OBJECTIVE To investigate patency and clinical outcomes of alloplastic and other venous interposition graft materials in pancreatic surgery. BACKGROUND Vascular pancreatic surgery is increasingly performed for locally advanced pancreatic neoplasms. Different than other centers, we prefer to use alloplastic vascular graft materials for superior mesenteric vein and portal vein interposition in pancreatic

This Viewpoint provides recommendations for surgeons to stay active amidst demanding professional and personal commitments to help manage stress, avoid burnout, and improve overall quality of life.

Importance International guidelines lack consistency in their recommendations regarding routine imaging in the follow-up after pancreatic resection for pancreatic ductal adenocarcinoma (PDAC). Consequently, follow-up strategies differ between centers worldwide. Objective To compare clinical outcomes, including recurrence-focused treatment and survival, in patients with PDAC recurrence who received

This cross-sectional study analyzes how pain assessment frequency and pain score magnitude and variability differ by age among trauma patients admitted in hospitals.

OBJECTIVE To examine perceived OR ergonomics facilitators and barriers, with a focus on the interdisciplinary team. SUMMARY BACKGROUND DATA Poor ergonomics causes musculoskeletal injuries affecting all operating room (OR) staff with repercussions on patient care, outcomes, and sustainability. Lack of ergonomic awareness and education are risk factors. METHODS We conducted a self-administered web-based

OBJECTIVE To quantify recent trends in access to timely, high-quality, affordable surgical care in the US. BACKGROUND Insufficient access to surgical care remains an ongoing concern in the US. Previous attempts to understand and quantify barriers in access to surgical care in the US lack a comprehensive, policy-relevant lens. METHODS This observational cross-sectional study evaluates multiple domains

OBJECTIVE To evaluate machine learning models' performance in predicting acute pancreatitis severity using early-stage variables while excluding laboratory and imaging tests. SUMMARY BACKGROUND DATA Severe acute pancreatitis (SAP) affects approximately 20% of acute pancreatitis (AP) patients and is associated with high mortality rates. Accurate early prediction of SAP and in-hospital mortality is crucial

Immunosuppression can be withdrawn from selected liver transplant recipients, although robust clinical predictors of tolerance remain elusive. The Immune Tolerance Network ITN056ST study (OPTIMAL) assessed clinical outcomes and mechanistic correlates of phased immunosuppression withdrawal (ISW) in non-autoimmune, non-viral adult liver transplant recipients. Enrolled subjects were ≥3 years post-transplant

Temporary mechanical circulatory support (tMCS) using extracorporeal life support (ECLS), has been widely implemented in patients with cardiogenic shock (CS), although evidence regarding its efficacy and safety remains unclear. This lack of clarity has recently raised concerns about the role of tMCS in CS management. Conducting randomized controlled trials (RCTs) in the context of CS poses significant

INTRODUCTION The Organ Care System and Non-ischemic Heart Preservation methods have emerged as significant advancements in heart transplantation, designed to mitigate ischemic injury and extend preservation times. However, their high costs and logistical complexities necessitate strategic utilization. METHODS We evaluated data from 83,761 heart transplants registered in the International Society for

Pediatric heart transplantation (HTx) faces challenges such as limited donor availability and the need for complex reconstructions, particularly in patients with congenital anomalies. Ex vivo perfusion offers a promising approach to minimize graft ischemic time and potentially expand the donor pool. We report our single-center experience using the TransMedics Organ Care System (OCS) for ex vivo perfusion

The increasing availability of clinically approved genetic tests for kidney disease has spurred the growth in the use of these tests in kidney transplant practice. Neither the testing options nor the patient population where this should be deployed has been defined and its value in kidney transplant evaluation has not been demonstrated. Transplant providers may not always be aware of the limitations

OBJECTIVE To review the surveillance of IPMN, the risk of pancreatic cancer and the cost of surveillance. BACKGROUND The increasing IPMN prevalence and low pancreatic cancer associated with IPMN question the necessity and cost-effectiveness of surveillance. Guidelines favour a 'watch and wait' approach, lacking clarity on stopping surveillance. This study aims to identify patients with pancreatic cancer

This Viewpoint discusses the elimination of the percentile score from the American Board of Surgery In-Training Examination (ABSITE) from the program director’s perspective.

ImportancePhysical biomarkers for stratifying patients with lung cancer into subtypes suggestive of outcomes are underexplored.ObjectiveTo investigate the clinical utility of respiratory sarcopenia for optimizing postoperative risk stratification in patients with non–small cell lung cancer (NSCLC).Design, Setting, and ParticipantsThis retrospective cohort study reviewed consecutive patients undergoing

This Viewpoint describes the elimination of the percentile score from the American Board of Surgery In-Training Examination (ABSITE) from the fellowship director’s perspective.

