3 research outputs found
Hypothermic machine perfusion in liver transplantation: a randomized trial
BACKGROUNDTransplantation of livers obtained from donors after circulatory death is associated with an increased risk of nonanastomotic biliary strictures. Hypothermic oxygenated machine perfusion of livers may reduce the incidence of biliary complications, but data from prospective, controlled studies are limited.METHODSIn this multicenter, controlled trial, we randomly assigned patients who were undergoing transplantation of a liver obtained from a donor after circulatory death to receive that liver either after hypothermic oxygenated machine perfusion (machine-perfusion group) or after conventional static cold storage alone (control group). The primary end point was the incidence of nonanastomotic biliary strictures within 6 months after transplantation. Secondary end points included other graft-related and general complications.RESULTSA total of 160 patients were enrolled, of whom 78 received a machine-perfused liver and 78 received a liver after static cold storage only (4 patients did not receive a liver in this trial). Nonanastomotic biliary strictures occurred in 6% of the patients in the machine-perfusion group and in 18% of those in the control group (risk ratio, 0.36; 95% confidence interval [CI], 0.14 to 0.94; P=0.03). Postreperfusion syndrome occurred in 12% of the recipients of a machine-perfused liver and in 27% of those in the control group (risk ratio, 0.43; 95% CI, 0.20 to 0.91). Early allograft dysfunction occurred in 26% of the machine-perfused livers, as compared with 40% of control livers (risk ratio, 0.61; 95% CI, 0.39 to 0.96). The cumulative number of treatments for nonanastomotic biliary strictures was lower by a factor of almost 4 after machine perfusion, as compared with control. The incidence of adverse events was similar in the two groups.CONCLUSIONSHypothermic oxygenated machine perfusion led to a lower risk of nonanastomotic biliary strictures following the transplantation of livers obtained from donors after circulatory death than conventional static cold storage.Cellular mechanisms in basic and clinical gastroenterology and hepatolog
Determinaci贸n de producci贸n de metano en caprinos alimentados con dietas con distintos cereales
Three primiparous 1.5 year old Murciano-Gra-
nadina female goats in maintenance were used.
Their average body weight was 33.08 卤 2.1 kg.
The objective was to determine methane production
in two diets differing of the type of cereal grain
(barley or corn). Two consecutive digestibility
trials were conducted using diets differing in the
cereal type (barley or maize grains). The adaptation
period has a duration of 7 days and the digestibility
period 5 days. Methane production (CH 4 ) was
determined by indirect calorimetry with an open
circuit mask adapted to small ruminants. Methane
production was determined on day four of
digestibility trial, before feeding and three more
measurements every 35 minutes during feeding.
There were no significant differences neither in
dry matter intake (758 g MS/goat and day on
average) nor in dry matter digestibility coefficients
(CDMS= 69.2% on average). Significant differences
(p<0.05) were observed in the methane produc-
tion during the feeding time with levels of 0.69 and
0.77 l/h for the barley and maize based diets,
respectively. No significant differences between
diets were observed when CH 4 was expressed
on gross energy intake basis, and the value
obtained for the experimental mixed diets was 4.8.Se utilizaron tres cabras prim铆paras de raza
Murciano-Granadina de un a帽o y medio de edad y
en estado de mantenimiento, con un peso medio de
33,08 卤 2,1 kg, con el objeto de determinar la
producci贸n de metano al administrarles dos dietas
que difirieron 煤nicamente en el tipo de cereal
(grano de cebada o ma铆z). Se realizaron dos
pruebas de digestibilidad consecutivas mediante
la administraci贸n de las dos dietas. Tras un perio-
do de adaptaci贸n de 7 d铆as se analiz贸 la digestibi-
lidad aparente durante 5 d铆as. La producci贸n de
metano (CH 4 ) se determin贸 por calorimetr铆a indi-
recta mediante una m谩scara de circuito abierto
adaptada a peque帽os rumiantes. El CH 4 se midi贸 el
d铆a 4 de la prueba de digestibilidad, antes de
administrar la raci贸n diaria y se realizaron tres
medidas m谩s cada 35 minutos mientras com铆an. No
se observaron diferencias significativas en el
consumo de materia seca (con 758 g MS/cabra y
d铆a de media), ni entre los coeficientes de diges-
tibilidad de materia seca de las dos dietas (CDMS=
69,2% de media). Durante la comida se observa-
ron diferencias (p<0,05) en la producci贸n de
metano con valores de 0,69 l/h para la dieta que
conten铆a grano de cebada frente a 0,77 l/h para la
dieta con grano de ma铆z. Cuando se expres贸 la
producci贸n de CH 4 sobre la ingesti贸n de energ铆a
(Ym) no se observaron diferencias significativas
entre dietas, y el valor medio para las dietas mixtas
estudiadas fue de 4,8