Adjunct Faculty
Adjunct faculty typically have an academic or research appointment at another institution and contribute or collaborate with one or more School of Medicine faculty members or programs.
Adjunct rank detailsVivian Rotman
Assistant Professor AdjunctAbout
Research
Publications
2025
High frequency of ABCB4 and ABCB11 gene variants in adult patients with idiopathic chronic or recurrent cholestasis
Bittencourt P, Rotman V, Codes L, de Andrade A, de Araújo Gama R, Celestino L, Paraná R, Ferraz M, de Athayde Costa L, Thompson R, Porta G. High frequency of ABCB4 and ABCB11 gene variants in adult patients with idiopathic chronic or recurrent cholestasis. Hepatology Communications 2025, 10: e0851. PMCID: PMC12708102, DOI: 10.1097/hc9.0000000000000851.Peer-Reviewed Original ResearchClinical and Prognostic Factors Associated With Inflammatory Bowel Disease in a Highly Admixed Population With Primary Sclerosing Cholangitis.
Nardelli M, Cançado G, Barros L, Dotta D, Faria L, Rotman V, Villela-Nogueira C, Ferraz M, Rocco R, Felga G, Martins A, Codes L, Mendes L, Silva M, Hyppolito E, Gomide G, Signorelli I, Oliveira M, Ivantes C, Chiara M, Borges V, Terrabuio D, Cançado E, Bittencourt P, Couto C. Clinical and Prognostic Factors Associated With Inflammatory Bowel Disease in a Highly Admixed Population With Primary Sclerosing Cholangitis. Journal Of Clinical Gastroenterology 2025 PMID: 40985598, DOI: 10.1097/mcg.0000000000002253.Peer-Reviewed Original ResearchPrimary sclerosing cholangitisInflammatory bowel disease diagnosisInflammatory bowel diseaseTransplant-free survivalAdvanced liver diseaseLiver transplantationLiver diseasePSC patientsSclerosing cholangitisAntinuclear antibodiesCombined outcomeAssociation of inflammatory bowel diseaseCombined outcome of deathAnti-smooth muscle antibodiesConcomitant inflammatory bowel diseasePrevalence of inflammatory bowel diseasePSC diagnosisBowel diseaseCohort of Brazilian patientsStudy Group databaseOutcome of deathCohort mortalityMuscle antibodiesAutoimmune hepatitisBrazilian patients
2024
Recurrence of Primary Sclerosing Cholangitis and De Novo Cholangiocarcinoma After Liver Transplantation: Results From the Brazilian Cholestasis Consortium
Bittencourt P, Nardelli M, Barros L, Cançado G, Cançado E, Terrabuio D, Villela‐Nogueira C, Ferraz M, Codes L, Rotman V, Rocco R, Felga G, Dotta D, de Souza Martins A, Mendes L, da Silva M, Hyppolito E, Gomide G, Signorelli I, de Oliveira M, Ivantes C, Chindamo M, de Almeida e Borges V, Faria L, Couto C. Recurrence of Primary Sclerosing Cholangitis and De Novo Cholangiocarcinoma After Liver Transplantation: Results From the Brazilian Cholestasis Consortium. Clinical Transplantation 2024, 38: e70002. PMID: 39436152, DOI: 10.1111/ctr.70002.Peer-Reviewed Original ResearchConceptsPrimary sclerosing cholangitisRecurrent primary sclerosing cholangitisLiver transplantationRecurrent PSCSclerosing cholangitisFollow-upRecurrence of primary sclerosing cholangitisRisk of disease recurrenceHigher risk of graft lossRisk of graft lossHigh riskMonths of follow-upDe novo inflammatory bowel diseaseStudy Group databaseAssociated with longer timeInflammatory bowel diseaseLT patientsDisease recurrenceGraft lossAllograft rejectionFemale patientsMELD scoreLaboratory variablesPosttransplant survivalCholangiocarcinomaAlkaline phosphatase and liver fibrosis at diagnosis are associated with deep response to ursodeoxycholic acid in primary biliary cholangitis
