S J Pelletier

..The current criteria for liver transplantation of candidates with HCC lead to acceptable 5-year survival while limiting the dropout rate. Liver Transpl 15:859-868, 2009. (c) 2009 AASLD...

..Although limited by the retrospective nature of the study, kidneys transplanted en bloc had a similar graft survival to ideal donors but may not maximize the number of successfully transplanted recipients...

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..Although HCV was predictive of an increased risk of death, consideration of other characteristics of HCV patients, including donor and recipient age and need for preoperative ICU care may identify those at significantly higher risk...

..Allowing adequate time for laboratory and culture results before initial treatment may be associated with a worse outcome in nosocomial infections...

..Antibiotic regimens containing aminoglycosides result in a similar outcome compared with non-aminoglycoside regimens in the treatment of gram-negative infections in surgical patients...

..The leukocyte response to infection was suppressed in the transplantation population. Post-transplantation infections which occur during the admission for transplantation have a markedly increased mortality...

..The Centers for Medicare and Medicaid Services (CMS) should consider risk-adjusted reimbursement for kidney transplantation...

..Our data suggest that several patient characteristics are associated with an increased risk of a urinary complication. The U-stitch technique should not be used for the ureteral anastomosis...

..These trends could relate to selection bias in the decision to prescribe induction immunosuppression, but further study is needed to better define the risks and benefits of antibody-induction regimens in this population...

..All parties (patient, physician, payer and medical center) should benefit from quality improvement, with payers having a financial interest in pancreas transplant surgical quality initiatives...

..Liver transplantation in severely obese patients is associated with wound infection and early death from multisystem organ failure, but has similar long-term outcomes when compared to non-obese controls...

..There is a need to maintain an open mind with regard to the use of livers from older donors due to the current situation of serious organ shortages...

..Transplantation is an independent predictor of infection in patients presenting without fever or leukocytosis. Leukocytosis, but not fever, may be predictive of hospital mortality in infected surgical patients...

..It is unknown, however, if these differences can be explained simply by the nosocomial nature of tertiary peritonitis and underlying severity of illness...

..To assess the importance of bloodstream infection (BSI) to outcomes among infected surgical patients...

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..Medical centers have a financial interest in transplant surgical quality improvement, but payers have the most to gain with improved surgical outcomes...

..However, the potential long-term benefits of steroid avoidance, including a decrease in severity of recurrent hepatitis C, remain under investigation...

..Antibiotic rotation was an independent predictor of survival (OR 6.27, 95% CI 2.78-14.16). CONCLUSION: Rotation of empirical antibiotic therapy seems to be a promising method to reduce infectious mortality in an ICU...

..26) and the combination of a female donor and male recipient (OR=1.97). CONCLUSION: Therefore, in nonemergency situations attention to these factors in donor allocation may minimize the possibility of HAT...

..Prolonged preservation with HTK compared to UW was not associated with excess risk to the graft or patient. In summary, HTK demonstrated efficacy similar to UW in terms of patient and graft survival...

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..Surgical infection in the elderly is associated with a high mortality and requires special consideration when treating this unique population...

..We hypothesize that the systems of care within academic medical centers are sufficiently disrupted with the beginning of a new academic year to affect patient outcomes...

..We identified the specific morbidity associated with urinary complications following renal transplantation and quantified the health care resources required to treat these patients at a high volume center...

..0001) survival benefit, including morbidly obese and underweight recipients. Our results suggest that high or low recipient BMI should not be a contraindication for LT...

..Donor, recipient, and technical factors appear to differentially affect the incidence of anastomotic biliary complications, with warm ischemia, use of HTK, and use of a stent emerging as the most important variables...

..We aimed to determine whether implementation of MELD affected the quality of organs transplanted, the type of patients who receive the higher-risk organs, and the impact of these changes on their posttransplant survival...

..In this retrospective review, we evaluated the records of all pediatric renal transplant recipients at our center from 1995 to 2004...

..39; 95% CI, 2.39-22.83). In conclusion, patients with cirrhosis complicated by PVT have an increased risk of death...

..Preemptive cholecystectomy in cardiac transplant patients with radiographic biliary pathology reduces the morbidity and mortality of biliary tract disease following heart transplantation compared with expectant management...

..This study examines donation after cardiac death (DCD) practices and outcomes in liver transplantation...

..The National Kidney Foundation Practice Guidelines urge prompt removal of the catheter, but the guidelines do not specifically address the problem of patients whose only option is a femoral arteriovenous (AV) graft...

..HCV-positive kidney transplant recipients have worse clinical outcomes than those who are HCV negative. The optimal immunosuppressive regimen in this group of patients remains uncertain...

..Complications after liver transplantation are common and expensive. The incremental costs of adult posttransplantation liver transplantation complications and who pays for these complications (center or payor) is unknown...

..The effect of intraoperative strict glucose control on surgical outcomes, including liver transplantation, has not been well evaluated...

..Therefore, altering infection-control practices to limit the dissemination of certain bacterial species may be more effective than attempts to control only antibiotic-resistant isolates...

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..Such a proactive approach toward quality improvement from the transplant community is an excellent investment for patients, providers and health care payers...

..The HTK group did have significantly more acute rejection within the first 180 days (25.0% vs. 9.8%, P<0.05). HTK is a suitable substitute for UW in the preservation of pancreas allografts...

..All parties (patient and families, physician, payer, and medical center) should benefit from quality improvement efforts, with payers having the largest financial interest...

..Contact isolation is commonly used to prevent transmission of resistant organisms. We hypothesized that contact isolation negatively impacts the amount of direct patient care...

..The objective of this study was to determine the effect of transfusion on outcomes among infected surgical patients...

..Graft mass has been demonstrated to be a determinant of outcome after kidney transplantation. An insufficient nephron might fail to meet the metabolic demands of the recipient and lead to hyperfiltration...

..The early graft function is not determined by donor gender. The effect of recipient gender on the graft function depends on the metabolic demands, which are higher in male recipients...

..The exact cause of these findings, whether physiologic or immunologic, remains unknown. If confirmed in larger data sets, the attention to these factors may minimize the possibility of PNF in non-emergency situations...