Search

Introduction: Liver transplantation (LT) is a well-established method applied for the treatment of various liver diseases, including primary and secondary malignancies, as well as acute liver failure triggered by different mechanisms. In turn, liver failure (PHLF) is the most severe complication observed after liver resection (LR). PHLF is an extremely rare indication for LT. The aim of the present study was to assess the results of LT in patients with PHLF. Methods: Relevant cases were extracted from the prospectively collected database of all LTs performed in our center. All clinical variables, details of the perioperative course of each patient and long-term follow-up data were thoroughly assessed. Results: Between January 2000 and August 2023, 2703 LTs were carried out. Among them, six patients underwent LT for PHLF, which accounted for 0.2% of all patients. The median age of the patients was 38 years (range 24–66 years). All patients underwent major liver resection before listing for LT. The 90-day mortality after LT was 66.7% (4 out of 6 patients), and all patients experienced complications in the posttransplant course. One patient required early retransplantation due to primary non-function (PNF). The last two transplanted patients are alive at 7 years and 12 months after LT, respectively. Conclusions: In an unselected population of patients with PHLF, LT is a very morbid procedure associated with high mortality but should be considered the only life-saving option in this group. [ABSTRACT FROM AUTHOR]

In this work, the dual effect of Na in the copper indium gallium diselenide (CIGS) absorber is studied. Na doping exhibits a drastic improvement of the cell efficiency mainly by an increase in the open‐circuit current and fill factor. However, when the Na content is too high, it can deteriorate the cell properties and performance. Nonetheless, it is still beneficial when compared with a cell without Na inside. Here, we therefore use electron backscatter diffraction, atom probe tomography, and admittance spectroscopy to understand why Na starts to deteriorate the properties when inserted excessively. More exactly, it is shown that a moderate addition of Na strongly decreases the open‐circuit voltage (VOC) deficit, whereas the opposite happens when the Na content is too high. Interestingly, this cell with deteriorated VOC value and characterized by a very high Na content exhibits a high density of not only grain boundaries and dislocations but also of Na‐rich clusters. These clusters may host a high concentration of deep defects and trap the electrons within the CIGS bulk. At this stage, Na still has its beneficial effects, but the cell properties start to deteriorate compared to the cell with a moderate content of Na, especially when found as clusters in the bulk. In conclusion, this work clearly demonstrates the dual effect of Na in the CIGS absorber. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is available in the text Objective: To compare the early results of mass and layered closure of upper abdominal transverse incisions. Summary of Background Data: Contrary to midline incisions, data on closure of transverse abdominal incisions are lacking. Methods: This is the first analysis of a randomized controlled trial primarily designed to compare mass with layered closure of transverse incisions with respect to incisional hernias. Patients undergoing laparotomy through upper abdominal transverse incisions were randomized to either mass or layered closure with continuous sutures. Incisional surgical site infection (incisional-SSI) was the primary end-point. Secondary end-points comprised suture-to-wound length ratio (SWLR), closure duration, and fascial dehiscence (clinicatrials.gov NCT03561727). Results: A total of 268 patients were randomized to either mass (n=134) or layered (n=134) closure. Incisional-SSIs occurred in 24 (17.9%) and 8 (6.0%) patients after mass and layered closure, respectively (P =0.004), with crude odds ratio (OR) of 0.29 [95% confidence interval (95% CI) 0.13–0.67; P =0.004]. Layered technique was independently associated with fewer incisional-SSIs (OR: 0.29; 95% CI 0.12–0.69; P =0.005). The number needed to treat, absolute, and relative risk reduction for layered technique in reducing incisional-SSIs were 8.4 patients, 11.9%, and 66.5%, respectively. Dehiscence occurred in one (0.8%) patient after layered closure and in two (1.5%) patients after mass closure (P >0.999). Median SWLR were 8.1 and 5.6 (P <0.001) with median closure times of 27.5 and 25.0 minutes (P =0.044) for layered and mass closures, respectively. Conclusions: Layered closure of upper abdominal transverse incisions should be preferred due to lower risk of incisional-SSIs and higher SWLR, despite clinically irrelevant longer duration. [ABSTRACT FROM AUTHOR]

This paper presents a mathematical model of the heat and mass transfer processes for a rotary-spray honey dehydrator with a heat pump and a closed air circuit. An analytical calculation model, based on the energy balance equations of the dehydrator and heat pump, was used to model the transient dehydration process of honey in a dehydrator. The presented article includes a different approach to modelling both the dryer and the heat pump assisting the drying process. The novel quality of this study lies in the use of original equations to determine the heat and mass transfer coefficients between honey and air and using an actual model of a cooling unit to model the honey dehydration process. The experimentally verified calculation algorithm enables an analysis of the effects of air flow rate, mixer rotation speed, and cooling unit power on the efficiency of the drying process. The dehydrator calculation model was used to minimize the drying time by selecting the optimal evaporative temperature values of the cooling unit. For fixed mixer speed and air flow rates, optimal values of evaporation temperatures allow for 8–13% reduction in honey drying time and an increase in the specific moisture extraction rate (SMER) by 4–32%. [ABSTRACT FROM AUTHOR]

Background: Data on routine hypothermic machine perfusion of livers procured from donors after brain death (DBD) are scarce, and the benefits of the method have only been demonstrated in extended criteria grafts. The aim of this study was to assess if end-ischemic dual hypothermic oxygenated machine perfusion (dHOPE) is superior to static cold storage (SCS) in preservation of livers procured from DBD donors with respect to long-term outcomes. Existing data on short-term outcomes favours dHOPE in patients receiving high-risk grafts., Methods: This prospective randomized controlled trial included 104 recipients of DBD livers randomly assigned to static cold storage arm (78 patients) and dHOPE arm (26 patients). Endpoints of interest were occurrence of biliary complications (biliary fistula, anastomotic, and nonanastomotic strictures) and overall patient (OS) and graft survival (GS) during two-year follow-up., Results: A total of 36 patients developed biliary complications (at least one event) - 6 events in dHOPE arm and 30 in SCS arm. There was no significant difference in biliary complications between groups (23.7% vs. 43.4% [P=0.11]). No differences were found significant with respect to anastomotic (19.9% vs. 33.7% [P=0.20]) and non-anastomotic strictures (0% vs. 11.1% [P=0.10]) as well as biliary fistulas (11.7% vs. 12.2% [P=0.93]). Survival analysis did not show significantly different result in the study population - OS: 92.3% in dHOPE and 83.9% in SCS (P=0.35), and GS: 92.3% and 81.4% (P=0.23), respectively. However, significant difference in GS was noted in recipients of high-risk grafts - 100% in dHOPE and 73.1% in SCS, respectively (P=0.038)., Conclusions: The long-term outcome data suggest that the routine use of dHOPE may be beneficial for recipients of high-risk grafts from DBD donors. The present study does not provide any evidence for benefits of dHOPE in low-risk grafts., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)