Cançado G, Fucuta P, Gomes N, Couto C, Cançado E, Terrabuio D, Villela-Nogueira C, Braga M, Nardelli M, Faria L, Oliveira E, Rotman V, Oliveira M, Cunha S, Silva M, Mendes L, Ivantes C, Codes L, de Almeida E Borges V, Pace F, Pessôa M, Signorelli I, Coral G, Bittencourt P, Ferraz M. Alkaline phosphatase and liver fibrosis at diagnosis are associated with deep response to ursodeoxycholic acid in primary biliary cholangitis. Clinics And Research In Hepatology And Gastroenterology 2024, 48: 102453. PMID: 39174006, DOI: 10.1016/j.clinre.2024.102453.Peer-Reviewed Original ResearchConceptsPrimary biliary cholangitisUrsodeoxycholic acidDeep responsesBiliary cholangitisLiver fibrosisNormalization of alkaline phosphataseProgressive autoimmune liver diseaseResponse to UDCA therapyYear of UDCA treatmentResponse to ursodeoxycholic acidBaseline alkaline phosphatase levelsAlkaline phosphataseAutoimmune liver diseaseStudy Group cohortAlkaline phosphatase levelsResponse scoresBaseline ALPToronto criteriaUDCA therapyUDCA treatmentPrognostic factorsPrognostic markerPhosphatase levelsLiver diseaseIncomplete responseMultiparametric magnetic resonance imaging of the liver and spleen in Gaucher disease
Parente D, de Melo Malta F, de Souza Cravo R, Luiz R, Rotman V, Perez R, Rodrigues R. Multiparametric magnetic resonance imaging of the liver and spleen in Gaucher disease. Abdominal Radiology 2024, 49: 3069-3077. PMID: 38642092, DOI: 10.1007/s00261-024-04293-w.Peer-Reviewed Original ResearchConceptsGD-DS3Spleen volumeGaucher diseaseSplenic volumeConclusionThe prevalenceIron overloadMR elastographySpleen stiffnessMultiparametric magnetic resonance imagingBiomarkers of disease severityLiver MR elastographyType 1 Gaucher diseaseLiver fat fractionLiver iron overloadPrevalence of hepatosplenomegalySeverity scoring systemMagnetic resonance imagingMultiparametric MRILaboratory variablesEffects of treatmentLiver stiffnessTreated patientsLiver fibrosisSeverity scoreMann-WhitneyA new and simple score to predict adequate and deep response to ursodeoxycholic acid in patients with primary biliary cholangitis: the ALP-A score
Cançado G, de Faria Gomes N, Couto C, Cançado E, Terrabuio D, Villela-Nogueira C, Braga M, Nardelli M, Faria L, Oliveira E, Rotman V, Oliveira M, da Cunha S, de Campos Mazo D, Mendes L, Ivantes C, Codes L, de Almeida e Borges V, de Lima Pace F, Pessôa M, Signorelli I, Coral G, Bittencourt P, Fucuta P, de Carvalho Filho R, Ferraz M. A new and simple score to predict adequate and deep response to ursodeoxycholic acid in patients with primary biliary cholangitis: the ALP-A score. European Journal Of Gastroenterology & Hepatology 2024, 36: 628-635. PMID: 38555601, DOI: 10.1097/meg.0000000000002744.Peer-Reviewed Original ResearchConceptsPrimary biliary cholangitisResponse to UDCAPrimary biliary cholangitis patientsUrsodeoxycholic acidBiliary cholangitisDerivation cohortResponse to ursodeoxycholic acidCohort of PBC patientsPredictive valueRisk of adverse outcomesNegative predictive valueUrsodeoxycholic acid treatmentUDCA responseProportion of patientsPositive predictive valueYear of treatmentALP-ARoutine clinical useAlternative therapeutic approachArea under the ROC curveLogistic regression analysisDeep respondersPBC patientsStandard treatmentNon-responders
2023
Risk factors for cancer in patients with primary biliary cholangitis and autoimmune hepatitis and primary biliary cholangitis overlap syndrome
Braga M, Cançado G, Bittencourt P, Couto C, Guedes L, Lima A, Ferraz M, Villela-Nogueira C, Nardelli M, Faria L, de Faria Gomes N, Oliveira E, Rotman V, Oliveira M, da Cunha S, Cunha-Silva M, Mendes L, Ivantes C, Codes L, de Almeida e Borges V, de Lima Pace F, Pessoa M, Signorelli I, Coral G, Filho J, Chagas A, Terrabuio D, Cançado E, Consortium M. Risk factors for cancer in patients with primary biliary cholangitis and autoimmune hepatitis and primary biliary cholangitis overlap syndrome. Annals Of Hepatology 2023, 28: 101105. PMID: 37088418, DOI: 10.1016/j.aohep.2023.101105.Peer-Reviewed Original ResearchConceptsHigh risk of hepatocellular carcinomaPrimary biliary cholangitisExtra-hepatic malignanciesPrimary biliary cholangitis patientsAutoimmune hepatitisAzathioprine therapyLaboratory featuresBiliary cholangitisPrevalence of smokingOverlap syndromeAutoimmune diseasesFactors associated with cancer developmentRisk factorsRisk of hepatocellular carcinomaHigh riskStudy Group databaseConcurrent autoimmune diseasesPrevalence of cirrhosisAMA-positiveAzathioprine useCREST syndromePBC patientsAssociated with cancerSjogren's syndromeHepatocellular carcinoma
