Raymond Storgaard (foodraft6)

Highly sensitized (HS) anti-human leukocyte antigens (HLA) patients awaiting kidney transplantation benefit from specific allocation programs. Serological monitoring at 3-month intervals is recommended to prevent unexpected positive crossmatch (XM), but this strategy is not evidence-based. Therefore, we assessed its relevance when using single-antigen flow bead (SAFB) and screening flow bead (SFB) assays. We included 166 HS patients awaiting a transplant and assessed their SAFB profile during the year preceding their inclusion. Anti-HLA antibodies were evaluated by SAFB assay and compared within patients as serum pairs, at 3, 6, and 9 months. We assessed the performance of SFB for detecting changes in SAFB profiles with 35 serum pairs. On comparing 354, 218, and 107 serum pairs at 3, 6 and 9 months, respectively, only 0.6%, 0.7%, and 1% of all antigens tested exceeded for the first time the unacceptable antigen threshold (mean fluorescence intensity≥2000) in the most recent sample. Irrespective of the follow-up period, the calculated panel-reactive antibodies increased by a mean of 1%, and there was no significant increase in the proportion of donors at risk for positivity of flow- and/or complement-dependent cytotoxicity XM. The SFB did not accurately detect the variations of SAFB profiles. Changes in HS patient profiles are anecdotal and show little association with transplant access or risk for positive XM. Less frequent monitoring in HS patients should be considered to improve cost-effectiveness without affecting transplant safety. Changes in HS patient profiles are anecdotal and show little association with transplant access or risk for positive XM. Less frequent monitoring in HS patients should be considered to improve cost-effectiveness without affecting transplant safety. The study aimed to determine whether the addition of cognitive impairment, depression, or both, to the assessment of physical frailty (PF) is associated with the risk of lung transplant (LTX) waitlist mortality. Since March 2013, all patients referred for LTX evaluation underwent PF assessment. Cognition was assessed using the Montreal Cognitive Assessment and depression assessed using the Depression in Medical Illness questionnaire. We assessed the association of 4 composite frailty measures PF ≥3 of 5 = frail, cognitive frailty (CogF ≥ 3 of 6 = frail), depressive frailty (DepF ≥ 3 of 6 = frail), and combined frailty (ComF ≥ 3 of 7 = frail) with waitlist mortality. The prevalence of PF was 78 (22%), CogF 100 (28%), DepF 105 (29%), and ComF 124 (34%). ENOblock order Waitlist survival in the non-PF group was 94% ± 2% versus 71% ± 7% in the PF group (p < 0.001). Cox proportional hazards regression analysis demonstrated that PF (Adjusted HR, 4.88; 95% CI, 2.06 - 11.56), mild cognitive impairment (Adjusted HR, 3.03; 95% CI, 1.05 - 8.78) and hypoalbuminemia (Adjusted HR, 0.89; 95% CI, 0.82 - 0.97) were independent predictors of waitlist mortality. There was no significant difference in the area under the curve of the 4 frailty measures. The addition of cognitive function and depression variables to the PF assessment increased the number of patients classified as frail. However, the addition of these variables, does not strengthen the association with LTX waitlist mortality compared to the PF measure. The addition of cognitive function and depression variables to the PF assessment increased the number of patients classified as frail. However, the addition of these variables, does not strengthen the association with LTX waitlist mortality compared to the PF measure.The success of percutaneous fixation of non or minimally displaced scaphoid waist fractures is reliant on optimal placement of the screw. This can be challenging for surgeons to achieve, potentially involving a large volume of intraoperative imaging, and surgical time. Mixed reality (MR) is a new technol