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https://www.readbyqxmd.com/read/28203455/risk-balancing-of-cold-ischemic-time-against-night-shift-surgery-possibly-reduces-rates-of-reoperation-and-perioperative-graft-loss
#1
Nikos Emmanouilidis, Julius Boeckler, Bastian P Ringe, Alexander Kaltenborn, Frank Lehner, Hans Friedrich Koch, Jürgen Klempnauer, Harald Schrem
Background. This retrospective cohort study evaluates the advantages of risk balancing between prolonged cold ischemic time (CIT) and late night surgery. Methods. 1262 deceased donor kidney transplantations were analyzed. Multivariable regression was used to determine odds ratios (ORs) for reoperation, graft loss, delayed graft function (DGF), and discharge on dialysis. CIT was categorized according to a forward stepwise pattern ≤1h/>1h, ≤2h/>2h, ≤3h/>3h,…, ≤nh/>nh. ORs for DGF were plotted against CIT and a nonlinear regression function with best R(2) was identified...
2017: Journal of Transplantation
https://www.readbyqxmd.com/read/28187014/delayed-donor-bone-marrow-infusion-induces-liver-transplant-tolerance
#2
Yan Xie, Yang Wu, Kang Xin, Jiao-Jing Wang, Hong Xu, Suzanne T Ildstad, Joseph Leventhal, Guang-Yu Yang, Zheng Zhang, Josh Levitsky
BACKGROUND: Nonmyeloablative conditioning followed by donor bone marrow infusion (BMI) to induce tolerance has not been robustly tested in liver transplantation (LT) and may be unsafe at the time of LT. We hypothesized T cell depleted BMI is effective in inducing tolerance when delayed after LT, resulting in potentially safer future clinical applications. METHODS: Nonimmunosuppressed syngeneic (Lewis to Lewis) and allogeneic (ACI to Lewis) rat LT transplants were initially performed as controls...
February 10, 2017: Transplantation
https://www.readbyqxmd.com/read/28182639/assessing-the-suitability-of-medial-sural-artery-perforator-flaps-in-tongue-reconstruction-an-outcome-study
#3
Shao-Yu Hung, Charles Yuen Yung Loh, Soo-Ha Kwon, Chia-Hsuan Tsai, Kai-Ping Chang, Huang-Kai Kao
INTRODUCTION: Oncological resection of the tongue can be reconstructed using a multitude of free flaps. The medial sural artery perforator (MSAP) flap has been well described in the literature in terms of its anatomy and harvest. However, functional outcome studies of post-reconstruction tongue defects using the MSAP flap have not been reported. This study represents the largest outcome study of patients with tongue reconstructions using MSAP flaps and a comprehensive review of its use...
2017: PloS One
https://www.readbyqxmd.com/read/28181984/factors-that-affected-functional-outcome-after-a-delayed-excision-and-split-thickness-skin-graft-on-the-dorsal-side-of-burned-hands
#4
Ryuji Shichinohe, Yamamoto Yuhei, Kunihiro Kawashima, Chu Kimura, Kentaro Ono, Katsumi Horiuchi, Tetsunori Yoshida, Naoki Murao, Toshihiko Hayashi, Emi Funayama, Akihiko Oyama, Hiroshi Furukawa
Early excision and skin grafting is the principle treatment for a burned hand although there are occasions when it cannot be done such as severe general condition, delayed consultation, and the lack of a definitive assessment of burn depth. This study analyzes the factors that affected function after a delayed excision and skin graft for hands with a deep dermal burn. This study retrospectively evaluated 43 burned hands that required a delayed excision and split-thickness skin graft on the dorsal side. Cases were required to only have split-thickness skin grafting from the dorsum of the hand and fingers distally to at least the proximal interphalangeal joint at least 8 days after the injury...
February 7, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28178341/enhanced-expression-of-two-discrete-isoforms-of-matrix-metalloproteinase-2-in-experimental-and-human-diabetic-nephropathy
#5
Sang Soo Kim, Nari Shin, Sun Sik Bae, Min Young Lee, Harin Rhee, Il Young Kim, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, David H Lovett, Sang Heon Song
BACKGROUND: We recently reported on the enhanced expression of two isoforms of matrix metalloproteinase-2 (MMP-2) in human renal transplantation delayed graft function. These consist of the conventional secreted, full length MMP-2 isoform (FL-MMP-2) and a novel intracellular N-Terminal Truncated isoform (NTT-MMP-2) generated by oxidative stress-mediated activation of an alternate promoter in the MMP-2 first intron. Here we evaluated the effect of hyperglycemia and diabetes mellitus on the in vitro and in vivo expression of the two MMP-2 isoforms...
