IMPACT OF VENOUS DRAINAGE AND REPERFUSION TECHNIQUE ON REPERFUSION INJURY AFTER ORTHOTOPIC LIVER TRANSPLANTATION
Bibliographic record
Abstract
P486 Aims: Venous drainage of an orthotopic liver transplant may be achieved either by caval replacement with a donor vena cava conduit (CC) or by anastomosis of the donor vena cava to the side of the preserved recipient vena cava, known as the piggy back technique (PB). Retrograde venous reperfusion (RR) of the graft while the portal anastomosis is made has recently been described as an alternative to the conventional orthograde reperfusion (OR) after portal vein anastomosis. PB and RR may be advantageous to intra-operative management because less caval clamping is required but their impact on the graft is not known. We reviewed our experience with these techniques to measure their effect on graft reperfusion. Methods: From January 2002 until Nov 2003, 132 patients (age 16 - 71) received 136 whole organ orthotopic liver transplants. These transplantations were categorized as follows: group 1 = CC / OR; group 2 = CC / RR; group 3 = PB / OR; group 4 = PB / RR. Patients were followed for patient survival, graft survival, vascular complications, transaminases, bilirubin, INR and creatinine. Results: There were 78, 13, 18, and 23 patients in groups 1, 2, 3 and 4 respectively. The groups did not differ with respect to recipient age, cause of liver disease, donor quality, cold ischemic time, transplantation urgency. Vena cava clamps times were 64 (12); 44 (6); 42 (14); 28 (6) minutes (SD) for groups 1, 2, 3, 4 respectively. Patient and graft survival were as follows: 95% and 92% in group 1; 100% and 92% in group 2; 100% and 94% in group 3; 96% and 96% in group 4. Postoperatively, maximum average ALT was 581, 804, 549 and 386; bilirubin was 83, 61, 77, 68; INR was 1.68, 1.72, 1.60 and 1.61; creatinine was 138, 139, 91 and 129 in groups 1, 2, 3 and 4 respectively. Conclusions: The piggy back technique and retrograde graft reperfusion allow for shorter and less complete clamping of the vena cava without impairing immediate graft function after liver transplantation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".