Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System

Previous researchers have modelled the decision to accept a donor organ for transplantation as a Markov decision problem, the solution to which is often a control-limit optimal policy: accept any organ whose match quality exceeds some health-dependent threshold; otherwise, wait for another. When competing transplant centers vie for the same organs, the decision rule changes relative to no competition; the relative size of competing centers affects the decision rules as well. Using center-specific graft and patient survival-rate data for cadaveric adult livers in the United States, we have found empirical evidence supporting these predictions.liver transplantation, competition, optimal stopping

Competition and Post-Transplant Outcomes in Cadaveric Liver Transplantation under the MELD Scoring System

Previous researchers have modelled the decision to accept a donor organ for transplantation as a Markov decision problem, the solution to which is often a control-limit optimal policy: accept any organ whose match quality exceeds some health-dependent threshold; otherwise, wait for another. When competing transplant centers vie for the same organs, the decision rule changes relative to no competition; the relative size of competing centers affects the decision rules as well. Using center-specific graft and patient survival-rate data for cadaveric adult livers in the United States, we have found empirical evidence supporting these predictions.liver transplantation; competition; optimal stopping

Welcome to the Journal of Renal and Hepatic Disorders

Welcome to the inaugural issue of the Journal of Renal and Hepatic Disorders. The aim of the journal is to promote the study and dissemination of research involving both renal and hepatic organ systems and their impact on the whole organism in both healthy and diseased states. In addition, the focus of the journal will provide a unique forum in which the interdependence and interactions between the liver and kidney will be of particular interest

Decision support for organ offers in liver transplantation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111780/1/lt24113.pd

A 3D Cu‐Naphthalene‐Phosphonate Metal–Organic Framework with Ultra‐High Electrical Conductivity

A conductive phosphonate metal–organic framework (MOF), [{Cu(H2O)}(2,6‐NDPA)0.5] (NDPA = naphthalenediphosphonic acid), which contains a 2D inorganic building unit (IBU) comprised of a continuous edge‐sharing sheet of copper phosphonate polyhedra is reported. The 2D IBUs are connected to each other via polyaromatic 2,6‐NDPA's, forming a 3D pillared‐layered MOF structure. This MOF, known as TUB40, has a narrow band gap of 1.42 eV, a record high average electrical conductance of 2 × 102 S m−1 at room temperature based on single‐crystal conductivity measurements, and an electrical conductance of 142 S m−1 based on a pellet measurement. Density functional theory (DFT) calculations reveal that the conductivity is due to an excitation from the highest occupied molecular orbital on the naphthalene‐building unit to the lowest unoccupied molecular orbital on the copper atoms. Temperature‐dependent magnetization measurements show that the copper atoms are antiferromagnetically coupled at very low temperatures, which is also confirmed by the DFT calculations. Due to its high conductance and thermal/chemical stability, TUB40 may prove useful as an electrode material in supercapacitors

An Examination of Liver Offers to Candidates on the Liver Transplant Wait-List

BACKGROUND & AIMS: We aimed to characterize offers of organs to candidates awaiting liver transplantation (LT). METHODS: We analyzed data from the United Network for Organ Sharing registry on all US LT candidates with non-fulminant disease who were offered livers from February 1 2005 to January 31, 2010 and ultimately received transplants. We excluded candidates with a final model for end-stage liver disease (MELD) scores <15. Livers were classified as high quality if they were from donors 18–50 years of age who were ≥170 cm tall, of non-black race, suffered brain death secondary to trauma, hepatitis C antibody-negative, not categorized as high risk by the Centers for Disease Control, and locally or regionally located. RESULTS: Of 33,389 candidates for LT, 20% died or were removed from the list and 64% were received LT; the median (interquartile range) number of liver offers for all candidates was 5 (range, 2–12). Of those who died or were removed from the list, 84% received ≥1 liver offer (s). Overall, 55% those who died or were removed from the list, and 57% of those who received LT, received ≥1 offer of a high-quality liver, when they had MELD scores ≥15 (P=.005). However, the proportion of last liver offers of high-quality to patients that underwent LT was twice that of patients that died or were removed from the list (28 vs 14%; P<0.001). Most liver offers (68%) were refused for reasons related to donor quality. CONCLUSIONS: Most candidates for LT who died or were removed from the list received ≥1 offer of a liver beforehand, and 55% received ≥1 offer of a high-quality liver. These findings indicate that a substantial proportion of wait-list mortality results in part from declined, rather than lack of opportunity, for transplantation. Understanding the real-time factors involved in the complex decision to accept a liver offer is vital to reducing wait-list mortality for LT candidates

A 3D Cu‐Naphthalene‐Phosphonate Metal–Organic Framework with Ultra‐High Electrical Conductivity

A conductive phosphonate metal–organic framework (MOF), [{Cu(H2O)}(2,6‐NDPA)0.5] (NDPA = naphthalenediphosphonic acid), which contains a 2D inorganic building unit (IBU) comprised of a continuous edge‐sharing sheet of copper phosphonate polyhedra is reported. The 2D IBUs are connected to each other via polyaromatic 2,6‐NDPA's, forming a 3D pillared‐layered MOF structure. This MOF, known as TUB40, has a narrow band gap of 1.42 eV, a record high average electrical conductance of 2 × 102 S m−1 at room temperature based on single‐crystal conductivity measurements, and an electrical conductance of 142 S m−1 based on a pellet measurement. Density functional theory (DFT) calculations reveal that the conductivity is due to an excitation from the highest occupied molecular orbital on the naphthalene‐building unit to the lowest unoccupied molecular orbital on the copper atoms. Temperature‐dependent magnetization measurements show that the copper atoms are antiferromagnetically coupled at very low temperatures, which is also confirmed by the DFT calculations. Due to its high conductance and thermal/chemical stability, TUB40 may prove useful as an electrode material in supercapacitors.TU Berlin, Open-Access-Mittel – 202