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Article ; Online: Spatial analysis of care for patients undergoing dialysis therapy in the state of Minas Gerais, Brazil, between 2015 and 2019.

Pereira, Claudio Vitorino / Leite, Isabel Cristina Gonçalves / Nogueira, Mário Círio / Ferreira, Gustavo Fernandes

Revista brasileira de epidemiologia = Brazilian journal of epidemiology

2024 Volume 27, Page(s) e240002

Abstract: Objective: To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais.: Methods: Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic ... ...

Abstract	Objective: To analyze the spatial flow of care for patients undergoing dialysis therapy in the health regions of the State of Minas Gerais. Methods: Ecological study whose population was patients undergoing dialysis therapy in public, philanthropic institutions or whose treatment was paid for by the Unified Health System in private clinics in partnership, in the State of Minas Gerais. Patients were grouped by health region of residence. The proportions of patients who underwent dialysis were calculated, as well as enrollment on the kidney transplant list in their own region of residence or outside it. Person correlations of these proportions with socioeconomic and care indicators of the health regions were estimated. Spatial exploratory techniques estimated general (Moran's I) and local (LISA) spatial correlation coefficients. Results: Regions with higher GDP had a higher number of nephrologists and a higher proportion of registrations in the region of residence. A cluster of regions with low GDP was identified further to the northeast of the State (also with lower nephrologist ratio values), a cluster with a high proportion of those registered on the transplant list in the center of the State, and a cluster with a low proportion of dialysis in the same region of residence further southeast. Conclusion: Regional disparities were evident in relation to the proportion of patients registered on the waiting list for kidney transplantation, the proportion of patients undergoing dialysis in the same region of residence and the proportion of patients registered on the waiting list for kidney transplantation in the same region of residence. residence.
MeSH term(s)	Humans ; Brazil ; Renal Dialysis ; Spatial Analysis ; Healthcare Disparities ; Regional Health Planning ; Renal Insufficiency, Chronic/therapy
Language	Portuguese
Publishing date	2024-01-19
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2183366-7
ISSN	1980-5497 ; 1980-5497
ISSN (online)	1980-5497
ISSN	1980-5497
DOI	10.1590/1980-549720240002
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Article ; Online: Global Perspective on Kidney Transplantation: Brazil.

Cristelli, Marina Pontello / Ferreira, Gustavo Fernandes / Medina-Pestana, José

Kidney360

2021 Volume 2, Issue 12, Page(s) 2016–2018

MeSH term(s)	Brazil/epidemiology ; Graft Survival ; Immunosuppressive Agents ; Kidney Transplantation
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2021-10-07
Publishing country	United States
Document type	Journal Article
ISSN	2641-7650
ISSN (online)	2641-7650
DOI	10.34067/KID.0003612021
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Article ; Online: The effect of population mobility restrictive measures on the incidence of SARS-CoV-2 infection in the early phase of the pandemic

Modelli de Andrade, Luis Gustavo / Ferreira, Gustavo Fernandes / Tedesco Silva, Helio

medRxiv

Abstract: Background: This analysis aims to assess the association between population restrictive measures and the cumulative number of confirmed COVID-19 cases in the early phase of pandemic. Methods: We compared mobility data extracted from the Mobility Reports ... ...

Abstract	Background: This analysis aims to assess the association between population restrictive measures and the cumulative number of confirmed COVID-19 cases in the early phase of pandemic. Methods: We compared mobility data extracted from the Mobility Reports provided by Google with the cumulative number of confirmed cases of COVID-19 of 15 countries provided by John Hopkins University. We compared the number of confirmed COVID-19 cases before and after the peak effect (PE) of population mobility restrictions in each country, defined as the highest percent reduction in mobility measurements. Results: Time to PE of population mobility restrictions ranged between 16 and 45 days after the report of the index COVID-19 confirmed case in each country. The most frequent reductions in activities were retail & recreation, parks, and transit & stations, ranging from 30% to 90%. Despite this variability in PE among the countries, the predicted smooth effect after the PE of population mobility restrictions was observed in almost all countries. Conclusions: These data suggest that the reduction in mobility was associated with a decrease in the cumulative total number of COVI-19 cases in each country, underscoring that the use of widely available real-time surveillance data might be a valuable resource during this pandemic
Keywords	covid19
Language	English
Publishing date	2021-04-19
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.04.13.21255382
Database	COVID19

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Article ; Online: A machine learning prediction model for waiting time to kidney transplant.

