A case of upper gingiva carcinoma with chronic graft-versus-host disease after allogenic bone marrow transplantation

A case of upper gingiva carcinoma with chronic graft-versus-host disease after allogenic bone marrow
transplantation
F Tsushima,* J Sakurai,* H Harada*
*Oral and Maxillofacial Surgery, Department of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and
Dental University, Tokyo, Japan.
ABSTRACT
Oral squamous cell carcinoma (OSCC) is one of the most common solid tumours occurring after haematopoietic stem cell transplantation (HSCT), especially in patients with chronic graft-versus-host-disease (cGVHD). We describe a case of OSCC that developed in a 51-year-old male 22 years after he had received allogeneic HSCT from his human leukocyte antigen-identical sister as a treatment for acute myelocytic leukaemia. The patient had presented with multiple white patchy lesions on the palatal gingiva and mucosa 16 years after HSCT; these lesions were consistent with the clinical features of cGVHD. Six years later, oral examination and biopsy revealed upper gingival squamous cell carcinoma (SCC) in areas of cGVHD, and he underwent tumour excision. Follow-up examination at 2 years and 4 months after the operation revealed no evidence of recurrence of local SCC or metastasis of the cervical lymph node. The current case highlights the susceptibility of patients with cGVHD to the development of OSCC even two decades after HSCT. Therefore, we recommend careful long-term follow-up of the oral cavity for patients with cGVHD.

http://onlinelibrary.wiley.com/doi/10.1111/adj.12343/full

XVIII ENCONTRO DE ENFERMAGEM E EQUIPE MULTIDISCIPLINAR EM TRANSPLANTE DE MEDULA ÓSSEA

XVIII ENCONTRO DE ENFERMAGEM E EQUIPE MULTIDISCIPLINAR EM TRANSPLANTE DE MEDULA ÓSSEA

http://www.sbtmo2015.com.br/

Dent Res J (Isfahan). 2015 May-Jun;12(3):199-208.

Oral manifestations in transplant patients.

Nappalli D1, Lingappa A2.

Author information

Abstract

Organ transplantation is a widely undertaken procedure and has become an important alternative for the treatment of different end-stage organ diseases that previously had a poor prognosis. The field of organ transplant and hematopoietic stem cell transplant is developing rapidly. The increase in the number oftransplant recipients also has an impact on oral and dental services. Most of the oral problems develop as a direct consequence of drug-induced immunosuppression or the procedure itself. These patients may present with oral complaints due to infections or mucosal lesions. Such lesions should be identified, diagnosed, and treated. New treatment strategies permit continuous adaptation of oral care regimens to the changing scope of oral complications. The aim of this review is to analyze those oral manifestations and to discuss the related literature.

http://www.ncbi.nlm.nih.gov/pubmed/26005458

XIV Congresso Brasileiro de Transplantes

Veja na programação o 3º Simpósio de Odontologia em Transplantes e participe!
http://www.congressoabto.org.br/2015/programa/24/

Grupo de Odontologia em Transplantes no Facebook

Caros colegas seguidores do blog,
Temos postado informações atualizadas e dinâmicas em nosso grupo do Facebook. Se você ainda não faz parte do grupo solicite sua participação que será prontamente aceita.
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Congresso Português de Transplantação de 2014

http://www.spt.pt/congresso/

Bem vindos

Caros Colegas,
O Congresso Português de Transplantação de 2014 realizar-se-á em Lisboa, no Sana Lisboa Hotel, de 09 a 11 de Outubro. A Sociedade Portuguesa de Transplantação (SPT) e a Associação Brasileira de Transplante de Órgãos (ABTO) juntam-se novamente, pelo décimo terceiro ano consecutivo, para o congresso conjunto. Este ano, contaremos também com a participação da Sociedade Espanhola de Transplantação (SET).

Como habitualmente será uma ocasião de excelência para a permuta de ideias, combinação de estratégias de trabalho e apresentação do trabalho científico desenvolvido pelos profissionais de saúde ligados a todas as áreas de transplante.

O sucesso do Congresso dependerá, naturalmente, do empenho e participação de todos. O prazo limite para o envio de trabalhos sob a forma de posters ou comunicações orais para o Congresso de Transplantação será 31 de Maio de 2014.

