Intraoperative hyperkaliemia complicating hand-assisted live-donor nephrectomy.
Bibliographic record
Abstract
OBJECTIVES: Live donation has become increasingly valuable as a potential source of kidneys for transplant with hand-assisted laparoscopic donation is an important method of organ procurement. An important consideration is adequate preoperative and intraoperative planning, and precautions to minimize potential risks in the donor while providing a graft with good primary function. MATERIALS AND METHODS: We present a case of live donation in which a hand-assisted laparoscopic approach was used to facilitate kidney donation. The process was complicated by a period of profound intraoperative hyperkalaemia, subsequently ascribed to rhabdomyolysis owing to muscle necrosis. RESULTS: A 46-year-old man underwent assessment for live kidney donation for his brother. Preoperative investigations revealed normal renal function with no contraindications to donation. However, at the time of donation, a period of unexplained hyperkalaemia occurred that resolved spontaneously with fluid resuscitation and aggressive diuresis. After surgery, he was demonstrated to have an elevated creatine kinase level associated with unilateral gluteal pain and bruising. There were no long-term complications, and the donor made a full recovery with normal renal function. Hyperkalaemia was ascribed to extensive rhabdomyolysis owing to positioning on the operating table at the time of surgery. CONCLUSIONS: Rhabdomyolysis associated with laparoscopic renal surgery requires prompt recognition and treatment while unexplained hyperkalaemia may herald its onset. It is important that an increased sense of vigilance is given to patients with increased muscularity or body mass, especially in donor nephrectomy patients, because of its effect on the remaining solitary kidney.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| 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) | 0.000 | 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 teacher head, 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".