This Viewpoint describes the elimination of the percentile score from the American Board of Surgery In-Training Examination (ABSITE) from the resident’s perspective.

ImportanceDelaying elective noncardiac surgery after a recent acute myocardial infarction is associated with better outcomes, but current American Heart Association recommendations are based on data that are more than 20 years old.ObjectiveTo examine the association between the time since a non–ST-segment elevation myocardial infarction (NSTEMI) and the risk of postoperative major adverse cardiovascular

BACKGROUND A juxtarenal abdominal aortic aneurysm is defined as a short (less than 4 mm) or no-neck aneurysm, which is often treated with open or complex endovascular repair. The evidence to support the best treatment strategy is scarce. The aim of this study was to assess the short- and mid-term outcomes of elective open surgical repair or fenestrated endovascular aneurysm repair for juxtarenal abdominal

BACKGROUND Chest wall perforator flaps are emerging in oncoplastic breast conservation, mostly as an alternative to mastectomy. However, standardization and consensus on patient selection, techniques, and outcomes have not yet been reached. The aim of this international multicentre collaborative study was to explore practice patterns and outcomes in high-volume centres from different countries. METHODS

OBJECTIVE This study aimed to compare the ability of a deep-learning platform (the MACSSwin-T model) with healthcare professionals in detecting cerebral aneurysms from operative videos. Secondly, we aimed to compare the neurosurgical team's ability to detect cerebral aneurysms with and without AI-assistance. BACKGROUND Modern microscopic surgery enables the capture of operative video data on an unforeseen

BACKGROUND Non-intubated extracorporeal membrane oxygenation (ECMO) has become an increasingly common method of support for patients with severe respiratory failure. Since data on its use as a bridge to lung transplant remain limited to single-center studies, we evaluated its use in a national cohort. METHODS Adult lung-only transplant recipients bridged with ECMO 5/4/2005-3/8/2023 in the United Network

BACKGROUND The management of chronic thromboembolic pulmonary hypertension (CTEPH) has advanced significantly in recent years, thereby improving patient prognosis. However, the impact of cancer on the outcomes of patients with CTEPH under current treatment remains unclear. This study aimed to investigate the prevalence of cancer in patients with CTEPH and determine how comorbid cancer affects their

BACKGROUND In lung transplantation (LuTx), various ischemic phases exist, yet the rewarming ischemia time (RIT) during implantation has often been overlooked. During RIT, lungs are deflated and exposed to the body temperature in the recipient's chest cavity. Our prior clinical findings demonstrated that prolonged RIT increases the risk of primary graft dysfunction. However, the molecular mechanisms

Static cold storage (SCS) is the standard technique for organ preservation during transplantation, resulting in cold ischemic injury. Hypoxia can induce Panx1 channels open, leading to release of ATP. However, it is unknown whether Panx1 play a role in SCS. Our research demonstrates that livers from Panx1-/- mice exhibited reduced ATP release, resulting in protected hepatocytes during preservation

Right ventricular (RV) pressure-volume (PV) loops require post-acquisition volume calibration by cardiac MRI (CMR) or hypertonic saline (HS). We defined the impact of these two volume calibration methods on rest-to-exercise ventricular contractility (end-systolic elastance: Ees), arterial afterload (Ea) and coupling (Ees/Ea). In a prospective study, 82 RV PV-loop datapoints (rest, exercise stages-every

Mucosal or endobronchial biopsies (EBB) are typically used in the diagnosis of directly visualized bronchial lesions, infection, and sarcoidosis, but their utility in the evaluation of lung transplant recipients is controversial. EBB represents an attractive alternative to transbronchial biopsy (TBB): EBB provides straightforward sampling of airway pathology with decreased complication rates due to

As a result of the increasing number of transplants being facilitated by kidney paired donation, and newer initiatives such as voucher donation, end-chain kidneys now constitute a considerable proportion of kidney paired donation transplants in the United States. Data on end-chain kidneys are limited. They may be lower in quality compared to non-end chain living donor kidneys. However, they can provide

OBJECTIVE This study examined the predictive value of Flavin Mononucleotide (FMN) levels in the flush solution used during cold storage of donor livers on outcomes post-transplantation. BACKGROUND Static cold storage for liver grafts induces hypoxia with subsequent impaired mitochondrial function and Flavin Mononucleotide (FMN) release upon reperfusion. METHODS This study enrolled 62 recipients who

INTRODUCTION A common limitation to normothermic ex situ heart perfusion (ESHP) is functional decline. We previously designed a cardioprotective normothermic perfusion protocol, incorporating adenosine-lidocaine cardioplegia, subnormothermic reperfusion, pyruvate and methylprednisolone supplementation, and hemofiltration to prevent myocardial functional decline over 4 hours. In this study, we added

