Pub Date : 2024-12-01DOI: 10.1016/j.transproceed.2024.11.004
Shang Xu, Zhilong Liu, Xinning Wang
Donation after Cardiac Death (DCD) is an important source of kidneys for kidney transplantation, but DCD kidney transplantation is associated with more complications, impacting the function of the transplanted kidney. Establishing a stable DCD kidney transplantation model in rats can help study the mechanisms of injury and complications prevention in DCD kidney transplantation. This review summarizes the current research status and progress in rat DCD kidney transplantation.
{"title":"Current Status and Development of Rat DCD Renal Transplantation Model","authors":"Shang Xu, Zhilong Liu, Xinning Wang","doi":"10.1016/j.transproceed.2024.11.004","DOIUrl":"10.1016/j.transproceed.2024.11.004","url":null,"abstract":"<div><div>Donation after Cardiac Death (DCD) is an important source of kidneys for kidney transplantation, but DCD kidney transplantation is associated with more complications, impacting the function of the transplanted kidney. Establishing a stable DCD kidney transplantation model in rats can help study the mechanisms of injury and complications prevention in DCD kidney transplantation. This review summarizes the current research status and progress in rat DCD kidney transplantation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2280-2283"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Here we investigated 2 different arterial reconstruction procedures with preservation of the gastroduodenal artery (GDA) in orthotopic liver transplantation (OLT).
Methods
A retrospective cohort study was conducted. The clinicopathological data of 40 pairs of donors and recipients who underwent OLT from May 2018 to August 2023 were analyzed. The GDA of all recipients was preserved during the hepatic arteries reconstruction, which were divided into 2 groups according to different anastomosis locations, namely the end-to-side group (E-S group, n = 17, Branch-patch between the common hepatic and the gastroduodenal artery) and end-to-end group (E-E group, n = 23, between common hepatic and proper hepatic).
Results
Demographics did not differ between both groups (P > .05). The warm ischemia time (WIT) was numerically longer in the E-S group (403.3 ± 103.3 vs 195.2 ± 35.8 s; P < .001), but the cold ischemia time (CIT) was numerically shorter in the E-S group (279.2 ± 74.7 vs 325.2 ± 15.1 min; P = .023). The time of artery reconstruction and duration of surgery was numerically shorter in the E-S group (21.0 ± 3.6 vs 51.0 ± 9.1 min, P < .001; 326.0 ± 103.4 vs 422.7 ± 24.6 min, P = .001). The E-S group had a lower resistance index (RI) (0.5 ± 0.3 vs 0.6 ± 0.1; P = .049).
Conclusion
Both groups showed no differences in artery and biliary complications. GDA preservation meets the anatomical and physiological requirements. E-S is superior to E-E by the time of hepatic artery reconstruction and RI.
目的：探讨原位肝移植（OLT）中保留胃十二指肠动脉（GDA）的两种不同的动脉重建方法。方法：采用回顾性队列研究。分析2018年5月至2023年8月40对肾移植供体和受体的临床病理资料。所有受术者在肝动脉重建过程中均保留GDA，根据吻合位置的不同分为2组，端侧组（E-S组，n = 17，肝总动脉与胃十二指肠动脉之间的分支贴片）和端端组（E-E组，n = 23，肝总动脉与肝原动脉之间的分支贴片）。结果：两组人口统计学差异无统计学意义（P < 0.05）。E-S组大鼠热缺血时间（WIT）数值上更长（403.3±103.3 vs 195.2±35.8 s）；P < 0.001)，但E-S组的冷缺血时间（CIT）较E-S组短（279.2±74.7 vs 325.2±15.1 min）；P = .023)。E-S组动脉重建时间和手术时间较E-S组短(21.0±3.6 min vs 51.0±9.1 min, P < 0.001；326.0±103.4 vs 422.7±24.6 min, P = .001)。E-S组耐药指数（RI）较低（0.5±0.3 vs 0.6±0.1）；P = .049)。结论：两组动脉及胆道并发症无明显差异。GDA保存符合解剖和生理要求。E-S在肝动脉重建及RI时间上优于E-E。
