Patient and graft survival are similar following whole-liver transplantations (WLTs) versus split-liver transplantations (SLTs) among pediatric and adult recipients, yet SLTs are rarely used. We sought to determine the survival benefit associated with accepting a splittable graft offer for SLT versus declining and waiting for a subsequent offer using 2010 to 2018 Scientific Registry of Transplant Recipients (SRTR) data on 928 pediatric and 1814 adult liver transplantation candidates who were ever offered a splittable graft. We compared eventual mortality, regardless of subsequent transplants, between those patients who accepted versus declined a split liver offer with adjustments for Pediatric End-Stage Liver Disease/Model for End-Stage Liver Disease (MELD) scores, diagnosis, and weight among pediatric candidates and matching for MELD score, height, and offer among adult candidates. Among pediatric candidates ≤7 kg, split liver offer acceptance versus decline was associated with a 63% reduction in mortality (adjusted hazard ratio [aHR], 0.37 [P = 0.01]; 93.1% versus 84.0% 1-year survival after decision). Within 1 year of decline for those ≤7 kg, 6.4% died and 31.1% received a WLT. Among pediatric candidates >7 kg, there was no significant difference associated with acceptance of a split liver offer (aHR, 1.07 [P = 0.81]; 91.7% versus 94.4% 1-year survival after decision). Within 1 year of decline for those >7 kg, 1.8% died and 45.8% received a WLT. Among adult candidates, split liver offer acceptance was associated with a 43% reduction in mortality (aHR, 0.57 [P = 0.005]; 92.2% versus 84.4% 1-year survival after decision). Within 1 year of decline for adult candidates, 7.9% died and 39.3% received a WLT. Accepting split liver offers for SLT could significantly improve survival for small children and adults on the waiting list.
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http://dx.doi.org/10.1002/lt.26393 | DOI Listing |
Front Nutr
December 2024
Department of Pedodontics, Affiliated Stomatology Hospital of Jinzhou Medical University, Jinzhou, China.
Introduction: A complicated scenario where "multiple disease threats coexist and multiple health influencing factors are intertwined" is demonstrated by the fact that dental caries, obesity myopia and scoliosis have emerged as global public health issues. The problem of diseases co-existing in living things can be resolved by using probiotics. , has gained attention recently due to its probiotic properties, useful traits, and potential medical applications.
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September 2024
MD, PhD, Infectious Diseases Department, University Hospital of Split, HR-21000 Split, Croatia, and University of Split School of Medicine, HR-21000 Split, Croatia, and University Department of Health Studies of the University of Split, HR-21000 Split, Croatia.
Introduction: Alveolar echinococcosis is one of the most pathogenic zoonoses caused by the larval forms of . It is endemic in central Europe, but from 2001 to 2018, eight European countries reported their first cases of alveolar echinococcosis. These numbers testify to unprecedented spread of the infection.
View Article and Find Full Text PDFHPB (Oxford)
December 2024
Fondazione IRCCS Policlinico San Matteo, SC Chirurgia Generale 1, Pavia, Italy. Electronic address:
Background: Cystic echinococcosis (CE) is a significant public health issue, primarily affecting the liver. While several management strategies exist, there is a lack of predictive tools to guide surgical decisions for hepatic CE. This study aimed to develop predictive models to support surgical decision-making in hepatic CE, enhancing the precision of patient allocation to surgical or non-surgical management pathways.
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December 2024
Hyphenated Mass Spectrometry Laboratory, Faculty of Science, University of Technology Sydney, PO Box 123, Broadway, 2007 NSW, Australia; School of Life Sciences, Faculty of Science, University of Technology Sydney, PO Box 123, Broadway, 2007 NSW, Australia.
The importance of sample preparation selection if often overlooked particularly for untargeted multi-omics approaches that gained popularity in recent years. To minimize issues with sample heterogeneity and additional freeze-thaw cycles during sample splitting, multiple -omics datasets (e.g.
View Article and Find Full Text PDFMed Phys
December 2024
Department of Electronics and Electrical Engineering, Indian Institute of Technology Guwahati, Assam, India.
Background: Measurement noise often leads to inaccurate shear wave phase velocity estimation in ultrasound shear wave elastography. Filtering techniques are commonly used for denoising the shear wavefields. However, these filters are often not sufficient, especially in fatty tissues where the signal-to-noise ratio (SNR) can be very low.
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