Publications by authors named "F Paterno"
The lack of health insurance is a major barrier to access to health care, even in the case of life-saving procedures such as liver transplantation (LT). Concerns about worse outcomes in uninsured patients have also discouraged the evaluation and transplantation of patients without adequate health insurance coverage. The aim of this study is to evaluate outcomes from the largest cohort of uninsured patients who underwent LT with the support of a state payment assistance program (also called charity care).
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- Hypothermic oxygenated machine perfusion (HMP-O2) is a new technique for preserving liver grafts, showing better results against traditional static cold storage (SCS) by reducing ischemia-reperfusion injury.
- The PILOT trial, a multicenter randomized study, involved 179 participants divided between HMP-O2 and SCS; results indicated noninferiority, with early allograft dysfunction rates of 11.1% for HMP-O2 compared to 16.4% for SCS.
- HMP-O2 also associated with a lower risk of early graft failure, primary nonfunction, and biliary strictures, suggesting it may enhance liver transplant outcomes in clinical settings.
Article Synopsis
- There is a critical need to accurately assess the risk of post-liver transplant mortality to improve patient selection and avoid futile procedures, with the recently developed Liver Immune Frailty Index (LIFI) showing promising results.
- LIFI outperforms traditional risk scores like MELD in predicting mortality, demonstrating a substantial difference in 1-year post-transplant mortality rates (1.4% for LIFI-low vs. 58.3% for LIFI-high).
- The study highlights the importance of pre-transplant immune assessments, suggesting that LIFI could be essential for identifying liver transplant candidates with the least risk of poor outcomes.
Article Synopsis
- Researchers wanted to find out how to tell if a redo liver transplant (redo-LT) is successful or not, especially since there aren't many organs available to transplant.
- They looked at data from 22 hospitals from 2010 to 2018, focusing on certain patients who had a better chance of having a good outcome after the surgery.
- They found that while most patients had a high survival rate after 1 year, those who had redo-LT for specific complications did not do as well, showing that some cases are riskier than others.