scholarly journals Retracted: The Impact of Graft Nephrectomy on Subsequent Transplants: Multivariate Analysis of Risk Factors for Second Graft Loss and for Multiple Transplantations–A Single-Center Retrospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-1 ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Emmanouil Giorgakis ◽  
Asim Syed ◽  
Hector Gonzalez

Introduction. The management of a failed primary allograft remains unclear and the evidence of the effect of transplantectomy to future transplants conflicting. Aim of this study is to review the impact of failed primary graft nephrectomy on future transplants. Materials/Methods. Retrospective study of 101 patients retransplanted in a single institution. Median follow-up was 68 months. Patients were divided into two groups; G1 (n=49) was the nephrectomy group; G2 (n=52) was the graft in situ group. The patients’ and second graft survival were analysed with the Kaplan-Meier method. The patients’ and transplant characteristics were analyzed with student’s t-test. The retransplant risk factors and the risk factors for multiple transplants were obtained via a logistic regression model. Results. The odds of second graft loss post-transplantectomy were high (OR = 5.24). Demographics, HLA mismatch and first graft rejection rates were similar among the two groups and did not affect the outcome. Transplantectomy accelerated the loss of a future failing graft. Multivariate analysis showed transplantectomy as independent risk factor for second allograft loss. Transplantectomy and younger age are significant independent risk factors for future multiple transplants. Conclusion. Transplantectomy of the failed primary graft is an independent risk factor for retransplant loss and for multiple renal transplants.


2021 ◽  
Author(s):  
Danielle Seidman ◽  
Brittney S. Zimmerman ◽  
Lauren Margetich ◽  
Serena Tharakan ◽  
Natalie Berger ◽  
...  

2021 ◽  
Author(s):  
Takuya Shiraishi ◽  
Hiroomi Ogawa ◽  
Chika Katayama ◽  
Katsuya Osone ◽  
Takuhisa Okada ◽  
...  

Abstract Purpose: While nutritional interventions may potentially lower the risk of peristomal skin disorders (PSDs) and their exacerbation, no prior studies have evaluated the relationship between PSDs and nutritional status using the Controlling Nutritional Status (CONUT) score. Therefore, the purpose of this study was to assess the impact of preoperative nutritional status on stoma development, and determine risk factors for postoperative PSDs and their increased severity. Methods: A retrospective analysis was performed in 116 consecutive patients with rectal cancer who underwent radical surgery with stoma creation, including ileostomy and colostomy. Results: PSDs were diagnosed in 32 patients (27.6%); 10 (8.7%) cases were defined as severe based on the ABCD-stoma score. A multivariate analysis indicated that the laparoscopic approach (odds ratio [OR], 3.221; 95% confidence interval [CI], 1.001–10.362; P = 0.050) and ileostomy (OR, 3.394; 95% CI, 1.349–8.535; P = 0.009) were both independent risk factors for PSD. In a separate multivariate analysis for severe PSD, the only independent risk factor was the CONUT score (OR, 11.298; 95% CI, 1.382–92.373; P = 0.024). Conclusion: Severe PSDs are associated with preoperative nutritional disorders, as determined via the CONUT score. Furthermore, PSDs may potentially increase in severity, regardless of stoma type.


2018 ◽  
Vol 53 (6) ◽  
pp. 1226-1229 ◽  
Author(s):  
Robert J. Obermeyer ◽  
Nina S. Cohen ◽  
Sheema Gaffar ◽  
Robert E. Kelly ◽  
M. Ann Kuhn ◽  
...  

2018 ◽  
Vol 46 (12) ◽  
pp. e75-e79 ◽  
Author(s):  
Haruka Hattori ◽  
Masayuki Maeda ◽  
Yasuhiro Nagatomo ◽  
Takahiro Takuma ◽  
Yoshihito Niki ◽  
...  