{"title":"Comparison of 2 Different Types of Arterial and Biliary Anastomoses While Preserving the Gastroduodenal Artery: A Retrospective Study","authors":"Yafei Guo, Zebin Zhu, Wei Wu, Hao Zheng, Xiaodong Yuan, Can Qi, Zhijun Xu, Xuefeng Li, Ning Wang, Jiwei Qin, Ruipeng Song, Jizhou Wang, Dalong Yin, Lianxin Liu, Shugeng Zhang, Björn Nashan","doi":"10.1016/j.transproceed.2024.10.040","DOIUrl":"10.1016/j.transproceed.2024.10.040","url":null,"abstract":"<div><h3>Objective</h3><div>Here we investigated 2 different arterial reconstruction procedures with preservation of the gastroduodenal artery (GDA) in orthotopic liver transplantation (OLT).</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted. The clinicopathological data of 40 pairs of donors and recipients who underwent OLT from May 2018 to August 2023 were analyzed. The GDA of all recipients was preserved during the hepatic arteries reconstruction, which were divided into 2 groups according to different anastomosis locations, namely the end-to-side group (E-S group, n = 17, Branch-patch between the common hepatic and the gastroduodenal artery) and end-to-end group (E-E group, n = 23, between common hepatic and proper hepatic).</div></div><div><h3>Results</h3><div>Demographics did not differ between both groups (<em>P</em> > .05). The warm ischemia time (WIT) was numerically longer in the E-S group (403.3 ± 103.3 vs 195.2 ± 35.8 s; <em>P</em> < .001), but the cold ischemia time (CIT) was numerically shorter in the E-S group (279.2 ± 74.7 vs 325.2 ± 15.1 min; <em>P</em> = .023). The time of artery reconstruction and duration of surgery was numerically shorter in the E-S group (21.0 ± 3.6 vs 51.0 ± 9.1 min, <em>P</em> < .001; 326.0 ± 103.4 vs 422.7 ± 24.6 min, <em>P</em> = .001). The E-S group had a lower resistance index (RI) (0.5 ± 0.3 vs 0.6 ± 0.1; <em>P</em> = .049).</div></div><div><h3>Conclusion</h3><div>Both groups showed no differences in artery and biliary complications. GDA preservation meets the anatomical and physiological requirements. E-S is superior to E-E by the time of hepatic artery reconstruction and RI.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2183-2190"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.transproceed.2024.11.011
Minyan Zheng , Yue Wu , Jie Xiang , Li Wang , Zhiwei Li , Feng Gao
Background
This study aimed to determine the risk factors and whether cardiac arrest (CA) in brain-death donors (DBD) could affect pancreas transplantation outcomes.
Methods
We analyzed data from the Scientific Registry of Transplant Recipients (2000-2020). The study included 21,499 pancreas transplantations, divided into CA-DBD and noCA-DBD groups based on whether the DBD had a history of CA.
Results
There were 1129 CA-DBD (5.3%) transplantations. The principal donor death cause for both groups was head trauma. Graft and patient survival rates were similar in both groups. CA time (CAT) was a risk factor for pancreatic graft survival in the univariate analysis (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.03-1.08; P = .010) and multivariate Cox regression model (HR, 1.03; 95% CI, 1.02-1.04; P =.015). Pancreas graft survival in those with CAT ≥30 minutes was significantly lower than in those with CAT <30 minutes and the noCA-DBD group (log-rank P = .018 and P = .014, respectively), which were comparable (log-rank P = .711). No relationships were found among the various transplantation types.
Conclusions
CA in donors did not affect the pancreatic graft prognosis. However, pancreatic donors with CAT ≥30 minutes should be meticulously evaluated.
