Acute kidney injury and post-reperfusion syndrome in liver transplantation

In the past decades liver transplantation (LT) has become the treatment of choice for patients with end stage liver disease (ESLD). The chronic shortage of cadaveric organs for transplantation led to the utilization of a greater number of marginal donors such as older donors or donors after circulatory death (DCD). The improved survival of transplanted patients has increased the frequency of long-term complications, in particular chronic kidney disease (CKD). Acute kidney injury (AKI) post-LT has been recently recognized as an important risk factor for the occurrence of de novo CKD in the long-term outcome. The onset of AKI post-LT is multifactorial, with pre-LT risk factors involved, including higher Model for End-stage Liver Disease score, more sever ESLD and pre-existing renal dysfunction, either with intra-operative conditions, in particular ischaemia reperfusion injury responsible for post-reperfusion syndrome (PRS) that can influence recipient’s morbidity and mortality. Post-reperfusion syndrome-induced AKI is an important complication post-LT that characterizes kidney involvement caused by PRS with mechanisms not clearly understood and implication on graft and patient survival. Since pre-LT risk factors may influence intra-operative events responsible for PRS-induced AKI, we aim to consider all the relevant aspects involved in PRS-induced AKI in the setting of LT and to identify all studies that better clarified the specific mechanisms linking PRS and AKI. A PubMed search was conducted using the terms liver transplantation AND acute kidney injury; liver transplantation AND post-reperfusion syndrome; acute kidney injury AND post-reperfusion syndrome; acute kidney injury AND DCD AND liver transplantation. Five hundred seventy four articles were retrieved on PubMed search. Results were limited to title/abstract of English-language articles published between 2000 and 2015. Twenty-three studies were identified that specifically evaluated incidence, risk factors and outcome for patients developing PRS-induced AKI in liver transplantation. In order to identify intra-operative risk factors/mechanisms specifically involved in PRS-induced AKI, avoiding confounding factors, we have limited our study to “acute kidney injury AND DCD AND liver transplantation”. Accordingly, three out of five studies were selected for our purpose

2,6-Dibromo-4-chloro­aniline

The title compound, C6H4Br2ClN, is almost planar (r.m.s. deviation = 0.024 Å) and two intra­molecular N—H⋯Br hydrogen bonds generate S(5) rings. In the crystal, N—H⋯Br hydrogen bonds link the mol­ecules into chains propagating in [010]

Double Walled Carbon Nanotube Simulator to Achieve Higher Accuracy in Finding Optical and Electrical Properties of the Tubes

Many Software have been made to predict the optical transition energy of Single Walled Carbon Nanotube. Predicting the Radial Breathing Mode frequency for Double Walled Carbon Nanotube has been really tough due to inter tube interaction. Experimental values show clear indication that these frequencies and Transition energies depends heavily on inter tube interaction and chirality of the Nanotube. All the previous software to predict any kinds of Band structure of CNT failed to take this effects into account. Moreover most of them gives fairly accurate value for Single Walled Carbon Nanotube. Here for the first time a software was built to predict different kinds of Parameter for Double Walled Carbon Nanotube. This software can be significant in simulating Resonant Raman Spectroscopy for DWNT. The equations used to predict the Band Structure of DWNT in this software is also the most accurate one till date

Identification of Finger Vein Images with Deep Neural Networks

To establish identification, individuals often utilize biometrics so that their identity cannot be exploited without their consent. Collecting biometric data is getting easier. Existing smartphones and other intelligent technologies can discreetly acquire biometric information. Authentication through finger vein imaging is a biometric identification technique based on a vein pattern visible under finger's skin. Veins are safeguarded by the epidermis and cannot be duplicated. This research focuses on the consistent characteristics of veins in fingers. We collected invariant characteristics from several cutting-edge deep learning techniques before classifying them using multiclass SVM. We used publicly available image datasets of finger veins for this purpose. Several assessment criteria and a comparison of different deep learning approaches were used to characterize the performance and efficiency of these models on the SDUMLA-HMT dataset.&nbsp

Survival Advantage Comparing Older Living Donor Versus Standard Criteria Donor Kidney Transplants

The aim of this analysis was to explore mortality outcomes for kidney transplant candidates receiving older living donor kidneys (age ≥60 years) versus younger deceased donors or remaining on dialysis. From 2000 to 2019, all patients on dialysis listed for their first kidney-alone transplant were included in a retrospective cohort analysis of UK transplant registry data. The primary outcome was all-cause mortality, with survival analysis conducted by intention-to-treat principle. Time-to-death from listing was modelled using nonproportional hazard Cox regression models with transplantation handled as a time-dependent covariate. A total of 32,978 waitlisted kidney failure patients formed the primary study cohort, of whom 18,796 (58.5%) received a kidney transplant (1,557 older living donor kidneys and 18,062 standard criteria donor kidneys). Older living donor kidney transplantation constituted only 17.0% of all living donor kidney transplant activity (overall cohort; n = 9,140). Recipients of older living donor kidneys had reduced all-cause mortality compared to receiving SCD kidneys (HR 0.904, 95% CI 0.845–0.967, p = 0.003) and much lower all-cause mortality versus remaining on the waiting list (HR 0.160, 95% CI 0.149–0.172, p < 0.001). Older living kidney donors should be actively explored to expand the living donor kidney pool and are an excellent treatment option for waitlisted kidney transplant candidates

Fractures in kidney transplant recipients : a comparative study between England and New York State

Objectives: Fractures are associated with high morbidity and are a major concern to kidney transplant recipients. There has not been any comparative analysis conducted between countries in the contemporary era to inform future international prevention trials. Materials and Methods: Data were obtained from the Hospital Episode Statistics and the Statewide Planning and Research Cooperative databases on all adult kidney transplants performed in England and New York State respectively (2003-2013) and on post-transplant fracture-related hospitalization (2003-2014). Results: In total, 18,493 English and 11,602 New York State kidney transplant recipients were included. Overall, 637 (3.4%) English and 398 (3.4%) New York State recipients sustained a fracture giving an unadjusted event rate of 7.0 and 5.9 per 1000 years respectively (P=0.948). A total of 147 (0.8%) English and 101 (0.9%) New York State recipients sustained a hip fracture, giving an unadjusted event rate of 1.6 and 1.5 per 1000 years respectively (P=0.480). There were no differences in the cumulative incidence of all fractures or hip fractures. One-year mortality after any fracture (9% and 11%) or after a hip fracture (15% and 17%) was not different between cohorts. Conclusions: Contemporaneous English and New York State kidney transplant recipients have very similar fracture rates and mortality post-fracture