Free The Organ
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Ischemia and reperfusion injury (IRI) is an inevitable event in conventional organ transplant procedure and is associated with significant mortality and morbidity post-transplantation. We hypothesize that IRI is avoidable if the blood supply for the organ is not stopped, thus resulting in optimal transplant outcomes. Here we described the first case of a novel procedure called ischemia-free organ transplantation (IFOT) for patients with end-stage liver disease. The liver graft with severe macrovesicular steatosis was donated from a 25-year-old man. The recipient was a 51-year-old man with decompensated liver cirrhosis and hepatocellular carcinoma. The graft was procured, preserved, and implanted under continuous normothermic machine perfusion. The recipient did not suffer post-reperfusion syndrome or vasoplegia after revascularization of the allograft. The liver function test and histological study revealed minimal hepatocyte, biliary epithelium and vascular endothelium injury during preservation and post-transplantation. The inflammatory cytokine levels were much lower in IFOT than those in conventional procedure. Key pathways involved in IRI were not activated after allograft revascularization. No rejection, or vascular or biliary complications occurred. The patient was discharged on day 18 post-transplantation. This marks the first case of IFOT in humans, offering opportunities to optimize transplant outcomes and maximize donor organ utilization.
Main outcomes and measures: The composite primary outcome was organ support-free days evaluated on an ordinal scale that combined in-hospital death (assigned a value of -1) and, for those who survived to hospital discharge, the number of days free of respiratory or cardiovascular organ support up to day 21 of the index hospitalization (range, -1 to 21 days; higher scores indicate less organ support and better outcomes). The primary safety outcome was major bleeding by 28 days as defined by the International Society on Thrombosis and Hemostasis.
Results: Enrollment of non-critically ill patients was discontinued when the prespecified criterion for futility was met. All 562 patients who were randomized (mean age, 52.7 [SD, 13.5] years; 41.5% women) completed the trial and 87% received a therapeutic dose of heparin by the end of study day 1. In the P2Y12 inhibitor group, ticagrelor was used in 63% of patients and clopidogrel in 37%. The median number of organ support-free days was 21 days (IQR, 20-21 days) among patients in the P2Y12 inhibitor group and was 21 days (IQR, 21-21 days) in the usual care group (adjusted odds ratio, 0.83 [95% credible interval, 0.55-1.25]; posterior probability of futility [defined as an odds ratio
Conclusions and relevance: Among non-critically ill patients hospitalized for COVID-19, the use of a P2Y12 inhibitor in addition to a therapeutic dose of heparin, compared with a therapeutic dose of heparin only, did not result in an increased odds of improvement in organ support-free days within 21 days during hospitalization.
Marvel at the sight and sound of the amazing Spreckels Organ, which consists of more than 5,000 pipes ranging in length from 12 inches to 32 feet. Housed in an ornate vaulted structure with highly embellished gables, the 100-plus-year-old organ comes to life each Sunday during free weekly concerts.
Organ transplantation is one of the miracles in medicine in the 20th century. However, in the current practice, all the donor organs suffer from ischemia/reperfusion injury (IRI), which compromise transplant outcomes and limits organ availability. Continuous efforts have been made in organ machine perfusion to ameliorate IRI. In 2017, ischemia-free organ transplantation (IFOT) was first proposed with the aim of complete avoidance of IRI in organ transplantation. The purpose of this review is to highlight the latest progresses in IFOT.
The feasibility of IFOT has been validated in liver, kidney, and heart transplantation. The results of the first nonrandomized controlled study demonstrate that ischemia-free liver transplantation (IFLT) may improve transplant outcomes and increase organ availability. Furthermore, laboratory results, including the absence of the characteristic pathological changes, gene transcription and metabolic reprogramming, as well as sterile inflammation activation in IFLT grafts, suggest the virtual avoidance of graft IRI in IFLT.
A post hoc sensitivity analysis was performed without use of dynamic borrowing and after excluding patients who did not receive a therapeutic dose of heparin. Similar bayesian analyses were carried out for the 2-level (death vs survival to hospital discharge), 3-level (death, organ support without death, and no organ support without death), and 4-level (death, invasive mechanical ventilation without death, organ support without invasive mechanical ventilation and without death, and no organ support without death) derivatives of the primary outcome with a cumulative logistic model and a flat Dirichlet prior.
