共查询到20条相似文献，搜索用时 0 毫秒
1.
M. Pitarch Martínez B. Sánchez Pérez F.J. León Díaz J.L. Fernández Aguilar J.A. Pérez Daga M.C. Montiel Casado J.M. Aranda Narváez M.Á. Suárez Muñoz J. Santoyo Santoyo 《Transplantation proceedings》2019,51(1):4-8
Background
As new sources of organs are needed, liver transplantation using donors after cardiac death (DCD) is progressively increasing, but outcomes with this method are still questioned. This study was accomplished to verify that DCD outcomes are comparable to those seen in donation after brain death (DBD).Methods
This was a prospective cohort study including 100 liver transplantation performed between 2014 and 2017, divided according to donor type in 75 DBD and 25 DCD.Results
DCD donors were younger (mean age: DCD 56 years, DBD 59 years; P = .009). Mean Modified End-stage Liver Disease (MELD) score was lower for DCD (DCD 16, DBD 19; P < .001). No differences were found regarding ischemia times and development of postreperfusion syndrome or coagulopathy. Primary graft dysfunction was more frequent in DCD (60%, DCD 29.3%; P = .006). Rates of primary graft nonfunction (DCD 0%, DBD 1.3%; P = .562) and acute rejection (DCD 20%, DBD 16.4%; P = .685) were similar. Acute kidney injury occurred more often in DBD (DCD 32%, DBD 12%; P = .051). Length of stay was comparable. Rates of biliary complications (DCD 20%, DBD 26.7%; P = .505) were similar, unlike ischemic cholangiopathy (DCD 12%, DBD 1.3%; P = .018). Retransplantation rates were also similar (DCD 8%, DBD 4%; P = .427) as was survival rate after 3 years (DCD 84%, DBD 86.7%; P = .739).Conclusion
DCD represents an additional graft source with results that are encouraging and may be comparable to DBD with a careful donor and recipient selection. 相似文献2.
3.
4.
5.
6.
7.
8.
I. Mirón Fernández F.J. León Díaz J. Sánchez Segura B. Sánchez Pérez J.A. Pérez Daga J.L. Fernández Aguilar M.C. Montiel Casado J. Santoyo Santoyo 《Transplantation proceedings》2019,51(1):80-82
Tumor load is often underdiagnosed on radiological examination previous to liver transplantation (LT) for hepatocarcinoma (CHC). Thus, post–liver transplant explant analysis is required following transplantation to assess the risk of the recurrence of CHC. The objectives were to compare the characteristics of CHC on pre-LT radiological examination and explant histology and validate three models for the prediction of recurrence based on data from a cohort of patients treated in our hospital.
Methods
A retrospective study was undertaken of 105 LTs for CHC performed in our unit between January 2006 and January 2015. The minimum follow-up was five years. The preoperative radiological tumor stage was compared to the explant-based histologic stage. Three prognostic models were validated using our cohort of patients.Results
Following Milan's criteria, the tumor load was underdiagnosed on pre-LT radiological examination in 20 patients, which accounted for 19% of the total sample. The 5-year overall recurrence was 6.6% for scores <4 and 33.3% for scores ≥4 according to Decaens' model; 7% for scores ≤7 and 25% for scores >7 in the Up-to-Seven model; and 3.6% for PCRS ≤0, 27.8% for PCRS1-2, and 100% for PCRS≥3 according to Chan's model. The predictive model for 5-year recurrence after LT with the greatest area under the curve was Chan's model (0.813 [95% CI: 0.650–0.977]) versus Decaens' model (0.674 [95% CI: 0.483–0.866]) and the Up-to-Seven model (0.481 [95% CI: 0.296–0.667]).Conclusions
A pre-LT radiological examination leads to the underdiagnosis of tumor load, and the risk for recurrence must be recalculated following LT. In light of the results obtained, Chan's model is more accurate in predicting 5-year recurrence of CHC post-LT based on 3 levels of risk. New prognostic models are needed to optimize the prediction of recurrence after liver transplantation for hepatocarcinoma. 相似文献9.
This article points out what is important to consider when planning to perform and analyze a commonly seen study involving a comparison of an innovation with something established. A hands-on guide on how to perform this type of research trial and how to choose proper statistical methods is given. 相似文献
10.
11.
Yiyong Tang Jingyi Hou Qingyue Li Fangqi Li Congda Zhang Weiping Li Rui Yang 《Arthroscopy》2019,35(9):2553-2561
12.
A. González-Castro M. Ortiz-Lasa J.C. Rodriguez-Borregan E. Rodrigo Calabia J.C. Ruiz San Millan T. Dierssen Soto 《Transplantation proceedings》2018,50(2):569-571
Background
The hyperchloremic metabolic acidosis triggered by the infusion of normal saline (NS) significantly increases the level of extracellular potassium. In this study we assessed the influence of proportion of NS administered in the perioperative period of renal transplantation on potassium levels in usual clinical practice.Methods
This study was a retrospective cohort analysis of patients undergoing renal transplantation during a 24-month period (2015–2016). To determine the influence of NS on K+ levels, simple linear regression and multiple linear regression analyses were performed, adjusted for the total volume of fluids administered, establishing the difference in serum K+ levels for each 20% increase in the proportion of NS.Results
As the proportion of NS administered increased, K+ levels at 24 hours were significantly increased (P = .026) (0.69 mEq/L K+ increase per 20% increase in NS ratio). Mean K+ values at 24 hours (adjusted for total volume of fluids administered) ranged from 4.17 mEq/L (95% confidence interval [CI] 3.7–4.56) in patients who did not receive NS to 4.85 mEq/L (95% CI 4.56–5.15) in those administered exclusively NS.Conclusion
The risk of developing hyperkalemia in patients who receive a balanced solution with potassium in its formulation compared with NS in the perioperative period of renal transplantation is not increased, but the volume of NS administered is significantly associated with increases in K+ levels at 24 hours. 相似文献13.
