An optimization framework to determine an optimal local sharing variance for organ allocation

In this study, we focus on the analysis of sharing variances which allow allocating organs within participating members before offering them at other levels. This type of variance has been successfully implemented in the past. For example, Florida and Tennessee created the Statewide Sharing program whereby kidneys are made available within-state donor service areas before they are made available for regional or national allocation. This program removed geographic disparities within those two states and resulted in better performance of the system in the states. Given these success stories, we propose a multi-period optimization model that can be used to determine the best policy for a local sharing program for any given OPO. We use liver allocation for the GALL OPO (i.e., LifeLink of Georgia) in the state of Georgia (USA) as a test case; however, our approach could be used for a variety of organs in any OPO.
Source: Operations Research for Health Care - Category: Hospital Management Source Type: research

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We report one case of a recent renal transplant recipient, who presented with gastrointestinal and respiratory symptoms, evolving into shock. The identification of Strongyloides stercoralis in the bronchoalveolar lavage (BAL) lead us to the diagnosis of SHS. Treatment with subcutaneous ivermectin was started, however the patient did not survive. Retrospective serum donor analysis allowed us to identify the donor as the source of infection.
Source: IDCases - Category: Infectious Diseases Source Type: research
Conclusions: The mPNI predicted AKI within 1-week better than other scoring systems in patients who underwent LDLT. The recommended cutoff value of mPNI is 8.7. PMID: 31929741 [PubMed - in process]
Source: International Journal of Medical Sciences - Category: Biomedical Science Tags: Int J Med Sci Source Type: research
In this study, we investigated the link between AF and senescence markers through the assessment of protein expression in the tissue lysates of human appendages from patients in AF, including paroxysmal (PAF) or permanent AF (PmAF), and in sinus rhythm (SR). The major findings of the study indicated that the progression of AF is strongly related to the human atrial senescence burden as determined by p53 and p16 expression. The stepwise increase of senescence (p53, p16), prothrombotic (TF), and proremodeling (MMP-9) markers observed in the right atrial appendages of patients in SR, PAF, and PmAF points toward multiple inter...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Study Design. Retrospective database review Objective. The aim of this study was to analyze the implications of solid organ transplant (SOT) on postoperative outcomes following elective one or two-level anterior cervical discectomy and fusion (ACDF). Summary of Background Data. Although SOTs have been associated with increased morbidity, postoperative outcomes in SOT recipients undergoing cervical spinal surgery are not well studied. Methods. A retrospective database review of Medicare patients younger than 85 years who underwent an elective one to two-level ACDF from 2006-2013 was conducted. Following our exclu...
Source: Spine - Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research
Organ preservation before transplantation is still a challenge. Both the University of Wisconsin and Bretschneider ’s histidine-tryptophan-ketoglutarate (HTK; Custodiol®) solution are standard for liver, kidney...
Source: Trials - Category: General Medicine Authors: Tags: Study protocol Source Type: research
ConclusionMPA-levels and IMPDH-activity in liver transplanted patients allows individual risk assessment. Patients with higher IMPDH inhibition acquire more often viral infections. Insufficient IMPDH inhibition is associated with development of non-anastomotic bile duct strictures and reduced re-transplantation-free survival.
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research
Publication date: January 2020Source: Archives of Cardiovascular Diseases Supplements, Volume 12, Issue 1Author(s): G. Coutance, Guillaume Bonnet, M. Racapé, J.P. Duong Van Huyen, P. Bruneval, Shaida Varnous, R. Guillemain, P. Rouvier, J.L. Taupin, X. Jouven, A. LoupyBackgroundThe diagnosis of cardiac allograft rejection is based on the histological analysis of a myocardial tissue sample obtained by endomyocardial biopsy (EMB), an invasive procedure at risk of complications. Our aim is to enable the shift from a protocol biopsy approach, to a precision medicine approach, in which the need for EMB is tailored to each...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
We describe a 5-month-old asymptomatic female patient with bilateral diffuse nephrocalcinosis and nephrolithiasis. Laboratory and genetic findings confirmed PH1. She was promptly administered conservative treatment consisting of high fluid intake, calcium oxalate crystallization inhibitors, and pyridoxine. Nephrocalcinosis and urolithiasis disappeared after 2 years of treatment. As far as we know, this is a unique case of a patient with an I244T/null mutation diagnosed after the neonatal period and with normal renal function, who remained asymptomatic during an 18-year follow-up. This case is also unique because of the lon...
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
Conclusion A great deal of progress is being made in the matter of treating aging: in advocacy, in funding, in the research and development. It can never be enough, and it can never be fast enough, given the enormous cost in suffering and lost lives. The longevity industry is really only just getting started in the grand scheme of things: it looks vast to those of us who followed the slow, halting progress in aging research that was the state of things a decade or two ago. But it is still tiny compared to the rest of the medical industry, and it remains the case that there is a great deal of work yet to be done at all...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Purpose of review Mesenchymal stromal cells (MSC) have been proposed as a novel cell therapy for immune-mediated diseases, including solid organ transplantation. Here, we provide an overview of recent preclinical and clinical studies in solid organ transplantation using MSC immunomodulatory therapy. Recent findings MSC have been tested successfully in models of corneal and lung transplantation, suggesting that either the programmed cell death protein 1/programmed death ligand 1 pathway or the generation of intermediary immune-regulatory monocyte-macrophage population are the main mechanisms of the protolerogenic effec...
Source: Current Opinion in Organ Transplantation - Category: Surgery Tags: TRANSPLANT IMMUNOLOGY: REJECTION, TOLERANCE AND HISTOCOMPATIBILITY: Edited by Paolo Cravedi Source Type: research
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