Banca de DEFESA: GIOVANNA KARINNY PEREIRA CRUZ

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : GIOVANNA KARINNY PEREIRA CRUZ
DATE: 14/02/2020
TIME: 14:00
LOCAL: Departamento de Enfermagem
TITLE:

Corneal donation-transplantation process: predictors of corneane tissue quality and graft failure.

KEY WORDS:

Corneal transplantation; Free Tissue Flaps; Corneal diseases; Graft Rejection; Epidemiology.

PAGES: 220
BIG AREA: Ciências da Saúde
AREA: Enfermagem
SUMMARY:

The objective of this study was to identify the factors inherent to the donation-transplantation process, the predictors of the quality of the corneal tissue captured and the cases of post-transplant graft failure in a reference service in the state of Rio Grande do Norte (RN). This is an epidemiological study with a quantitative approach, consisting of two steps. The first consisted of a retrospective, longitudinal, descriptive and analytical cohort study that addressed the process of corneal uptake by the Human Ocular Tissue Bank (BTOH) until transplantation was performed. The second stage corresponded to a hospital-based, longitudinal, descriptive and analytical case-control study, which included transplanted patients with corneal graft failure from a newborn reference service. For the cohort study sample, the corneas processed by the newborn BTOH (n = 419) were considered in order to identify the predictors of the quality of the donated corneas. The case-control study sample consisted of patients transplanted with corneal tissue who developed graft failure after transplantation (n = 27 cases and 54 controls). The study was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, under opinion No. 2,454,077 and CAAE 80007117.8.0000.5537. Data were collected in their entirety from January to October 2018 and organized into spreadsheets for descriptive and inferential analysis procedures. For descriptive analysis, the Statistical Package for Social Sciences (SPSS), version 25.0 software was used. The description of the variables and their distribution patterns were presented by frequencies and measures of central tendency, while for multivariate analysis measures of magnitude of effect (odds ratio and relative risk) and association measures (chi-square or exact test) were applied. Fisher) to a significance level of 0.05. Logistic regression analysis was used to adjust the final model. The results were presented in two chapters referring to the cohort and case-control studies, entitled respectively: “the donation process and corneal tissue quality” and “the donation-transplantation process and corneal graft failure”. Regarding corneal donors (cohort / n = 419), it was found that the epidemiological profile showed a prevalence of individuals with a mean age of 42.53 years, male (73.99%), living in the state capital and region. metropolitan area (45.35%). The main cause of death was associated with the pathophysiological mechanism of cardiorespiratory arrest (86.4%). Regarding the chronological variables of the donation process, the following means were obtained: death-enucleation (5 hours and 33 minutes), death-preservation (7 hours and 43 minutes) and enucleation-preservation (2 hours and 9 minutes). Of the donated corneas 17.18% were discarded due to expiration date. The quality of the corneal tissue evaluated by slit lamp presented excellent (1.91%), good (51.79%), fair (20.29%) and poor (26.01%) final ratings. The clinical profile of patients undergoing corneal transplantation in the case-control study was characterized by male subjects (50.62%), with an overall mean age of 52.31 years (cases: 56.15 years; control: 50, 39 years old). The average time since tissue immersion in preservation medium and transplantation was 9.46 days. The variable corneal quality in the comparison between groups was excellent / good (cases: 59.26% versus controls: 79.63%) and fair / poor (cases: 40.74% versus controls: 20.37%). ). Corneal graft failure showed a statistically significant relationship with the variables: donor corneal button size, donor-recipient button size difference, cause of death, stromal disturbances, and time between enucleation and death. The identification of the inherent variables in the donation-transplantation process that may interfere with the survival of the corneal tissue after transplantation in a particular service requires proper investigation, due to the growing rate of corneal transplants performed each year worldwide and because they are treated. of a procedure that involves risks of failure.

BANKING MEMBERS:
Interna - 1552864 - ALLYNE FORTES VITOR
Externa à Instituição - ELEN FERRAZ TESTON - UFMS
Presidente - 1352508 - MARCOS ANTONIO FERREIRA JUNIOR
Externo à Instituição - OLECI PEREIRA FROTA - UFMS
Interna - 1220598 - VIVIANE EUZEBIA PEREIRA SANTOS