MP52-02 INITIAL EXPERIENCE WITH RENAL TRANSPLANTS AFTER MEDICAL ASSISTANCE IN DYING: FIRST SERIES IN NORTH AMERICA
Notice bibliographique
Résumé
You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery II (MP52)1 Apr 2020MP52-02 INITIAL EXPERIENCE WITH RENAL TRANSPLANTS AFTER MEDICAL ASSISTANCE IN DYING: FIRST SERIES IN NORTH AMERICA Samir Sami*, Max Levine, Andrew Rasmussen, Alp Sener, and Patrick Luke Samir Sami*Samir Sami* More articles by this author , Max LevineMax Levine More articles by this author , Andrew RasmussenAndrew Rasmussen More articles by this author , Alp SenerAlp Sener More articles by this author , and Patrick LukePatrick Luke More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000914.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In 2016, Canadian federal legislation was passed creating a regulatory framework for medical assistance in dying (MAiD) for individuals who were suffering from a medically futile condition and foreseeable death. As there is a paucity of literature on transplantation from MAiD donors, we report our unique experience and first reported outcomes in North America. METHODS: We retrospectively analyzed all renal transplant recipients from MAiD donors at London Health Sciences Centre, beginning in 2018. Patients eligible for MAiD underwent circulatory death after administration of life ending therapy and organ procurement was performed as per standard protocol. Ethics approval was obtained to review these outcomes. RESULTS: There were a total of 4 patients who became kidney donors and one kidney-pancreas donor. The indication for MAiD in the donors included 3 with debilitating neurological disease, 1 with heart failure and 1 who previously suffered a significant fall resulting in quadriplegia. Mean donor age was 53.66 ±13.17, median warm ischemia time (WIT) was 17 minutes, and median cold ischemia time (CIT) was 9 hours. One perioperative death occurred due to medical complication unrelated to renal graft function. No delayed graft function was encountered and only two patients experienced slow graft function. Median 30 day creatinine was 108 μmol. CONCLUSIONS: MAiD associated organ donation represents a potential means to increase the donor pool for those awaiting deceased donor organs. The controlled nature of MAiD associated circulatory death has the potential to minimize the deleterious effects of prolonged WIT that may be associated with standard donation after circulatory death. Our institution’s early experience is encouraging, with low WIT, and favorable early graft function results. Ongoing assessment of MAiD outcomes is required to better quantify the quality of these donation opportunities compared to conventional deceased donors. Source of Funding: N/A © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e772-e772 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samir Sami* More articles by this author Max Levine More articles by this author Andrew Rasmussen More articles by this author Alp Sener More articles by this author Patrick Luke More articles by this author Expand All Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».