ABSTRACT
BACKGROUND: Controlled donation after circulatory death (cDCD) has expanded the donor pool for liver transplantation (LT). However, transfusion requirements and perioperative outcomes should be elucidated. The aim of this multicenter study was to assess red blood cell (RBC) transfusions, one-year graft and patient survival after LT after cDCD with normothermic regional perfusion (NRP) compared with donors after brain death (DBD). METHODS: 591 LT carried out in ten centers during 2019 were reviewed. Thromboelastometry was used to manage coagulation and blood product transfusion in all centers. Normothermic regional perfusion was the standard technique for organ recovery. RESULTS: 447 patients received DBD and 144 cDCD with NRP. Baseline MCF Extem was lower in the cDCD group There were no differences in the percentage of patients (63% vs. 61% p = 0.69), nor in the number of RBC units transfused (4.7 (0.2) vs 5.5 (0.4) in DBD vs cDCD, p = 0.11. Twenty-six patients (6%) died during admission for LT in the DBD group compared with 3 patients (2%) in the cDCD group (p = 0.15). To overcome the bias due to a worse coagulation profile in cDCD recipients, matched samples were compared. No differences in baseline laboratory data, or in intraoperative use of RBC or one-year outcome data were observed between DBD and cDCD recipients. CONCLUSIONS: cDCD with NRP is not associated with increased RBC transfusion. No differences in graft and patient survival between cDCD and DBD were found. Donors after controlled circulatory death with NRP can increasingly be utilized with safety, improving the imbalance between organ donors and the ever-growing demand.
Subject(s)
Brain Death , Liver Transplantation , Cohort Studies , Graft Survival , Humans , Organ Preservation , Perfusion , Tissue DonorsABSTRACT
OBJECTIVE: To assess the 2 most recently developed sets of spondylarthropathy (SpA) diagnostic and classification criteria [Amor and the European Spondyloarthropathy Study Group (ESSG)] in a survey involving a Spanish population with rheumatic disease. METHODS: The survey involved a cross sectional study of 1549 patients with rheumatic disease, who were examined over a week by 36 expert rheumatologists at 28 Spanish rheumatological centers. The head researcher at each participating center was to diagnose patients as having definite SpA, possible SpA, or as having other rheumatic diseases (definite controls) based on the physician's experience and assessment with no reference to the criteria under study. RESULTS: Overall a total of 218 patients were classified as having definite SpA, 1242 as definite controls and 89 as having possible SpA. An analysis of the patients diagnosed as definite showed 90.8 and 83.5% sensitivity, 96.2 and 95.2% specificity, 80.8 and 75.5% positive predictive value, and 98.4 and 97.0% negative predictive value for the Amor and ESSG criteria sets, respectively. CONCLUSIONS: Both the Amor and ESSG criteria had excellent intrinsic (sensitivity and specificity) and extrinsic (positive and negative predictive value) performance, with no substantial differences between the 2. The results support use of the criteria for classifying SpA in daily rheumatological practice. Although not intended as diagnostic criteria, they make useful tools for the early identification of initial, atypical, or undifferentiated forms, which fail to strictly meet the diagnostic criteria of the entities that make up the SpA group.
Subject(s)
Rheumatic Diseases/classification , Rheumatic Diseases/diagnosis , Spinal Diseases/classification , Spinal Diseases/diagnosis , Arthritis/diagnostic imaging , Arthritis/immunology , Cross-Sectional Studies , Female , HLA-B27 Antigen/analysis , Humans , Male , Predictive Value of Tests , Radiography , Rheumatic Diseases/physiopathology , Sacroiliac Joint/diagnostic imaging , Sensitivity and Specificity , Spinal Diseases/physiopathology , Time FactorsABSTRACT
We analysed serum uric acid concentrations in a group of healthy male and female volunteers in Córdoba (Spain) possessing varying nutritional habits, in order to correlate them with their usual alcohol intake as measured according to a protocolized, blind dietary questionnaire. There was no significant correlation between the serum uric acid and the amount of alcohol regularly drunk by either male or female individuals. These results suggest that a moderate alcohol intake has no effect on uricaemia in healthy individuals.
