Transplantation proceedings
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Observational Study
Incidence and Predictors of Increased Coronary Calcium Scores in Liver Transplant Recipients.
Cardiovascular complications in liver transplant recipients are common. A coronary calcium score >400 determined by coronary computed tomographic angiography (coronary CT) provides useful information for predicting postoperative cardiovascular complications in liver transplant recipients. However, little is known about the association between risk factors and increased coronary calcium scores in coronary CT preformed as a preoperative cardiovascular evaluation before liver transplantation. We evaluated the incidence and cardiovascular risk factors of a coronary calcium score >400 in liver transplant recipients. ⋯ We found that old age, male sex, and diabetes mellitus were predictors of a coronary calcium score >400, which is associated with cardiovascular complications after liver transplantation. This study can provide useful information for preoperative cardiovascular evaluation in liver transplant recipients.
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Health care providers encourage organ donation on a regular basis. The objective of this study was to analyze the coherence of the attitudes of health care providers toward organ donation, their willingness to receive organs and the differences among different health care practitioners and other hospital workers regarding to this ethical issue. ⋯ Among health care providers, physicians and nurses tended to be more likely to be in favor of organ donation. The majority of the participants were willing to accept an organ, and there was a statistical correlation between disposition to donation and willingness to receive an organ.
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Rotation thromboelastometry (ROTEM®) is increasingly used in liver transplantation (LT). Of the ROTEM® parameters, maximum clot firmness (MCF) of EXTEM (MCFEXT) and INTEM (MCFINT) are influenced by both platelet count (PLT) and fibrinogen concentration (FIB), whereas MCF of FIBTEM (MCFFIB) is solely influenced by FIB. We aimed to determine whether using MCFs of thromboelastometry could reliably predict both PLT and FIB and to evaluate their relations in patients with thrombocytopenia and hypofibrinogenemia during LT. ⋯ Both PLT and FIB can be reliably quantified by MCFs of thromboelastometry, reducing the needs for additional laboratory tests to know values of thrombocytopenia and hypofibrinogenemia in patients undergoing LT.
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Hyperlactatemia may occur early after cardiac surgery and is correlated with prognosis. This study was conducted to analyze the perioperative variables and postoperative outcomes among heart transplant recipients with extremely high lactate levels (>15 mmol/L). ⋯ Extreme hyperlactatemia commonly occurred early after heart transplantation and mostly recovered within 30 hours; however, with delayed extubation time after operation.
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We estimated that many patients on the waiting list for kidney transplantation in Turkey have immunologicaly incompatible suitable living donors. Paired exchange kidney transplantation (PETx) is superior to desensitization for patients with incompatible donors. Recently we decided to begin an international PETx program. ⋯ In our institute, a 5% increase was obtained in living-related kidney transplantations by the help of PETx on a national basis. We believe that international PETx may also have the potential to expand the donor pool.