AIM To compare the performance of 3 published delayed graftfunction(DGF) calculators that compute the theoretical risk of DGF for each patient.METHODS This single-center,retrospective study included 247 consecutive ki...AIM To compare the performance of 3 published delayed graftfunction(DGF) calculators that compute the theoretical risk of DGF for each patient.METHODS This single-center,retrospective study included 247 consecutive kidney transplants from a deceased donor.These kidney transplantations were performed at our institution between January 2003 and December 2012.We compared the occurrence of observed DGF in our cohort with the predicted DGF according to three different published calculators. The accuracy of the calculators was evaluated by means of the c-index(receiver operating characteristic curve).RESULTS DGF occurred in 15.3% of the transplants under study.The c index of the Irish calculator provided an area under the curve(AUC) of 0.69 indicating an acceptable level of prediction,in contrast to the poor performance of the Jeldres nomogram(AUC = 0.54) and the Chapal nomogram(AUC = 0.51). With the Irish algorithm the predicted DGF risk and the observed DGF probabilities were close. The mean calculated DGF risk was significantly different between DGF-positive and DGF-negative subjects(P < 0.0001). However,at the level of the individual patient the calculated risk of DGF overlapped very widely with ranges from 10% to 51% for recipients with DGF and from 4% to 56% for those without DGF.The sensitivity,specificity and positive predictive value of a calculated DGF risk ≥ 30% with the Irish nomogram were 32%,91% and 38%. CONCLUSION Predictive models for DGF after kidney transplantation are performant in the population in which they were derived,but less so in external validations.展开更多
Background： In this study the physiological implications of artificial rearing were investigated. Low（LBW） and normal birth weight（NBW） piglets were compared as they might react differently to stressors caused by...Background： In this study the physiological implications of artificial rearing were investigated. Low（LBW） and normal birth weight（NBW） piglets were compared as they might react differently to stressors caused by artificial rearing. In total, 42 pairs of LBW and NBW piglets from 16 litters suckled the sow until d19 of age or were artificially reared starting at d3 until d19 of age. Blood and tissue samples that were collected after euthanasia at 0, 3, 5, 8 and 19 d of age. Histology, ELISA, and Ussing chamber analysis were used to study proximal and distal small intestine histomorphology, proliferation, apoptosis, tight junction protein expression, and permeability. Furthermore, small intestine,liver and systemic redox parameters（GSH, GSSG, GSH-Px and MDA） were investigated using HPLC.Results： LBW and NBW artificially reared piglets weighed respectively 40 and 33% more than LBW and NBW sowreared piglets at d19（P 〈 0.01）. Transferring piglets to a nursery at d3 resulted in villus atrophy, increased intestinal FD-4 and HRP permeability and elevated GSSG/GSH ratio in the distal small intestine at d5（P 〈 0.05）. GSH concentrations in the proximal small intestine remained stable, while they decreased in the liver（P 〈 0.05）. From d5 until d19, villus width and crypt depth increased, whereas PCNA, caspase-3, occludin and claudin-3 protein expressions were reduced. GSH,GSSG and permeability recovered in artificially reared piglets（P 〈 0.05）.Conclusion： The results suggest that artificial rearing altered the morphology, permeability and redox state without compromising piglet performance. The observed effects were not depending on birth weight.展开更多
文摘AIM To compare the performance of 3 published delayed graftfunction(DGF) calculators that compute the theoretical risk of DGF for each patient.METHODS This single-center,retrospective study included 247 consecutive kidney transplants from a deceased donor.These kidney transplantations were performed at our institution between January 2003 and December 2012.We compared the occurrence of observed DGF in our cohort with the predicted DGF according to three different published calculators. The accuracy of the calculators was evaluated by means of the c-index(receiver operating characteristic curve).RESULTS DGF occurred in 15.3% of the transplants under study.The c index of the Irish calculator provided an area under the curve(AUC) of 0.69 indicating an acceptable level of prediction,in contrast to the poor performance of the Jeldres nomogram(AUC = 0.54) and the Chapal nomogram(AUC = 0.51). With the Irish algorithm the predicted DGF risk and the observed DGF probabilities were close. The mean calculated DGF risk was significantly different between DGF-positive and DGF-negative subjects(P < 0.0001). However,at the level of the individual patient the calculated risk of DGF overlapped very widely with ranges from 10% to 51% for recipients with DGF and from 4% to 56% for those without DGF.The sensitivity,specificity and positive predictive value of a calculated DGF risk ≥ 30% with the Irish nomogram were 32%,91% and 38%. CONCLUSION Predictive models for DGF after kidney transplantation are performant in the population in which they were derived,but less so in external validations.
基金supported by a grant from the government agency for Innovation by Science and Technology(IWT-LO 100856)
文摘Background： In this study the physiological implications of artificial rearing were investigated. Low（LBW） and normal birth weight（NBW） piglets were compared as they might react differently to stressors caused by artificial rearing. In total, 42 pairs of LBW and NBW piglets from 16 litters suckled the sow until d19 of age or were artificially reared starting at d3 until d19 of age. Blood and tissue samples that were collected after euthanasia at 0, 3, 5, 8 and 19 d of age. Histology, ELISA, and Ussing chamber analysis were used to study proximal and distal small intestine histomorphology, proliferation, apoptosis, tight junction protein expression, and permeability. Furthermore, small intestine,liver and systemic redox parameters（GSH, GSSG, GSH-Px and MDA） were investigated using HPLC.Results： LBW and NBW artificially reared piglets weighed respectively 40 and 33% more than LBW and NBW sowreared piglets at d19（P 〈 0.01）. Transferring piglets to a nursery at d3 resulted in villus atrophy, increased intestinal FD-4 and HRP permeability and elevated GSSG/GSH ratio in the distal small intestine at d5（P 〈 0.05）. GSH concentrations in the proximal small intestine remained stable, while they decreased in the liver（P 〈 0.05）. From d5 until d19, villus width and crypt depth increased, whereas PCNA, caspase-3, occludin and claudin-3 protein expressions were reduced. GSH,GSSG and permeability recovered in artificially reared piglets（P 〈 0.05）.Conclusion： The results suggest that artificial rearing altered the morphology, permeability and redox state without compromising piglet performance. The observed effects were not depending on birth weight.
