In 1958 Francis Moore described the orthotopic liver transplantation technique in dogs. In 1963, Starzl et al. performed the first liver transplantation. In the first five liver transplantations no patient survived more than 23 days. In 1967, stimulated by Calne who used antilymphocytic serum, Starzl began a successful series of liver transplantation. Until 1977, 200 liver transplantations were performed in the world. In that period, technical problems were overcome. Roy Calne, in 1979, used the first time cyclosporine in two patients who had undergone liver transplantation. In 1989, Starzl et al. reported a series of 1,179 consecutives patients who underwent liver transplantation and reported a survival rate between one and five years of 73% and 64%, respectively. Finally, in 1990, Starzl et al. reported successful use of tacrolimus in patents undergoing liver transplantation and who had rejection despite receiving conventional immunosuppressive treatment. Liver Transplantation Program was initiated at Hospital Israelita Albert Einstein in 1990 and so far over 1,400 transplants have been done. In 2013, 102 deceased donors liver transplantations were performed. The main indications for transplantation were hepatocellular carcinoma (38%), hepatitis C virus (33.3%) and alcohol liver cirrhosis (19.6%). Of these, 36% of patients who underwent transplantation showed biological MELD score > 30. Patient and graft survival in the first year was, 82.4% and 74.8%, respectively. A major challenge in liver transplantation field is the insufficient number of donors compared with the growing demand of transplant candidates. Thus, we emphasize that appropriated donor/receptor selection, allocation and organ preservation topics should contribute to improve the number and outcomes in liver transplantation.

Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery-and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies.

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Intestinal transplantation has shown exceptional growth over the past 10 years. At the end of the 1990’s, intestinal transplantation moved out of the experimental realm to become a routine practice in treating patients with severe complications related to total parenteral nutrition and intestinal failure. In the last years, several centers reported an increasing improvement in survival outcomes (about 80%), during the first 12 months after surgery, but long-term survival is still a challenge. Several advances led to clinical application of transplants. Immunosuppression involved in intestinal and multivisceral transplantation was the biggest gain for this procedure in the past decade due to tacrolimus, and new inducing drugs, mono- and polyclonal anti-lymphocyte antibodies. Despite the advancement of rigid immunosuppression protocols, rejection is still very frequent in the first 12 months, and can result in long-term graft loss. The future of intestinal transplantation and multivisceral transplantation appears promising. The major challenge is early recognition of acute rejection in order to prevent graft loss, opportunistic infections associated to complications, post-transplant lymphoproliferative disease and graft versus host disease; and consequently, improve results in the long run.

Introdução: No cotidiano diário somos cada vez mais expostos a realização de tarefas simultâneas, em uma condição de dupla tarefa. Nessas situações dizemos que há a interferência de uma tarefa sobre outra. A dupla tarefa pode influenciar o tempo para respostas motoras, o que pode ser um limitante para ações físicas em idosos. Objetivo: Determinar os efeitos de duplas tarefas com diferentes demandas cognitivas sobre o tempo de reação de jovens e idosos independentes. Métodos: Participaram deste estudo 27 jovens (26 ± 8 anos) e 27 idosos (77 ± 5 anos). O tempo de reação foi avaliado em três condições: simples, realizando contagem regressiva e ouvindo música. Resultados: Jovens e idosos diferiram no tempo de reação para as três condições. O tempo de reação é mais prejudicado pela dupla tarefa envolvendo contagem. Os efeitos das duplas tarefas foram similares entre os dois grupos. Conclusões: Uma dupla tarefa que exija atenção, como a tarefa de contagem regressiva, afeta negativamente o tempo de reação de jovens e idosos, o que não é observado na dupla tarefa de ouvir música passivamente. Estes resultados podem servir de fundamentação para inclusão de dupla tarefa em atividades motoras e cognitivas em terapias de movimento ou reabilitação em idosos.ABSTRACT Introduction: In the daily routine we are requested to perform simultaneous tasks, which characterize a dual-task condition. In these situations one task may influence performance of another. The dual task may influence motor responses latencies, which can limit performance of motor actions in older people. Objective: To analyze the effects of interference tasks on the youth reaction time and independent elderly. Methods: Participants in this study were 27 young (26 ± 8 years old) and 27 older adults (77 ± 5 years old). The reaction time was evaluated in the simple condition, while performing countdown aloud, and while listening to music. Results: The reaction time is more impaired in the counting task. The effects of dual task were similar in the two groups. Conclusions: A dual task requiring attention, as the task of counting, negatively affects reaction time performance in young and older adults, while listening to music passively had no effect on reaction time. These results can serve as a basis for inclusion of dual task in motor and cognitive activities in movement therapy or rehabilitation in the elderly. Duplas tarefas têm efeito similar sobre o tempo de reação em jovens e idosos independentes Duals tasks have similar effect on reaction time in young and independent older adultsComo citar este artigo: NEVES, D.; KUNZLER, M. R.; da ROCHA, E. S.; MELLO-CARPES, P. B.; CARPES, F. Duplas tarefas têm efeito similar sobre o tempo de reação em jovens e idosos independentes. Revista Saúde (Sta. Maria). 2019; 45 (2).

Background Perioperative pain management in small infants weighing <10 kg undergoing liver transplantation is challenging. The use of TEA in this setting has not been reported, as well as its potential role to facilitate IE, ie, in the OR. Methods We describe here the use of TEA in two small infants who had IE after a LDLT procedure. Results TEA was successfully performed and IE was achieved in both cases. Postoperative analgesia assessment in the OR was satisfactory according to the FLACC pain scale, with scores of 2 and 3 for each patient, respectively. There were no major complications in the postoperative period, and the two children were discharged home uneventfully. Conclusions The use of TEA and its influence on IE rate and other perioperative outcomes should be more explored in small infants undergoing LDLT.