2022
Response to Ursodeoxycholic Acid May Be Assessed Earlier to Allow Second-Line Therapy in Patients with Unresponsive Primary Biliary Cholangitis
Cançado G, Couto C, Terrabuio D, Cançado E, Villela-Nogueira C, Ferraz M, Braga M, Nardelli M, Faria L, de Faria Gomes N, Oliveira E, Rotman V, Oliveira M, da Cunha S, Cunha-Silva M, Mendes L, Ivantes C, Codes L, de Almeida e Borges V, de Lima Pace F, Pessoa M, Guedes L, Signorelli I, Coral G, Levy C, Bittencourt P. Response to Ursodeoxycholic Acid May Be Assessed Earlier to Allow Second-Line Therapy in Patients with Unresponsive Primary Biliary Cholangitis. Digestive Diseases And Sciences 2022, 68: 514-520. PMID: 35989386, DOI: 10.1007/s10620-022-07654-x.Peer-Reviewed Original ResearchConceptsSecond-line therapyPrimary biliary cholangitisUrsodeoxycholic acidBiliary cholangitisResponse to ursodeoxycholic acidBaseline alkaline phosphataseMulticenter retrospective cohortBaseline liver enzyme levelsMonths of treatmentLiver enzyme levelsSecond-lineAdvanced diseasePOISE trialTreatment initiationRetrospective cohortConclusionsAfter 6Absence of responseNon-respondersPatientsTherapyResponse criteriaModerate agreementEarly additionMonthsCholangitisFibrates for the Treatment of Primary Biliary Cholangitis Unresponsive to Ursodeoxycholic Acid: An Exploratory Study
Cançado G, Couto C, Guedes L, Braga M, Terrabuio D, Cançado E, Ferraz M, Villela-Nogueira C, Nardelli M, Faria L, de Oliveira E, Rotman V, de Campos Mazo D, de Almeida e Borges V, Mendes L, Codes L, Pessoa M, Signorelli I, Levy C, Bittencourt P. Fibrates for the Treatment of Primary Biliary Cholangitis Unresponsive to Ursodeoxycholic Acid: An Exploratory Study. Frontiers In Pharmacology 2022, 12: 818089. PMID: 35126149, PMCID: PMC8811361, DOI: 10.3389/fphar.2021.818089.Peer-Reviewed Original ResearchPrimary biliary cholangitisUrsodeoxycholic acidBiochemical response to ursodeoxycholic acidSuboptimal response to UDCAResponse to UDCAResponse to ursodeoxycholic acidConclusion:Methods:Primary biliary cholangitis patientsResults:Treatment response ratesAdd-on treatmentYear of treatmentCombination therapyPBC patientsBiliary cholangitisMulticenter databaseTreatment initiationClinical trialsPatientsResponse ratePBC-1TreatmentCiprofibrateBezafibrate
2021
Clinical features and treatment outcomes of primary biliary cholangitis in a highly admixed population
Cançado G, Braga M, Ferraz M, Villela-Nogueira C, Terrabuio D, Cançado E, Nardelli M, Faria L, de Faria Gomes N, de Oliveira E, Rotman V, de Oliveira M, da Cunha S, de Campos Mazo D, Mendes L, Ivantes C, Codes L, de Almeida e Borges V, de Lima Pace F, Pessoa M, Signorelli I, Coral G, Bittencourt P, Levy C, Couto C, Consortium M. Clinical features and treatment outcomes of primary biliary cholangitis in a highly admixed population. Annals Of Hepatology 2021, 27: 100546. PMID: 34600142, DOI: 10.1016/j.aohep.2021.100546.Peer-Reviewed Original ResearchConceptsPrimary biliary cholangitisOutcomes of primary biliary cholangitisResponse to UDCAClinical featuresAutoimmune hepatitisUrsodeoxycholic acidTreatment outcomesBiliary cholangitisHistological stageAssociated with primary non-responseOutcomes of Brazilian patientsResponse to UDCA therapyFeatures of primary biliary cholangitisTreated with ursodeoxycholic acidBaseline alkaline phosphatasePrimary non-responseBaseline aspartate aminotransferaseAdvanced histological stageAdd-on therapyLiver-related causesConcurrent autoimmune diseasesNon-adherence to treatmentAlkaline phosphataseAlkaline phosphatase levelsAspartate aminotransferase