Participem!

Com os nossos cumprimentos,

Domingos Machado		Fernando Macário
Presidente do Congresso		Presidente da SPT

Comissão de Odontologia ABTO - 2014

Em outubro de 2010 foi aprovada junto à diretoria da ABTO a formação da Comissão de Odontologia da Associação Brasileira de Transplante de Órgãos cujos objetivos são as ações de suporte de informação sobre saúde bucal aos pacientes junto ao GAT (Grupo de Apoio ao Transplantado), suporte e orientação aos profissionais da Odontologia e demais membros da equipe multiprofissional com relação aos temas relacionados à boca e suas respectivas repercussões no grupo de pacientes transplantados, além do desenvolvimento de pesquisas científicas no campo da Odontologia em Transplantes.
A Comissão de Odontologia é composta por especialistas que atuam ativamente na área de Odontologia em Transplantes e trabalha em colaboração com colegas que atuam no manejo dos pacientes transplantados. Para o desenvolvimento de suas atividades, conta com parcerias nacionais e internacionais de referência na área.

Membros
FABIO LUIZ CORACIN (COORDENADOR)

Especialista em Patologia Bucal, Doutor em Odontologia e Mestre em Clínica Médica. Patologista Assistente do Serviço de Transplante de Células Tronco Hematopoiéticas do Hospital das Clínicas de São Paulo e Professor Doutor da Diretoria de Saúde da Universidade Nove de Julho – São Paulo.


ISABELA SOARES DE CASTRO

Especialista em Odontopediatria, 2005, Odontoclinica Central do Exército (OCEX); Especialista em Pacientes Especiais, 2013, Universidade de São Paulo USP – SP; Mestre em Odontopediatria, 2010, Universidade do Estado do Rio de Janeiro (UERJ).


LILIANE ELZE FALCÃO LINS KUSTERER

Especialista em Estomatologia e Cirurgia e Traumatologia Bucomaxilofacial
Doutora em Patologia Humana-FIOCRUZ-FMB-UFBA; Livre-Docente em Bioética- FMB-UFBA


PAULO SÉRGIO DA SILVA SANTOS

Mestre e Doutor em Patologia Bucal. Professor Doutor do Departamento de Estomatologia e Docente do Curso de Pós-Graduação em Ciências Odontológicas Aplicadas da Faculdade de Odontologia de Bauru, USP – SP.


RENATO COSTA FRANCO BALDAN

Mestre em Estomatologia UNESP, Especialista em Periodontia APCD, Residência pelo Hospital do Câncer de São Paulo - AC Camargo.

WALMYR RIBEIRO DE MELLO

Mestrando em Ciências Médicas – FMUSP, Coordenador da Equipe de Odontologia Hospitalar do Hospital Samaritano de São Paulo.

http://www.abto.org.br/abtov03/default.aspx?mn=560&c=1069&s=0&friendly=comissao-de-odontologia-abto

16° Simpósio de Odontologia em Hematologia

16° Simpósio de Odontologia em Hematologia
Data: 8 de novembro de 2014 (Sábado)
Multidisciplinar
Sala: Tapera
8:30 – 18:00 Luiz Antonio de Souza Coordenador
Luiz Antonio de Souza Moderador
8:30 – 8:40
Wellington do Espírito Santo
Cavalcanti e Maria de Fátima
Pombo Montoril
Abertura Oficial do 16º
Simpósio
8:40- 8:45 Discussão
8:45 – 9:05 Maria Infante
Por que mudar? O caso da gestão
de unidades de saúde no Brasil
9:05 – 9:25 Walmyr Mello
Gestão em Odontologia:
Diferença entre o público e o
privado
9:25- 9:35 Discussão
9:35 – 10:00 Inês Beatriz da Silva Rath
Atendimento odontológico a
pacientes da onco-hematologia
do HU/UFSC
10:00 – 10:30 Intervalo
Geisa Badauy Lauria da Silva Moderador
10:30 – 11:00 Silvia Inês Ferreira
Imunofenotipagem por
citometria de fluxo: Utilização em
onco-hematologia
11:00 – 11:15 Discussão
11:15 – 11:45 Lee I Ching
Utilização da imuno-histoquímica
no diagnóstico das lesões bucais
11:45 – 12:00 Discussão
12:00 – 12:50
Denise Linhares Gerent e
Frederico Medeiros
Novos anticoagulantes orais na
prática médica e odontológica
12:50 – 13:00 Discussão
13:00 – 14:30 Almoço
Eduardo de Pádua Moderador
14:30 – 14:55 Liliane Grando
Boca seca e ardência bucal: uma
epidemia?
14:55 – 15:20 Cassius Torres Pereira
Acompanhamento da cavidade
oral dos pacientes com anemia
de Fanconi
15:20 -15:30 Discussão
15:30 – 16:00 Intervalo
Luiz Alberto Valente Soares
Junior Moderador
16:00 – 16:25 Glauco de Oliveira
Como socializar o conhecimento
em odontologia
16:25 – 16:45 Luiz Antonio de Souza
Ações para capacitar a contrareferência
em hematologia
16:45 – 17:00 Discussão
17:00 – 17:45
Héliton Spíndola Antunes
(moderador) Apresentação Oral
17:45 – 18:00
Perla Porto Leite Shitara
(moderador) Assembléia