2019 ◽  
Vol 160 (5) ◽  
pp. 810-817 ◽  
Author(s):  
Ashley M. Nassiri ◽  
James W. Pichert ◽  
Henry J. Domenico ◽  
Mitchell B. Galloway ◽  
William O. Cooper ◽  
...  

Objectives To analyze unsolicited patient complaints (UPCs) among otolaryngologists, identify risk factors for UPCs, and determine the impact of physician feedback on subsequent UPCs. Methods This retrospective study reviewed UPCs associated with US otolaryngologists from 140 medical practices from 2014 to 2017. A subset of otolaryngologists with high UPCs received peer-comparative feedback and was monitored for changes. Results The study included 29,778 physicians, of whom 548 were otolaryngologists. UPCs described concerns with treatment (45%), communication (19%), accessibility (18%), concern for patients and families (10%), and billing (8%). Twenty-nine (5.3%) otolaryngologists were associated with 848 of 3659 (23.2%) total UPCs. Male sex and graduation from a US medical school were statistically significantly associated with an increased number of UPCs ( P = .0070 and P = .0036, respectively). Twenty-nine otolaryngologists with UPCs at or above the 95th percentile received peer-comparative feedback. The intervention led to an overall decrease in the number of UPCs following intervention ( P = .049). Twenty otolaryngologists (69%) categorized as “responders” reduced the number of complaints an average of 45% in the first 2 years following intervention. Discussion Physician demographic data can be used to identify otolaryngologists with a greater number of UPCs. Most commonly, UPCs expressed concern regarding treatment. Peer-delivered, comparative feedback can be effective in reducing UPCs in high-risk otolaryngologists. Implications for Practice Systematic monitoring and respectful sharing of peer-comparative patient complaint data offers an intervention associated with UPCs and concomitant malpractice risk reduction. Collegial feedback over time increases the response rate, but a small proportion of physicians will require directive interventions.


Author(s):  
Stefano Raimondo ◽  
Massimo Sartelli ◽  
Federico Coccolini ◽  
Paola Fugazzola ◽  
Raffaele Bova ◽  
...  

Intra-abdominal infections (cIAIs) constitute an important cause of morbidity and mortality. Numerous risk factors may influence prognosis of cIAIs. This study aims to evaluate which parameters and scores may better predict prognostic outcomes in cIAIs. This is a single-center prospective observational study. Data from sixty-five patients were collected during a four-month period. Univariate and multivariate analysis for physiological parameters and ROC curves for SIRS, qSOFA and WISS scores were calculated in relation to mortality, intensive care unit (ICU) admission and surgical complications. Blood oxygen saturation level (SpO2), heart and respiratory rate, systolic blood pressure (SBP), level of consciousness, INR, C-reactive protein (CRP), white blood cells, source control and health care-acquired infections affect prognosis in cIAIs according to univariate analysis. On multivariate analysis level of consciousness, SpO2, CRP, diffuse peritonitis, INR and SBP significantly influenced prognosis in cIAIs. AUROC for WISS score were 0.89 for mortality, 0.86 for major complications, 0.76 for ICU admission. In our study many risk factors adversely affect prognostic outcomes in cIAIs; PIPAS study probably may provide even better results on that. Moreover, WISS score reached remarkable performance in predicting mortality and major surgical complications in abdominal sepsis; qSOFA did not achieve satisfactory results in none of analyzed outcomes.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Christian Morath ◽  
Gerhard Opelz ◽  
Martin Zeier ◽  
Caner Süsal

In kidney transplantation, antibody-mediated allograft injury caused by donor HLA-specific antibodies (DSA) has recently been identified as one of the major causes of late graft loss. This paper gives a brief overview on the impact of DSA development on graft outcome in organ transplantation with a focus on risk factors forde novoalloantibody induction and recently published guidelines for monitoring of DSA during the posttransplant phase.


2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Jun Cao ◽  
Chunyan Peng ◽  
Xiwei Ding ◽  
Yonghua Shen ◽  
Han Wu ◽  
...  

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