{"title":"Impact of Preprocurement Cardiac Arrest in Brain-Dead Donors on the Outcome of Pancreas Transplantation","authors":"Minyan Zheng , Yue Wu , Jie Xiang , Li Wang , Zhiwei Li , Feng Gao","doi":"10.1016/j.transproceed.2024.11.011","DOIUrl":"10.1016/j.transproceed.2024.11.011","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine the risk factors and whether cardiac arrest (CA) in brain-death donors (DBD) could affect pancreas transplantation outcomes.</div></div><div><h3>Methods</h3><div>We analyzed data from the Scientific Registry of Transplant Recipients (2000-2020). The study included 21,499 pancreas transplantations, divided into CA-DBD and noCA-DBD groups based on whether the DBD had a history of CA.</div></div><div><h3>Results</h3><div>There were 1129 CA-DBD (5.3%) transplantations. The principal donor death cause for both groups was head trauma. Graft and patient survival rates were similar in both groups. CA time (CAT) was a risk factor for pancreatic graft survival in the univariate analysis (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.03-1.08; <em>P</em> = .010) and multivariate Cox regression model (HR, 1.03; 95% CI, 1.02-1.04; <em>P</em> =.015). Pancreas graft survival in those with CAT ≥30 minutes was significantly lower than in those with CAT <30 minutes and the noCA-DBD group (log-rank <em>P</em> = .018 and <em>P</em> = .014, respectively), which were comparable (log-rank <em>P</em> = .711). No relationships were found among the various transplantation types.</div></div><div><h3>Conclusions</h3><div>CA in donors did not affect the pancreatic graft prognosis. However, pancreatic donors with CAT ≥30 minutes should be meticulously evaluated.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2255-2262"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.transproceed.2024.10.044
Arvind Bakthavatsalam , Billanna Hwang , Michael S. Mulligan
Introduction
Lung transplantation (LTx) is a critical treatment for end-stage pulmonary diseases. Delayed sternal closure (DSC) has been noted in cardiac surgery for several decades and is a viable strategy for patients who are hemodynamically unstable, at high risk for postoperative bleeding, and/or require prolonged cardiopulmonary bypass. However, DSC use and its effects on LTx clinical outcomes are not well-defined.
Methods
A retrospective analysis was performed on patients who had undergone LTx between January 1, 2010, and October 1, 2018, at the University of Washington. Patients under the age of 18, undergoing repeat LTx, other solid organ transplantation, and/or had prior major cardiothoracic surgery were excluded. Patients were classified into 2 categories: DSC and primary sternal closure (PSC) groups. We examined hospital length of stay (LOS), intensive care unit (ICU) LOS, duration on the ventilator, and overall survival.
Results
A total of 370 patients were identified, with 350 patients in the PSC group and 20 patients in the DSC group. The median hospital LOS, ICU LOS and duration on the ventilator in the DSC group were 23.0 ± 3.8, 16.0 ± 3.6, and 9.0 ± 3.5 compared with 15.0 ± 0.8, 5.0 ± 0.5, and 1.0 ± 0.3 in the PSC group, respectively (All P < .01). Kaplan–Meier analysis revealed that, at 1, 3, and 5 years, the DSC group had a survival of 75.0%, 60.0%, and 55.0%, and the PSC group had a survival of 91.4%, 82.6% and 75.1% respectively (P = .019).
Conclusion
DSC is not uncommon in LTx and patients who do require DSC had a longer duration on the ventilator, ICU LOS, and hospital LOS. Additionally, the DSC group had a worse survival compared with the PSC group. DSC is unlikely to be the sole factor influencing worse survival, but may be a marker of underlying patient factors that negatively affect survival.
