Transplantation proceedings
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Educating physicians about transplantation during undergraduate training can improve organ procurement rates. The aim of this study was to evaluate and analyze the knowledge of medical students regarding transplantation. ⋯ Medical students have limited knowledge about organ transplantation; there is a need for educational intervention early in the medical curriculum.
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Renin-angiotensin system (RAS) blockade has cardioprotective and renoprotective effects in the general population; however, whether dual blockade using angiotensin-receptor blockade (ARB) plus a renin inhibitor, aliskiren, can minimize severe proteinuria in kidney transplant recipients remains undetermined. ⋯ Dual blockade of the RAS with ARB II plus aliskiren therapy demonstrated an additive effect to decrease severe proteinuria and blood pressure in kidney transplant recipients. Neither relevant adverse effects in renal function nor anemia or hyperkalemia were observed. These findings might contribute to prolonging long-term kidney graft survival.
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Treatment with proliferation signal inhibitors (PSIs; sirolimus/everolimus) is a therapeutic option for renal transplant recipients, especially those who develop chronic graft nephropathy (CGN) or a neoplasm. We sought to analyze the efficacy and safety of conversion to PSIs. ⋯ Conversion to PSIs is a safe, useful therapeutic option for carefully selected patients, when renal function has not undergone marked deterioration and there is no proteinuria. Although side effects are common, most are mild; withdrawal of PSIs was necessary in a relatively low percentage of cases.
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The shortage of donor organs has prompted increased acceptance of hearts from donors with more comorbidities. With increasing frequency, hearts are being offered from patients who have undergone a resuscitated cardiac arrest (RCA). Our aim was to compare the rate of complications in the postoperative and follow-up periods, depending on whether the transplanted organ came from a donor who had undergone an RCA. ⋯ Patients receiving a heart from a patient with an in-hospital RCA and subsequent hemodynamic stability have a similar outcomes to other HT patients.
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Hepatic resection may be associated with postoperative coagulopathy. However, there is limited information about the predictors affecting coagulopathy after donor hepatectomy. We evaluated the contributors of maximal changes in prothrombin time (PT), activated thromboplastin time (aPTT), and platelet count in the development of postoperative coagulopathy. ⋯ We found that long anesthesia duration, low BMI, and small remnant liver volume were predictors of coagulation derangement. These results provide a better understanding of risk factors affecting changes in coagulation profiles after living donor hepatectomy.