ABSTRACT
External compression is a rare cause of acute lower limb ischemia. Workers required to wear immersion suits during helicopter simulation training are exposed to external compressive forces which can alter the hemodynamics in arterial bypass conduits. Herein a case of arterial thromboembolization to the lower limb following the wearing of an immersion suit, in a patient who had undergone arterial bypass surgery 13 yr previously is presented. The potential for this episode of acute leg ischemia being a direct result of the compressive forces exerted by the immersion suit and the possible implications for wearers of immersion suits following arterial graft surgery is discussed.
Subject(s)
Arterial Occlusive Diseases/etiology , Immersion , Ischemia/etiology , Leg/blood supply , Protective Clothing/adverse effects , Arterial Occlusive Diseases/diagnosis , Humans , Ischemia/diagnosis , Male , Middle Aged , Popliteal ArteryABSTRACT
Recent refinements in technique mean islet cell transplantation offers the chance of a cure to an increasing patient cohort with diabetes. Such developments put pressure upon the scarce resource of donor organs, with potential competition between the modalities of cellular and solid organ transplantation. This questionnaire based study examines current patterns of donor pancreas procurement and use. Reasons for non procurement are studied together with the attitudes of transplant professionals to pancreas allocation. The minority of potentially useful pancreata are currently made available to either whole pancreas or islet transplant programs. Whilst professionals appreciate the role of each modality, there is a need to define criteria for pancreas allocation to avoid under use of donor organs.