Sapiertein Silva, Juliana Feiman / Ferreira, Gustavo Fernandes / Perosa, Marcelo / Nga, Hong Si / de Andrade, Luis Gustavo Modelli

PloS one

2021 Volume 16, Issue 5, Page(s) e0252069

Abstract: Background: Predicting waiting time for a deceased donor kidney transplant can help patients and clinicians to discuss management and contribute to a more efficient use of resources. This study aimed at developing a predictor model to estimate time on a ...

Abstract	Background: Predicting waiting time for a deceased donor kidney transplant can help patients and clinicians to discuss management and contribute to a more efficient use of resources. This study aimed at developing a predictor model to estimate time on a kidney transplant waiting list using a machine learning approach. Methods: A retrospective cohort study including data of patients registered, between January 1, 2000 and December 31, 2017, in the waiting list of São Paulo State Organ Allocation System (SP-OAS) /Brazil. Data were randomly divided into two groups: 75% for training and 25% for testing. A Cox regression model was fitted with deceased donor transplant as the outcome. Sensitivity analyses were performed using different Cox models. Cox hazard ratios were used to develop the risk-prediction equations. Results: Of 54,055 records retrieved, 48,153 registries were included in the final analysis. During the study period, approximately 1/3 of the patients were transplanted with a deceased donor. The major characteristics associated with changes in the likelihood of transplantation were age, subregion, cPRA, and frequency of HLA-DR, -B and -A. The model developed was able to predict waiting time with good agreement in internal validation (c-index = 0.70). Conclusion: The kidney transplant waiting time calculator developed shows good predictive performance and provides information that may be valuable in assisting candidates and their providers. Moreover, it can significantly improve the use of economic resources and the management of patient care before transplant.
MeSH term(s)	Adolescent ; Adult ; Brazil/epidemiology ; Humans ; Kidney Failure, Chronic/epidemiology ; Kidney Failure, Chronic/therapy ; Kidney Transplantation/standards ; Machine Learning ; Male ; Middle Aged ; Registries ; Tissue Donors/statistics & numerical data ; Tissue and Organ Procurement/statistics & numerical data ; Waiting Lists ; Young Adult
Language	English
Publishing date	2021-05-20
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0252069
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Article: Impact of the COVID-19 Pandemic on Solid Organ Transplant and Rejection Episodes in Brazil's Unified Healthcare System.

de Andrade, Luis Gustavo Modelli / Barbosa, Abner Macola Pacheco / da Rocha, Naila Camila / de Almeida Cardoso, Marilia Mastrocolla / de Almeida, Juliana Tereza Coneglian / Machado-Rugolo, Juliana / Arantes, Lucas Frederico / Pontes, Daniela Ferreira Salomão / Ferreira, Gustavo Fernandes

Journal of clinical medicine

2022 Volume 11, Issue 21

Abstract: Background: Brazil has the world's largest public organ transplant program, which was severely affected by the COVID-19 pandemic. The primary aim of the study was to evaluate differences in solid organ transplants and rejection episodes during the COVID- ...

Abstract	Background: Brazil has the world's largest public organ transplant program, which was severely affected by the COVID-19 pandemic. The primary aim of the study was to evaluate differences in solid organ transplants and rejection episodes during the COVID-19 pandemic compared to the five years before the pandemic in the country. Methods: A seven-year database was built by downloading data from the DATASUS server. The pandemic period was defined as March 2020 to December 2021. The pre-pandemic period was from January 2015 to March 2020. Results: During the pandemic, the number of solid organ transplants decreased by 19.3% in 2020 and 22.6% in 2021 compared to 2019. We found a decrease for each evaluated organ, which was more pronounced for lung, pancreas, and kidney transplants. The seasonal plot of rejection data indicated a high rejection rate between 2018 and 2021. There was also an 18% (IRR 1.18 (95% CI 1.01 to 1.37), Conclusions: The total number of organ transplants performed in 2021 represents a setback of six years. Transplant procedures were concentrated in the Southeast region of the country, and a higher proportion of rejections occurred during the pandemic. Together, these findings could have an impact on transplant procedures and outcomes in Brazil.
Language	English
Publishing date	2022-11-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11216581
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Article: Living unrelated kidney donors: ethical aspects of living kidney donation in Brazil.

