Scottheath7708

To describe a new stapedotomy in which is removed only the stapes head not the entire stapes superstructure and its long-term results.

Prospective study.

The study was started on January 2015 and ended on September 2020. Seventy patients with otosclerosis were included in the study. They underwent stapedotomy from January 2015 to April 2016. The main follow-up for the study group was (5.1 yrs). The study group was divided into two groups (A and B) according the short hearing results (1 yr) and long hearing results (5.1 yrs). Group A including short hearing results. Group B including long hearing results. For all patients in groups A and B, the surgeon (M.G.), microscope, the anesthesia (local), the approach (transcanal), the prostheses (piston-type), and the new stapedotomy (removal of the stapes head only and not of the entire stapes superstructure), were identical.

No patients exhibited postoperative dizziness or worsening of bone conduction. Cutting the stapes neck never caused bleeding or footplate complications. The average time to perform the new stapedotomy was 15 minutes. Air-bone gap (ABG) closure to within 10 dB was achieved in 66 of 70 (94.28%) cases in group A and in 65 of 70 (92.85%) cases in group B. This difference was not statistically significant.

The Malafronte's stapedotomy is an easy, safety, minimally invasive, and fast surgical technique. Its hearing outcomes are good and stable over time.

The Malafronte's stapedotomy is an easy, safety, minimally invasive, and fast surgical technique. Its hearing outcomes are good and stable over time.

Recently, continuous nonoxygenated hypothermic machine perfusion (HMP) has been implemented as standard preservation method for deceased donor kidneys in the Netherlands. This study was designed to assess the effect of the implementation of HMP on early outcomes after transplantation.

Kidneys donated in the Netherlands from 2016 to 2017 were intended to be preserved by HMP. A historical cohort (2010-2014) preserved by static cold storage (CS) was chosen as control group. Primary outcome was delayed graft function (DGF). Additional analyses were performed on safety, graft function and survival up until 2 years after transplantation.

Data was collected on 2493 kidneys. CNO agonist Analyses showed significantly more DCD, pre-emptive and retransplants in the project cohort. Of the 681 kidneys that were transplanted during the project, 81% was preserved by HMP. No kidneys were discarded due to HMP related complications. DGF occurred in 38.2% of the project cohort versus 43.7% of the historical cohort (p <0.001), with a significantly shorter duration within the project cohort (7 versus 9 days, p = 0.003). Multivariate regression analysis showed an odds ratio of 0.69 (95% CI 0.553 - 0.855) for the risk of DGF when using HMP compared to CS (p = 0.001). There was no significant difference in kidney function, graft and recipient survival up until 2 years post transplantation.

This study showed that HMP as standard preservation method for deceased donor kidneys is safe and feasible. HMP was associated with a significant reduction of DGF.

This study showed that HMP as standard preservation method for deceased donor kidneys is safe and feasible. HMP was associated with a significant reduction of DGF.Diabetes is common in patients wait-listed for liver transplantation due to end-stage liver disease or to hepatocellular cancer as well as in post-transplant phase (post-transplantation diabetes mellitus-PTDM). In both conditions the presence of diabetes severely affects disease burden and long-term clinical outcomes; careful monitoring and appropriate treatment are pivotal to reduce cardiovascular events and graft and recipients' death. We thoroughly reviewed the epidemiology of diabetes in the transplant setting and the different therapeutic options, from lifestyle intervention to antidiabetic drug use - including the most recent drug classes available - and to the inclusion of bariatric surgery in the treatment cascade. In wait-listed patients, the old paradigm that insulin should be the treatment of choice in the presence of severe liver dysfunction is no longer valid; novel antidiabetic agents may provide adequate glucose control without the risk of hypoglycemia, also offering cardiovascular protection. The same evidence applies to the post-transplant phase, where oral or injectable noninsulin agents should be considered to treat patients to target, limiting the impact of disease on daily living, without interaction with immunosuppressive regimens. The increasing prevalence of liver disease of metabolic origin (nonalcoholic fatty liver) among liver transplant candidates, also having a higher risk of noncirrhotic hepatocellular cancer, is likely to accelerate the acceptance of new drugs and invasive procedures, as suggested by international guidelines. Intensive lifestyle intervention programs remain however mandatory, both before and after transplantation. Achievement of adequate control is mandatory to increase candidacy, to prevent de-listing and to improve long-term outcomes.

Acute Kidney Injury (AKI) is a common complication after liver transplantation (LT) but the specific impact of rapidly resolving AKI is not elucidated. This study investigates the factors associated with early recovery from AKI and its association with post-LT outcomes.

Retrospective analysis of 441 liver transplant recipients with end-stage liver disease without pretransplant renal impairment. AKI was defined according to KDIGO criteria and early renal recovery by its disappearance within 7 days post-LT.

146 patients (32%) developed a post-LT AKI, of whom 99 (69%) recovered early and 45 (31%) did not. Factors associated with early recovery were KDIGO stage 1 (OR14.11; 95%CI5.59-40.22; P<0.0001), minimum prothrombin time >50 % (OR4.50; 95%CI1.67-13.46; P=0.003) and AST peak value <1000 U/L (OR4.07; 95%CI1.64-10.75; P=0.002) within 48h post-LT. Patients with early recovery had a renal prognosis similar to that of patients without AKI with no difference in estimated glomerular filtration rate between D7 and one year.