Sheehanmendez2347

There is evidence to suggest social support is associated with likelihood of substance misuse relapse after transplantation but there is a lack of consistent evidence for an association between social support and post-transplant adherence, rejection or survival across all organ transplant types. Psychosocial evaluations should be undertaken by a trained individual and should comprise multiple consultations with the transplant candidate, family members, and healthcare professionals. Tools exist which can be useful for guiding and standardising assessment, but research is needed to determine how well scores predict post-transplant outcomes. Few studies have evaluated interventions designed to improve psychosocial functioning specifically pretransplant. We highlight the challenges of carrying out such research and make recommendations regarding future work.

We review the literature on the efficacy and safety outcomes of secondary Descemet stripping endothelial keratoplasty (DSEK) and Descemet membrane endothelial keratoplasty (DMEK).

Literature search of English-written publications up to 27th September 2020 in PubMed database, using the terms "endothelial keratoplasty" in combination with keywords "secondary" or "repeat". In addition, we manually searched the references of the primary articles.

27 studies (n = 651 eyes) were retained and reviewed, including 10 studies on repeat DSEK, 8 studies on repeat DMEK, 6 studies of DMEK following DSEK, and 3 studies of DSEK after failed DMEK. All studies reported significant improvement in visual acuity after secondary EK. Twelve studies compared visual outcomes between primary and secondary EK, reporting conflicting findings. Sixteen studies reported endothelial cell loss rates (%ECL) after secondary EK, and only one study reported significantly increased %ECL compared with primary EK. Allograft rejection episodess are "low-risk" as primary EK eyes. Further larger, prospective studies are encouraged to obtain additional quality data on secondary corneal endothelial allotransplantation.Online Supplemental Appendix; http//links.lww.com/TP/C177.Donation after circulatory death (DCD) donors are an increasingly more common source of livers for transplantation in many parts of the world. Events that occur during DCD liver recovery have a significant impact on the success of subsequent transplantation. This working group of the International Liver Transplantation Society evaluated current evidence as well as combined experience and created this guidance on DCD liver procurement. Best practices for the recovery and transplantation of livers arising through DCD after euthanasia and organ procurement with super-rapid cold preservation and recovery as well as postmortem normothermic regional perfusion are described, as are the use of adjuncts during DCD liver procurement.The Israeli Transplant Law grants priority in organ allocation to patients signing a donor-card. Liver transplant (LT) candidates get additional 2 points on their MELD score for signing a donor-card, 0.1 points for a relative holding a card, and 5 points if a relative donated an organ. We studied the effect of the priority program on waiting list mortality and allocation changes due to priority.

Using Israeli Transplant data of 531 adult LT candidates with chronic liver disease listed between 2012-2018 we compared waitlist mortality and transplant rate of candidates with and without priority. Then we analyzed liver allocations resulting from additional priority points and followed outcome of patients who were skipped in-line.

Of the 519 candidates 294 did not sign a donor-card, 82 signed, 140 had a relative sign, and for 3 a relative donated an organ. The rates of waitlist mortality in these 4 groups were 22.4%, 0%, 21.4% and 0%, respectively, and the transplant rates were 50%, 59.8%, 49.3% and 100%, respectively. Of the 30 patients who were skipped due to priority, 24 subsequently underwent transplant, 2 are on the waiting list, and 4 died within 0.75, 1.75, 7 and 17 months.

The 2 points added to the MELD score were associated with lower waitlist mortality and higher transplant rate for candidates signing a donor-card without significantly affecting access to transplant during allocation. Further research and consideration of optimal policy when granting priority for candidates signing a donor card should continue.

The 2 points added to the MELD score were associated with lower waitlist mortality and higher transplant rate for candidates signing a donor-card without significantly affecting access to transplant during allocation. Further research and consideration of optimal policy when granting priority for candidates signing a donor card should continue.

Little is known about the incidence and nature of sharps injuries caused by subdermal intraoperative neurophysiologic monitoring (IONM) needle electrodes. In their institution, the authors observed a series of sharps injuries attributed to placement of needles in the orbicularis oris (OO).

One large academic institution's sharps injury monitoring database was queried for all reported events over 3 years. The de-identified list was filtered for sharps events occurring in the operating room, and the descriptions of the sharps injuries were individually evaluated. Interventions were performed to attempt to decrease the number of sharps injuries from IONM needles, particularly those placed in OO. Similar data were then collected for 3 months post-intervention.

Pre-intervention, 327 sharps injuries were reported over the span of 3 years, of which 13 (4.0%) were attributed to IONM needles not in OO and 5 (1.5%) were attributed to IONM needles in OO. Post-intervention, 41 sharps injuries were reported in 3 mono IONM needles.

In mesial temporal lobe epilepsy with hippocampal sclerosis, there is parietal atrophy and cognitive involvement in related domains. In this context, we hypothesized that inhibitory input into somatosensory cortex and thalamus may be increased in these patients, which could improve after epilepsy surgery. Thus, we analyzed the inhibitory function of somatosensory system by studying surround inhibition (SI) and recovery function of somatosensory evoked potentials in patients with mesial temporal lobe epilepsy with hippocampal sclerosis.

Nine patients with unoperated mesial temporal lobe epilepsy with hippocampal sclerosis, 10 patients who underwent epilepsy surgery, and 12 healthy subjects were included. For SI of somatosensory evoked potentials, we recorded somatosensory evoked potentials after stimulating median or ulnar nerve at wrist separately and after median and ulnar nerves simultaneously and calculated SI% in all participants. see more For recovery function of somatosensory evoked potentials, paired stimulation of median nerve at 40- and 100-millisecond intervals was performed.