Notes

Skeletal Survey within Several Myeloma: Position involving Image resolution.
A total of 21,282 lung transplantations were performed during the study period. Compared with patients with GFR >50ml/min/1.73m
, survival was significantly worse for patients with GFR 30-50ml/min/1.73m
. Multivariate analysis of patients with GFR 30-50ml/min/1.73m
demonstrated outpatient status and age less than 60 to be predictive of superior survival. After propensity matching, survival of this "highly performing" subset with GFR 30-50ml/min/1.73m
was no different from patients with normal GFR.

Outpatient recipients under the age of 60 represent an optimal subset of patients with GFR 30-50ml/min/1.73m
. Lung transplant listing should not be declined only based on a GFR less than 50ml/min/1.73m
.
Outpatient recipients under the age of 60 represent an optimal subset of patients with GFR 30-50ml/min/1.73m2. Lung transplant listing should not be declined only based on a GFR less than 50ml/min/1.73m2.
the axillary artery can be cannulated for antegrade cerebral perfusion directly or by employing a prosthetic vascular graft anastomosed to the artery.

From 2008 until 2019, 688 patients underwent axillary artery cannulation. click here Of those, 287 underwent direct cannulation and 401 cannulation through a side graft. We identified risk factors for cannulation-related complications, and after propensity score matching, we compared the two matched cohorts' cannulation-related and postoperative outcomes.

A smaller axillary-artery diameter (odds ratio, 0.70; 95% confidence interval, 0.56-0.87) and emergency surgery (odds ratio, 2.23; 95% confidence interval, 1.27-3.92) were identified as risk factors for cannulation-associated complications. In the propensity-score matched cohorts (n = 266 in each), the number of patients suffering cannulation-related complications was significantly higher in the direct cannulation group than in the side graft group (n=33 [12.4%] vs n=15 [5.6%], p=0.01). The direct group's incidence of iatrogenic axillary artery dissection was significantly higher (n=17 [6.4%] vs n=4 [1.5%], p=0.008); their incidence of postoperative stroke was also significantly higher (n=39 [14.7%] vs n=21 [7.9%], p=0.025). Patients cannulated with a side graft needed more (3.0 [1.0, 6.0] vs 4.0 [2.0, 7.0] p = 0.009) transfusions of blood products.

Cannulating the right axillary through a vascular prosthetic graft reduces cannulation-related complications such as iatrogenic axillary artery dissection, and lowers stroke rates. To help prevent cannulation-related complications and stroke, we recommend the routine use of a side graft when cannulating the axillary artery.
Cannulating the right axillary through a vascular prosthetic graft reduces cannulation-related complications such as iatrogenic axillary artery dissection, and lowers stroke rates. To help prevent cannulation-related complications and stroke, we recommend the routine use of a side graft when cannulating the axillary artery.
Pediatric heart transplant (HTx) recipients with congenital heart defects require complex concomitant surgical procedures with the risk of prolonging the allograft's ischemic time. Ex- vivo allograft perfusion with the Organ Care System (OCS) may improve survival of these challenging patients.

Retrospective, single center study. A consecutive series of 8 children with allografts preserved using the OCS was compared to 13 children after HTx with cold storage of the donor heart from 3/2018 to 3/2020.

Median recipients age in the control group was 18 (range 1- 189) months vs. 155 (83- 214) months in the OCS group, the baseline differences between the two groups were not significant. 50% of the children in the OCS group had complex congenital heart defects (vs. 15% of the controls). Median operation time during HTx in the OCS group was 616 (270- 809) min vs. 329 (283- 617) min. Due to the time of ex- vivo allograft perfusion (265 (202- 372) minutes) median total ischemia time was significantly shorter in the OCS group 78 (52- 111) vs. 222 (74-326) minutes. The incidence of primary graft failure, renal or hepatic failure did not differ between the groups. Graft function and the occurrence of any treated rejection at follow up revealed no significant difference between the two groups. One-year survival was 88% in the OCS group (vs. 85%).

Ex-vivo allograft perfusion enabled complex pediatric heart transplantations, yielding outcomes as positive as those of children whose donor hearts were stored in ice-cold solution.
Ex-vivo allograft perfusion enabled complex pediatric heart transplantations, yielding outcomes as positive as those of children whose donor hearts were stored in ice-cold solution.Neurological disorders are the most unpredictable and feared complications after open surgery or endovascular aortic repair. Paraplegia due to spinal cord injury is well known after thoracoabdominal aortic surgery, but not after valvular surgery. We herein present a case of paraplegia after mitral and tricuspid valve surgery in a patient with a history of surgery involving the thoracoabdominal and abdominal aorta. The paraplegia was likely caused by temporary postoperative hypotension as low as 40 mmHg for more than 10 minutes with decreased spinal perfusion in the intensive care unit.Hyperammonemia after lung transplant is a severe complication which can result in cerebral herniation. It is associated with up to 70% mortality in patients who have had solid organ transplantation. We describe a rare case in which hyperammonemia was emergently and successfully treated with plasmapheresis in a re-do double lung transplant patient who developed shocked liver.
Donor hearts and lungs are more susceptible to the inflammatory physiologic changes that occur after brain death. Prior investigations have shown that protocolized management of potential organ donors can rehabilitate donor organs that are initially deemed unacceptable. In this review, we discuss advances in donor management models with particular attention to the specialized donor care facility (SDCF) model. In addition, we review specific strategies to optimize donor thoracic organs and improve organ yield in thoracic transplantation.

We performed a literature review by searching the Pubmed database for MeSH terms associated with organ donor management models. We also communicated with our local organ procurement organization to gather published and unpublished information first-hand.

The SDCF model has been shown to improve the efficiency of organ donor management and procurement while reducing costs and minimizing travel and its associated risks. Lung protective ventilation, recruitment of atelectatic lung, and hormone therapy (e.
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