Journal of the American College of Surgeons
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Split liver transplantation is an excellent option for expansion of the donor organ pool. However, reports of increased morbidity in split liver recipients may limit use of this technique. ⋯ We demonstrated excellent outcomes in adult and pediatric recipients using carefully selected donors for liver splitting. We recommend escalation of the use of split liver transplants to expand the donor pool for cadaveric liver transplantation.
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The use of kidneys with multiple renal arteries (MRA) and right kidneys procured laparoscopically for living donor kidney transplantation (LDKT) remains controversial. We aimed to evaluate the short- and long-term outcomes of recipients of LDKT using laparoscopically procured MRA and right kidneys. ⋯ Excellent long-term outcomes can be obtained after LDKT using laparoscopically procured MRA and right-sided donor kidneys. Unavailability of an SRA left kidney should not preclude LDKT.
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Randomized Controlled Trial Multicenter Study
Current use and surgical efficacy of laparoscopic colectomy in colon cancer.
The Clinical Outcomes in Surgical Therapy trial demonstrated that laparoscopic colectomy (LC) was equivalent to open colectomy (OC) for 30-day mortality, time to recurrence, and overall survival in colon cancer (CC) patients. Current use of LC for CC is not well known. ⋯ This study demonstrated a steadily increasing use of LC for the surgical treatment of CC between 2004 and 2009, with LC preferred by study completion. Surgical efficacy was similar in stage III CC patients.
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We hypothesized that immune mediator concentrations in the bronchoalveolar fluid (BALF) are predictive of bronchiolitis obliterans syndrome (BOS) and demonstrate specific patterns of dysregulation, depending on the presence of acute cellular rejection, BOS, aspiration, and timing of lung transplantation. ⋯ The BALF levels of IL-15, IL-17, basic fibroblast growth factor, tumor necrosis factor-α, myeloperoxidase, and α1-antitrypsin at 6 to 12 months after lung transplantation are predictive of early-onset BOS, and those with BOS and aspiration have an augmented chemotactic and inflammatory balance of pulmonary leukocytes and immune mediators. These data justify the surgical prevention of aspiration and argue for the refinement of antirejection regimens.