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| 1 | Anticoagulation in simultaneous pancreas kidney transplantation - On what basis?显示文摘BACKGROUND Despite technical refinements,early pancreas graft loss due to thrombosis continues to occur.Conventional coagulation tests(CCT)do not detect hypercoagulability and hence the hypercoagulable state due to diabetes is left untreated.Thromboelastogram(TEG)is an in-vitro diagnostic test which is used in liver transplantation,and in various intensive care settings to guide anticoagulation.TEG is better than CCT because it is dynamic and provides a global hemostatic profile including fibrinolysis.AIM To compare the outcomes between TEG and CCT(prothrombin time,activated partial thromboplastin time and international normalized ratio)directed anticoagulation in simultaneous pancreas and kidney(SPK)transplant recipients.METHODS A single center retrospective analysis comparing the outcomes between TEG and CCT-directed anticoagulation in SPK recipients,who were matched for donor age and graft type(donors after brainstem death and donors after circulatory death).Anticoagulation consisted of intravenous(IV)heparin titrated up to a maximum of 500 IU/h based on CCT in conjunction with various clinical parameters or directed by TEG results.Graft loss due to thrombosis,anticoagulation related bleeding,radiological incidence of partial thrombi in the pancreas graft,thrombus resolution rate after anticoagulation dose escalation,length of the hospital stays and,1-year pancreas and kidney graft survival between the two groups were compared.RESULTS Seventeen patients who received TEG-directed anticoagulation were compared against 51 contemporaneous SPK recipients(ratio of 1:3)who were anticoagulated based on CCT.No graft losses occurred in the TEG group,whereas 11 grafts(7 pancreases and 4 kidneys)were lost due to thrombosis in the CCT group(P=0.06,Fisher’s exact test).The overall incidence of anticoagulation related bleeding(hematoma/gastrointestinal bleeding/hematuria/nose bleeding/re-exploration for bleeding/post-operative blood transfusion)was 17.65%in the TEG group and 45.10%in the CCT group(P=0.05,Fisher’s exact test).The incidence of radiologically confirmed partial thrombus in pancreas allograft was 41.18%in the TEG and 25.50%in the CCT group(P=0.23,Fisher’s exact test).All recipients with partial thrombi detected in computed tomography(CT)scan had an anticoagulation dose escalation.The thrombus resolution rates in subsequent scan were 85.71%and 63.64%in the TEG group vs the CCT group(P=0.59,Fisher’s exact test).The TEG group had reduced blood product usage{10 packed red blood cell(PRBC)and 2 fresh frozen plasma(FFP)}compared to the CCT group(71 PRBC/10 FFP/2 cryoprecipitate and 2 platelets).The proportion of patients requiring transfusion in the TEG group was 17.65%vs 39.25%in the CCT group(P=0.14,Fisher’s exact test).The median length of hospital stay was 18 days in the TEG group vs 31 days in the CCT group(P=0.03,Mann Whitney test).The 1-year pancreas graft survival was 100%in the TEG group vs 82.35%in the CCT group(P=0.07,log rank test)and,the 1-year kidney graft survival was 100%in the TEG group vs 92.15%in the CCT group(P=0.23,log tank test).CONCLUSION TEG is a promising tool in guiding judicious use of anticoagulation with concomitant prevention of graft loss due to thrombosis,and reduces the length of hospital stay. | Jeevan Prakash Gopal Frank JMF Dor Jeremy S Crane Paul E Herbert Vassilios E Papalois Anand SR Muthusamy | 2020 | World Journal of Transplantation2020，10，7： | 2 |
| 2 | Neural tube defects and derangement of homocysteine metabolism显示文摘 | Steegers-theunissen RPM Boers GHJ Tribels JMF | 1991 | N Engl J Med1991，324，： | 1 |
| 3 | STACS:new active contour scheme for cardiac MR image segmentation显示文摘 | Pluempitiwiriyawej C Moura JMF Wu Y | 2005 | IEEE Trans MI2005，24，： | 1 |
| 4 | 显示文摘 | Chiu LCM Wan JMF | 1999 | Cancer Lett1999，145，： | 1 |
| 5 | DILAND: An algorithm for distributed sensor localization with noisy distance measurements 显示文摘 | Khan UA Kar S Moura JMF | 2010 | IEEE Transactions on Signal Processing2010，58，3： | 1 |
| 6 | Emoirieal analysis of the relationship hetween corporate reputation and financial performance: A Survey of the literature显示文摘 | Sabate JMF Puente EQ | 2003 | Corporate Reputation Review2003，6，2： | 1 |
