Discarded livers tested by normothermic machine perfusion in the VITTAL trial:Secondary end points and 5-year outcomes

Normothermic machine perfusion (NMP) enables pretransplant assessment of high-risk donor livers. The VITTAL trial demonstrated that 71% of the currently discarded organs could be transplanted with 100% 90-day patient and graft survivals. Here, we report secondary end points and 5-year outcomes of this prospective, open-label, phase 2 adaptive single-arm study. The patient and graft survivals at 60 months were 82% and 72%, respectively. Four patients lost their graft due to nonanastomotic biliary strictures, one caused by hepatic artery thrombosis in a liver donated following brain death, and 3 in elderly livers donated after circulatory death (DCD), which all clinically manifested within 6 months after transplantation. There were no late graft losses for other reasons. All the 4 patients who died during the study follow-up had functioning grafts. Nonanastomotic biliary strictures developed in donated after circulatory death livers that failed to produce bile with pH &gt;7.65 and bicarbonate levels &gt;25 mmol/L. Histological assessment in these livers revealed high bile duct injury scores characterized by arterial medial necrosis. The quality of life at 6 months significantly improved in all but 4 patients suffering from nonanastomotic biliary strictures. This first report of long-term outcomes of high-risk livers assessed by normothermic machine perfusion demonstrated excellent 5-year survival without adverse effects in all organs functioning beyond 1 year (ClinicalTrials.gov number NCT02740608).</p

X-Ray Detection of the Inner Jet in the Radio Galaxy M84

Peer reviewe

A Chandra observation of the X-ray environment and jet of 3c 296

Peer reviewe

The physics of jets in FRI radio galaxies

We model jets in low-luminosity (FR I) radio galaxies as intrinsically symmetrical, axisymmetric, decelerating relativistic flows with transverse velocity gradients. This allows us to derive velocity fields and the three-dimensional distributions of magnetic-field ordering and rest-frame emissivity. A conservation-law analysis, combining the kinematic model with X-ray observations of the surrounding IGM, gives the profiles of internal density, pressure, Mach number and entrainment rate along the jets. We summarize our recently-published results on 3C 31 and outline new work on other sources and adiabatic jet models.Comment: 4 pages, 2 figures, to appear in The Physics of Relativistic Jets in the Chandra and XMM Era, eds G. Brunetti, D.E. Harris, R.M. Sambruna, G. Setti, New Astronomy Review