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| 1 | Anticoagulation in simultaneous pancreas kidney transplantation - On what basis?显示文摘BACKGROUND Despite technical refinements,early pancreas graft loss due to thrombosis continues to occur.Conventional coagulation tests(CCT)do not detect hypercoagulability and hence the hypercoagulable state due to diabetes is left untreated.Thromboelastogram(TEG)is an in-vitro diagnostic test which is used in liver transplantation,and in various intensive care settings to guide anticoagulation.TEG is better than CCT because it is dynamic and provides a global hemostatic profile including fibrinolysis.AIM To compare the outcomes between TEG and CCT(prothrombin time,activated partial thromboplastin time and international normalized ratio)directed anticoagulation in simultaneous pancreas and kidney(SPK)transplant recipients.METHODS A single center retrospective analysis comparing the outcomes between TEG and CCT-directed anticoagulation in SPK recipients,who were matched for donor age and graft type(donors after brainstem death and donors after circulatory death).Anticoagulation consisted of intravenous(IV)heparin titrated up to a maximum of 500 IU/h based on CCT in conjunction with various clinical parameters or directed by TEG results.Graft loss due to thrombosis,anticoagulation related bleeding,radiological incidence of partial thrombi in the pancreas graft,thrombus resolution rate after anticoagulation dose escalation,length of the hospital stays and,1-year pancreas and kidney graft survival between the two groups were compared.RESULTS Seventeen patients who received TEG-directed anticoagulation were compared against 51 contemporaneous SPK recipients(ratio of 1:3)who were anticoagulated based on CCT.No graft losses occurred in the TEG group,whereas 11 grafts(7 pancreases and 4 kidneys)were lost due to thrombosis in the CCT group(P=0.06,Fisher’s exact test).The overall incidence of anticoagulation related bleeding(hematoma/gastrointestinal bleeding/hematuria/nose bleeding/re-exploration for bleeding/post-operative blood transfusion)was 17.65%in the TEG group and 45.10%in the CCT group(P=0.05,Fisher’s exact test).The incidence of radiologically confirmed partial thrombus in pancreas allograft was 41.18%in the TEG and 25.50%in the CCT group(P=0.23,Fisher’s exact test).All recipients with partial thrombi detected in computed tomography(CT)scan had an anticoagulation dose escalation.The thrombus resolution rates in subsequent scan were 85.71%and 63.64%in the TEG group vs the CCT group(P=0.59,Fisher’s exact test).The TEG group had reduced blood product usage{10 packed red blood cell(PRBC)and 2 fresh frozen plasma(FFP)}compared to the CCT group(71 PRBC/10 FFP/2 cryoprecipitate and 2 platelets).The proportion of patients requiring transfusion in the TEG group was 17.65%vs 39.25%in the CCT group(P=0.14,Fisher’s exact test).The median length of hospital stay was 18 days in the TEG group vs 31 days in the CCT group(P=0.03,Mann Whitney test).The 1-year pancreas graft survival was 100%in the TEG group vs 82.35%in the CCT group(P=0.07,log rank test)and,the 1-year kidney graft survival was 100%in the TEG group vs 92.15%in the CCT group(P=0.23,log tank test).CONCLUSION TEG is a promising tool in guiding judicious use of anticoagulation with concomitant prevention of graft loss due to thrombosis,and reduces the length of hospital stay. | Jeevan Prakash Gopal Frank JMF Dor Jeremy S Crane Paul E Herbert Vassilios E Papalois Anand SR Muthusamy | 2020 | World Journal of Transplantation2020，10，7： | 2 |
| 2 | Increased basal intracellular signaling patterns do not correlate with JAK2 genotype in human myeloproliferative neoplasms显示文摘 | Anand S Stedham F Gudgin E | 2011 | {H}Blood2011，，06： | 1 |
| 3 | Use and implications of paleoweathering surfaces in mineral exploration in Australia显示文摘 | SMITH R E ANAND R R ALLEY N F | 2000 | Ore Geology Reviews2000，16，34： | 1 |
