Abstract:
BACKGROUND:Infants have the highest wait-list mortality of all liver transplantation candidates. Deceased-donor split-liver transplantation, a technique that provides both an adult and pediatric graft, might be the best way to decrease this disproportionate mortality. Yet concern for an increased risk to adult split recipients has discouraged its widespread adoption. We aimed to determine the current risk of graft failure in adult recipients after split-liver transplantation. STUDY DESIGN:United Network for Organ Sharing data from 62,190 first-time adult recipients of deceased-donor liver transplants (1995-2010) were analyzed (889 split grafts). Bivariate risk factors (p < 0.2) were included in Cox proportional hazards models of the effect of transplant type on graft failure. RESULTS:Split-liver recipients had an overall hazard ratio of graft failure of 1.26 (p < 0.001) compared with whole-liver recipients. The split-liver hazard ratio was 1.45 (p < 0.001) in the pre-Model for End-Stage Liver Disease era (1995-2002) and 1.10 (p = 0.28) in the Model for End-Stage Liver Disease era (2002-2010). Interaction analyses suggested an increased risk of split-graft failure in status 1 recipients and those given an exception for hepatocellular carcinoma. Excluding higher-risk recipients, split and whole grafts had similar outcomes (hazard ratio = 0.94; p = 0.59). CONCLUSIONS:The risk of graft failure is now similar between split and whole-liver recipients in the vast majority of cases, which demonstrates that the expansion of split-liver allocation might be possible without increasing the overall risk of long-term graft failure in adult recipients. Additional prospective analysis should examine if selection bias might account for the possible increase in risk for recipients with hepatocellular carcinoma or designated status 1.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Cauley RP,Vakili K,Fullington N,Potanos K,Graham DA,Finkelstein JA,Kim HBdoi
10.1016/j.jamcollsurg.2013.06.005subject
Has Abstractpub_date
2013-10-01 00:00:00pages
672-684.e1issue
4eissn
1072-7515issn
1879-1190pii
S1072-7515(13)00444-4journal_volume
217pub_type
杂志文章abstract:BACKGROUND:Multiple reports have demonstrated pancreatic cancer patients undergoing surgery have superior outcomes at high-volume hospitals. This study noted trends in access to high-volume centers for pancreatic resection and identified gaps in improving access. STUDY DESIGN:We performed a retrospective analysis of t...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2009.09.011
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Trauma services are increasingly providing emergency surgery care by creating "acute care surgery" teams. We compared two periods at a Level I trauma center to determine if trauma service coverage would negatively impact timely management of acute appendicitis. STUDY DESIGN:All patients admitted through the...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2008.01.016
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Few graduating residents seek surgical critical care (SCC) fellowships; fewer than half of positions fill. We hypothesized substantial differences exist in practice patterns and attitudes between SCC surgeons in academic practice (ACs) and in private practice (PVTs). STUDY DESIGN:A survey instrument was sen...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.10.004
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:To better understand how the COVID-19 pandemic has affected surgical trainees' and early-career surgeons' professional and personal experiences, a survey of the membership of the American College of Surgeons (ACS) Resident and Associate Society (RAS) and Young Fellows Association (YFA) was performed. STUDY ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2020.09.026
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Shared decision making requires informing patients and ensuring that treatment decisions reflect their goals. It is not clear to what extent this happens for patients considering total joint replacement (TJR) for hip or knee osteoarthritis. STUDY DESIGN:We conducted a cross-sectional mail survey of osteoart...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2013.06.002
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:After excision of an abnormal gland, the dynamics of intraoperative parathyroid hormone (PTH) levels signal whether or not more hypersecreting tissue is present. This quantitative assurance of operative success has led to targeted exploration of the hyperfunctioning gland(s). Some have questioned the need fo...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2006.02.003
更新日期:2006-05-01 00:00:00
abstract::A technique for replacement of a feeding jejunostomy tube using endoscopic direct visualization is described herein. It can be used in patients who have had a previously placed open jejunostomy tube removed after recovery from resection of the gastrointestinal tract. This is accomplished quite easily using local anest...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Although breast-conserving surgery is the standard of care for early-stage breast cancer, many women report breast asymmetry after this procedure. Risk factors for poor esthetic outcomes are not well understood. STUDY DESIGN:A self-administered survey was sent to patients who underwent lumpectomy (n = 898) ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2007.07.029
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The role of preoperative ERCP and endoscopic sphincterotomy (ES) in the diagnosis and treatment of suspected common bile duct stones (CBDS) in the laparoscopic age is controversial. The preoperative diagnosis of CBDS by ERCP and the removal of CBDS by ES are advantageous because of technical difficulties in ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,评审
doi:10.1016/s1072-7515(98)00241-5
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:The efficacy and safety of magnetic sphincter augmentation (MSA) with the LINX device (Torax Medical) has been reported in several short-and long-term studies, rivaling historic results of laparoscopic Nissen fundoplication (LNF), but with fewer side effects. However, there have been no studies comparing pat...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.02.025
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Most studies comparing surgical results of laparoscopic procedures for gastric cancer with open gastrectomies have been conducted based on limited experience. We aimed to compare laparoscopy-assisted distal gastrectomy (LADG) and conventional open distal gastrectomy (ODG) after a protracted learning experien...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2006.02.028
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Previous studies have documented significant differences between administrative data and registry data in the determination of postoperative MI. The goal of this study was to characterize discordance between administrative and registry data in the determination of postoperative myocardial infarction (MI). S...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2017.09.016