14.
A. Alperi I. Pascual B.D. Molina I. Silva R. Lorca D. Hernández-Vaquero P. Avanzas J.L. Lambert C.M. de la Tassa 《Transplantation proceedings》2017,49(7):1667-1671
Patients with solid-organ transplants usually present at the emergency department with nonspecific symptoms. The physician should consider a great variety of syndromes and diseases, given the greater risk that solid-organ transplant patients carry because of immunosuppression and transplant-related conditions. Myocardial infarction caused by cardiac allograft vasculopathy must be always suspected and ruled out, even when initial symptoms do not orientate in that direction. We present a case that conjugates signs that can be present in different pathologies. It shows that fever is not always related to infection or rejection but could also appear in acute cardiac allograft vasculopathy. It emphasizes the need of a multi-disciplinary team led by a heart transplant specialist when dealing with this sort of clinical case. 相似文献
15.
L. Martínez-Alarcón A. Ríos G. Ramis J. Gómez-Laguna X. Moll V. Falceto F. San Román-Acaso F. San Román-Llorens J.J. Quereda J.M. Herrero-Medrano L. Mendonça J.L. Martin-Barrasa O.M. Fernández A.I. López-Navas A.M. Hernández A. Muñoz P. Ramírez P. Parrilla 《Transplantation proceedings》2018,50(2):362-365
Background
Veterinarians often hold decision-making positions in the public health care system and can therefore influence public opinion about organ donation and transplantation (ODT). The aim of this work was to analyze the attitude of Spanish veterinary students toward ODT, because they may influence public opinion in the future, and to determine the factors that condition it.Methods
This was a sociologic, interdisciplinary, multicenter, observational study in Spain. The study population was students studying for a veterinary degree in Spain (n = 9000), and a sample of 2815 students (confidence of 99% and precision of ±1%) was stratified by geographic area and academic year. A validated questionnaire of attitude toward ODT (PCID-DTO-Ríos) was self-administered and anonymous.Results
Of the 2815 selected students (2790 plus the 0.9% per type of sample), 2650 completed the questionnaire (response rate, 94.14%): 83% (n = 2207) of the respondents were in favor of donation and 17% against. The following main variables were related to a favorable attitude: being female (odds ratio [OR], 0.752; P = .034); knowing a donor (OR, 1.834; P = .003); having discussed the matter with one's family (OR, 1.587; P = .002); having spoken about the subject in social circles with friends (OR, 1.633; P < .001), and being in favor of donating a deceased family member's organs (OR, 2.403; P < .001).Conclusions
Seventeen percent of Spanish veterinary students were not in favor of ODT. It is important to know the factors that determine their attitude, because this will make it possible to optimize the resources invested in campaigns to promote ODT and to take more specific action. 相似文献16.
F.J. León Díaz J.L. Fernández Aguilar S. Nicolás de Cabo M. Pérez Reyes B. Sánchez Pérez C. Montiel Casado J.A. Pérez Daga J.M. Aranda Narváez M.A. Suárez Muñoz F. Arenas González M.M. Florez Rías J.L. Pelaez Angulo J. Santoyo Santoyo 《Transplantation proceedings》2018,50(2):539-542
Introduction
Ischemia reperfusion injury (IRI) is the main cause of early allograft dysfunction (EAD) and subsequent primary allograft failure (PAF).Objectives
The purpose of this study is to compare IRI, EAD, and PAF in liver transplantation in a cohort of patients perfused with histidine-tryptophan-ketoglutarate (HTK) solution and University of Wisconsin (UW) solution versus HTK alone.Methods
A randomized trial was performed to compare outcomes in liver recipients who underwent transplantation surgery in the University Regional Hospital of Malaga, Spain. Forty patients were randomized to two groups. Primary endpoints included IRI, EAD, PAF, re-intervention, acute cellular rejection, retransplantation, arterial complications, and biliary complications at postoperative day 90.Results
Postoperative glutamic oxaloacetic transaminase (1869.15 ± 1559.75 UI/L vs. 953.15 ± 777.27 UI/L; P = .004) and glutamic pyruvic transaminase (1333.60 ± 1115.49 U/L vs. 721.70 ± 725.02 U/L; P = .023) were significantly higher in patients perfused with HTK alone. A clear tendency was observed in recipients perfused with HTK alone to present moderate to severe IRI (7 patients in the HTK + UW solution group vs. 15 patients in the HTK-alone solution group; P = .06), EAD (0 patients in the HTK + UW solution group vs. 0 patients in the HTK-alone solution group; P = .76), and PAF (3 patients in the HTK + UW solution group vs. 8 patients in the HTK-alone solution group; P = .15).Conclusions
Initial perfusion with HTK solution followed by UW solution in liver transplantation improves early liver function as compared to perfusion with HTK alone. 相似文献17.
18.
19.