RESUMEN
BACKGROUND: Protocol endoscopy with biopsy is currently the gold standard of small bowel transplantation (SBTx) monitoring, however it is invasive, costly, needs skilled operator, may require anesthesia and may cause complications. We investigated fecal calprotectin level (FCL) as a candidate noninvasive marker for monitoring patients after SBTx. METHODS: A pilot study was performed to test the use of FCL measurement in following up SBTx patients. Ileostomy effluents were collected at various postoperative days before endoscopy and biopsy. FCLs were measured by enzyme-linked immunosorbent assay and a cut-off level of 100 ng/mg was considered positive. The results were retrospectively evaluated in combination with clinical, endoscopic, and histopathological findings. FCLs are presented as median nanogram per milligram. RESULTS: FCLs were measured in 122 samples that were obtained from 29 patients after SBTx. Only 1 of 69 positive FCL did not accompany abnormal findings. Retrospective evaluation showed that 11 samples from six patients (FCL: 217) coincided with rejection episodes, six samples from three patients (FCL: 125) coincided with viral enteritis, 51 samples from 21 patients (FCL: 207) coincided with nonspecific inflammation, 11 samples from two patients (FCL: 998) coincided with chronic intestinal ulceration, and finally 50 samples from 19 patients (FCL: 43) coincided with normal findings. No significant FCL difference was found between rejection, infection, and inflammation. FCL evolution in individuals showed that FCL can predict rejection days before histopathological diagnosis. CONCLUSION: FCL is a sensitive test for ongoing organic intestinal allograft pathologies. It might be useful as prescreening marker to avoid unnecessary endoscopies.
Asunto(s)
Heces/química , Intestino Delgado/trasplante , Complejo de Antígeno L1 de Leucocito/análisis , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Ileostomía , Monitoreo Fisiológico/métodos , Proyectos Piloto , Estudios Retrospectivos , Trasplante Homólogo/mortalidad , Trasplante Homólogo/fisiología , Resultado del TratamientoRESUMEN
A pacientes diagnosticados de Enfermedad de Chagas por estudios en el Laboratorio de Inmunología e Histocompatibilidad del H. Carlos Andrade Marín, con cambios electrocardiográficos con onda "Q" significativa, y coronariografía normal, en el Laboratorio de Medicina Nuclear se les efectuó estudios de perfusión con radiotrazadores: Talio 201 y ventriculografíaradioisotópica con Tecnecio 99m Ultratag RBG. Se xomprobó la existencia de alteraciones en la perfusión con cambios negativos en la movilidad de los segmentos afectados que producen disminución de la Fracción de eyección global y segmentaria.