Background Scarring can greatly impact quality of life for individuals (ie, causing depression posttraumatic stress disorder, body image issues). Those who wish to be anonymous live liver donors are warned of the potential negative psychological impacts associated with the large scar left from liver donation surgery. Given the unique degree of autonomy that these patients have over their surgery, we explore whether a sample of 26 anonymous live liver donors experience a unique relationship with their scar. Method Anonymous donors participated in a semistructured qualitative interview examining their experience with donation. Interviews were audio-recorded, transcribed, and analyzed using the constant comparison method for themes pertaining, more specifically, to participants' perception of their scar. Results Five main themes were identified - a marker of satisfaction about the donation experience, a physical reminder of donation, a trigger for recipient-related thoughts, an awareness tool, and a potential threat to anonymity. Avapritinib manufacturer Donors did not voice any body image or cosmetic concerns due to their scars. Instead, discussions about the negative aspects of scarring centered around the identifying nature of their scar. Conclusions These findings help underscore the distinctiveness of anonymous living liver donors as a patient population. Preparing ALLDs for different types of cosmetic issues relating to their scar (ie, as a possible threat to their desired anonymity) may be more appropriate than preparing them in the same way as other donor populations.Background There is a growing interest in left lateral sectionectomy (LLS) for donor hepatectomy. No data are available concerning the safety of the robotic (ROB) approach. Methods A retrospective comparative study was conducted on 75 consecutive minimally invasive donor hepatectomies. The first 25 robotic (ROB) procedures performed from November 2018 to July 2019 were compared to our first (LAP1) and last 25 (LAP2) laparoscopic cases performed between May 2013 and October 2018. Short-term donors and recipients' outcomes were analyzed. Results No conversions were noticed in ROB whereas two conversions (8%) were recorded in LAP1 and none in LAP2. Blood loss was significantly less in ROB compared to LAP1 (p= less then 0.001) but not in LAP2. Warm ischemia time was longer in ROB (p= less then 0.001) with respect to the other groups. Operative time was similar in the 3 groups (p=0.080); however, the hospital stay was shorter in ROB (p=0.048). The trend in operative time in ROB was significantly shorter compared to LAP1 and LAP2 linear R 0.478, p= less then 0.001; R 0.012, p=0.596; R 0.004, p=0.772, respectively. Donor morbidity was nihil in ROB, similar in LAP1 and LAP2 (n=3-12%) (p=0.196). ROB procedures required less postoperative analgesia (p=0.002). Recipients complications were similar for all groups (p=0.274) and no early re-transplantations were recorded. Conclusions Robotic LLS for donor hepatectomy is a safe procedure with results comparable to the laparoscopy in terms of donor morbidity and overall recipients' outcome when the procedure is performed by experts. Certainly, its use is currently very limited.Introduction We hypothesized that the addition of 4 doses of abatacept to our standard acute graft versus host disease (GVHD) prophylaxis would reduce the incidence of day+100 severe acute GVHD in children with transfusion dependent beta- thalassemia major undergoing a myeloablative allogeneic hematopoietic stem cell transplant (HSCT), without impacting engraftment. Methods Twenty-four children with beta-thalassemia major received abatacept at a dose of 10 mg/kg intravenously on days -1, +5, +14 and +28 after HSCT in addition to calcineurin inhibitors and methylprednisolone. Outcomes were compared to 8 beta thalassemia patients who received standard acute GVHD prophylaxis. Results There was no difference in engraftment between the 2 groups. No patient had grades III- IV acute GVHD by day+100 in the abatacept cohort compared to 50% in the standard acute GVHD prophylaxis group (p=0.001). Viral reactivation occurred in 5 children in the standard acute GVHD cohort and in 20 children in the abatacept cohort (p=0.2). Thalassemia-free survival after HSCT was 100% in the abatacept cohort compared to 62.5% in the standard cohort at last follow up (p=0.007). Conclusions Adding abatacept to our routine GVHD prophylaxis reduced the incidence of day+100 severe acute GVHD without impacting engraftment or survival.Background Acute kidney injury (AKI) after liver transplantation is associated with increased morbidity and mortality. It remains controversial whether the choice of vena cava reconstruction technique impacts AKI. Methods This is a single-center retrospective cohort of 897 liver transplants performed between June 2009 and September 2018 using either the vena-cava preserving piggyback technique or caval replacement technique without veno-venous bypass or shunts. The association between vena cava reconstruction technique and stage of postoperative AKI was assessed using multivariable ordinal logistic regression. Causal mediation analysis was used to evaluate warm ischemia time as a potential mediator of this association. Results The incidence of AKI (AKI Stage ≥ 2) within 48 hours after transplant was lower in the piggyback group (40.3%) compared to the caval replacement group (51.8%, P less then 0.001). Piggyback technique was associated with a reduced risk of developing a higher stage of postoperative AKI (OR 0.49, 95% CI 0.37 - 0.65, P less then 0.001). Warm ischemia time was shorter in the piggyback group and identified as potential mediator of this effect. There was no difference in renal function (estimated glomerular filtration rate and the number of patients alive without dialysis) 1 year after transplant. Conclusions Piggyback technique, compared to caval replacement, was associated with a reduced incidence of AKI after liver transplantation. There was no difference in long-term renal outcomes between the 2 groups.External ventricular drain (EVD) placement and management pose risks to neurocritically ill patients. Yet, little is known about EVD management or hospital EVD management practices and policies in US hospitals. A narrative review was conducted to describe EVD-related publications reported in PubMed and Embase between 1953 and 2019, and a survey was used to examine US hospital EVD practices and policies, including adherence to EVD guideline recommendations. Overall, 912 relevant articles were published between 1953 and 2019 (average 21; range, 0 to 102 articles, per year), primarily related to indications for EVD placement (n=275, 30.2%), EVD-associated complications (n=206, 22.6%), and EVD care (n=200, 21.9%). The number of EVD publications increased over time (R=0.7), and most publications addressed EVD-associated infection (n=296, 73.4%) and EVD insertion (n=195, 45.2%). Survey responses were received from 30 hospitals (37.5% response rate), and reported use of antimicrobial-impregnated catheters in 80% of hospitals, preinsertion antibiotic administration in 70%, collection of cerebrospinal fluid samples for suspicion of ventriculitis in 73.