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The Flexibility in Surgical Training (FIST) consortium project was designed to evaluate the feasibility and resident outcomes of optional subspecialty-focused training within general surgery residency training. STUDY DESIGN:After approval by the American Board of Surgery, R4 and R5 residents were permitted ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2017.12.024
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Peripheral ports represent a new option for central venous access that have a low complication rate while providing long duration. This study provides five years of evaluation of this device. STUDY DESIGN:All patients had follow-up evaluation concurrently, with detailed information collected for the first 7...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:Closed-suction drains, implants, and acellular dermal matrix (ADM) are routinely used in tissue expander-based immediate breast reconstruction (TE-IBR). Each of these factors is thought to increase the potential for surgical site infection (SSI). Although CDC guidelines recommend only 24 hours of antibiotic ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jamcollsurg.2016.02.018
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Recent literature suggests that focus in health care should shift from reducing costs to improving quality; where quality of health care improves, cost reduction will follow. Our primary aim was to investigate whether improving the quality of surgical colorectal cancer care, by using a national quality impro...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.09.020
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The American College of Surgeons (ACS) has collected comprehensive data about surgical residents for the past 12 years and has published an annual report, the Longitudinal Study of Surgical Residents. In 1994, the ACS and the American Medical Association (AMA) agreed to collaborate in collecting data about s...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Acute limb ischemia initiates a systemic inflammatory response, including pulmonary polymorphonuclear leukocyte (PMN) sequestration and acute lung injury. Lung injury is partly attributed to release by PMN's of extracellular matrix (ECM) modifying metalloproteinases (MMPs). We hypothesized that acute hindlim...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/S1072-7515(03)00134-0
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) has become an important surgical quality program in the United States, yet few studies describe their methods for handling missing data. Our study examines the impact of missing data on predictive models for short-term...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.05.010
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:We compared the rates of stroke, death, and/or MI between men and women, stratified by symptomatic status and procedure type (carotid endarterectomy [CEA] or carotid artery stent [CAS]). STUDY DESIGN:Using the Nationwide Inpatient Sample, crude and propensity-matched rates of the composite end point of stro...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2019.02.054
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Axillary nodal status is an important prognostic predictor in patients with breast cancer. This study evaluated the sensitivity and specificity of ultrasound-guided core biopsy (Ax US-CB) at detecting axillary nodal metastases in patients with primary breast cancer, thereby determining how often sentinel lym...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.09.024
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Commonly performed elective gastrointestinal surgical procedures are carried out with low morbidity and mortality in hospitals throughout the United States. Complex operative procedures on the alimentary tract are performed with a relatively low frequency and are associated with higher mortality. Volume and ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(99)00072-1
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Several authors have questioned the need for axillary lymph node dissection in T1a breast cancer (primary tumors 5 mm or less in diameter), although current practice typically includes routine axillary lymph node dissection. STUDY DESIGN:We retrospectively reviewed the records of 2,242 breast cancers in our...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Hepatic resection of metastatic carcinoid cancer can prolong survival and control symptomatic endocrinopathy. Decompensated carcinoid heart disease (CHD) can develop in some patients with metastatic carcinoid cancers, which can preclude operation for resectable hepatic metastases. We hypothesized that outcom...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.03.029
更新日期:2011-07-01 00:00:00
abstract::The preoperative diagnosis of inflammatory aneurysms of the abdominal aorta (IAAA) is seldom made, yet knowledge of its presence would be an aid to the surgeon. A heightened awareness of the variety of clinical presentations of IAAA should prompt the clinician to consider this entity in the differential diagnosis of b...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-06-01 00:00:00
abstract:BACKGROUND:There has been a recent focus on sex-based disparities within the field of academic surgery. However, the proportion of female surgeons conducting NIH-funded research is unknown. STUDY DESIGN:The NIH RePORTER (Research Portfolio Online Reporting Tools Expenditures and Results) was queried for R01 grants fro...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2020.06.013
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:An intraoperative adverse event (iAE) is often directly attributable to the surgeon's technical error and/or suboptimal intraoperative judgment. We aimed to examine the psychological impact of iAEs on surgeons as well as the surgeons' attitude about iAE reporting. STUDY DESIGN:We conducted a web-based cross...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2016.12.039
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The NSQIP database enables measurement of postoperative outcomes across a spectrum of practice settings. This allows for observations about potential effects of resident participation in surgical care during training. STUDY DESIGN:We queried the NSQIP database for 6 index laparoscopic surgical procedures pe...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.08.014
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to develop a performance-based laparoscopic suturing curriculum using simulators and to test the effectiveness (transferability) of the curriculum. STUDY DESIGN:Surgical residents (PGY1 to PGY5, n = 17) proficient in basic skills, but with minimal laparoscopic suturing experien...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jamcollsurg.2005.02.021
更新日期:2005-07-01 00:00:00
abstract::One hundred and seventy consecutive patients undergoing parathyroid gland exploration and bilateral thyroidectomy received, postoperatively, routine oral calcium supplementation, close monitoring of total serum calcium, and addition of vitamin D for specific criteria, all to accomplish a postoperative course free of s...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00