Ferreira, Gustavo Fernandes / Guedes, Clarissa Diniz

Indian journal of medical ethics

2011 Volume 8, Issue 2, Page(s) 112–114

Abstract: Brazil has established the largest public kidney transplantation system in the world .46.2% of transplants in 2008 came from living donors. The vast majority of these involved relatives of the recipient; less than 8% came from unrelated donors. In 2008, ... ...

Abstract	Brazil has established the largest public kidney transplantation system in the world .46.2% of transplants in 2008 came from living donors. The vast majority of these involved relatives of the recipient; less than 8% came from unrelated donors. In 2008, Brazil's health minister proposed banning unrelated donors in kidney transplantation. A large number of the over 35,000 Brazilians on the waiting list for a kidney would be denied a transplant without the use of unrelated donors. Brazilian culture has a unique feature, the "informal family", that is not legally recognised as a "family entity and is bound by affection rather than genetic or legal ties. It is vital that Brazil establishes a regulated, standardised, and ethical system of organ procurement; creates awareness about transplantation in physicians and the public; upgrades facilities and standardises medical care, and enforces legislation for transplantation. However, outlawing the use of unrelated donors would result in injustice for many patients who seek kidneys.
MeSH term(s)	Brazil ; Health Care Sector/ethics ; Health Care Sector/legislation & jurisprudence ; Humans ; Kidney Transplantation/ethics ; Living Donors/ethics ; Living Donors/legislation & jurisprudence ; Tissue and Organ Procurement/ethics ; Tissue and Organ Procurement/legislation & jurisprudence
Language	English
Publishing date	2011-04
Publishing country	India
Document type	Journal Article
ISSN	0974-8466
ISSN	0974-8466
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Article ; Online: Excesso de peso em portadores de doença renal crônica candidatos a transplante renal = Overweight in chronic renal disease patients candidates for kidney transplantation

Vanelli, Chislene Pereira / Freitas, Elaine Barbeta de / Bastos, Kamille Vidon / Ferreira, Gustavo Fernandes

Ciência & Saúde, Vol 10, Iss 3, Pp 127-

2017 Volume 132

Abstract: Objetivo: Descrever aspectos do perfil clínico e nutricional da população atendida no processo de triagem de candidatos a transplante renal. Materiais e Métodos: Estudo de caráter descritivo retrospectivo, realizado no período de fevereiro/2012 a ... ...

Abstract	Objetivo: Descrever aspectos do perfil clínico e nutricional da população atendida no processo de triagem de candidatos a transplante renal. Materiais e Métodos: Estudo de caráter descritivo retrospectivo, realizado no período de fevereiro/2012 a dezembro/2013 no Ambulatório de Triagem Multidisciplinar Pré-transplante da Santa Casa de Misericórdia de Juiz de Fora (MG/Brasil). Foram avaliados 410 indivíduos candidatos a inscrição em lista de espera para transplante renal, maiores de 18 anos de idade, clinicamente estáveis, com função renal inferior a 15mL/min e/ou em programa de terapia renal substitutiva. Resultados: Nefroesclerose hipertensiva foi a principal etiologia da doença renal. Excesso de peso foi observado em 46,6% da amostra e 51,0% apresentava síndrome metabólica. O índice de massa corporal foi maior em indivíduos com o transplante renal contraindicado. Obesidade abdominal foi encontrada em 71,3% das mulheres. Valores de albumina e creatinina estiveram mais elevados em pacientes que tiveram o transplante renal efetivado. Conclusão: O excesso de peso, presente em aproximadamente metade da amostra, se mostrou como um fator que pode dificultar a efetividade do transplante renal, pois no presente estudo indivíduos com obesidade foram menos transplantados quando comparados aqueles eutróficos
Keywords	nefrologia ; rins - transplante ; obesidade ; medicina ; Public aspects of medicine ; RA1-1270
Language	Portuguese
Publishing date	2017-01-01T00:00:00Z
Publisher	Editora da Pontifícia Universidade Católica do Rio Grande do Sul - EDIPUCRS
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Mycophenolate-based Immunosuppressive Regimen Is Associated With Increased Mortality in Kidney Transplant Patients With COVID-19.