http://hemo.org.br/?page_id=1019

Oral complaints and dental care of haematopoietic stem cell transplant patients: a qualitative survey of patients and their dentists

Abstract

Purpose

Little is known about the understanding of the oral and dental needs of haematopoietic stem cell transplant (HSCT) patients or about dentists’ views and experiences regarding this patient group. This information is essential if we want to improve the standard of peri-HSCT dental care.

The primary objective of this qualitative survey was to explore the following:

1. The understanding of dental care pre- and post-HSCT
2. The subjective oral complaints of HSCT patients both short- and long-term
3. The relationship of these oral complaints to the severity of oral mucositis during hospitalization

The secondary objective was to explore the opinions of dentists regarding dental care before and after HSCT.

Patients and methods

All adult patients who survived HSCT at the Radboud University Medical Centre between 2010 and 2011 (n = 101) received a questionnaire. During hospitalization, mucositis scores were recorded daily in the patient’s chart. The patients’ dentist (n = 88) was also sent a questionnaire after permission of the patient.

Results

Ninety-six out of 101 patients (95 %) responded. The average period since HSCT was 19 months (range 8–31 months). The overall mean maximum mucositis score was 6.6 (sd = 3.3). Only eight patients reported not having visited a dentist pre-HSCT. The majority of the patients (59 %) reported short-term oral complaints, and 28 % reported long-term oral complaints. Fifty-two dentists responded (59 %). Nine had not performed pre-HSCT screening and eight dentists reported screening their patients but could not complete the necessary treatments. Only 44 dentists succeeded in completing the required treatments. The most important advice of the dentist was to reinforce the importance of regular dental care.

Conclusion

Most patients report short-term and/or long-term oral complaints after HSCT. Most dentists stress the importance of regular dental care before and after HSCT but report not being familiar with the particular dental care needs of this patient group. The high response rate and the high rate of HSCT-related oral complaints emphasize the need of further research in this area.

Supportive Care in Cancer

June 2014

Jacolien Bos-den Braber, 

Carin M. J. Potting, 

Ewald M. Bronkhorst, 

Marie-Charlotte D. N. J. M. Huysmans, 

Nicole M. A. Blijlevens

http://link.springer.com/article/10.1007/s00520-014-2297-x

Manifestações Bucais associadas à imunossupressão em pacientes submetidos a transplante de Coração

Manifestações Bucais associadas à imunossupressão em pacientes  submetidos a transplante de Coração
Oral manifestations associated with immunosuppression  in patients undergoing heart transplant

Rev Soc Cardiol Estado de São Paulo. 2014;24(1 Supl A):39-43
RSCESP (72594)-2097

Paulo sérgio da silva santos
Paola Ferreira teixeira
karin sá Fernandes

A condição de imunossupressão de pacientes transplantados  cardíacos possibilita o surgimento de manifestações bucais  importantes que representam risco para o sucesso do  transplante cardíaco. A avaliação e o acompanhamento  odontológico desses pacientes são fundamentais na prevenção
dessas manifestações bucais e infecções sistêmicas. Por meio  do relato dos casos clínicos de três pacientes transplantados  cardíacos, apresentamos e discutimos as condições clínicas e  as opções terapêuticas das manifestações bucais mais comuns  neste grupo de pacientes.