{"title":"Clinical Outcomes in Delayed Sternal Closure in Lung Transplantation","authors":"Arvind Bakthavatsalam , Billanna Hwang , Michael S. Mulligan","doi":"10.1016/j.transproceed.2024.10.044","DOIUrl":"10.1016/j.transproceed.2024.10.044","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung transplantation (LTx) is a critical treatment for end-stage pulmonary diseases. Delayed sternal closure (DSC) has been noted in cardiac surgery for several decades and is a viable strategy for patients who are hemodynamically unstable, at high risk for postoperative bleeding, and/or require prolonged cardiopulmonary bypass. However, DSC use and its effects on LTx clinical outcomes are not well-defined.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on patients who had undergone LTx between January 1, 2010, and October 1, 2018, at the University of Washington. Patients under the age of 18, undergoing repeat LTx, other solid organ transplantation, and/or had prior major cardiothoracic surgery were excluded. Patients were classified into 2 categories: DSC and primary sternal closure (PSC) groups. We examined hospital length of stay (LOS), intensive care unit (ICU) LOS, duration on the ventilator, and overall survival.</div></div><div><h3>Results</h3><div>A total of 370 patients were identified, with 350 patients in the PSC group and 20 patients in the DSC group. The median hospital LOS, ICU LOS and duration on the ventilator in the DSC group were 23.0 ± 3.8, 16.0 ± 3.6, and 9.0 ± 3.5 compared with 15.0 ± 0.8, 5.0 ± 0.5, and 1.0 ± 0.3 in the PSC group, respectively (All <em>P</em> < .01). Kaplan–Meier analysis revealed that, at 1, 3, and 5 years, the DSC group had a survival of 75.0%, 60.0%, and 55.0%, and the PSC group had a survival of 91.4%, 82.6% and 75.1% respectively (<em>P</em> = .019).</div></div><div><h3>Conclusion</h3><div>DSC is not uncommon in LTx and patients who do require DSC had a longer duration on the ventilator, ICU LOS, and hospital LOS. Additionally, the DSC group had a worse survival compared with the PSC group. DSC is unlikely to be the sole factor influencing worse survival, but may be a marker of underlying patient factors that negatively affect survival.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2231-2236"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.transproceed.2024.11.019
Fu Yan , Zhou Sun , Guofu Liang , Chao Liu , Yulin Niu
Objective
Secondary hyperparathyroidism (sHPT) is a common symptom of chronic kidney disease (CKD), and at the time of transplantation, more than two-thirds of patients with end-stage renal disease have secondary hyperparathyroidism. After kidney transplantation, parathyroid function is normalized in some kidney transplant recipients, but up to 50% of kidney transplant recipients develop tertiary hyperparathyroidism (tHPT) 1 year after kidney transplantation. The effect of parathyroidectomy on the grafts is currently unclear; thus, we conducted a meta-analysis of relevant studies to evaluate changes in graft function 1 year after parathyroidectomy, aiming to assess the procedure's safety in renal transplant recipients.
Methods
A thorough exploration was conducted across Embase, PubMed, Web of Science, and the Cochrane Library databases to gather pertinent literature spanning from January 1, 2000, to December 31, 2023. The search criteria encompassed terms such as “kidney transplantation,” “parathyroidectomy,” and “hyperparathyroidism.”
Results
Twelve studies were scrutinized to assess alterations in graft functionality at 1, 3, 6, and 12 months postparathyroidectomy. The meta-analysis unveiled a notable decline in overall glomerular filtration rate and a concurrent elevation in serum creatinine 1 year postparathyroidectomy, signifying an impairment in graft function compared to the preoperative phase. Significant heterogeneity was observed among the studies.
Conclusion
Following parathyroidectomy in renal transplant recipients 1 year postsurgery, calcium and parathyroid hormone levels normalized. Nonetheless, there was evident impairment in graft function and an elevated risk of graft loss. Hence, the safety of parathyroidectomy in patients with secondary hyperparathyroidism postrenal transplantation necessitates meticulous consideration.
