Dual en bloc technique for adult renal transplantation
Bibliographic record
Abstract
INTRODUCTION: We describe and provide follow-up for a novel simplified technique permitting dual en bloc (DEB) transplantation of adult organs using single in situ arterial and venous anastomoses. METHODS: Twenty-two adult DEB transplants were performed at our center between 2001 and 2012, utilizing 44 kidneys en bloc. Results were compared with 20 solitary transplants from expanded criteria donors (ECD) associated with lower terminal serum creatinines and Remuzzi biopsy scores vs DEB group. Adult DEB implants had donor inferior vena cava connected to recipient external iliac vein and "Y" arterial interposition graft anastomosed to the recipient iliac artery. Ureters were conjoined prior to implantation as a single patch into the recipient bladder. RESULTS: Mean operative time was 206±57 minutes in DEB vs 180±30 minutes in single transplants (P<.05). Delayed graft function rate was 23% vs 25% in both groups. At 12-month follow-up, mean serum creatinine was 152±66 μmol/L vs in 154±52 μmol/L DEB and single kidney transplant recipients, respectively (P=NS). Three-year overall and graft specific survival were 86% and 84% in the DEB group, respectively (P=NS). Complication rates were similar between groups. CONCLUSIONS: This DEB renal transplantation technique is safe and effective in adults. By employing techniques used to conjoin organ vasculature ex vivo, the number of in situ anastomoses is reduced, thereby minimizing operative ischemic time and potential for complications associated with extensive vascular dissection.
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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 | 0.000 | 0.000 |
| 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".