Requião-Moura, Lúcio R / Modelli de Andrade, Luís Gustavo / de Sandes-Freitas, Tainá Veras / Cristelli, Marina Pontello / Viana, Laila Almeida / Nakamura, Mônica Rika / Garcia, Valter Duro / Manfro, Roberto Ceratti / Simão, Denise Rodrigues / Almeida, Ricardo Augusto Monteiro de Barros / Ferreira, Gustavo Fernandes / Costa, Kellen Micheline Alves Henrique / de Lima, Paula Roberta / Pacheco-Silva, Alvaro / Charpiot, Ida Maria Maximina Fernandes / Deboni, Luciane Mônica / Ferreira, Teresa Cristina Alves / Mazzali, Marilda / Calazans, Carlos Alberto Chalabi /

Oriá, Reinaldo Barreto / Tedesco-Silva, Hélio / Medina-Pestana, José

Transplantation

2022 Volume 106, Issue 10, Page(s) e441–e451

Abstract: Background: The chronic use of immunosuppressive drugs is a key risk factor of death because of coronavirus disease 2019 (COVID-19) in kidney transplant recipients (KTRs), although no evident association between the class of immunosuppressive and ... ...

Abstract	Background: The chronic use of immunosuppressive drugs is a key risk factor of death because of coronavirus disease 2019 (COVID-19) in kidney transplant recipients (KTRs), although no evident association between the class of immunosuppressive and outcomes has been observed. Thus, we aimed to compare COVID-19-associated outcomes among KTRs receiving 3 different immunosuppressive maintenance regimes. Methods: This study included data from 1833 KTRs with COVID-19 diagnosed between March 20 and April 21 extracted from the national registry before immunization. All patients were taking calcineurin inhibitor associated with mycophenolate acid (MPA, n = 1258), azathioprine (AZA, n = 389), or mammalian targets of rapamycin inhibitors (mTORi, n = 186). Outcomes within 30 and 90 d were assessed. Results: Compared with patients receiving MPA, the 30-d (79.9% versus 87.9% versus 89.2%; P < 0.0001) and 90-d (75% versus 83.5% versus 88.2%; P < 0.0001) unadjusted patient survivals were higher in those receiving AZA or mTORi, respectively. Using adjusted multivariable Cox regression, compared with patients receiving AZA, the use of MPA was associated with a higher risk of death within 30 d (adjusted hazard ratio [aHR], 1.70; 95% confidence interval [CI], 1.21-2.40; P = 0.003), which was not observed in patients using mTORi (aHR, 0.78; 95% CI, 0.45-1.35; P = 0.365). At 90 d, although higher risk of death was confirmed in patients receiving MPA (aHR, 1.46; 95% CI, 1.09-1.98; P = 0.013), a reduced risk was observed in patients receiving mTORi (aHR, 0.59; 95% CI, 0.35-0.97; P = 0.04) compared with AZA. Conclusions: This national cohort data suggest that, in KTRs receiving calcineurin inhibitor and diagnosed with COVID-19, the use of MPA was associated with higher risk of death, whereas mTORi use was associated with lower risk of death.
MeSH term(s)	Azathioprine ; COVID-19 ; Calcineurin Inhibitors/adverse effects ; Enzyme Inhibitors ; Humans ; Immunosuppressive Agents/adverse effects ; Kidney Transplantation/adverse effects ; Mycophenolic Acid/adverse effects ; Sirolimus/adverse effects ; TOR Serine-Threonine Kinases
Chemical Substances	Calcineurin Inhibitors ; Enzyme Inhibitors ; Immunosuppressive Agents ; TOR Serine-Threonine Kinases (EC 2.7.11.1) ; Mycophenolic Acid (HU9DX48N0T) ; Azathioprine (MRK240IY2L) ; Sirolimus (W36ZG6FT64)
Language	English
Publishing date	2022-06-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000004251
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Article ; Online: Distinct Outcomes of Kidney Transplant Recipients With Recent COVID-19 According to the Timing of Infection.