目的：继发性甲状旁腺功能亢进（sHPT）是慢性肾脏疾病（CKD）的常见症状，在移植时，超过三分之二的终末期肾脏疾病患者有继发性甲状旁腺功能亢进。肾移植后，一些肾移植受者的甲状旁腺功能恢复正常，但高达50%的肾移植受者在肾移植后1年发生三级甲状旁腺功能亢进（tHPT）。甲状旁腺切除术对移植物的影响目前尚不清楚；因此，我们对相关研究进行了荟萃分析，以评估甲状旁腺切除术后1年移植物功能的变化，旨在评估该手术在肾移植受者中的安全性。方法：全面检索Embase、PubMed、Web of Science和Cochrane Library数据库，收集2000年1月1日至2023年12月31日的相关文献。搜索标准包括“肾移植”、“甲状旁腺切除术”和“甲状旁腺功能亢进”等术语。“结果：12项研究被仔细审查，以评估甲状旁腺切除术后1、3、6和12个月移植物功能的改变。荟萃分析显示，甲状旁腺切除术后1年，总体肾小球滤过率显著下降，血清肌酐升高，与术前相比，移植物功能受损。研究之间存在显著的异质性。结论：肾移植术后1年行甲状旁腺切除术后，钙和甲状旁腺激素水平恢复正常。尽管如此，移植物功能明显受损，移植物丧失的风险升高。因此，肾移植后继发性甲状旁腺功能亢进患者行甲状旁腺切除术的安全性需要慎重考虑。
{"title":"Effect of Parathyroidectomy After Renal Transplantation on Grafted Kidney Function Within One Year: A Meta-Analysis","authors":"Fu Yan , Zhou Sun , Guofu Liang , Chao Liu , Yulin Niu","doi":"10.1016/j.transproceed.2024.11.019","DOIUrl":"10.1016/j.transproceed.2024.11.019","url":null,"abstract":"<div><h3>Objective</h3><div>Secondary hyperparathyroidism (sHPT) is a common symptom of chronic kidney disease (CKD), and at the time of transplantation, more than two-thirds of patients with end-stage renal disease have secondary hyperparathyroidism. After kidney transplantation, parathyroid function is normalized in some kidney transplant recipients, but up to 50% of kidney transplant recipients develop tertiary hyperparathyroidism (tHPT) 1 year after kidney transplantation. The effect of parathyroidectomy on the grafts is currently unclear; thus, we conducted a meta-analysis of relevant studies to evaluate changes in graft function 1 year after parathyroidectomy, aiming to assess the procedure's safety in renal transplant recipients.</div></div><div><h3>Methods</h3><div>A thorough exploration was conducted across Embase, PubMed, Web of Science, and the Cochrane Library databases to gather pertinent literature spanning from January 1, 2000, to December 31, 2023. The search criteria encompassed terms such as “kidney transplantation,” “parathyroidectomy,” and “hyperparathyroidism.”</div></div><div><h3>Results</h3><div>Twelve studies were scrutinized to assess alterations in graft functionality at 1, 3, 6, and 12 months postparathyroidectomy. The meta-analysis unveiled a notable decline in overall glomerular filtration rate and a concurrent elevation in serum creatinine 1 year postparathyroidectomy, signifying an impairment in graft function compared to the preoperative phase. Significant heterogeneity was observed among the studies.</div></div><div><h3>Conclusion</h3><div>Following parathyroidectomy in renal transplant recipients 1 year postsurgery, calcium and parathyroid hormone levels normalized. Nonetheless, there was evident impairment in graft function and an elevated risk of graft loss. Hence, the safety of parathyroidectomy in patients with secondary hyperparathyroidism postrenal transplantation necessitates meticulous consideration.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2134-2143"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.transproceed.2024.11.003
Jacques Neelankavil , Reed Harvey , Jure Marijic , Michael Tan , Lorraine Lubin , Ali Salehi , Theodora Wingert , Tristan Grogan , David Sayah , Abbas Ardehali
Aspiration is one of many risk factors for chronic lung allograft dysfunction, which continues to limit survival in lung transplant recipients. Oropharyngeal dysphagia (OPD) occurring after lung transplant surgery increases the risk of antegrade aspiration. While the incidence and risk factors for OPD have been well described in cardiac surgery, there is less known in the lung transplant population. The aim of this retrospective, single-center study was to determine the incidence of clinically significant OPD in lung transplant recipients and to identify patient and procedural risk factors for OPD in this population. A total of 158 lung transplant recipients who underwent postoperative fiberoptic endoscopic evaluation of swallowing (FEES) were included in the study. The incidence of OPD was 67.1% (106/158) with 29.8% (47) having a complete absence of swallowing function. Female sex, cardiopulmonary bypass, duration of intubation, and an increased number of transesophageal echocardiography (TEE) clips were associated with OPD. The incidence of OPD in this study is consistent with the limited data available in lung transplant literature, and higher than that of general cardiac surgery. An increased number of acquired TEE clips is a novel OPD risk factor in this population and a modifiable target for future intervention.
