Publications by authors named "Lachlan McMichael"
Article Synopsis
- The study focuses on improving organ donation and transplant efficiency in British Columbia, Canada, through enhanced cooperation between organ procurement organizations and transplant programs.
- It analyzed metrics from nearly 2,000 referred deceased organ donors over four years to determine the effectiveness of various implemented policies and practices.
- Key findings include high consent rates (78%) and utilization rates (99%) of kidneys from eligible donors, with strategies like dedicated coordinators and improved communication significantly contributing to the system's success.
Aim: Kidney transplantation remains the preferred standard of care for patients with kidney failure. Most patients do not access this treatment and wide variations exist in which patients access transplantation. We sought to develop a model to estimate post-kidney transplant survival to inform more accurate comparisons of access to kidney transplantation.
View Article and Find Full Text PDFBackground: The Kidney Donor Profile Index (KDPI) is a percentile score summarizing the likelihood of allograft failure: A KDPI ≥85% is associated with shorter allograft survival, and 50% of these donated kidneys are not currently used for transplantation. Preemptive transplantation (transplantation without prior maintenance dialysis) is associated with longer allograft survival than transplantation after dialysis; however, it is unknown whether this benefit extends to high-KDPI transplants. The objective of this analysis was to determine whether the benefit of preemptive transplantation extends to recipients of transplants with a KDPI ≥85%.
View Article and Find Full Text PDFThe inclusion of blood group- and human leukocyte antigen-compatible donor and recipient pairs (CPs) in kidney paired donation (KPD) programs is a novel strategy to increase living donor (LD) transplantation. Transplantation from a donor with a better Living Donor Kidney Profile Index (LKDPI) may encourage CP participation in KPD programs. We undertook parallel analyses using data from the Scientific Registry of Transplant Recipients and the Australia and New Zealand Dialysis and Transplant Registry to determine whether the LKDPI discriminates death-censored graft survival (DCGS) between LDs.
View Article and Find Full Text PDFUse and Outcomes of Induction Therapy in Well-Matched Kidney Transplant Recipients.
Clin J Am Soc Nephrol
February 2022
Article Synopsis
- The study examined induction immunosuppression treatment in low-immune risk kidney transplant recipients well-matched with their donors based on specific genetic markers.
- Among 2976 participants, no significant differences were found in allograft survival or acute rejection rates between those treated with T cell-depleting antibodies and those receiving an IL-2 receptor antagonist or no induction therapy at all.
- The results suggest that using either T cell-depleting therapy or IL-2 receptor antagonists does not improve outcomes for first kidney transplant recipients with strong HLA matching.
Background: Dying physicians may present unique challenges to palliative care teams. Studies of dying physicians are scarce, but those that exist suggest a potential absence of a coordinating clinician, prolongation of curative treatments, resistance to palliative care input and barriers to discussing psychosocial needs.
Aim: The aim was to describe and examine the care provided to physician-patients referred to an Australian palliative care service, and to identify issues faced by the physician-patient and by the treating team.