Oral care of the patient with liver failure, pretransplant—a retrospective study

Oral care of the patient with liver  failure, pretransplant—a retrospective study
Jeffery L. Hicks, DDS*
Professor, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
You have full text access to this content

Special Care in DentistryEarly View, Article first published online: 19 MAY 2014

Liver failure patients seeking liver transplant in our teaching hospital undergo dental clearance by our Hospital Dentistry Department. A retrospective analysis of 500 patient dental charts was performed. All patients were evaluated previously by physicians and the medical diagnosis of liver failure for each patient was determined. Patients were examined and a treatment plan was formed consisting of the oral care required prior to dental clearance for liver transplant. An oral care treatment algorithm was constructed that, along with clinical parameters, guided the oral care in the pretransplant period. The oral care necessary to clear the patient for transplant was completed for each patient. Besides computing the average cost of oral care necessary to clear patients, analyses were performed to look for correlations among laboratory tests required before oral surgical procedures.

Curso de Aperfeiçoamento em Odontologia Hospitalar - FUNBEO

Julho está chegando e com ele a 3ª turma do Curso de Aperfeiçoamento em Odontologia Hospitalar da FUNBEO junto à Faculdade de Odontologia de Bauru, Universidade de São Paulo. Ainda há vagas!!!! Acesse o site da FUNBEO e conheça mais detalhes e informações sobre o curso:
http://www.funbeo.com.br/do/Curso_view/128/aperfeicoamento_em_odontologia_hospitalar

Viral Opportunistic Infections in Organ and Tissue Transplanted Patients: Comparison between Clinical Examination and PCR

International Journal of Clinical Dentistry ISSN: 1939-5833
Volume 7, Number 1 © Nova Science Publishers, Inc.
VIRAL OPPORTUNISTIC INFECTIONS IN ORGAN
AND TISSUE TRANSPLANTED PATIENTS:
COMPARISON BETWEEN CLINICAL EXAMINATION
AND PCR
Paulo Sérgio da Silva Santos, DDS, MSc, PhD1,
José Endrigo Tinoco-Araujo, MSc, PhDc2, Ana Paula Bloise, DDS3,
and José Roberto Pereira Lauris, MSc, PhD4
1Professor, Stomatology Department, Bauru School of Dentistry,
University of São Paulo, Bauru, Brazil
2Graduate student, Stomatology Department, Bauru School of Dentistry,
University of São Paulo, Bauru, Brazil
3Paulista University, São Paulo, Brazil
4Professor, Department of Paedodontics, Orthodontics and Public Health of Dentistry,
Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
ABSTRACT
Purpose: To evaluate correlation between clinical suspicion and laboratory diagnosis
of viral opportunistic infections in transplanted patients.
Methods: We assessed 29 patients with oral infections with a clinical aspect of viral
lesions. We scraped the oral lesions, collected secretions using swab and sent samples to
the molecular biology laboratory for PCR according to the clinical diagnostic hypotheses.
Results: We found 44.8% of cases suspected of having HSV, 6.9% of CMV and in
48.3% there was doubts about the diagnosis. The PCR was positive for HSV in 34.5% of
cases, for CMV in 6.9%, for both HSV and CMV in 10.3% and negative in 46.7% of the
cases.
The sensitivity of clinical examination was 100% for both HSV and CMV, but the
possibility of having the infection by HSV or CMV was respectively 44% and 25%. We
suggest that clinical examination is not sufficient to establish the final diagnosis of viral
lesions in transplanted patients, making it necessary for exams of high reliability as the
PCR.