{"title":"Incidence and Risk Factors for Clinically Significant Oropharyngeal Dysphagia After Lung Transplantation","authors":"Jacques Neelankavil , Reed Harvey , Jure Marijic , Michael Tan , Lorraine Lubin , Ali Salehi , Theodora Wingert , Tristan Grogan , David Sayah , Abbas Ardehali","doi":"10.1016/j.transproceed.2024.11.003","DOIUrl":"10.1016/j.transproceed.2024.11.003","url":null,"abstract":"<div><div>Aspiration is one of many risk factors for chronic lung allograft dysfunction, which continues to limit survival in lung transplant recipients. Oropharyngeal dysphagia (OPD) occurring after lung transplant surgery increases the risk of antegrade aspiration. While the incidence and risk factors for OPD have been well described in cardiac surgery, there is less known in the lung transplant population. The aim of this retrospective, single-center study was to determine the incidence of clinically significant OPD in lung transplant recipients and to identify patient and procedural risk factors for OPD in this population. A total of 158 lung transplant recipients who underwent postoperative fiberoptic endoscopic evaluation of swallowing (FEES) were included in the study. The incidence of OPD was 67.1% (106/158) with 29.8% (47) having a complete absence of swallowing function. Female sex, cardiopulmonary bypass, duration of intubation, and an increased number of transesophageal echocardiography (TEE) clips were associated with OPD. The incidence of OPD in this study is consistent with the limited data available in lung transplant literature, and higher than that of general cardiac surgery. An increased number of acquired TEE clips is a novel OPD risk factor in this population and a modifiable target for future intervention.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2226-2230"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.transproceed.2024.11.009
Siegfredo R. Paloyo , Ferri P. David-Paloyo , Rose Marie R. Liquete , Enrique T. Ona
End-stage liver disease is arguably one of the leading burdensome diseases among developing countries such as the Philippines. Although liver transplantation is considered the treatment of choice for decompensated cirrhosis, the establishment of a robust transplant program locally has been protracted as numerous obstacles continue to plague our transplant landscape. Issues on cost, options of having the transplant done overseas, and low rates of deceased donation are some of the difficulties that hamper our program's progress and development. In this study, we aim to present our experience and discuss hurdles, describing the current status of liver transplantation in the country.
Herein we report our initial 68 liver transplants covering 35 years. A retrospective review was performed including all transplants done in 4 active transplant centers from August 1988 to December 2023. Recipients were mostly male patients (69%) with hepatitis B as the most common (32%) primary liver disease. Deceased donor liver transplant was more common (65%) with recipients having a median Model for End-Stage Liver Disease (MELD) score of 22. Among living donor liver transplants, 58% of the grafts were from the left lateral segment. Outcomes can be divided into two eras, with the first era (1988-2010) having a 1-year graft survival of only 25%. The second era (2011-present) was marked with surgical refinements and advancing knowledge, improving 1-year graft survival to 64% and 67% for adult and pediatric transplants, respectively. Indeed, the establishment of a liver transplant program requires a team approach and most fundamentally, full training in liver transplantation and the management of its complications. Optimal patient selection remains essential in achieving excellent survival outcomes. Last, Filipinos with liver cirrhosis now have an opportunity for a significant improvement in their quality of life by undergoing transplantation in their native country.
{"title":"Liver Transplantation in the Philippines: Light at the End of the Tunnel","authors":"Siegfredo R. Paloyo , Ferri P. David-Paloyo , Rose Marie R. Liquete , Enrique T. Ona","doi":"10.1016/j.transproceed.2024.11.009","DOIUrl":"10.1016/j.transproceed.2024.11.009","url":null,"abstract":"<div><div>End-stage liver disease is arguably one of the leading burdensome diseases among developing countries such as the Philippines. Although liver transplantation is considered the treatment of choice for decompensated cirrhosis, the establishment of a robust transplant program locally has been protracted as numerous obstacles continue to plague our transplant landscape. Issues on cost, options of having the transplant done overseas, and low rates of deceased donation are some of the difficulties that hamper our program's progress and development. In this study, we aim to present our experience and discuss hurdles, describing the current status of liver transplantation in the country.</div><div>Herein we report our initial 68 liver transplants covering 35 years. A retrospective review was performed including all transplants done in 4 active transplant centers from August 1988 to December 2023. Recipients were mostly male patients (69%) with hepatitis B as the most common (32%) primary liver disease. Deceased donor liver transplant was more common (65%) with recipients having a median Model for End-Stage Liver Disease (MELD) score of 22. Among living donor liver transplants, 58% of the grafts were from the left lateral segment. Outcomes can be divided into two eras, with the first era (1988-2010) having a 1-year graft survival of only 25%. The second era (2011-present) was marked with surgical refinements and advancing knowledge, improving 1-year graft survival to 64% and 67% for adult and pediatric transplants, respectively. Indeed, the establishment of a liver transplant program requires a team approach and most fundamentally, full training in liver transplantation and the management of its complications. Optimal patient selection remains essential in achieving excellent survival outcomes. Last, Filipinos with liver cirrhosis now have an opportunity for a significant improvement in their quality of life by undergoing transplantation in their native country.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2178-2182"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent decades, China has experienced a shortage of donated bodies and organs for dissection during medical education and clinical transplantation. This study investigated and analyzed motivational factors affecting body and organ donation in China.
