Tailored desensitization strategies in ABO blood group antibody incompatible renal transplantation.

ABO blood group incompatible renal transplantation, using desensitization procedures, is an effective strategy. Efforts have been made to reduce desensitization: these are usually applied to all patients indiscriminately. The Guy's Hospital ABO blood group incompatible desensitization regimen uses a tiered approach, tailoring strategy according to initial antibody titres.

Rituximab in renal transplantation.

Rituximab is a chimeric anti-CD20 monoclonal antibody that leads to B cell depletion. It is not licensed for use in renal transplantation but is in widespread use in ABO blood group incompatible transplantation. It is an effective treatment for post-transplant lymphoproliferative disorder, and is also used in both HLA antibody incompatible renal transplantation and the treatment of acute rejection.

Distribution of ABO blood group antibody titers in pediatric patients awaiting renal transplantation: implications for organ allocation policy.

Background: Blood group-incompatible transplantation is one strategy used when a potential recipient does not have a compatible living donor. Current practice includes desensitization strategies to reduce antibody titers. However, when antibodies are low, in cardiac transplantation in neonates for example, no desensitization is required.

Outcome of surgical complications following simultaneous pancreas-kidney transplantation.

Background: Simultaneous pancreas-kidney (SPK) transplantation carries a higher risk of surgical complications than kidney transplantation alone. We aimed to establish the incidence of surgical complications after SPK transplantation and determine the effect on graft and patient survival.

Methods: Outcomes of all SPK transplants performed at our centre were compared between patients who experienced a surgical complication (SC group) and those who did not (NSC group).

Laparoscopic donor nephrectomy does not compromise outcomes for pediatric transplant recipients.

Background: Despite the apparent safety of laparoscopic kidney procurement (laparoscopic donor nephrectomy [LDN]) in adults, doubts have persisted about its use in pediatric recipients, following the publication of a United Network for Organ Sharing analysis, which suggested that rejection rates were higher after LDN when compared with open procurement (open donor nephrectomy [ODN]) for children. The aim of this study was to determine whether acute rejection rates, and graft and patient survival, were worse after LDN for pediatric recipients. The analysis included both short and medium term outcomes.

Informed prognosis [corrected] after abdominal aortic aneurysm repair using predictive modeling techniques [corrected].

Objective: To identify the best method for the prediction of postoperative mortality in individual abdominal aortic aneurysm surgery (AAA) patients by comparing statistical modelling with artificial neural networks' (ANN) and clinicians' estimates.

Methods: An observational multicenter study was conducted of prospectively collected postoperative Acute Physiology and Chronic Health Evaluation II data for a 9-year period from 24 intensive care units (ICU) in the Thames region of the United Kingdom. The study cohort consisted of 1205 elective and 546 emergency AAA patients.

The longer patients are in hospital before Intensive Care admission the higher their mortality.

Objective: To explore the relationship between hospital mortality and time spent by patients on hospital wards before admission to the intensive care unit (ICU).

Design: Observational study of prospectively collected data.

Setting: Participating intensive care units within the North East Thames Regional Database.

Surgical mortality score: risk management tool for auditing surgical performance.

Existing methods of risk adjustment in surgical audit are complex and costly. The present study aimed to develop a simple risk stratification score for mortality and a robust audit tool using the existing resources of the hospital Patient Administration System (PAS) database. This was an observational study for all patients undergoing surgical procedures over a two-year period, at a London university hospital.