Oral Mucositis: Prevention and Treatment

Héliton Spindola Antunes1, Paulo Sérgio da Silva Santos2,
Fábio Luiz Coracin3, Geisa Badauy Lauria Silva4,
Luiz Antonio de Souza5, and Luiz Alberto Soares Valente Jr.6*
1DDS, PhD of the Clinical Research Coordination,
National Cancer Institute of Brazil (INCA)
2DDS, PhD, Professor of the Stomatology Department, Bauru School of Dentistry,
University of Sao Paulo, Brazil
3DDS, PhD of the Bone Marrow Transplant Service,
Clinicas Hospital from School of Medicine – University of Sao Paulo;
Professor of Pathology and Oral Medicine in Nove de Julho University, Sao Paulo, Brazil
4DDS, MSc of the Bone Marrow Transplant Service and of Pediatric Oncology in Araújo
Jorge Hospital (HAJ/ACCG)
5DDS of the Blood Center in Santa Catarina (HEMOSC)
6DDS, MSc of the Dentistry Division in Clinicas Hospital,
School of Medicine – University of Sao Paulo, Brazil
ABSTRACT
Oral Mucositis (OM) is one of the main complications of patients submitted to the
oncologic treatment. The incidence of oral mucositis varies, and is intimately related to
the toxicity of chemotherapy and radiotherapy protocol. Prolonged or profound oral
mucositis leads to significant pain and morbidity and depending on its progression, it may
be necessary to interrupt the treatment followed or not by hospitalization.
OM occurs approximately in seven to ten days after chemotherapy and from the
second week of radiotherapy. Although it is a toxic reaction and inflammation that is
studied for a long time, the molecular and cell mechanisms described recently may
contribute for the appearance of new protocols of prevention. In the context of options
studied in the prevention of OM, there are efficient alternatives as cryotherapy, growth
factor of keratinocytes and the low-level lasers that promote a reduction in the incidence
of OM and pain during the period of the oncologic treatment.
The aim of this chapter was to investigate the available literature regarding OM,
searching relevant articles and eligible clinical trials in order to obtain additional
information about prevention and treatment interventions to OM.

 Members of the Committee of Dentistry from the Brazilian Association of Hematology and Hemotherapy.

Oral Health Status of Cirrhotic Patients in List of Liver Transplantation and of Viral Hepatitis Carriers

Oral Health Status of Cirrhotic Patients in List of Liver Transplantation 
and of Viral Hepatitis Carriers
Liliane Lins1,2* and Antônio Fernando Pereira Falcao

http://www.omicsonline.org/2161-0991/2161-0991-2-116.pdf

ASSOCIE-SE: ASSOCIAÇÃO BRASILEIRA DE TRANSPLANTE DE ÓRGÃOS.

Dispositivo Intraoral

Dispositivo intraoral de odontologiaemtransplantes.blogspot.com é licenciado sob uma Licença Creative Commons Atribuição-NãoComercial-SemDerivados 3.0 Não Adaptada.

II SIMPÓSIO DE ODONTOLOGIA EM TRANSPLANTES - ABTO /CRORJ

II SIMPÓSIO DE ODONTOLOGIA EM TRANSPLANTES - ABTO /CRORJ
TRANSPLANTES: TCTH, RENAL, HEPÁTICO, CARDÍACO, OSSOS

PROGRAMAÇÃO

13h00 - 14h00	Tx célula tronco hemat - Biologia / Indicações Toxidades e Manejo / Infecções Efeitos tardios
14h00 - 15h00	Tx Renal - Preparo e Indicações Preparo Bucal Infecções bucais e repercussões
15h00 - 15h30	COFFEE-BREAK
15h30 - 16h30	Tx Hepático - Critérios e indicações Preparo Bucal / Complicações
16h30 - 17h30	Sucessos e Insucessos em Transplante de Ossos Transplante cardíaco Abordagem odontológica

XIII Congresso Brasileiro de Transplantes 2013

Do Patients with Solid Organ Transplants or Breast Implants Require Antibiotic Prophylaxis before Dental Treatment?

Eric T. Stoopler, DMD; Ying Wai Sia, DMD; Arthur S. Kuperstein, DDS

J Can Dent Assoc 2012;78:c5

Human solid organ transplantation has evolved into a predictable therapeutic modality due to advances in medical and surgical care and improved understanding of the immune system. At its peak in 2007, the Canadian Organ Replacement Register documented 1042 organ donors (living and deceased) and 2127 completed organ transplants.¹ The overwhelming majority of donated organs were deceased donor kidneys.¹ Records from the United States show that, between 1999 and 2008, patient and graft survival improved for almost every organ type.²*

With the large number of people receiving organ transplants and those who have already received a transplant living longer, dental professionals will be providing oral health care to an increasing number of patients in this specific population. The question of administering antibiotic prophylaxis to these patients, as well as to patients with breast implants, before invasive dental treatment is addressed in this article.