2017: PloS One
https://www.readbyqxmd.com/read/28176336/effect-of-hypothermic-machine-perfusion-on-the-preservation-of-kidneys-donated-after-cardiac-death-a-single-center-randomized-controlled-trial
#6
Wei Wang, Dawei Xie, Xiaopeng Hu, Hang Yin, Hang Liu, Xiaodong Zhang
To assess the application of a hypothermic machine perfusion device (LifePort) in kidney transplantation from donation after cardiac death (DCD) donors, 24 pairs of DCD kidneys were randomly divided into two groups: one of the paired kidneys from the same donor was perfused with the LifePort machine (hypothermic machine perfusion [HMP]), and the contralateral kidney was prepared using common static cold preservation (CCP). The two groups were compared with respect to the incidence of delayed graft function (DGF), level of graft function, and pathological changes in time-zero biopsy specimens...
February 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28166393/donor-specific-antibodies-c1q-binding-improvement-in-kidney-graft-management
#7
Sylvie Ferrari-Lacraz
The diagnosis of acute antibody mediated rejection (ABMR) after kidney transplantation is based on three parameters: 1) decreased renal function, 2) histopathological signs of rejection, 3) presence of Donor Specific Antibody (DSA) [1]. Patient survival, as well as graft survival have improved since 5 to 10 years [2], thanks to several factors, including better management of patients, better immunosuppressive regimens, detection and avoidance of DSA. Although anti-HLA antibodies follow-up have improved ABMR management, its treatment remains challenging, and outcome may be worsened because of a delay in the diagnosis...
February 6, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28160019/reconstructive-surgery-of-the-amputated-ring-finger
#8
Ricardo Monreal
PURPOSE: Loss of a fourth digit below the level of the proximal phalanx results in a weakened grip, loss of skilled movements, and the amputation stump is repeatedly traumatized. Transposition of an adjacent fifth digital ray can improve hand function and cosmetic appearance by closing the gap created by the missing digit. Digital ray amputation is not a commonly performed procedure. However, when performed correctly it can dramatically improve hand function and cosmesis. The aim of this study was to evaluate the functional and aesthetic results of the fifth ray radial translation and intercarpal arthrodesis in mutilating ring finger injuries...
February 3, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28144601/proximal-fifth-metatarsal-fractures-anatomy-classification-treatment-and-complications
#9
REVIEW
Chi Nok Cheung, Tun Hing Lui
CONTEXT: Fractures of proximal fifth metatarsal are one of the most common fractures of the foot. EVIDENCE ACQUISITION: A search of PubMed for studies on proximal fifth metatarsal fracture and Jones fracture focusing on the classification and management was performed. The reference list of the retrieved articles was searched for additional related studies. RESULTS: The vascular supply and soft tissue anatomy of the fifth metatarsal explains the increased risk of delayed union and non-union in fractures at the metaphyseal-diaphyseal junction...
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28141909/improving-the-outcomes-of-organs-obtained-from-controlled-donation-after-circulatory-death-donors-using-abdominal-normothermic-regional-perfusion
#10
Eduardo Miñambres, Borja Suberviola, Beatriz Dominguez-Gil, Emilio Rodrigo, Juan Carlos Ruiz-San Millan, Juan Carlos Rodríguez-San Juan, Maria Angeles Ballesteros
Donation after circulatory death (DCD) has experienced a significant expansion over the last decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared to donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow prior to organ recovery in cDCD has been proposed as a better alternative than rapid recovery to reverse the effect of ischemia and improve recipients' outcome...
