The potential impact of using donations after cardiac death on the liver transplantation program and waiting list in the state of Sao Paulo, Brazil

2008 ◽  
Vol 14 (12) ◽  
pp. 1732-1736 ◽  
Author(s):  
Eleazar Chaib ◽  
Eduardo Massad
Keyword(s):  
Liver Transplantation ◽  
Cardiac Death ◽  
Sao Paulo ◽  
The State ◽  
Waiting List ◽  
São Paulo ◽  
Transplantation Program ◽  
Potential Impact

scholarly journals Adoption of MELD score increases the number of liver transplant

2014 ◽  
Vol 27 (3) ◽  
pp. 201-203 ◽  
Author(s):  
Lucas Souto NACIF ◽  
Wellington ANDRAUS ◽  
Rodrigo Bronze MARTINO ◽  
Vinicius Rocha SANTOS ◽  
Rafael Soares PINHEIRO ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Survival Rates ◽  
Sao Paulo ◽  
Meld Score ◽  
The State ◽  
São Paulo ◽  
Liver Transplants ◽  
Mean Values ◽  
Before And After ◽  
End Stage

BACKGROUND: Liver transplantation is performed at large transplant centers worldwide as a therapeutic intervention for patients with end-stage liver diseases. AIM: To analyze the outcomes and incidence of liver transplantation performed at the University of São Paulo and to compare those with the State of São Paulo before and after adoption of the Model for End-Stage Liver Disease (MELD) score. METHOD: Evaluation of the number of liver transplantations before and after adoption of the MELD score. Mean values and standard deviations were used to analyze normally distributed variables. The incidence results were compared with those of the State of São Paulo. RESULTS: There was a high prevalence of male patients, with a predominance of middle-aged. The main indication for liver transplantation was hepatitis C cirrhosis. The mean and median survival rates and overall survival over ten and five years were similar between the groups (p>0.05). The MELD score increased over the course of the study period for patients who underwent liver transplantation (p>0.05). There were an increased number of liver transplants after adoption of the MELD score at this institution and in the State of São Paulo (p<0.001). CONCLUSION: The adoption of the MELD score led to increase the number of liver transplants performed in São Paulo.

scholarly journals The Impact of the Introduction of MELD on the Dynamics of the Liver Transplantation Waiting List in São Paulo, Brazil

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Eleazar Chaib ◽  
Eduardo Massad ◽  
Bruno Butturi Varone ◽  
Andre Leopoldino Bordini ◽  
Flavio Henrique Ferreira Galvão ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Deceased Donor ◽  
Sao Paulo ◽  
Meld Score ◽  
Waiting List ◽  
São Paulo ◽  
Clear Trend ◽  
Number Of Patients ◽  
Liver Transplantations ◽  
The Impact

Until July 15, 2006, the time on the waiting list was the main criterion for allocating deceased donor livers in the state of São Paulo, Brazil. After this date, MELD has been the basis for the allocation of deceased donor livers for adult transplantation. Our aim was to compare the waitlist dynamics before MELD (1997–2005) and after MELD (2006–2012) in our state. A retrospective study was conducted including the data from all the liver transplant candidate waiting lists from July 1997 to December 2012. The data were related to the actual number of liver transplantations (Tr), the incidence of new patients on the list (I), and the number of patients who died while being on the waitlist (D) from 1997 to 2005 (the pre-MELD era) and from 2006 to 2012 (the post-MELD era). The number of transplantations from 1997 to 2005 and from 2006 to 2012 increased nonlinearly, with a clear trend to levelling to equilibrium at approximately 350 and 500 cases per year, respectively. The implementation of the MELD score resulted in a shorter waiting time until liver transplantation. Additionally, there was a significant effect on the waitlist dynamics in the first 4 years; however, the curves diverge from there, implying a null long-range effect on the waitlist by the MELD scores.

scholarly journals Critical analysis of the allocation policy for liver transplantation in Brazil

2003 ◽  
Vol 58 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Hoel Sette Jr. ◽  
Telesforo Bacchella ◽  
Marcel Cerqueira César Machado
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Distributive Justice ◽  
Waiting Time ◽  
Sao Paulo ◽  
Waiting List ◽  
Third Party ◽  
São Paulo ◽  
Donor Pool ◽  
Number Of Patients

Liver transplantation is now the standard treatment for end-stage liver disease. Given the shortage of liver donors and the progressively higher number of patients waiting for transplantation, improvements in patient selection and optimization of timing for transplantation are needed. Several solutions have been suggested, including increasing the donor pool; a fair policy for allocation, not permitting variables such as age, gender, and race, or third-party payer status to play any role; and knowledge of the natural history of each liver disease for which transplantation is offered. To observe ethical rules and distributive justice (guarantee to every citizen the same opportunity to get an organ), the "sickest first" policy must be used. Studies have demonstrated that death has no relationship with waiting time, but rather with the severity of liver disease at the time of inclusion. Thus, waiting time is no longer part of the United Network for Organ Sharing distribution criteria. Waiting time only differentiates between equally severely diseased patients. The authors have analyzed the waiting list mortality and 1-year survival for patients of the State of São Paulo, from July 1997 through January 2001. Only the chronological criterion was used. According to "Secretaria de Estado da Saúde de São Paulo" data, among all waiting list deaths, 82.2% occurred within the first year, and 37.6% within the first 3 months following inclusion. The allocation of livers based on waiting time is neither fair nor ethical, impairs distributive justice and human rights, and does not occur in any other part of the world.

The Daily Routine of Students in the Classroom

2020 ◽  
Vol 8 (3) ◽  
pp. 157-163
Author(s):  
Lilian Marques Silva
Keyword(s):  
Elementary School ◽  
Public School ◽  
Data Collection ◽  
New Technologies ◽  
Sao Paulo ◽  
The State ◽  
Daily Routine ◽  
São Paulo ◽  
Access To Information ◽  
Technological Advances

The almost instantaneous access to information provided by technological advances has revolutionized the behavior of people and of the classrooms too. Teachers had to adapt themselves to new technologies to maintain students interested and attentive to the discipline being taught. In this work, the behavior of the students of the 6th grade of elementary school II during class was observed. The school chosen is a public school in the State of São Paulo (Brazil). The research was based on data collection. The students were observed by being filmed during six months. The results showed that the students were interested in the classes and committed to the activities. The place that the student chooses to sit in the classroom influences the behavior of the teacher, because the more distant the teacher, the less he participates in the class.

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