Solid Organ Transplants

The oral health care provider plays an important role in overall management of the solid organ transplant patient. At many transplant centres, examination of both the hard and soft tissues of the oral cavity is often carried out by a dental professional to determine oral and dental health status before transplantation.³ As the patient's immune system is often significantly suppressed in the weeks to months following the transplant to prevent organ rejection, the risk of infection (viral, bacterial or fungal) is a concern and dental treatment during that time is recommended only on an emergency basis.^3,4 As the patient moves into the stable post-transplantation period, risk of infection generally decreases and oral health care may be sought more routinely.

Evidence supporting the use of antibiotic prophylaxis among patients with solid organ transplants before dental treatment is extremely limited.^3-6 In 2003, Guggenheimer and colleagues³ reported that postoperative guidelines for recipients of solid organ transplants frequently advise treatment with antibiotics before dental procedures, but there are no data from controlled clinical trials to support this recommendation, nor is a consensus evident. However, the authors state that because bacteremia arising from invasive dental procedures represents a significant risk in the immunocompromised patient, premedication is usually recommended.

In a 2005 survey of dental care protocols at organ transplant centres in the United States, 239 out of 294 centres (83%) reported recommending antibiotic prophylaxis for dental treatment following an organ transplant.⁷ However, because the overall response rate to this survey was only 38%, these results do not represent a consensus. The authors of the study reiterated that, at that time, there was no documentation of transient bacteremia from an invasive dental procedure posing another threat to the immunosuppressed organ transplant recipient.

In 2007, a systematic review by Lockhart and colleagues⁵ concluded that it is difficult to determine the likelihood that invasive dental procedures will cause morbidity or mortality in immunosuppressed patients and classified the finding as Class IIB (usefulness/efficacy less well-established by evidence/opinion) and Level C (based on expert opinion, case studies or standard of care).

In a recent article, Scully and colleagues⁸ recommend administering antibiotic prophylaxis to organ transplant patients before invasive dental procedures (particularly during the 6 months after transplantation) without citing evidence-based research to support their recommendation.

In 2007, the American Heart Association (AHA) published revised guidelines for the prevention of infective endocarditis using a stronger evidence-based approach. In relation to organ transplants, these guidelines recommend providing antibiotic prophylaxis before specific dental procedures in cardiac transplantation recipients with cardiac valvulopathy to prevent infective endocarditis.⁹ The guidelines have been endorsed by members of the Canadian Cardiovascular Society.¹⁰

Breast Implants

First described by Czerny in 1895, breast augmentation is now the most common cosmetic procedure among American women.¹¹ Infections after breast augmentation are relatively uncommon, with most occurring within the early postoperative period (i.e., 4 weeks).¹² Endogenous breast flora, such as Propionibacterium acnes and coagulase-negative Staphylococcus, have been implicated in the etiology of these types of infections.¹² Ellenbogen¹³ postulated a causal relation between dental prophylaxis and rapid breast encapsulation within weeks of the surgical procedure based on personal experience. Late infections (months to years after implantation) are even less common at a reported rate of 1:10 000.^12,14 Bacteremia, as a consequence of an invasive procedure or distant antecedent infection, is thought to cause seeding of the breast implant capsule or periprosthetic space.¹²

Few articles in the literature implicate bacteremia secondary to dental procedures as the etiology for late breast implant infection. In a survey, Brand¹⁴ found 2 cases of late infection thought to have originated after an episode of bacterial stomatitis and after extensive dental treatment. In both cases, the identified cause was Staphylococcus aureus, an organism considered part of normal oral microflora.¹⁵ S. aureus has been implicated as the most common microbiological agent responsible for periprosthetic breast implant infections.¹⁶ Hunter and colleagues¹⁷ reported a case in which a woman developed a late breast implant infection associated with Clostridium perfringens after completion of extensive dental therapy, including abscess drainage, endodontic treatment and crown placement. Most recently, Chang and colleagues¹² reported a late breast infection with coagulase-negative Staphylococcus and Streptococcus viridians, which developed after periodontal surgery to treat recurrent periodontitis.

