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Introduction: Living kidney donation risk is likely to differ according to donor’s demographic characteristics. Methods: Systematic review and meta-analysis of the effects of age, sex, body mass index (BMI) and ethnicity on donor’s kidney function, end stage renal disease (ESRD) incidence, survival, proteinuria, hypertension, and surgical complications. Results: 5129 studies were identified, 31 meeting the inclusion criteria, mainly from USA and Europe. Donors aged > 60 years had on average 9.54 ml/min/1.73m2 lower eGFR compared to younger donors(p30 was found to significantly lower donor’s eGFR 1-year post-donation: on average the eGFR of obese donors was 2.7 ml/min/1.7m2 lower (95%CI: -3.24 to -2.15 p Conclusion: Obesity and male sex were associated with inferior outcomes. Post-donation, donors aged>60 increased their eGFR gap, compared to younger donors. African donors had a higher incidence of ESRD compared to Caucasian donors. BMI lowers eGFR post-donation, although the clinical significance is minimal.

Purpose Ensuring competence for surgical trainees requires holistic assessment of the qualities and competencies necessary to practice safely and effectively. To determine the next steps toward achieving this aim, the authors conducted a systematic review to summarize and appraise the available evidence related to any assessment approach to postgraduate surgical training and to identify the dominant themes for assessment approaches across different specialties or countries. Method Medline and Embase were searched on January 10, 2019, without language or time restrictions. Any peer-reviewed study that described an assessment framework (in practice or novel) throughout postgraduate surgical training globally was included. An iterative review and thematic analysis were performed on full-text articles to determine assessment themes. Studies were then grouped by assessment themes. A tailored quality assessment of the studies included in the final analysis was conducted. Assessment themes and validity were compared across surgical specialties and countries. Results From an initial 7,059 articles, 91 studies (evaluating 6,563 surgical trainees) were included in the final analysis. Ten defined assessment themes were extracted. Ten studies (11.0%) were deemed low risk of bias based on the quality assessment tool used and thus were determined to be high quality. Minor differences in assessment themes were observed between specialties and countries. Assessment themes neglected by individual surgical specialties and assessment themes that need validated assessment tools were identified. Conclusions This review highlights the low quality of evidence and fragmented efforts to develop and optimize surgical assessments. The minor differences observed demonstrate a common approach, globally and across specialties, related to surgical assessments. A paradigm shift in assessment approaches, which will require national and international collaboration, is required to optimize design and validation so that a comprehensive assessment of surgical competence can be implemented. © 2021 Lippincott Williams and Wilkins. All rights reserved.

The coronavirus disease 2019 (COVID-19) pandemic has posed a significant challenge to physicians and healthcare systems worldwide. Evidence about kidney transplant (KTx) recipients is still limited. A systematic literature review was performed. We included 63 articles published from 1 January until 7 July 2020, reporting on 420 adult KTx recipients with confirmed COVID-19. The mean age of patients was 55 ± 15 years. There was a male predominance (67%). The majority (74%) were deceased donor recipients, and 23% were recently transplanted (

Objectives Faced with a costly and demanding learning curve of surgical skills acquisition, the growing necessity for improved surgical curricula has now become irrefutable. We took this opportunity to formulate a teaching framework with the capacity to provide holistic surgical education at the undergraduate level. Setting Data collection was conducted in all the relevant healthcare centres the participants worked in. Where this was not possible, interviews were held in quiet public places. Participants We performed an in-depth retrospective evaluation of a proposed curriculum, through semi-structured interviews with 10 participants. A targeted sampling technique was employed in order to identify senior academics with specialist knowledge in surgical education. Recruitment was ceased on reaching data saturation after which thematic data analysis was performed using NVivo 11. Results Thematic analysis yielded a total of 4 main themes and 29 daughter nodes. Majority of study participants agreed that the current landscape of basic surgical education is deficient at multiple levels. While simulation cannot replace surgical skills acquisition taking place in operating rooms, it can be catalytic in the transition of students to postgraduate training. Our study concluded that a standardised format of surgical teaching is essential, and that the Integrated Generation 4 (IG4) framework provides an excellent starting point. Conclusions Through expert opinion, IG4 has been validated for its capacity to effectively accommodate learning in a safer and more efficacious environment. Moreover, we support that through dissemination of IG4, we can instil a sense of motivation to students as well as develop robust data sets, which will be amenable to data analysis through the application of more sophisticated methodologies. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This research focuses on Deceased Organ Donation (DOD) not only as an isolated individual decision, made by the individual and affecting solely that individual, but as a decision, which is made within a social context and influenced by it. This research project focuses on health literacy practices of renal patients regarding DOD.

