstico de PAF. Material y método Se evaluaron 6 pacientes trasplantados por PAF entre abril de 1986 y diciembre de 2012. Resultados La edad media fue de 57,7+16 años, los pacientes de origen español eran mayores de 60 años. Todos los pacientes presentaban síntomas progresivos en forma de polineuropatía mixta. En 2 pacientes se realizó un doble trasplante hepatocardiaco secuencial, efectuándose en primer lugar el trasplante hepático. La supervivencia del paciente y del injerto fue del 80% a los uno, 3 y 5 años. Conclusiones El único tratamiento etiológico eficaz para la PAF es el trasplante hepático. Una detección temprana es la clave para el tratamiento y el control, evitándose el daño orgánico irreversible.Item Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over(World Journal of Gastroenterology, 2018) Caso Maestro, Óscar; Jiménez Romero, Luis Carlos; Justo Alonso, Iago; Calvo Pulido, Jorge; Lora Pablos, David; Marcacuzco Quinto, Alberto Alejandro; Cambra Molero, Félix; García-Sesma Pérez-Fuentes, Álvaro; Pérez Flecha, Marina; Muñoz Arce, Carlos; Loinaz Segurola, Carmelo; Manrique Municio, AlejandroAIM To increase the number of available grafts. METHODS This is a single-center comparative analysis performed between April 1986 and May 2016. Two hundred and twelve liver transplantation (LT) were performed with donors ≥ 70 years old (study group). Then, we selected the first cases that were performed with donors < 70 years old immediately after the ones that were performed with donors ≥ 70 years old (control group). RESULTS Graft and patient survivals were similar between both groups without increasing the risk of complications, especially primary non-function, vascular complications and biliary complications. We identified 5 risk factors as independent predictors of graft survival: recipient hepatitis C virus (HCV)-positivity [hazard ratio (HR) = 2.35; 95% confidence interval (CI): 1.55-3.56; P = 0.00]; recipient age (HR = 1.04; 95%CI: 1.02-1.06; P = 0.00); donor age X model for end-stage liver disease (D-MELD) (HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); donor value of serum glutamic-pyruvic transaminase (HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); and donor value of serum sodium (HR = 0.96; 95%CI: 0.94-0.99; P = 0.00). After combining D-MELD and recipient age we obtained a new scoring system that we called DR-MELD (donor age X recipient age X MELD). Graft survival significantly decreased in patients with a DR-MELD score ≥ 75000, especially in HCV patients (77% vs 63% at 5 years in HCV-negative patients, P = 0.00; and 61% vs 25% at 5 years in HCV-positive patients; P = 0.00).Item Trasplante hepático como tratamiento de la polineuropatía amiloidótica familiar en pacientes mayores de 60 años(Medicina Clínica, 2015) Marcacuzco Quinto, Alberto Alejandro; Manrique Municio, Alejandro; Jiménez Romero, Luis Carlos; Loinaz Segurola, Carmelo; Calvo Pulido, Jorge; Justo Alonso, Iago; García-Sesma Pérez-Fuentes, Álvaro; Abradelo De Usera, Manuel; Cambra Molero, Félix; Caso Maestro, Óscar; Moreno González, EnriqueBackground and objective: Familial amyloid polyneuropathy (FAP) is the most prevalent type of hereditary systemic amyloidosis. It is an autosomal dominant disease characterized by the deposition of an abnormal variant transthyretin. It has a worldwide distribution, with localized endemic areas in Portugal, Sweden and Japan. In Spain there is an endemic focus, located in Mallorca. Liver transplantation is the only curative option for patients with FAP. The aim of this study was to describe the clinical and demographic characteristics of patients transplanted with a diagnosis of PAF. Material and method: Six patients with PAF underwent liver transplantation between April 1986 and December 2012. Results: The mean age was 57.7+16 years, patients of Spanish origin were older than 60 years. All patients had progressive symptoms as mixed polyneuropathy. In 2 patients, combined heart-liver transplants sequentially were performed. Patient survival and graft was 80% at one, 3 and 5 years. Conclusions: The only effective treatment for etiologic PAF is liver transplantation. Early detection is the key to the treatment and control, avoiding