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71.
Tommy Ivanics Michael Rizzari Dilip Moonka Abbas Al-Kurd Khortnal Delvecchio Toshihiro Kitajima Ahmed M. Elsabbagh Kelly Collins Atsushi Yoshida Marwan Abouljoud Shunji Nagai 《American journal of transplantation》2021,21(3):1100-1112
The success of direct-acting antiviral (DAA) therapy has led to near-universal cure for patients chronically infected with hepatitis C virus (HCV) and improved post–liver transplant (LT) outcomes. We investigated the trends and outcomes of retransplantation in HCV and non-HCV patients before and after the introduction of DAA. Adult patients who underwent re-LT were identified in the Organ Procurement and Transplantation Network/United Network for Organ Sharing database. Multiorgan transplants and patients with >2 total LTs were excluded. Two eras were defined: pre-DAA (2009-2012) and post-DAA (2014-2017). A total of 2112 re-LT patients were eligible (HCV: n = 499 pre-DAA and n = 322 post-DAA; non-HCV: n = 547 pre-DAA and n = 744 post-DAA). HCV patients had both improved graft and patient survival after re-LT in the post-DAA era. One-year graft survival was 69.8% pre-DAA and 83.8% post-DAA (P < .001). One-year patient survival was 73.1% pre-DAA and 86.2% post-DAA (P < .001). Graft and patient survival was similar between eras for non-HCV patients. When adjusted, the post-DAA era represented an independent positive predictive factor for graft and patient survival (hazard ratio [HR]: 0.67; P = .005, and HR: 0.65; P = .004) only in HCV patients. The positive post-DAA era effect was observed only in HCV patients with first graft loss due to disease recurrence (HR: 0.31; P = .002, HR 0.32; P = .003, respectively). Among HCV patients, receiving a re-LT in the post-DAA era was associated with improved patient and graft survival. 相似文献
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Lung Transplant Center Volume Ameliorates Adverse Influence of Prolonged Ischemic Time on Mortality
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D. Hayes Jr. M. G. Hartwig J. D. Tobias D. Tumin 《American journal of transplantation》2017,17(1):218-226
The influence of prolonged ischemic time on outcomes after lung transplant is controversial, but no research has investigated ischemic time in the context of center volume. We used data from the United Network for Organ Sharing to estimate the influence of ischemic time on patient survival conditional on center volume in the post–lung allocation score era (2005–2015). The analytic sample included 14 877 adult lung transplant recipients, of whom 12 447 were included in multivariable survival analysis. Patient survival was improved in high‐volume centers compared with low‐volume centers (log‐rank test p = 0.001), although mean ischemic times were longer at high‐volume centers (5.16 ± 1.70 h vs. 4.83 ± 1.63 h, p < 0.001). Multivariable Cox proportional hazards regression stratified by transplant center found an adverse influence of longer ischemic time at low‐volume centers but not at high‐volume centers. At centers performing 50 transplants in the period 2005–2015, for example, 8 versus 6 h of ischemia were associated with an 18.9% (95% confidence interval 6.5–32.7%; p < 0.001) greater mortality hazard, whereas at centers performing 350 transplants in this period, no differences in survival by ischemic time were predicted. Despite longer mean ischemic time at high‐volume transplant centers, these centers had favorable patient outcomes and no adverse survival implications of prolonged ischemia. 相似文献
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Risk of tumor transmission after thoracic allograft transplantation from adult donors with central nervous system neoplasm—A UNOS database study
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《Research in autism spectrum disorders》2014,8(11):1425-1433
The current studies evaluated variables affecting sharing exhibited by children with autism spectrum disorder. Study 1 evaluated the effects of manipulating item preference on the level of assistance needed to exhibit sharing behavior for 4 children with autism. Item preference clearly affected 2 participants’ percentage of independent sharing. Preference did not have as clear of an effect for a third participant. However, sharing a high-preference item generally required a higher level of prompting (e.g., vocal prompts) to share. The fourth participant's percentage of independent sharing was not influenced by preference, and his independent sharing behavior was similar across item preference. Study 2 assessed the effectiveness of a token reinforcement procedure as an intervention designed to increase independent sharing of high-preference items for the two participants who did not independently share those items during Study 1. Independent sharing increased for both participants when the token procedure was in place and decreased when it was removed. 相似文献
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Joanna T. Swinarska Robert J. Stratta Jeffrey Rogers Amy Chang Alan C. Farney Giuseppe Orlando Amber Reeves-Daniel Venkat Gurram Michael D. Gautreaux Colleen L. Jay 《Journal of the American College of Surgeons》2021,232(4):493-502
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79.
本期“国际生命伦理学家”栏目介绍挪威卑尔根大学哲学系主任Reidar Lie教授.本文分三部分,第一部分是他的简历,他目前的研究方向是:国际合作研究的伦理问题,发展中国家卫生改革的伦理问题.第二部分是他提供的最新代表作“疾病监测、受益和样本共享”.文章考查了世界卫生组织内部有关建立流感大流行准备框架的争论,这个争论涉及那些贡献样本的国家能够预期有哪些受益作为回报,特别是在获得大流行的流感疫苗上,虽然在2011年达成了协议,但基本的争议问题并没有得到解决.第三部分是他就生命伦理学与科学哲学的关系、生命伦理学的规范性以及生命伦理学家了解临床和研究实践等问题所作的回答. 相似文献
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