2篇
您的检索式：作者名="Stuart Cleland"
|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Massive haemorrhage in liver transplantation:Consequences,prediction and management显示文摘From its inception the success of liver transplantation has been associated with massive blood loss. Massive transfusion is classically defined as > 10 units of red blood cells within 24 h, but describing transfusion rates over a shorter period of time may reduce the potential for survival bias. Both massive haemorrhage and transfusion are associated with increased risk of mortality and morbidity(need for dialysis/surgical site infection) following liver transplantation although causality is difficult to prove due to the observational design of most trials. The blood loss associated with liver transplantation is multifactorial. Portal hypertension secondary to cirrhosis results in extensive collateral circulation, which can bleed during hepatectomy particular if portal pressures are increased. Avoiding volume loading and maintenance of a low central venous pressure together with the use of vasopressors have been shown to reduce blood loss and transfusion during liver transplantation, but may increase the risk of renal impairment post-operatively. Coagulation defects may be present pre-transplant, but haemostasis is often re-balanced due to a deficit in both proand anti-coagulation factors. Further derangement of haemostasis may develop in the anhepatic and neohepatic phases due to absent hepatic metabolic function, hyperfibrinolysis and platelet sequestration in the donor liver. Point-of-care tests of coagulation such as the viscoelastic tests rotation thromboelastometry/thromboelastometry allow and more accurate and rapid assessment of these derangements in coagulation and guide the use of factor replacement and antifibrinolytics. Transfusion protocols guided by these tests have been shown to reduce transfusion rates compared with conventional coagulation tests, but have not shownimprovements in mortality or morbidity. Pre-operative factors associated with massive transfusion include previous surgery, re-do transplantation, the aetiology and severity of liver disease. Intra-operatively the use of piggy-back technique and avoiding veno-veno bypass has been shown to reduced blood loss. | Stuart Cleland Carlos Corredor Jia Jia Ye Coimbatore Srinivas Stuart A Mc Cluskey | 2016 | World Journal of Transplantation2016，6，2： | 11 |
| 2 | Heart‘omicsin’AGEing (HOMAGE):design,research objectives and characteristics of the common database显示文摘Heart failure is common in older people and its prevalence is increasing.The Heart 'omics' in AGEing(HOMAGE) project aims to provide a biomarker approach that will improve the early diagnosis of heart failure.A large clinical database,based on(1) prospective population studies or(2) cross-sectional,prospective studies or randomized controlled trials(RCTs) of patients at risk for or with overt cardiovascular disease will be constructed to determine most promising 'omics'-based biomarkers to identify the risk of developing heart failure and/or comorbidities.Population studies,patient cohorts and RCTs are eligible for inclusion in the common database,if they received ethical approval to obtain and share data and have baseline information on cardiovascular risk factors.Currently,the HOMAGE database includes 43,065 subjects,from 20 studies in eight European countries,including healthy subjects from three population studies in France,Belgium and Italy(n = 7,124),patients with heart failure(n = 4,312) from four cohorts in the UK,Spain and Switzerland and patients at high risk for cardiovascular disease(n = 31,629) in 13 cohorts.It is anticipated that more partners will join the consortium and enlarge the pooled data.This large merged database will be a useful resource with which to identify candidate biomarkers that play a role in the mechanism underlying the onset and progression of heart failure. | Lotte Jacobs Lutgarde Thijs Yu Jin Faiez Zannad Alexandre Mebazaa Philippe Rouet Florence Pinet Christophe Bauters Burkert Pieske Andreas Tomaschitz Mamas Mamas Javier Diez Kenneth McDonald John G F Cleland Hans-Peter Brunner-La Rocca Stephane Heymans Roberto Latini Serge Masson Peter Sever Christian Delles Stuart Pocock Timothy Collier Tatiana Kuznetsova Jan A Staessen | 2014 | The Journal of Biomedical Research2014，28，5： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员