Transplantation proceedings
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Review Meta Analysis
Diagnostic value of serum procalcitonin in solid organ transplant recipients: a systematic review and meta-analysis.
To perform a systematic review and meta-analysis to define the role of procalcitonin (PCT) in identifying infectious complication in organ transplant recipients. ⋯ The existing literature suggests reasonable sensitivity and specificity for the PCT test in identifying infection complications among patients undergoing solid organ transplantation. Given the imperfect sensitivity and specificity of the PCT test, medical decisions should be based on both PCT test results and clinical findings.
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Organ procurement and transplant activity from controlled donation after circulatory death (DCD) was evaluated over an 11-year period to determine whether this program influenced the transplant and donation after brain death (DBD) activities. ⋯ This DCD program implementation enlarged the DD pool and did not compromise the development of DBD programs. The potential DCD pool might be underused and seems to be a valuable organ donor source.
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The Model for End-Stage Liver Disease (MELD) score has been validated to predict the mortality rate of patients with various chronic liver diseases on the waiting list for liver transplantation (LT). The aim of this study was to assess the value of the postoperative MELD scoring system as an early postoperative predictor of outcome in patients undergoing living donor LT (LDLT). ⋯ The early postoperative MELD scoring system is feasible as an index for prediction of postoperative mortality following LDLT.
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Comparative Study
Long-term outcomes of kidney transplantation from expanded criteria deceased donors at a single center: comparison with standard criteria deceased donors.
Our objective was to compare the clinical outcomes of adult kidney transplants from expanded criteria deceased donors (ECD) with those from concurrent standard criteria deceased donors (SCD). Between January 2000 and December 2011, we transplanted 195 deceased donor renal transplants into adult recipients, including 31 grafts (15.9%) from ECDs and 164 grafts (84.1%) from SCDs. ECDs were classified using the United Network for Organ Sharing (UNOS) definitions. ⋯ There were no significant differences in graft survival (P = .111) or patient survival (P = .562) between the 2 groups. Although intermediate-term renal function followed longitudinally was better in SCD kidney recipients, graft and patient survival of ECD kidney recipients were comparable with those of SCD kidney recipients. In conclusion, use of renal grafts from ECDs is a feasible approach to address the critical organ shortage.
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There is an increasing demand for lung transplantation in patients in advanced respiratory failure. Although many of these patients do not require mechanical ventilation or extracorporeal membrane oxygenation, an increasing number are critically ill. In this single-center study, we have analyzed our experience with lung transplantation in subjects who were inpatients at the time of their transplant and not expected to survive to discharge. ⋯ Lung transplantation in critically ill inpatients, although associated with a survival advantage compared to not transplanting them, does give poorer survival results compared to postoperative survival in outpatient patients.