Papers by Francisco Caballero
Cell Metabolism, 2006
The etiology of progression from steatosis to steatohepatitis (SH) remains unknown. Using nutriti... more The etiology of progression from steatosis to steatohepatitis (SH) remains unknown. Using nutritional and genetic models of hepatic steatosis, we show that free cholesterol (FC) loading, but not free fatty acids or triglycerides, sensitizes to TNF-and Fas-induced SH. FC distribution in endoplasmic reticulum (ER) and plasma membrane did not cause ER stress or alter TNF signaling. Rather, mitochondrial FC loading accounted for the hepatocellular sensitivity to TNF due to mitochondrial glutathione (mGSH) depletion. Selective mGSH depletion in primary hepatocytes recapitulated the susceptibility to TNF and Fas seen in FC-loaded hepatocytes; its repletion rescued FC-loaded livers from TNF-mediated SH. Moreover, hepatocytes from mice lacking NPC1, a late endosomal cholesterol trafficking protein, or from obese ob/ob mice, exhibited mitochondrial FC accumulation, mGSH depletion, and susceptibility to TNF. Thus, we propose a critical role for mitochondrial FC loading in precipitating SH, by sensitizing hepatocytes to TNF and Fas through mGSH depletion.
Journal of Hepatology, 2009
Background/Aims: Non-alcoholic fatty liver disease (NAFLD) pathogenesis remains unknown. Due to t... more Background/Aims: Non-alcoholic fatty liver disease (NAFLD) pathogenesis remains unknown. Due to the emerging role of free cholesterol (FC) in NAFLD, our aim was to examine the correlation between FC accumulation in patients with NAFLD and the expression of enzymes that regulate cholesterol homeostasis.
Clinical Transplantation, 2003
The terms extended donor or expanded donor mean changes in donor acceptability criteria. In almos... more The terms extended donor or expanded donor mean changes in donor acceptability criteria. In almost all cases, the negative connotations of these terms cannot be justified. Factors considered to affect donor or organ acceptability have changed with time, after showing that they did not negatively affect graft or patient survival per se or when the adequate measures had been adopted. There is no age limit to be an organ donor. Kidney and liver transplantation from donors older than 65 years can have excellent graft and patient actuarial survival and graft function. Using these donors can be from an epidemiological point of view the most important factor to esablish the final number of cadaveric liver and kidney transplantations. Organs with broad structural parenchyma lesion with preserved functional reserve and organs with reversible functional impairment can be safely transplanted. Bacterial and fungal donor infection with the adequate antibiotic treatment of donor and/or recipient prevents infection in the latter. The organs, including the liver, from donors with infection by the hepatitis B and C viruses can be safely transplanted to recipients with infection by the same viruses, respectively. Poisoned donors and non-heart-beating donors, grafts from transplant recipients, reuse of grafts, domino transplant and splitting of one liver for two recipients can be an important and safe source of organs for transplantation.
American Journal of Transplantation, 2005
Bacterial infections are frequent in cadaveric organ donors and can be transmitted to the transpl... more Bacterial infections are frequent in cadaveric organ donors and can be transmitted to the transplantation recipient, which could have devastating consequences for the recipients if adequate preventive measures are not adopted. From the 355 consecutive brain dead cadaveric organ donors procured at our center in the last four years, 2000-2003, four of them (1.1%) had bacterial endocarditis as cause of death. The bacteria responsible for the endocarditis were Staphylococcus epidermidis, coagulase-negative Staphylococcus, Staphylococcus hominis and Streptococcus viridans, respectively. We performed five kidney and two liver transplantations on seven recipients. All donors and recipients received antibiotic treatment against the germ causing the respective endocarditis. Infection by the bacteria responsible for the endocarditis in the respective donors was not transmitted to any of the recipients. Six of the seven recipients were alive with normal-functioning grafts after between 13 and 24 months' follow-up. Transplantectomy was performed on one kidney recipient due to thrombosis of the renal vein of the graft not related to the endocarditis. Liver and kidney transplantation from donors dying from bacterial endocarditis can be performed without causing the transmission of infection to the recipient or the dysfunction of the graft.
Transplantation, 2002
To date, few data are available on older donor renal grafts transplanted into young recipients. W... more To date, few data are available on older donor renal grafts transplanted into young recipients. We compare 63 kidneys grafts from donors older than 60 years transplanted into recipients younger than 60 years (group 1) with a control group of 235 patients in whom both recipients and donors were younger than 60 years (group 2). Patient survival rates at 1 and 5 years, respectively, were 98% and 95% (group 1) and 95% and 84% (group 2) (P=0.01). Graft survival rates were 95% and 83% in group 1 versus 94% and 81% in group 2, although death censoring was significant (100% and 98% group 1 vs. 96% and 86% group 2, P=0.04). In group 1, plasmatic creatinemia was significantly higher. The aged donor, female donor-male recipient combination, and the presence of acute rejection alone or together with acute tubular necrosis, were determinants for worse renal functioning at 1 year after transplantation. Seven patients had chronic nephropathy not related to any clinical parameter. We conclude that kidneys from older donors can be successfully transplanted to younger patients.