Contrary to immune cells, the response of the kidney structural cells in rejection is less established. We performed single-cell RNA sequencing on 18 kidney transplant biopsies from 14 recipients. Single-cell RNA sequencing identified cells from the major compartments of the kidney, next to infiltrated immune cells. Endothelial cells from the glomerulus, peritubular capillaries and vasa recta showed

Direct-acting antiviral agents have facilitated the utilization of hepatitis C virus (HCV)+ organs in HCV nucleic acid amplification test (NAT)- recipients. We evaluated trends in HCV NAT+ listing and impact on transplant probability, waitlist mortality, and likelihood of receiving HCV NAT+ organs using the United Network for Organ Sharing dataset of adult patients waitlisted for liver transplantation

ImportanceMajor surgery sometimes involves long recovery or even permanent institutionalization. Little is known about long-term trajectories of postoperative recovery, as surgical registries are limited to 30-day outcomes and care can occur across various institutions.ObjectiveTo characterize long-term postoperative recovery trajectories.Design, Setting, and ParticipantsThis retrospective cohort study

Allograft fibrosis is increasingly detected in graft biopsies as the postoperative period extends, potentially emerging as a pivotal determinant of long-term graft function and graft survival among pediatric recipients. Currently, there is a paucity of non-invasive diagnostic tools capable of identifying allograft fibrosis in pediatric recipients of liver transplants. This study involved 507 pediatric

Organ availability remains a persistent problem in lung transplantation. The use of organs from donors with chronic thromboembolic disease has not been described. In this report, we discuss 2 lung transplant recipients who received organs from donors with acute bilateral pulmonary embolism. All organs underwent backtable pulmonary thromboendarterectomy (PTE) prior to implantation and notably showed

OBJECTIVE To undertake a systematic review of the medical literature on telesurgery, with a key focus on identifying the key technical and non-technical themes searched in medical articles and to analyze gaps in the current knowledge base on telesurgery. BACKGROUND It has now been over two decades since the first successful case of telesurgery and since this time there have been significant technological

OBJECTIVE To assess 30-day outcomes of da Vinci robotic-assisted (dV-RAS) versus laparoscopic/thoracoscopic (lap/VATS) or open oncologic surgery. SUMMARY BACKGROUND DATA Complex procedures in deep/narrow spaces especially benefit from dV-RAS. Prior procedure-specific comparisons are not generalizable. METHODS PubMed, Scopus and EMBASE were systematically searched (latest: 11/17/2023) following PRISMA

OBJECTIVE To investigate the incidence of male sexual dysfunction (SD) including erectile dysfunction (ErD) and ejaculatory dysfunction (EjD) after minimally invasive rectal cancer surgery. BACKGROUND Male SD significantly affects post-rectal cancer surgery quality of life (QOL). Current assessments using the International Index of Erectile Function-5 are unsuitable for patients with reduced postoperative

OBJECTIVE To validate the ISGPS definition and grading system of PPAP after pancreatoduodenectomy (PD). SUMMARY BACKGROUND DATA In 2022, the International Study Group for Pancreatic Surgery (ISGPS) defined post-pancreatectomy acute pancreatitis (PPAP) and recommended a prospective validation of its diagnostic criteria and grading system. METHODS This was a prospective, international, multicenter study

BACKGROUND Few tools exist for early identification of patients at risk for chronic lung allograft dysfunction (CLAD). We previously showed hyaluronan (HA), a matrix molecule that regulates lung inflammation and fibrosis, accumulates in bronchoalveolar lavage fluid (BALF) and blood in CLAD. We aimed to determine if early posttransplant HA elevations inform CLAD risk. METHODS HA was quantified in 3080

Intestinal transplantation (ITx) is the definitive treatment for intestinal failure but has the highest rejection rate among solid organ transplants, requiring high doses of immunosuppression with high rates of infection, graft-versus-host disease, and malignancy. Transplant tolerance would overcome the need for long-term immunosuppression. Using non-myeloablative conditioning, our laboratory has developed

OBJECTIVE This study aimed to investigate the prevalence and distribution of carcinoma in the liver margin (LM) of resected perihilar cholangiocarcinoma (pCCA) and establish a method for LM examination. BACKGROUND LM is the largest margin in resected pCCA with undefined status and assessment method. METHODS 227 pCCA cases underwent major hepatectomy were divided into a discovery cohort (n=101) assessed

BACKGROUND The ScanCLAD study reported a lower incidence of chronic lung allograft dysfunction (CLAD) with the use of once-daily tacrolimus vs twice-daily cyclosporine. Using the International Society for Heart and Lung Transplantation (ISHLT) Thoracic Organ Transplant (TTX) Registry data, we evaluated the hypothesis that tacrolimus is superior to cyclosporine in real-world clinical practice. METHODS