Methodology
Thirty-three body and organ donation volunteers were interviewed in-depth, and their donation motivations were investigated. The data were decomposed, detected, compared, conceptualized, and categorized using open, correlation, and selective coding based on grounded theory.
Results
The results were used to construct a model that elucidates the foundation of body and organ donation based on “humanistic medical care” and “death in existentialism” as driving forces for body and organ donors.
Conclusions
This study provides new theoretical perspectives that contribute to interpreting behavior related to body and organ donation and offers a theoretical basis for related policymaking and promotional work.
{"title":"Motivational Factors Affecting Body and Organ Donation in China Identified Based on Grounded Theory","authors":"Yunfeng Wang , Ping Dong , Yukun Zhou , Shanshan Gao , Luqing Zhang","doi":"10.1016/j.transproceed.2024.11.005","DOIUrl":"10.1016/j.transproceed.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>In recent decades, China has experienced a shortage of donated bodies and organs for dissection during medical education and clinical transplantation. This study investigated and analyzed motivational factors affecting body and organ donation in China.</div></div><div><h3>Methodology</h3><div>Thirty-three body and organ donation volunteers were interviewed in-depth, and their donation motivations were investigated. The data were decomposed, detected, compared, conceptualized, and categorized using open, correlation, and selective coding based on grounded theory.</div></div><div><h3>Results</h3><div>The results were used to construct a model that elucidates the foundation of body and organ donation based on “humanistic medical care” and “death in existentialism” as driving forces for body and organ donors.</div></div><div><h3>Conclusions</h3><div>This study provides new theoretical perspectives that contribute to interpreting behavior related to body and organ donation and offers a theoretical basis for related policymaking and promotional work.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2115-2123"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To explore the mechanism of action of diosgenin and JAK/STAT in SD rat renal ischemia-reperfusion (I/R) injury.
Method
A renal I/R injury model was established, rat was divided into four groups: control group, sham surgery group, I/R model group, and diosgenin pretreatment group. 48 hours after the completion of modeling, blood was collected for testing of SCr, BUN, and Kim-1. After blood collection, bilateral kidneys were cut and stored in liquid nitrogen for HE staining. Western blot was used to detect the protein expression levels of JAK and STAT in each group. Compare and analyze the differences in JAK/STAT expression levels among different groups.
Result
Compared with the I/R model group, the Scr, Bun, and Kim-1 concentrations of the three treatment groups were significantly lower, the other three treatment groups showed significant improvement in symptoms of renal vacuolar degeneration and interstitial edema in rats, the expression levels of JAK and STAT in the three groups were significantly lower, while the difference between the three groups was not significant.