Transplantation, 1998
We report on a patient with an extensive cerebral infarction secondary to enterococcal endocardit... more We report on a patient with an extensive cerebral infarction secondary to enterococcal endocarditis that, in spite of adequate antibiotic treatment, evolved to brain death. The patient was evaluated as a potential organ donor; renal and liver function were normal and both liver and kidneys appeared nor-
Artificial Intelligence in Medicine, 2003
The use of multi-agent systems (MAS) in health-care domains is increasing. Such agent-mediated me... more The use of multi-agent systems (MAS) in health-care domains is increasing. Such agent-mediated medical systems can manage complex tasks and have the potential to adapt gracefully to unexpected events. However, in these kinds of systems the issues of privacy, security and trust are particularly sensitive in relation to matters such as agents' access to patient records, what is acceptable behaviour for an agent in a particular role and the development of trust both between (heterogeneous) agents and between users and agents.
Transplant International, 1998
Abstract We report on a patient with an extensive cerebral infarction secondary to enterococcal e... more Abstract We report on a patient with an extensive cerebral infarction secondary to enterococcal endocarditis that, in spite of adequate antibiotic treatment, evolved to brain death. The patient was evaluated as a potential organ donor; renal and liver function were normal and both liver and kidneys appeared normal on ultrasonographic examination. When negativity of serial blood and urine cultures was ascertained, liver and kidneys were retrieved for transplantation. The organs were transplanted into three recipients with good results after 14 months of follow-up. All of the recipients received antibiotic prophylaxis against Enterococcus faecalis. None of them has presented infectious complications to date. This case emphasizes that patients with enterococcal endocarditis may be potential organ donors provided both donor and recipients are adequately treated. This is especially important when organs are urgently needed.
Artificial Intelligence in Medicine, 2003
The use of Multi-Agent Systems (MAS) in health-care domains is increasing. Such Agent-mediated Me... more The use of Multi-Agent Systems (MAS) in health-care domains is increasing. Such Agent-mediated Medical Systems can manage complex tasks and have the potential to adapt gracefully to unexpected events. However, in these kinds of systems the issues of privacy, security and trust are particularly sensitive in relation to matters such as agents' access to patient records, what is acceptable behaviour for an agent in a particular role and the development of trust both between (heterogeneous) agents and between users and agents.
Ai Communications, 2003
In this paper we extend the formalization of Carrel, a virtual organization for the procurement o... more In this paper we extend the formalization of Carrel, a virtual organization for the procurement of tissues for transplant, to deal also with organs. We focus on the organ allocation process to show how it can be formalized with the ISLANDER specification language and we also present the first version of a mechanism to federate several geographically-distributed Carrel platforms with the objective of addressing some of the technical issues in the establishment of a pan-European tissue and organ distribution service.
Transplantation Proceedings, 2002
Transplantation Proceedings, 2003
Amniotic membrane transplantation has been used for Ͼ90 years for cutaneous and mucous lesions fo... more Amniotic membrane transplantation has been used for Ͼ90 years for cutaneous and mucous lesions for regeneration of tissues. In recent years its effectiveness has been demonstrated in the treatment of diseases of the ocular surface. We present our experience with 53 amniotic membrane transplantations for different ocular pathologies with two different forms of implantation. The 53 cases were divided into three groups according to pathology and type of implant. Group 1 included 24 eyes with amniotic membrane grafts after resection of extensive conjunctival lesions. Group 2 included 19 eyes with amniotic membrane grafts for corneal pathology, and group 3 consisted of 10 eyes with amniotic membrane patches for corneal epithelial defects without ulceration. No intra-or postoperative complications were observed during an average follow-up period of 32 months (24 -48 months). Group 1 demonstrated rapid healing of the lesions with minimal scarring in all cases. In group 2 a favorable response was observed in 16 of 19 cases. In group 3 complete healing was achieved in only 3 of 10 cases, and the time for which the graft remained was related to the success of the treatment. The primary intention was to achieve prolonged fixation of the implant. Finally, amniotic membrane transplantation is a safe and effective technique for the treatment of different pathologies of the ocular surface. After the resection of extensive conjunctival lesions it is currently the preferred treatment. In corneal pathology, it represents an additional therapeutic alternative when conservative medical treatments fail.
IEEE Expert / IEEE Intelligent Systems, 2006
Transplantation, 1997
We report on a patient with an extensive cerebral infarction secondary to enterococcal endocardit... more We report on a patient with an extensive cerebral infarction secondary to enterococcal endocarditis that, in spite of adequate antibiotic treatment, evolved to brain death. The patient was evaluated as a potential organ donor; renal and liver function were normal and both liver and kidneys appeared nor-
Transplantation Proceedings, 1999
... Auteur(s) / Author(s). CABALLERO F. ; LOPEZ-NAVIDAD A. ; LEAL J. ; GARCIA-SOUSA S. ; SORIANO ... more ... Auteur(s) / Author(s). CABALLERO F. ; LOPEZ-NAVIDAD A. ; LEAL J. ; GARCIA-SOUSA S. ; SORIANO JA ; DOMINGO P. ; Affiliation(s) du ou des auteurs / Author(s) Affiliation(s). ... Mots-clés anglais / English Keywords. Organ donation. ; Family environment. ; Attitude. ; ...
Transplantation Proceedings, 2002
Transplantation Proceedings, 2002
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Papers by Francisco Caballero