Essential Skills in the Management of Surgical Cases (ESMSC) is an international wet lab simulation course aimed at undergraduate students. It combines basic science workshops, case-based lectures and ex vivo skills modules, as well as in vivo dissections using a swine model. This study aims to evaluate the effectiveness of high-fidelity In Vivo Simulation-Based Learning for undergraduate level trainees. Also our goal was to compare the skill-based performance of final year students vs. more junior-level ones. Forty undergraduate delegates at clinical rotation level (male = 28, female = 12, mean age = 23.12, 22–24, SD = 0.69) attended this 2-day course in Athens. N = 1 (2.5 %) was year 3, N = 4 (10 %) were year 4, N = 23 (57.5 %) were year 5 and N = 12 (30 %) were year 6. N = 30 (75 %) came from Hellenic universities, N = 8 (20 %) from the UK and N = 2 (5 %) from Germany. N = 20 (50 %) attended the in vivo dissections module first, and then the ex vivo one (type A rotation), whereas N = 20 followed the reverse training sequence with the ex vivo dissection first, followed by the in vivo one (type B rotation). The mean global rating scores for type A rotation were better in both the in vivo by 0.10 (2.40 vs. 2.30) and ex vivo modules by 0.15 (2.85 vs. 2.70), though it did not reach statistical significance (p > 0.05). Furthermore, the mean improvement of performance, in the laparoscopic skills station for the type A rotation, was better compared to type B by 0.351 (2.00 vs. 1.65, p = 0.003). Year 6 students performed better in the laparoscopic station (2.00 vs. 1.75, p = 0.059), whereas years 3, 4 and 5 performed better in the in vivo (2.42 vs. 2.16, p = 0.157) as well as the ex vivo dissections (2.78 vs. 2.75, p = 0.832), though none of those comparisons reached statistical significance. Delegates seemed to appreciate and enjoy the in vivo dissections as reflected in the feedback (8.67/10, min = 6 and max = 10, SD = 1.79). Although medical students seem to appreciate in vivo dissections modules, currently, further evidence is needed to support their recommendation in the undergraduate level. Surgical skills should be part of the undergraduate curriculum to improve final year students’ performance in the theatre. © 2016, Association of Surgeons of India.

This paper presents the use of tubing to store clinical microdialysis samples for delayed analysis with high temporal resolution, offering an alternative to traditional discrete offline microdialysis sampling. Samples stored in this way were found to be stable for up to 72 days at −80 °C. Examples of how this methodology can be applied to glucose and lactate measurement in a wide range of in vivo monitoring experiments are presented. This paper presents a general model, which allows for an informed choice of tubing parameters for a given storage time and flow rate avoiding high back pressure, which would otherwise cause the microdialysis probe to leak, while maximising temporal resolution.

Background: Undergraduate Surgical Education is becoming an essential element in the training of the future generation of safe and efficient surgeons. Essential Skills in the Management of Surgical Cases (ESMSC), is an international, joint applied surgical science and simulation-based learning wet lab course. Methods: We performed a review of the existing literature on the topic of undergraduate surgical education. Following that, we analyzed the feedback questionnaire received 480 from 2 recent series of ESMSC courses (May 2015, n = 49 and November 2015, n = 40), in order to evaluate European Union students' (UK, Germany, Greece) views on the ESMSC course, as well as on the undergraduate surgical education. Results Using a 10 point graded scale, the overall ESMSC concept was positively evaluated, with a mean score of 9.41 ± 0.72 (range: 8–10) and 8.94 ± 1.1 (range: 7–10). The majority of delegates from both series [9.86 ± 0.43 (range: 8–10) and 9.58 ± 0.91 (range: 6–10), respectively] believed that ESMSC should be incorporated in the undergraduate surgical curriculum. Comparison of responses from the UK to the Greek Medical Student, as well as the findings from the third and fourth year versus the fifth and sixth year Medical Students, revealed no statistically significant differences pertaining to any of the questions (p > 0.05). Conclusions: Current evidence in the literature supports the enhancement of surgical education through the systematic use of various modalities that provide Simulation-Based Training (SBT) hands-on experience, starting from the early undergraduate level. The findings of the present study are in agreement with these previous reports. Copyright © 2017 Taylor & Francis Group, LLC.

