2024 Scholars' Research Symposium Abstract: Analysis of First 50 Liver Transplants in a Rural Midwest Medical Center.

Introduction: Chronic liver disease, a progressive deterioration of liver function, has become a significant health problem in the United States. According to the National Vital Statistics Report 2017 from the Center for Disease Control and Prevention, approximately 4.5 million adults have been diagnosed with chronic liver disease and cirrhosis (end-stage liver disease), which is 1.

Taking Control of Your Health: Self-Measured Blood Pressure Program in Yankton, South Dakota.

Background: Identification and management of hypertension is one of the most common problems for primary care providers. Rural settings have increased rates of hypertension due to a variety of factors including access to care, socioeconomic factors, and restricted strategies to identify hypertension outside of the clinic setting. To address this challenge, a self-measured blood pressure (SMBP) program was employed at a rural clinic in South Dakota with a goal of increasing the number of patients with well-controlled blood pressure.

Acetabular labral entrapment following spontaneous nonconcentric reduction of posterior hip dislocation in a child.

Traumatic pediatric hip dislocations are uncommon and can occur following minor trauma. This injury may be overlooked, as pediatric hip dislocations can reduce spontaneously prior to medical attention. In this scenario, the presenting hip radiographs may provide evidence of a prior transient hip dislocation episode by demonstrating signs of a nonconcentric hip reduction, and prompt further evaluation with advanced imaging.

Combined antegrade-retrograde cystourethroscopic rendezvous procedure for the management of a severe urethral stricture during kidney transplantation: A case report.

Introduction: External bladder drainage with an indwelling transurethral catheter is standard during kidney transplant. Difficult Foley catheter placement is a frequent problem and one of the most common reasons for intraoperative urology consults. Suprapubic catheters are usually placed if retrograde urologic instrumentation options fail to cross the urethral obstruction.

Local Anesthetic Systemic Toxicity During Transversus Abdominis Plane Block With Liposomal Bupivacaine.

Local anesthetic systemic toxicity (LAST) is a rare but potentially fatal outcome associated with local anesthetic administration. Liposomal bupivacaine (LB; EXPAREL®) is a widely used local anesthetic with extended-release and liposomal formulation that carries an improved cardiac and central nervous system safety profile. However, there is limited data regarding LAST associated with liposomal bupivacaine.

"Triple V-Plasty": Creation of a Single Orifice for Three Renal Arteries in Live-Donor Transplantation.

Background: Donor renovascular anatomic variations can hinder renal transplantation (RT), especially from live donors. Back-table vascular reconstruction can be effective in the use of renal allografts with multiple renal arteries (RAs), helping to expand the pool of live donors.

Surgical Technique: Sequential V-plasty of 3 donor RAs using fine, non-absorbable, monofilament (7-0 or 8-0 polypropylene) suture in an uninterrupted fashion successfully enabled the creation of a single, wide ostium for anastomosis with the target inflow recipient artery.

Triple V-plasty: Novel Renovascular Reconstruction Technique in Live-Donor Transplantation.

Introduction: Donor renovascular anomalies, including multiplicity, length and caliber of blood vessels, could hinder renal transplantation, especially from live-donors. However, meticulous back-bench vascular reconstruction ascertaining orientation and patency of individual vessels can be effective in utilization of renal grafts with multiple renal arteries, helping to expand the pool of live-donors.

Surgical Technique: Sequential v-plasty of individual donor renal arteries using fine, non-absorbable, monofilament (7-0 or 8-0 Prolene) suture in an uninterrupted fashion enables creation of a single, wide ostium for anastomosis with the target, inflow recipient (usually external or common iliac) artery.

A Modified Single Mercedes Incision Surgical Technique for Simultaneous Liver Kidney Transplant: A Case Series Report.

Background: The traditional approach in simultaneous liver-kidney transplantation (SLKT) involves two separate and sequential incisions. We describe modification of the classic Mercedes incision which limits the operation to a single incision yet provides and maintains adequate exposure enabling safe dual-allograft transplantation.

Methods: Modification of the standard Mercedes incision includes bilateral, subcostal, muscle splitting incision 4-finger-breadths below the rib-edge with a midline, cephalad incision, and inferior±medial, ipsilateral extension on the side of intended iliac fossa laterality for renovascular and ureteroneocystostomy anastomosis.

Modified Mercedes Single Incision for Combined Liver Kidney Transplant: A Case Series Report.

Background: The traditional approach in combined liver-kidney transplantation involves 2 separate and sequential incisions. We describe a modification of the standard Mercedes incision that allows a single-incision operation while providing and maintaining adequate exposure to enable safe dual-allograft transplantation.

Methods: Modification of the standard Mercedes incision includes bilateral, subcostal, muscle splitting incision 4 fingerbreadths below the rib edge with a midline, cephalad incision and inferior ± medial ipsilateral extension on the side of intended iliac fossa laterality for renovascular and ureteroneocystostomy anastomosis.