PD54-01 MISSED OPPORTUNITIES FOR DCD KIDNEY DONORS: EVALUATION OF WARM ISCHEMIC TIME AND ASSOCIATED FUNCTIONAL WARM ISCHEMIC TIME
Bibliographic record
Abstract
You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery I (PD54)1 Apr 2019PD54-01 MISSED OPPORTUNITIES FOR DCD KIDNEY DONORS: EVALUATION OF WARM ISCHEMIC TIME AND ASSOCIATED FUNCTIONAL WARM ISCHEMIC TIME Jeffrey Law*, Karen Hornby, Clare Payne, Alp Sener, and Patrick Luke Jeffrey Law*Jeffrey Law* More articles by this author , Karen HornbyKaren Hornby More articles by this author , Clare PayneClare Payne 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/10.1097/01.JU.0000557054.54734.50AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Many transplant centres utilize a hard cut off of 2 hours of warm ischemic time (WIT), defined as the time from withdrawal of life-sustaining measures to cold organ flush, to exclude donation after circulatory determination of death (DCD) kidney donation. As a result, 30% of withdrawals to retrieve DCD organs fail to produce kidney transplants in Ontario. In order to assess our ability to increase organ yield, we wanted to characterize WIT, and functional WIT (fWIT, time from systolic blood pressure <50 mmHg to cold organ flush), as well as determine the time at which potential donors eventually die in those that did not become organ donors. METHODS: A retrospective review of all DCD kidney donors in Ontario was performed utilizing the Trillium Gift of Life Database from April 2013 to April 2018 in order to determine: 1. The WIT of all DCD kidney donors in Ontario; 2. The percentage of DCD kidney donors that have a 30 minute fWIT; 3. The time in which potential donors eventually die in those that did not become organ donors. RESULTS: Of 350 DCD kidney donors analyzed, 46.9% had <0.5 hours, 51.7% between 0.5 - 2 hours and 1.4% >2 hours of WIT. In each of these categories (WIT <0.5h, 0.5 - 2 hours and >2 hours), the percentage of patients with fWIT <30min were 100%, 94.4% and 100% respectively (p = NS). There were 106 potential donors who did not end up donating due to WIT >2 hours. Of these, 20.8% died between 2-4 hours, 10.4% between 4 - 6 hours and 68.8% beyond 6 hours. CONCLUSIONS: The percentage of donors with fWIT > 30 min did not increase with increasing WIT in DCD donors that went on to donate organs. These data support assessment of waiting up to 4 hours for DCD kidney donation as long as fWIT remains low given the shortage of available organ donors. Source of Funding: None London, Canada; Toronto, Canada; London, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1004-e1004 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeffrey Law* More articles by this author Karen Hornby More articles by this author Clare Payne More articles by this author Alp Sener More articles by this author Patrick Luke More articles by this author Expand All Advertisement PDF downloadLoading ...
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.029 | 0.006 |
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".