Domino liver transplantation (DLT) utilizes the explanted liver of one liver transplant recipient as a donor graft in another patient. While there may be unique risks associated with DLT, it is unclear if DLT has less favorable long-term outcomes than deceased donor liver transplantation (DDLT). We used a propensity score matching approach to compare the outcomes of DLT recipients to DDLT recipients. The United Network for Organ Sharing (UNOS) registry was queried for patients undergoing DLT or DDLT in 2002-2016. Each DLT recipient was matched to a unique DDLT recipient to compare mortality and graft failure. There were 126 DLT and 62 835 DDLT recipients meeting inclusion criteria. After propensity score matching on recipient pre-transplant characteristics, 123 DLT cases were matched to DDLT controls from the same UNOS region. On stratified Cox proportional hazards regression, DLT incurred no increase in the hazard of mortality [hazard ratio (HR) = 1.4; 95% confidence interval (CI): 0.8, 2.7; P = 0.265] or graft failure (HR = 1.2; 95% CI: 0.7, 2.1; P = 0.556) compared to DDLT. Using a large national registry, a propensity-matched analysis found no increased risk of mortality or graft failure associated with DLT compared to DDLT.
While abstract presentation facilitates rapid dissemination of survey research findings, the impact and utility of such studies may be limited until a full manuscript is published. In our review, 25% of abstracts presenting survey data at major anesthesiology meetings were eventually published. Larger sample sizes and a target population of patients or caregivers increased the likelihood of survey research being published in full form.
Every year, millions of children undergo anesthesia for a multitude of procedures. However, studies in both animals and humans have called into question the safety of anesthesia in children, implicating anesthetics as potentially toxic to the brain in development. To date, no studies have successfully elucidated the mechanism(s) by which anesthesia may be neurotoxic. Animal studies allow investigation of such mechanisms, and neonatal piglets represent an excellent model to study these effects due to their striking developmental similarities to the human brain.This protocol adapts the use of enzyme-based microelectrode array (MEA) technology as a novel way to study the mechanism(s) of anesthesia-induced neurotoxicity (AIN). MEAs enable real-time monitoring of in vivo neurotransmitter activity and offer exceptional temporal and spatial resolution. It is hypothesized that anesthetic neurotoxicity is caused in part by glutamate dysregulation and MEAs offer a method to measure glutamate. The novel implementation of MEA technology in a piglet model presents a unique opportunity for the study of AIN.
New technology has facilitated survey research of anesthesia professional society members. We evaluated prevailing metrics of quality and impact of published research studies based on surveys of anesthesiologists. We hypothesized that adherence to recommended practices (such as use of reminders) would be associated with increased survey response rates, and that higher response rates would be associated with higher article impact. Using the MEDLINE database, we identified 45 English-language research articles published in 2010-2017 reporting original data from surveys of anesthesiologists. The median response rate was 37% (IQR: 25-46%). Recommended survey practices, including the use of reminders (p = 0.861) and validated questionnaires (p = 0.719), were not correlated with response rates. In turn, survey response rates were not associated with measures of article impact (p = 0.528). The impact of published research based on surveys of anesthesiologists, as measured by citation scores (p = 0.493) and Altmetrics (p = 0.826), may be driven primarily by the novel data or questions raised using survey methodology, but does not appear to be associated with response rates. Improving reporting of survey methodology and understanding possible sources of non-response bias are important for future studies in this area.
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