Background Essential Skills in the management of Surgical Cases – ESMSC is an International Combined Applied Surgical Science and Wet Lab course aimed at the undergraduate level. ESMSC combines interactive basic science workshops and case-based learning, with basic surgical training modules (BST) on Ex Vivo and In Vivo swine model. In Vivo Dissections include more advanced modules i.e. Abdominal Anatomy Dissections and Cardiac Transplant. Aim To evaluate the educational environment of a novel course, as well as to compare Medical students' perceptions across various groups. Materials and Methods 83 Delegates from King's College London (KCL) and several Hellenic Medical Schools attended the ESMSC course. The DREEM inventory was distributed upon completion of the modules. Results The mean overall score for DREEM inventory was 148.05/200(99–196, SD = 17.90). Cronbach's Alpha value was 0.818, indicating good internal consistency of the data. Year 3/4 Students have a significantly positive “Perception of Learning”, when compared to Year 5/6 (36.43 vs. 33.75, p = 0.017). KCL Students have a more positive view of the course compared to their Greek counterparts (155.19 vs. 145.62/200, p = 0.034). No statistical significant difference was noted when comparing male vs. female students (p > 0.05). Conclusions Students seem to positively rate the ESMSC educational environment. Junior as well as KCL students appear to be more enthusiastic. Further research should focus on the optimal strategy for early involvement and motivation of various students' groups in BST. © 2016 The Author(s)

Background. Essential Skills in the Management of Surgical Cases (ESMSC) is an international, animal model-based course. It combines interactive lectures with basic ex vivo stations and more advanced wet lab modules, that is, in vivo dissections and Heart Transplant Surgery on a swine model. Materials and Methods. Forty-nine medical students (male, N = 27, female N = 22, and mean age = 23.7 years) from King's College London (KCL) and Greek Medical Schools attended the course. Participants were assessed with Direct Observation of Procedural Skills (DOPS), as well as Multiple Choice Questions (MCQs). Paired t-test associations were used to evaluate whether there was statistically significant improvement in their performance. Aim. To evaluate the effectiveness of a combined applied surgical science and wet lab simulation course as a teaching model for surgical skills at the undergraduate level. Results. The mean MCQ score was improved by 2.33/32 (P < 0.005). Surgical skills competences, as defined by DOPS scores, were improved in a statically significant manner (P < 0.005 for all paired t-test correlations). Conclusions. ESMSC seems to be an effective teaching model, which improves the understanding of the surgical approach and the basic surgical skills. In vivo models could be used potentially as a step further in the Undergraduate Surgical Education. © 2015 Michail Sideris et al.

Simultaneous pancreas and kidney transplantation (SPK) is considered an extremely effective and well-established therapeutic option for selected patients with end-stage renal disease (ESRD), secondary to type 1 diabetes. Vascular complications in pancreas transplantation are more common than in any other solid organ transplant. Thrombosis is the most frequently observed surgical complication of pancreatic transplantation. We report a case of a successful management regarding the thrombosed distal pancreatic segment during SPK transplantation. Int Surg

A shortage of organ donors and the large number of patients desperately waiting for kidney transplant have led to the search for new sources of transplantable organs. The waiting list has grown at an alarming rate resulting in increased waiting times and deaths. The introduction of non heart beating (NHB) donation programmes generates a lot of ethical issues. How should death of a patient be defined in the case of NHB donation? Is there a strict separation of responsibilities of the medical teams in the different phases of the procedure (patient treatment and actual donation)? How should consent be obtained? Is sufficient respect and care given to the patient and his family? How is the viability of the organs assessed and how should the organs be allocated? We believe that it is very important to debate these issues and to try to outline an ethical framework for NHB donation that can enjoy the widest possible community support. Bull Med Ethics

Open donor nephrectomy for live donor kidney transplantation is a safe procedure that has been used for more than 30 years with excellent results. Laparoscopic donor nephrectomy is a relatively new technique that has the potential of decreased postoperative pain, less incisional morbidity, and shorter recovery time. Furthermore, it has been reported that this potentially less traumatic approach increases the number of potential live donors. This review article focuses on the currently used laparoscopic techniques in live kidney donation as well as the controversy regarding its efficacy, safety, and future. JSLS