Drake Drake (davidstem88)

All patients had maintenance therapy based on cyclosporine, mycophenolate mofetil, and prednisone, with an average baseline creatinine level of 1.3 mg/dL. The average days until rejection event were 952 days. DISCUSSION AND CONCLUSION AMR treatment with bortezomib was effective, showing stable renal function at 24 months. Patients had adequate tolerance for administration. So far, these results contrast with the literature reviewed, so additional studies and follow-up are required for a new evaluation. BACKGROUND Little has changed in donor management and liver utilization rates in Brazil over the last decade. With a growing demand for liver donations, organ waste is an important obstacle toward better patient care. The study of discarded donors helps to shed light on the possibilities of increasing organ usage, including by using extended criteria donors. CH7233163 METHODS We retrospectively analyzed all discarded liver donors in a high-volume Brazilian transplant center from January 2015 to December 2018. Pertinent clinical and laboratorial data were collected from the donors' electronic health records. RESULTS In our study period, there were 248 liver harvests, of which 67 (27.0%) were discarded. Most discarded donors were male (65.7%). More than three-quarters of donors were Caucasian (79.1%). Median donor body mass index was 26.27 kg/m2, and most discarded donors presented no comorbidities. Donor liver injury tests were abnormal in 56 (83.5%) out of 67 discarded donors. Forty-three (64.1%) donors presented elevated transaminases. Alanine aminotransferase levels were elevated in 35 (52.2%) discarded donors, with a median value of 38 U/L. Half of all discarded livers were due to graft-related issues. Twenty-eight organs (41.79%) presented external pathologic alterations. Organ refusal due to donor clinical and laboratorial condition was reported in 24 cases. CONCLUSION It is clear there is a considerable issue of organ waste in Brazil, with the subjective judgment of graft quality and inadequate interpretation of donor's laboratorial exams leading to excessive denial of organs that could be fitted into extended criteria for donation. BACKGROUND The Balance of Risk (BAR) score is a simple test that combines donor and recipient variables to predict liver transplant success. It has been validated in different publications, with cut-off points of between 15 and 18 points proposed depending on the region. The aim of this study is to test the validity of the BAR score and to find the optimal cut-off point for our population. MATERIALS AND METHODS A retrospective cohort of 164 liver transplant patients was selected between January 2012 and July 2019. All were older than 18 years and were treated in a Spanish tertiary-level hospital. RESULTS The receiver operating characteristic curve between BAR and 5-year survival yields a result of 0.622 (P = .046), placing the cut-off point at ≥7 (sensitivity 61.5%, specificity 61.6%). Patients with a BAR score  less then 7 and a BAR score ≥7 have an estimated 5-year survival of 53.91 vs 47.51 months, respectively (log rank = .032). The only 2 variables associated with increased survival were a BAR score of  less then 7 (hazard ratio = 2.566; P  less then .001) and a body mass index  less then 30 (hazard ratio = 6.667; P  less then .001). CONCLUSIONS A low BAR score correlates well with liver transplant survival at 5 years. The BAR is a simple tool that should be used for donor-recipient matching. Due to the characteristics, resources, and population in our environment, a BAR score of 7 would be the optimum cut-off point for a liver transplant. Transbronchial biopsy (TBB) using standard forceps is the main procedure to establish the presence of lung allograft rejection (AR) after lung transplantation. Few studies report the use of the transbronchial cryobiopsy (TCB) as a scheduled procedure for surveillance purposes in lung allogra