目的探讨薯蓣皂苷与JAK/STAT在SD大鼠肾缺血再灌注损伤中的作用机制：方法：建立SD大鼠肾缺血再灌注损伤模型，将大鼠分为四组：对照组、假手术组、I/R模型组和地奥司宁预处理组。模型制作完成 48 小时后，采血检测 SCr、BUN 和 Kim-1。采血后，切取双侧肾脏并保存在液氮中进行 HE 染色。用 Western blot 检测各组 JAK 和 STAT 的蛋白表达水平。比较并分析不同组间 JAK/STAT 表达水平的差异：与I/R模型组相比，三个治疗组的Scr、Bun和Kim-1浓度明显降低，其他三个治疗组大鼠肾空泡变性和间质水肿症状明显改善，三个治疗组的JAK和STAT表达水平明显降低，三组间差异无显著性。
{"title":"Diosgenin Mediated JAK/STAT Signal Channel Improving SD Rat Renal Ischemia-Reperfusion","authors":"Jinran Yang, Xinchang Li, Chengmei Long, Youfu Zhang, Hua Yang, Tongchang Chen, Xuyang Wang, Xiaomei Huang","doi":"10.1016/j.transproceed.2024.11.007","DOIUrl":"10.1016/j.transproceed.2024.11.007","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the mechanism of action of diosgenin and JAK/STAT in SD rat renal ischemia-reperfusion (I/R) injury.</div></div><div><h3>Method</h3><div>A renal I/R injury model was established, rat was divided into four groups: control group, sham surgery group, I/R model group, and diosgenin pretreatment group. 48 hours after the completion of modeling, blood was collected for testing of SCr, BUN, and Kim-1. After blood collection, bilateral kidneys were cut and stored in liquid nitrogen for HE staining. Western blot was used to detect the protein expression levels of JAK and STAT in each group. Compare and analyze the differences in JAK/STAT expression levels among different groups.</div></div><div><h3>Result</h3><div>Compared with the I/R model group, the Scr, Bun, and Kim-1 concentrations of the three treatment groups were significantly lower, the other three treatment groups showed significant improvement in symptoms of renal vacuolar degeneration and interstitial edema in rats, the expression levels of JAK and STAT in the three groups were significantly lower, while the difference between the three groups was not significant.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2292-2297"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.transproceed.2024.11.018
Sinan Efe Yazici , Ahmet Atasever , Ebru Turan , Yildiray Yuzer
Introduction
Living donor liver transplantation is encouraged due to the limited availability of cadaveric donors. However, this patient group is at risk for various complications. Diaphragmatic hernia is a rare complication but often requires reoperation. Given its poor characterization, clinicians and radiologists should remain vigilant about this potential issue.
Case Series
At our center, after 1233 donor hepatectomy operations performed between 2004 and 2024, 2 cases (0.16%) of postoperative diaphragmatic hernia were observed. Both patients were operated on under emergency conditions and via a transabdominal approach. We present these 2 cases along with a literature review.
Results
Patients should be treated even if they are asymptomatic. As far as we know, 38 cases have been reported in the literature, with most treated surgically. Both transabdominal and transthoracic approaches can be used. Primary repair or mesh repair can be performed. The patients in our series are followed up without any problems after the operation. If left untreated, it can lead to complications that may result in death. In our article, we aim to present this rare complication through 2 case reports, accompanied by a review of the relevant literature.
{"title":"An Inside Into a Rare Living Liver Donor Hepatectomy Complication: Acute Mechanical Bowel Obstruction Resulting from a Diaphragmatic Hernia","authors":"Sinan Efe Yazici , Ahmet Atasever , Ebru Turan , Yildiray Yuzer","doi":"10.1016/j.transproceed.2024.11.018","DOIUrl":"10.1016/j.transproceed.2024.11.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Living donor liver transplantation is encouraged due to the limited availability of cadaveric donors. However, this patient group is at risk for various complications. Diaphragmatic hernia is a rare complication but often requires reoperation. Given its poor characterization, clinicians and radiologists should remain vigilant about this potential issue.</div></div><div><h3>Case Series</h3><div>At our center, after 1233 donor hepatectomy operations performed between 2004 and 2024, 2 cases (0.16%) of postoperative diaphragmatic hernia were observed. Both patients were operated on under emergency conditions and via a transabdominal approach. We present these 2 cases along with a literature review.</div></div><div><h3>Results</h3><div>Patients should be treated even if they are asymptomatic. As far as we know, 38 cases have been reported in the literature, with most treated surgically. Both transabdominal and transthoracic approaches can be used. Primary repair or mesh repair can be performed. The patients in our series are followed up without any problems after the operation. If left untreated, it can lead to complications that may result in death. In our article, we aim to present this rare complication through 2 case reports, accompanied by a review of the relevant literature.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"56 10","pages":"Pages 2219-2225"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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