the irreversible organ damage.Item Innate Lymphoid cells groups 1 and 3 in the epitelial compartment of functional human intestinal allografts(American Journal of transplantation, 2016) Talayero, Paloma; Mancebo Sierra, María Esther; Calvo Pulido, Jorge; Rodríguez Muñoz, Sarbelio; Bernardo, I.; Laguna Goya, Rocio; Cano Romero, Francisco; García-Sesma Pérez-Fuentes, Álvaro; Loinaz Segurola, Carmelo; Jiménez Romero, Luis Carlos; Justo Alonso, Iago; Paz Artal, Estela NatividadWe examined intraepithelial lymphocytes (IELs) in 213 ileal biopsies from 16 bowel grafts and compared them with 32 biopsies from native intestines. During the first year posttransplantation, grafts exhibited low levels of IELs (percentage of CD103(+) cells) principally due to reduced CD3(+) CD8(+) cells, while CD103(+) CD3(-) cell numbers became significantly higher. Changes in IEL subsets did not correlate with histology results, isolated intestine, or multivisceral transplants, but CD3(-) IELs were significantly higher in patients receiving corticosteroids. Compared with controls, more CD3(-) IELs of the grafts expressed CD56, NKp44, interleukin (IL)-23 receptor, retinoid-related orphan receptor gamma t (RORγt), and CCR6. No difference was observed in granzyme B, and CD3(-) CD127(+) cells were more abundant in native intestines. Ex vivo, and after in vitro activation, CD3(-) IELs in grafts produced significantly more interferon (IFN)-γ and IL-22, and a double IFNγ(+) IL-22(+) population was observed. Epithelial cell-depleted grafts IELs were cytotoxic, whereas this was not observed in controls. In conclusion, different from native intestines, a CD3(-) IEL subset predominates in grafts, showing features of natural killer cells and intraepithelial ILC1 (CD56(+) , NKp44(+) , CCR6(+) , CD127(-) , cytotoxicity, and IFNγ secretion), ILC3 (CD56(+) , NKp44(+) , IL-23R(+) , CCR6(+) , RORγt(+) , and IL-22 secretion), and intermediate ILC1-ILC3 phenotypes (IFNγ(+) IL-22(+) ). Viability of intestinal grafts may depend on the balance among proinflammatory and homeostatic roles of ILC subsets.Item Trasplante hepático en pacientes con antigeno de superficie del virus B de la hepatitis : Estudio clínico y urológico(2002) Loinaz Segurola, Carmelo; Moreno González, EnriqueLos objetivos de este trabajo son documentar el curso evolutivo de los pacientes trasplantados con hbsag+, ver el efecto de los fármacos antivirales y la inmunoprofilaxis, de otros factores como configuración genética, coinfección, alcohol, valorar los métodos diagnósticos utilizados y comparar los resultados con otros grupos de indicaciones. Para ello contamos con 19 pacientes hbsag+ en los que se realizan 21 trasplantes, 7 de ellos con hbeag+. Cinco tratados preoperatoriamente con interferón y 2 después del trasplante. Los resultados obtenidos permiten afirmar que estos pacientes se pueden beneficiar del trasplante hepático, sin que haya diferencias significativas en cuanto a supervivencia con otros grupos de pacientes, siendo importante la selección pretrasplante, la utilización de antivirales y gammaglobulina antihepatitis b. Las técnicas de diagnostico de infección viral deben ser sensibles (pcr, hibridación). La coinfección empeora el pronóstico y el abandono de hábitos tóxicos puede mejorarlo.Item Sinusoidal obstruction syndrome after liver transplantation: A multicenter observational study(Liver Transplantation, 2022) Caballero Marcos, Aránzazu; Peligros, Isabel; Pérez Rojas, Judith; Campos Varela, Isabel; Colmenero, Jordi; Gómez Bravo, Miguel Ángel; Justo Alonso, Iago; Otero, Alejandra; Molina Pérez, Esther; González Diéguez, Luisa; Baliellas, Carme; Romero Cristobal, Mario; Aguilera, Victoria; Castells, Lluís; Díaz, Alba; Marín Gómez, Luis Miguel; Loinaz Segurola, Carmelo; Bañares Cañizares, Rafael; Salcedo, MagdalenaDiagnosis of sinusoidal obstruction syndrome (SOS) after hematopoietic cell transplantation (HCT) is based on clinical criteria including weight gain, ascites, hepatomegaly, and jaundice.[1] However, clinical and histological features and prognosis of SOS after liver transplantation (LT) seem to differ from SOS after HCT.[2, 3] We aimed to determine the characteristics and outcomes of SOS after LT.