Manfro, Arthur Gus / de Sandes-Freitas, Tainá Veras / Garcia, Valter Duro / Keitel, Elizete / Cristelli, Marina Pontello / Viana, Laila Almeida / Ferreira, Gustavo Fernandes / Campos, Juliana Bastos / Simão, Denise Rodrigues / Coelho, Maria Eduarda Heinzen de Almeida / Costa, Kellen Micheline Alves Henrique / Pereira Júnior, Tomás / Moschetta, Marina Oliboni / Baptista, Maria Alice Sperto Ferreira / Simões, Marcela Giraldes / Kroth, Leonardo Viliano / Deboni, Luciane Monica / Esmeraldo, Ronaldo de Matos / Medina-Pestana, Jose Osmar /

Manfro, Roberto Ceratti

Transplantation

2022 Volume 106, Issue 9, Page(s) e416–e417

MeSH term(s)	COVID-19 ; Humans ; Kidney Transplantation/adverse effects ; SARS-CoV-2 ; Transplant Recipients
Language	English
Publishing date	2022-06-01
Publishing country	United States
Document type	Letter
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000004218
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Article ; Online: Temporal Reduction in COVID-19-Associated Fatality Among Kidney Transplant Recipients: The Brazilian COVID-19 Registry Cohort Study.

de Sandes-Freitas, Tainá Veras / Cristelli, Marina Pontello / Requião-Moura, Lucio Roberto / Modelli de Andrade, Luís Gustavo / Viana, Laila Almeida / Garcia, Valter Duro / de Oliveira, Claudia Maria Costa / Esmeraldo, Ronaldo de Matos / de Lima, Paula Roberta / Charpiot, Ida Maria Maximina Fernandes / Ferreira, Teresa Cristina Alves / Franco, Rodrigo Fontanive / Costa, Kellen Micheline Alves Henrique / Simão, Denise Rodrigues / Ferreira, Gustavo Fernandes / Santana, Viviane Brandão Bandeira de Mello / Almeida, Ricardo Augusto Monteiro de Barros / Deboni, Luciane Monica / Saldanha, Anita Leme da Rocha /

Noronha, Irene de Lourdes / de Oliveira, Lívia Cláudio / de Carvalho, Deise De Boni Monteiro / Oriá, Reinaldo Barreto / Medina-Pestana, Jose Osmar / Tedesco-Silva Junior, Helio

Transplant international : official journal of the European Society for Organ Transplantation

2022 Volume 35, Page(s) 10205

Abstract: Data from the general population suggest that fatality rates declined during the course of the pandemic. This analysis, using data extracted from the Brazilian Kidney Transplant COVID-19 Registry, seeks to determine fatality rates over time since the ... ...

Abstract	Data from the general population suggest that fatality rates declined during the course of the pandemic. This analysis, using data extracted from the Brazilian Kidney Transplant COVID-19 Registry, seeks to determine fatality rates over time since the index case on March 3rd, 2020. Data from hospitalized patients with RT-PCR positive SARS-CoV-2 infection from March to August 2020 (35 sites, 878 patients) were compared using trend tests according to quartiles (Q1: <72 days; Q2: 72-104 days; Q3: 105-140 days; Q4: >140 days after the index case). The 28-day fatality decreased from 29.5% (Q1) to 18.8% (Q4) (
MeSH term(s)	COVID-19 ; Cohort Studies ; Humans ; Kidney Transplantation/adverse effects ; Registries ; SARS-CoV-2 ; Transplant Recipients
Language	English
Publishing date	2022-02-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	639435-8
ISSN	1432-2277 ; 0934-0874
ISSN (online)	1432-2277
ISSN	0934-0874
DOI	10.3389/ti.2022.10205
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