| 7 | Pre-emptive live donor kidney transplantation-moving barriers to opportunities:An ethical,legal and psychological aspects of organ transplantation view显示文摘Live donor kidney transplantation(LDKT)is the optimal treatment modality for end stage renal disease(ESRD),enhancing patient and graft survival.Pre-emptive LDKT,prior to requirement for renal replacement therapy(RRT),provides further advantages,due to uraemia and dialysis avoidance.There are a number of potential barriers and opportunities to promoting pre-emptive LDKT.Significant infrastructure is needed to deliver robust programmes,which varies based on socio-economic standards.National frameworks can impact on national prioritisation of pre-emptive LDKT and supporting education programmes.Focus on other programme’s components,including deceased kidney transplantation and RRT,can also hamper uptake.LDKT programmes are designed to provide maximal benefit to the recipient,which is specifically true for pre-emptive transplantation.Health care providers need to be educated to maximize early LDKT referral.Equitable access for varying population groups,without socioeconomic bias,also requires prioritisation.Cultural barriers,including religious influence,also need consideration in developing successful outcomes.In addition,the benefit of pre-emptive LDKT needs to be emphasised,and opportunities provided to potential donors,to ensure timely and safe work-up processes.Recipient education and preparation for pre-emptive LDKT needs to ensure increased uptake.Awareness of the benefits of pre-emptive transplantation require prioritisation for this population group.We recommend an approach where patients approaching ESRD are referred early to pre-transplant clinics facilitating early discussion regarding pre-emptive LDKT and potential donors for LDKT are prioritized for work-up to ensure success.Education regarding preemptive LDKT should be the norm for patients approaching ESRD,appropriate for the patient’s cultural needs and physical status.Pre-emptive transplantation maximize benefit to potential recipients,with the potential to occur within successful service delivery.To fully embrace preemptive transplantation as the norm,investment in infrastructure,increased awareness,and donor and recipient support is required. | David van Dellen Lisa Burnapp Franco Citterio Nizam Mamode Greg Moorlock Kristof van Assche Willij CZuidema Annette Lennerling Frank JMF Dor | 2021 | World Journal of Transplantation2021，11，4： | 1 |
| 8 | An approximate theory of order in alloys显示文摘 | Jmf Cowley | | 0，，5： | 1 |
| 9 | Fabrication of Si3N4-SiC nano-composite ceramic through temperature-induced gelation and liquid phase sintering 显示文摘 | XU X MEI S FERREIRA JMF | 2006 | Journal of the European Ceramic Society2006，26，3： | 1 |
| 10 | Distributed sensor localization in random environments using minimal number of anchor nodes显示文摘 | Khan UA Kar S Moura JMF | 2009 | IEEE Transactions on Signal Processing2009，57，5： | 1 |
| 11 | Indoorlocalization and Navigation for Blind Persons UsingVisual Landmarks and A GIS 显示文摘 | SerrSo M Rodrigues JMF Rodrigues JI | 2012 | Procedia ComputerScience2012，14，4： | 1 |
| 12 | Processing of porous ceramics by starch consolidation显示文摘 | Lyckfeldt O Ferreira JMF | 1998 | J Eur Ceram Soc1998，18，： | 1 |
| 13 | Multiresidue screening of neutral pesticides in water samples by high performance liquid ehromatography-eleetrospray mass spectrometry 显示文摘 | Nogueira JMF Sandra T Sandra P | 2004 | Analytica Chimica Acta2004，502，2： | 1 |
| 14 | Airlift-driven external-loop tubular photobioreaetors for outdoor production of mieroalgae: assessment of design and performance 显示文摘 | FERNANDEZ FGA SEVILLA JMF PEREZ JAS | 2001 | Chemical Engineering Science2001，56，8： | 1 |
| 15 | Processing of porous ceramics by 'starch consolidation' 显示文摘 | Lyckfeldt O Ferreira JMF | 1998 | Journal of the European Ceramic Society1998，18，2： | 1 |
| 16 | Clinieopatho- logic features of renal cell carcinoma incidentally detected through radiological studies显示文摘 | Vazquez VB Alvarez - Muglca M Gomez JMF | 2008 | Aetasurol ESP2008，32，10： | 1 |
| 17 | Changes in net N mineralization rates and soil N and P pools in pine forest wildfire chronosequence显示文摘 | Duran J Rodriguez A Palacios JMF Gallardo A | | 0，，： | 1 |
| 18 | Polysaccharopeptides derived from Coriolus versicolor potentiate the S-phase specific cytotoxicity of Camptothecin (CPT) on human leukemia HL- 60 cells 显示文摘 | Wan JMF Sit WH Yang XT | 2010 | Chinese Medicine2010，，5： | 1 |
| 19 | The culture duration affects the immunomodulatory and anticancer effect of polysaceharopeptide derived from Coriolus versieolor 显示文摘 | Lee CL Yang XT Wan JMF | 2006 | Enzyme and Microbial Technology2006，38，： | 1 |
| 20 | Valproic acid induces growth arrest,apoptosis, and senescence in meduUoblastomas by increasing histone hyperacetylfion and regulating expression of P21Cip1, CDK4, and CMYC 显示文摘 | Li XN Shu Q Su JMF | 2005 | Mol Cancer Ther2005，4，12： | 1 |
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