Journal of the American College of Surgeons
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Flow cytometric crossmatching is currently the method of choice for most transplantation programs before kidney transplantation. In July of 2017, our program implemented the virtual crossmatch, without a prospective physical crossmatch, for the majority of patients in the setting of a new kidney allocation system implemented by the United Network for Organ Sharing. ⋯ Kidney transplantation can be safely performed with virtual crossmatching, without a prospective physical crossmatch with improved CIT and potentially reduced DGF rate without increased risk of rejection.
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Literature is varied regarding risk factors associated with diabetes development after major pancreatic resection. The aim was to develop and validate a scoring index that preoperatively predicts the development of diabetes after pancreaticoduodenectomy and distal pancreatectomy. ⋯ The Post-pancreatectomy Diabetes Index predicts the development of diabetes and pre-diabetes in patients undergoing major pancreatectomy using routine endocrine laboratories and pre-surgical clinical data.
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The CDC reported in 2017 that the largest increments in probability of continued use were observed after days 5 and 31 on opioid therapy. This study demonstrates the correlation between a system-wide pain management and opioid stewardship effort with reductions in discharge prescriptions for elective surgical patients. ⋯ A system-wide, multipronged pain management and opioid reduction program significantly reduced opioid discharge prescriptions written for more than 5 days. This approach can serve as a model for other healthcare systems attempting to reduce opioid prescribing and combat the opioid crisis in the US.