Clinical Recommendations

Antibiotic Prophylaxis and Solid Organ Transplants

Based on current evidence-based research, we do not recommend routine administration of antibiotic prophylaxis to patients with solid organ transplants before invasive dental treatment.^5,18 Oral health care providers should discuss the patient's overall health status and planned dental procedures with the patient's physician or transplant surgeon or both, and the decision to administer antibiotic prophylaxis should be made on a case-by-case basis.^6,18 If antibiotic prophylaxis is recommended, the patient's physician should prescribe the medication (type, dose, instructions). Regarding patients with cardiac transplants, we recommend providing antibiotic prophylaxis to patients according to the 2007 AHA guidelines.^9,10

Antibiotic Prophylaxis and Breast Implants

Based on current evidence-based research and scant case reports, we do not recommend routine administration of antibiotic prophylaxis to patients with breast implants before invasive dental treatment.^6,18-20 However, patients with a history of complications after breast implant surgery, especially infection, may warrant antibiotic prophylaxis before invasive dental treatment, and this decision must be made in consultation with the patient's surgeon. If antibiotic prophylaxis is recommended, the patient's surgeon should prescribe the medication (type, dose, instructions).

*The data and analyses reported in the 2009 Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients have been supplied by UNOS and Arbor Research under contract with HHS/HRSA. The authors alone are responsible for reporting and interpreting these data; the views expressed herein are those of the authors and not necessarily those of the U.S. Government.

References:

1. 2009 Annual report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: transplant data 1999–2008. Rockville, Md: United States Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation; 2009. Available: www.ustransplant.org/annual_reports/current
   /default.htm (accessed 2011 Nov. 10).
2. Guggenheimer J, Eghtesad B, Stock DJ. Dental management of the (solid) organ transplant patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(4):383-9.
3. Goldman KE. Dental management of patients with bone marrow and solid organ transplantation. Dent Clin North Am. 2006;50(4):659-76, viii.
4. Lockhart PB, Loven B, Brennan MT, Fox PC. The evidence base for the efficacy of antibiotic prophylaxis in dental practice. J Am Dent Assoc. 2007;138(4):458-74; quiz 534-5, 437.
5. Little JW, Falace DA, Miller CS, Rhodus NL. Antibiotic prophylaxis in dentistry: an update. Gen Dent. 2008;56(1):20-8.
6. Guggenheimer J, Mayher D, Eghtesad B. A survey of dental care protocols among US organ transplant centers. Clin Transplant2005;19(1):15-8.
7. Scully C, Kumar N, Diz Dios P. Hot topics in special care dentistry. 5. Transplant patients. Dent Update. 2009;36(7):445.
8. Wilson W, Taubert KA, Gewitz M, Lockhart PB, Baddour LM, Levison M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. J Am Dent Assoc. 2008;139 Suppl:3-24S.
9. Embil JM, Chan KL. The American Heart Association 2007 endocarditis prophylaxis guidelines: a compromise between science and common sense. Can J Cardiol. 2008;24(9):673-5.
10. Pelosi MA 3rd, Pelosi MA 2nd. Breast augmentation. Obstet Gynecol Clin North Am. 2010;37(4):533-46, viii.
11. Chang J, Lee GW. Late hematogenous bacterial infections of breast implants: two case reports of unique bacterial infections. Ann Plast Surg. 2011;67(1):14-6.
12. Ellenbogen R. Breast implant encapsulation in association with dental work. Plast Reconstr Surg. 1986;78(4):541.
13. Brand KG. Infection of mammary prostheses: a survey and the question of prevention. Ann Plast Surg. 1993;30(4):289-95.
14. Smith AJ, Jackson MS, Bagg J. The ecology of Staphylococcus species in the oral cavity. J Med Microbiol. 2001;50(11):940-6.
15. Khan UD. Breast augmentation, antibiotic prophylaxis, and infection: comparative analysis of 1,628 primary augmentation mammoplasties assessing the role and efficacy of antibiotics prophylaxis duration. Aesthetic Plast Surg. 2010;34(1):42-7. Epub 2009 Oct 20.
16. Hunter JG, Padilla M, Cooper-Vastola S. Late Clostridium perfringens breast implant infection after dental treatment. Ann Plast Surg.1996;36(3):309-12.
17. Baker KA. Antibiotic prophylaxis for selected implants and devices. J Calif Dent Assoc. 2000;28(8):620-6.
18. Pittet B, Montandon D, Pittet D. Infection in breast implants. Lancet Infect Dis. 2005;5(2):94-106.
19. Davenport J. Breast implants & premedication for dental work. Hawaii Dent J. 2006;37(6):16.

