Transplantation proceedings
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Facial allotransplantation represents a novel frontier in the reconstruction of complex human facial defects. To develop more refined surgical techniques and yield fine results, it is required to make a suitable animal model. The development of a model of composite facial and scalp allograft in canines is more appealing: In large animals, canine facial anatomy is the most similar to humans; its facial nerve anatomy also resembles humans'; and canines possess the most similar facial vascular anatomy to humans. These factors led to the development of a canine composite facial allograft model. ⋯ We documented that this model is well qualified in every aspect for use as a standard transplantation training model and future research work.
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Comparative Study
Outcomes of expanded-criteria deceased donor kidney transplantation in a single center.
In an effort to expand the deceased donor pool, transplant centers have accepted expanded-criteria donors as appropriate for many of the patients in the deceased donor pool. We investigated expanded-criteria deceased donor kidney transplantation and compared the outcomes of kidney transplantation according to donor types. ⋯ The use of expanded-criteria deceased donor had no impact on graft or patient survival after kidney transplantation.
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A left ventricular assist device (LVAD) is essential for treating patients with advanced heart failure. However, LVAD-related infection is a significant cause of mortality and morbidity, with bloodstream infection (BSI) especially associated with high mortality. We investigated the incidence of infectious complications in patients who received an LVAD and evaluated the effects of early and appropriate intervention for LVAD-related infection. ⋯ LVAD-related infections, such as drive-line and cannula infections, were common, whereas the incidence of BSI was low in our LVAD-implanted patients. Our results highlight the importance of early and appropriate intervention including antibiotics and wound care for device-related infections for reducing the incidence of potentially fatal BSI.
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Fluid restriction has been used to decrease central venous pressure as a strategy of fluid management during living donor liver donation (LDLD). However, potential risks such as hemodynamic instability are also involved during the procedure. Monitoring of preload or preload responsiveness is therefore crucial during LDLD. The aim of this study was to explore the efficiency of an innovative bioreactance method that introduced the noninvasive cardiac output monitor (NICOM, Cheetah Medical, Vancouver, Wash, United States), as surrogate indicator for preload responsiveness during LDLD. ⋯ Our study has shown that SVV measured from the bioreactance technique is a poor indicator for monitoring preload responsiveness during LDLD.
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Corrected flow time (FTc) has been utilized as preload indicator in recent literature. Accurate estimation of preload status during living donor liver donation (LDLD) is important due to fluid restriction. We evaluate the effectiveness of FTc as a surrogate of preload indicator during LDLD. ⋯ FTc is a noninvasive, easily obtainable, and essentially good preload indicator during LDLD.