| 4 | Increased basal intracellular signaling patterns do not correlate with JAK2 genotype in human myeloproliferative neoplasms 显示文摘 | Anand S Stedham F Gudgin E | 2011 | Blood2011，118，6： | 1 |
| 5 | Towards improved clinical and physiological assessments of recovery in spinal cord injury:a clinical initiative显示文摘 | Ellaway P H Anand P Bergstrom E M | 2004 | Spinal Cord2004，42，6： | 1 |
| 6 | Targeted disruption of the CD18 or ICAM-1 gene inhibits choroidal neovascularization 显示文摘 | Sakurai E Taguchi H Anand A Ambati BK Gragoudas ES Miller JW | 2003 | Invest Ophthalmol Vis Sci2003，44，6： | 1 |
| 7 | 肾素血管紧张素系统抑制剂与高血压患者新型冠状病毒肺炎易感性的关系:一项初级保健倾向评分匹配的队列研究显示文摘肾素血管紧张素系统(renin-angiotensin system,RAS)抑制剂被认为影响严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus-2,SARS-CoV-2)的易感性。本研究调查高血压患者处方与新型冠状病毒肺炎(新冠肺炎)的发病率和全因死亡率之间是否存在关联。方法:研究者在英国大型初级保健数据库(健康改善网络)中进行了一项倾向得分匹配的队列研究. | 刘青(摘译) 郑武洪(审校) Haroon S Subramanian A Cooper J Anand A Gokhale K Byne NDhalla S Acosta-Mena D Taverner T Okoth K Wang J Chandan JS Sainsbury C Zemedikun DT Thomas GN Parekh D Marshall T Sapey E Adderley NJ Nirantharakumar K | 2021 | 中华高血压杂志2021，29，8： | 1 |
| 8 | The relationship between plasma osteoprotegerin levels and coronary artery calcification in uncomplicated type 2 diabetic subjects 显示文摘 | Anand DV Lahiri A Lim E | 2006 | J Am Coll Cardiol2006，47，9： | 1 |
| 9 | Therelationship between plsam osteopro- tegerin levels and coronary artey clasification in complicated type diabitic subjects 显示文摘 | Anand DV lahiri A Lin E | 2006 | J Am Coil Car- diol2006，47，9： | 1 |
| 10 | Pulmonary haemodynamics of the Yak, Cattle, and cross breeds at high altitude显示文摘 | Anand I S Harris E Ferrari R | 1986 | Thorax1986，41，： | 1 |
| 11 | The relationgship between plasma osteoprotegerin levels and coronary artery calcificaton in complicated type diabetic subjects 显示文摘 | Anand DV lahiri A Lim E | 2006 | J Am Coll Cardiol2006，47，9： | 1 |
| 12 | Determinants of progression of coro-nary artery calcification in type 2 diabetes role of glycemic control and in-flammatory/vascular calcification markers 显示文摘 | Anand DV Lim E Darko D | 2007 | J Am CoU Cardiol2007，50，23： | 1 |
| 13 | Business as usual: The acceptance and perpetuation of corruption in or- ganizations 显示文摘 | Anand V Ashforth B E Joshi M | 2005 | Academy of Management Executive2005，19，： | 1 |
| 14 | Prevalence of silient myocardial ischemia asymptomatic individuals with subclinical atherisclerosis detected by electron beam tomography 显示文摘 | Anand DV Lim E Raval U | 2004 | J Nucl Cardiol2004，11，4： | 1 |
| 15 | The relationship between plasma osteoprotegerin levels and coronary artery calcification in uncomplicated type 2 diabetic subjects显示文摘 | Anand DV Lahiri A Lim E | 2006 | Am Coll Cardiol2006，47，11： | 1 |
| 16 | Cardiac resynchronization ther- apy reduces the risk of hospitalizations in patients with advanced heart failure:results from the Comparison of Medical Therapy, Pa- cing and Defibrillation in Heart Failure (COMPANION) trial显示文摘 | Anand IS Carson P Galle E | 2009 | Circulation2009，119，7： | 1 |
| 17 | Organic cation transporters in human nasal primary culture: expression and functional activity 显示文摘 | Shao D Massoud E Anand U | 2013 | Ther Deliv2013，4，4： | 1 |
| 18 | Treatment of industrial wastewater effluents using hydrodynamic显示文摘 | Anand G Chakinala Parag R Gogate Arthur E Burgess | 2008 | Ultrasonics Sonochemistry2008，15，1： | 1 |
| 19 | Risk stratification in uncomplicated type 2 diabetes: prospective evaluation of the combined use of coronary artery calcium imaging and selective myocardial perfusion scintigraphy显示文摘 | Anand DV Lim E Hopkins D | 2006 | Eur Heart J2006，27，6： | 1 |
| 20 | The relationship between plasma osteprotegerin lavels and coronary artery calcification in uncomplicated type 2 diabetic subjects显示文摘 | Anand DV Lahiri A Lim E | 2006 | J Am Coll Cardiol2006，47，9： | 1 |
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