January 31, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28139330/management-of-the-obese-kidney-transplant-candidate
#11
REVIEW
Julie Lesage, John S Gill
Obesity is an increasingly common condition that can exclude end stage renal disease patients from consideration of kidney transplantation. The optimal management of obese transplant candidates is uncertain, especially the use of pharmacologic therapies or bariatric surgery. We review the rationale to consider transplantation in obese patients, the impact of obesity on access to kidney transplantation, the evidence for obese patients to lose weight loss prior to kidney transplantation, peri-operative management considerations and specific weight loss strategies prior to transplantation...
January 12, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28137205/delayed-chest-closure-with-skin-approximation-after-lung-transplant-in-oversized-graft
#12
Prashant N Mohite, Anton Sabashnikov, Aron-Frederik Popov, Mohamed Zeriouh, Javid Fatullayev, Massimo Cappocia, Mohamed Amrani, Martin Carby, André R Simon
Closure of the chest after lung transplant in cases of oversized grafts is often difficult. Lung volume reduction and delayed closure of the chest with Bogota bag are the only options available in such situations. Here, we propose to keep the sternum and intercostal spaces open and approximate skin over it. Once lung function improves and reperfusion-related edema recovers, the chest can be closed.
January 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28129763/prediction-of-clinical-outcomes-after-kidney-transplantation-from-deceased-donors-with-acute-kidney-injury-a-comparison-of-the-kdigo-and-akin-criteria
#13
Jeong Ho Kim, Young Soo Kim, Min Seok Choi, Young Ok Kim, Sun Ae Yoon, Ji-Il Kim, In Sung Moon, Bum Soon Choi, Cheol Whee Park, Chul Woo Yang, Yong-Soo Kim, Byung Ha Chung
BACKGROUND: Acute kidney injury (AKI) is frequently detected in deceased donors (DDs), and it could be associated with adverse clinical outcomes in corresponding kidney transplant recipients (KTRs). In this regard, we sought to identify which criteria is better between the KDIGO and AKIN criteria for the diagnosis of AKI in DDs in the prediction of clinical outcomes after kidney transplantation (KT). METHODS: Two hundred eighty-five cases of deceased donor kidney transplantation (DDKT) were included...
January 27, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28129389/limited-clinical-utility-of-remote-ischemic-conditioning-in-renal-transplantation-a-meta-analysis-of-randomized-controlled-trials
#14
Chang-Cheng Zhou, Yu-Zheng Ge, Wen-Tao Yao, Ran Wu, Hui Xin, Tian-Ze Lu, Ming-Hao Li, Kai-Wei Song, Min Wang, Yun-Peng Zhu, Meng Zhu, Li-Guo Geng, Xiao-Fei Gao, Liu-Hua Zhou, Sheng-Li Zhang, Jia-Geng Zhu, Rui-Peng Jia
OBJECTIVE: We conducted this meta-analysis of randomized controlled trials (RCTs) to investigate whether remote ischemic conditioning (RIC) could improve graft functions in kidney transplantation. METHODS: PubMed, Web of Science, and Cochrane Library were comprehensively searched to identify all eligible studies by October 5, 2016. The treatment effects were examined with risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI)...
2017: PloS One
https://www.readbyqxmd.com/read/28125938/vascularized-versus-non-vascularized-bone-grafts-in-the-treatment-of-scaphoid-non-union
#15
Christoph Hirche, Lingyun Xiong, Christian Heffinger, Matthias Münzberg, Sebastian Fischer, Ulrich Kneser, Thomas Kremer
INTRODUCTION: Conventional non-vascularized bone grafts as well as vascularized bone grafts are used to treat scaphoid non-union (SN). Due to limited available studies, the field of application using both grafts for SN still remains controversial. The aim of this study was to evaluate a treatment algorithm for the use of both vascularized versus non-vascularized bone grafts based on clinical outcomes and quality of life (QoL) to improve the level of evidence. MATERIALS AND METHODS: Based on a retrospective cohort study, including 28 patients with vascularized and 45 patients with conventional bone grafts, functional parameters, radiological outcome, Mayo-wrist-score, and QoL by SF-36 were applied to statistically compare the outcome of these two techniques...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28121893/complications-and-long-term-outcomes-of-free-fibula-reconstruction-following-resection-of-a-malignant-tumor-in-the-extremities
#16
