Dealing with Interaction Between Bipolar Multiple Criteria Preferences in PROMETHEE Methods

In this paper, we consider the bipolar approach to Multiple Criteria Decision Analysis (MCDA). In particular we aggregate positive and negative preferences by means of the bipolar PROMETHEE method. To elicit preferences we consider Robust Ordinal Regression (ROR) that has been recently proposed to derive robust conclusions through the use of the concepts of possible and necessary preferences. It permits to take into account the whole set of preference parameters compatible with the preference information provided by the Decision Maker (DM)

Aortoduodenal Fistula Forms From Primary Aortic Stump Graft in a Two-Time Multi-Visceral Transplant Patient with Presentation of Gastrointestinal Bleed and Bowel Perforation: A Case Report

Usually not diagnosed until open laparotomy, aortoduodenalfistulas (ADF) are one of the rarest complications of intestinal transplant surgery. With an incidence rate of only 0.04% at autopsy and only 250 documented cases since the early 1800’s, aortoduodenal fistulas are the most deadly complications of intestinal transplantation with a mortality rate of 100% without surgical intervention. A 39 year old, two-time multi-visceral transplant African American female patient suffered from a primary aortoduodenal fistula formation in a primary modified multi-visceral transplant aortic stump graft site. With emergency open laparotomy repair, revascularization of the secondary multi-visceral transplant was performed, saving the life of the patient and preserving the current multi-visceral transplant. Due to the rising number of intestinal transplants and multi-visceral transplants performed, clinicians should always have high suspicion of aortoduodenal fistulas in any transplant patient that presents with acute abdominal pain and lower gastrointestinal bleeding. With quick diagnosis, survival rate of aortoduodenal fistulas in multi-visceral transplant patientsmay improve