XIII Congresso Brasileiro de Transplantes - Envio de trabalhos!!!

Increased infection risk postliver transplant without pretransplant dental treatment

1. J Helenius-Hietala^1,2,*, 
2. F Åberg³, 
3. JH Meurman^1,2, 
4. H Isoniemi³

Article first published online: 6 AUG 2012

DOI: 10.1111/j.1601-0825.2012.01974.x

Oral Diseases

Volume 19, Issue 3, pages 271–278, April 2013

Objective

Infections cause considerable morbidity after liver transplantation (LT). Acute liver failure is a rapidly progressing life-threatening condition where pretransplant dental evaluation is not always possible. We investigated how missing pretransplant dental treatment in acute or subacute liver failure correlates with post-transplant infectious complications.

Subjects and methods

Medical and dental data came from hospital records and infection data from the Finnish LT registry. The follow-up was until February 2011. Of 51 patients (LT during 2000–2006), 16 had and 35 did not have dental treatment pretransplant.

Results

Univariate Cox regression analysis demonstrated a 2.46-fold (95% CI 1.06–5.69) infection risk among the patients omitted from dental treatment. After adjustment for either pretransplant factors alone or both pre- and post-transplant factors, the corresponding infection risk increased, respectively, to 8.17-fold (95% CI 2.19–30.6) and 8.54-fold (95% CI 1.82–40.1). This increased risk involved a variety of bacterial, viral, and fungal infections of various sources both < 6 and > 6 months after transplantation.

Conclusion

High risk of infections was noticed in acute liver failure patients without pretransplant dental treatment, but a more severe medical condition might have influenced the results. We encourage eradication of dental infection foci whenever clinical condition allows.

39th EBMT Annual Meeting in 2013

39th EBMT Annual Meeting in 2013

The scientific programme is busy and of an excellent standard. We open on Sunday night with some, hopefully short, welcome speeches, followed by the two award winning clinical and scientific abstracts and the EBMT lecture, give this year by Professor Peter Parham. The Working Parties and oral and poster abstract presentations remain at the heart of the meeting and will discuss the work of EBMT members. The Education, Workshop and Controversy sessions will do ‘what it says on the box’. The Plenaries are a mixture of clinical management, basic and translational science and health economics, and are designed to challenge us all, New this year are the ‘Basic Science Elite’ sessions where extra time and discussion will be given to the best of our more scientific submissions. Our traditional joint sessions with WMDA, ASBMT and WBMT will include a celebration of the one millionth transplant, performed in 2013, and a tribute to the legacy of E Donnal Thomas. Individual sessions will be dedicated to the interests of colleagues in Cell Processing (Monday) and Paediatrics (Tuesday). The scientific programme is accompanied by specialist meetings of the nurses, data managers, quality managers and statisticians and also promise to be of the highest quality.

http://www.congrex.ch/ebmt2013.html

Oral Health Status of Cirrhotic Patients in List of Liver Transplantation and of Viral Hepatitis Carriers

Oral Health Status of Cirrhotic Patients in List of Liver Transplantation
and of Viral Hepatitis Carriers
Liliane Lins and Antônio Fernando Pereira Falcao


Acesse o artigo na íntegra: http://www.omicsonline.org/2161-0991/2161-0991-2-116.pdf

XIII Congresso Brasileiro de Transplantes - 2013

http://www.congressoabto.org.br/2013/

O futuro do transplante dependerá então do desenvolvimento de novas alternativas como o xenotransplante, a engenharia de tecidos e o transplante de tecidos compostos. Essas estratégias inovadoras serão apresentadas por pesquisadores internacionais durante o XIII Congresso Brasileiro de Transplantes.