Matthew T Houdek, Eric R Wagner, Allen T Bishop, Alexander Y Shin, Peter S Rose, Franklin H Sim, Steven L Moran
BACKGROUND: To achieve limb salvage and provide the patient with a functional extremity, vascularized free fibula transfer has become the workhorse for segmental bony reconstruction. Because of various host factors, there has been a high complication rate following oncologic reconstruction. The authors reviewed the experience of their institution with the use of free fibula reconstruction following an oncologic resection in the extremities. METHODS: The authors reviewed 56 cases of free fibula transfer performed for limb salvage following oncologic resection from 1994 through 2013...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28115329/protocol-of-a-randomised-controlled-open-label-trial-of-ex-vivo-normothermic-perfusion-versus-static-cold-storage-in-donation-after-circulatory-death-renal-transplantation
#17
Sarah A Hosgood, Kourosh Saeb-Parsy, Colin Wilson, Christopher Callaghan, Dave Collett, Michael L Nicholson
INTRODUCTION: Ex vivo normothermic perfusion (EVNP) is a novel technique that reconditions the kidney and restores renal function prior to transplantation. Phase I data from a series of EVNP in extended criteria donor kidneys have established the safety and feasibility of the technique in clinical practice. METHODS AND ANALYSIS: This is a UK-based phase II multicentre randomised controlled trial to assess the efficacy of EVNP compared with the conventional static cold storage technique in donation after circulatory death (DCD) kidney transplantation...
January 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28114242/effect-of-ratio-of-residual-alveolar-bone-to-graft-material-in-contact-with-fixture-surface-on-marginal-bone-loss-of-implants-in-augmented-maxillary-sinuses-a-1-year-retrospective-study
#18
Chan-Ho Park, Dong-Won Lee, Jeong-Ho Yun, Ik-Sang Moon
PURPOSE: The purpose of this retrospective study was to evaluate the influences of height or area ratio of residual alveolar bone to graft material on marginal bone loss around implants in the augmented maxillary sinuses with delayed implant placement. MATERIALS AND METHODS: In this study, 42 patients with Astra implants in sinuses that had been augmented with alloplasts and allografts or xenografts (alveolar bone height ≤ 5 mm) were selected. Marginal bone level surrounding 1 implant per sinus was assessed by radiographic imaging at the time of final restoration delivery and 12 months after functional loading...
February 2017: Implant Dentistry
https://www.readbyqxmd.com/read/28104162/hypoxia-inducible-factor-1%C3%AE-expression-in-kidney-transplant-biopsy-specimens-after-reperfusion-is-associated-with-early-recovery-of-graft-function-after-cadaveric-kidney-transplantation
#19
T Oda, T Ishimura, N Yokoyama, S Ogawa, H Miyake, M Fujisaw
BACKGROUND: Ischemia/reperfusion injury during kidney transplantation (KTx) delays allograft recovery. Hypoxia-inducible factor-1α (HIF-1α) is the key regulator of the protective response to ischemia/reperfusion injury. We evaluated the impact of the HIF-1α signaling pathway on allograft recovery during cadaveric KTx. METHODS: Between 1996 and 2015, 46 patients underwent cadaveric KTx. The expression levels of HIF-1α-related proteins, including phosphoinositide 3-kinase, phosphorylated (p)-Akt, p-mammalian target of rapamycin, p-Eukaryotic translation initiation factor 4E, p-S6 ribosomal protein, and HIF-1α, were immunohistochemically evaluated and semi-quantitatively scored in graft biopsy specimens after 1 hour of revascularization...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104138/a2-to-b-blood-type-incompatible-deceased-donor-kidney-transplantation-in-a-recipient-infected-with-the-human-immunodeficiency-virus-a-case-report
#20
R C Forbes, A DeMers, B P Concepcion, D R Moore, H M Schaefer, D Shaffer
BACKGROUND: With the introduction of the Kidney Allocation System in the United States in December 2014, transplant centers can list eligible B blood type recipients for A2 organ offers. There have been no prior reports of ABO incompatible A2 to B deceased donor kidney transplantation in human immunodeficiency virus-positive (HIV+) recipients to guide clinicians on enrolling or performing A2 to B transplantations in HIV+ candidates. We are the first to report a case of A2 to B deceased donor kidney transplantation in an HIV+ recipient with good intermediate-term results...
January 2017: Transplantation Proceedings
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