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- Abbassi, Fariba, et al.
(författare)
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Novel Benchmark Values for Redo Liver Transplantation Does the Outcome Justify the Effort?
- 2022
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Ingår i: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 276:5, s. 860-867
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To define benchmark cutoffs for redo liver transplantation (redo-LT). Background: In the era of organ shortage, redo-LT is frequently discussed in terms of expected poor outcome and wasteful resources. However, there is a lack of benchmark data to reliably evaluate outcomes after redo-LT. Methods: We collected data on redo-LT between January 2010 and December 2018 from 22 high-volume transplant centers. Benchmark cases were defined as recipients with model of end stage liver disease (MELD) score <= 25, absence of portal vein thrombosis, no mechanical ventilation at the time of surgery, receiving a graft from a donor after brain death. Also, high-urgent priority and early redo-LT including those for primary nonfunction (PNF) or hepatic artery thrombosis were excluded. Benchmark cutoffs were derived from the 75th percentile of the medians of all benchmark centers. Results: Of 1110 redo-LT, 373 (34%) cases qualified as benchmark cases. Among these cases, the rate of postoperative complications until discharge was 76%, and increased up to 87% at 1-year, respectively. One-year overall survival rate was excellent with 90%. Benchmark cutoffs included Comprehensive Complication Index CCI (R) at 1-year of <= 72, and in-hospital and 1-year mortality rates of <= 13% and <= 15%, respectively. In contrast, patients who received a redo-LT for PNF showed worse outcomes with some values dramatically outside the redoLT benchmarks. Conclusion: This study shows that redo-LT achieves good outcome when looking at benchmark scenarios. However, this figure changes in high-risk redo-LT, as for example in PNF. This analysis objectifies for the first-time results and efforts for redo-LT and can serve as a basis for discussion about the use of scarce resources.
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| 3. |
- Sinn, T., et al.
(författare)
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Lessons learned from three university experiments onboard the REXUS/BEXUS sounding rockets and stratospheric balloons
- 2013
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Ingår i: 64th International Astronautical Congress 2013. - : International Astronautical Federation. - 9781629939094 ; , s. 7965-7976
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Konferensbidrag (refereegranskat)abstract
- Over the last three years the authors have been involved in three experiments that were or will be launched on sounding rockets and high altitude balloons with the REXUS/BEXUS program (Rocket-borne / Balloon-borne Experiments for University Students). The first experiment, called Suaineadh was launched from Esrange (Kiruna, Sweden) onboard REXUS 12 in March 2012. Suaineadh had the purpose of deploying a web in space by using centrifugal forces. The payload was lost during re-entry but was recovered 18 month later in early September 2013. StrathSat-R is the second experiment, which had the purpose of deploying two cube satellites with inflatable structures from the REXUS 13 sounding rocket, was launched first in May 2013 and will be launched a second time in spring 2014. The last experiment is the iSEDE experiment which has the goal of deploying an inflatable structure with disaggregated electronics from the high altitude balloon BEXUS15/16 in October 2013. All these experiments have been designed, built and flown in a timeframe of one and a half to two years. This paper will present the lessons learned in project management, outreach, experiment design, fabrication and manufacturing, software design and implementation, testing and validation as well as launch, flight and post-flight. Furthermore, the lessons learned during the recovery mission of Suaineadh will be discussed as well. All these experiments were designed, built and tested by a large group of university students of various disciplines and different nationalities. StrathSat-R and iSEDE were built completely at Strathclyde but the Suaineadh experiment was a joint project between Glasgow and Stockholm which was especially tricky during integration while approaching the experiment delivery deadline. This paper should help students and professionals across various disciplines to build and organise these kinds of projects more efficiently without making the same, sometimes expensive, mistakes all over again.
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