Logistic and cumulative logistic models were used for binary and ordinal outcomes in the secondary and subgroup analyses. Odds ratios and 95% CIs were estimated through a random-effects logistic regression model that accounted for the same covariates in the primary analysis model. For time remaining alive and time remaining alive and free of organ support (the latter as a post hoc analysis), hazard ratios and 95% CIs were estimated through a frailty proportional hazards model that accounted for the same covariates in the primary analysis model.
The National Park Service has several days each year that are Fee-Free Days. Entrance fees are waived at Organ Pipe Cactus National Monument and other National Park Service sites for visitors to celebrate these special occasions. The fee-free days provide a great opportunity to visit a new place or an old favorite! Amenity fees such as camping fees are separate and still required.
The picture speaks for itself. Within the beautifully decorated town hall of the city of Leeds in England lies this spectacular organ, towering high into the music hall and silencing the sounds of the city with its earth shuddering, rich, harmonic tones.
We spent some time with organist Dr Simon Lindley who told us all about how the instrument works, it's history and even a guided tour up in to the inside of the organ itself! Simon crafted 6 versatile presets for us and we began the painstaking process of sampling this incredible feat of engineering. Over the next few months we spent many evenings in the town hall recording every single note with multiple round robins and over 10 second note recordings to capture the true sonic character of the organ.
Everyone involved in the project worked long hours and for free, so we felt that it was only right to give away the fruits of our labour and hope that the spirit of this incredible instrument could spread throughout the world and help people to craft wonderful music that moves people to do good things.
We packaged the sounds up into a custom Kontakt 5 instrument with a lovely photo of the organ in all of it's splendor, as well as sampler instruments for Kontakt 4, EXS24, Reason NN-XT and Ableton Sampler. We hope you enjoy making music and spread the word about this wonderful organ so others can too!
Join us on Friday afternoons at 12:15 pm for this weekly series of midday organ concerts featuring innovative programs by recitalists from across the United States and abroad. There is no charge for admission, but we invite a donation of $10. All performances take place in the Church.
Free for Bay Area residents. Advance tickets recommended. No additional concert ticket required. Seating is limited on a first-come first-served basis. Every Saturday, we offer free general admission to all residents of the six Bay Area counties; additional fees may apply for special exhibitions.
Organ Meats: A mix and match of organs. Because there is only 1 or 2 of a certain organ per cow, we cannot guarantee you will get a certain type of organ. We will do our best to distribute evenly. Box may or may not include; Tongue, Heart, Kidney, Liver, Oxtail, Kidney Fat.
This heroic organ was built in 1891 as Roosevelt's Opus 494. It was honored by the Organ Historical Society with Citation #50 in 1984. Unfortunately, the condition of the magnificent building deteriorated past the point of safety. The organ was dismantled and placed in storage in 2013 by the Organ Clearing House.
While everyone is familiar with the ubiquitous electro-pneumatic organs built by Möller, few realize that the firm produced hundreds of lovely tracker-action organs in the last decades of the 19th century and beginning of the 19th.
Here's a beautiful one-manual organ, recently restored by David Storey, ready for relocation, ideal for a rural church, small chapel, or for grand service as a Choir Organ \"down front\" in a larger church with a principal organ in rear gallery.
The Kilgen Organ Company is often hidden in the shadows behind giants like Skinner, Aeolian-Skinner, Kimball, and Casavant. But Kilgen organs reflect the best of the early 20th century American expressive symphonic organ. This fine instrument is relatively compact, and contains a rich variety of specialized tone colors. A real treat for the creative organist.
Ernest Skinner Opus 847 was built in 1930 for a private theater. It is equipped with Skinner's Duo-Art automatic player. The organ is privately owned, and the owners will consider donating the organ to an institution that would restore and install it in a place where the public could experience it.
Here's a perfect example of the ubiquitous twelve-stop Hook & Hastings organ. The Organ Clearing House has relocated dozens of similar organs. Beautiful tone, fine keyboard action, and lots of versatility in a modest instrument.
Organ donation is the act of taking healthy organs and tissues from one person and giving them to someone else. Making the decision to donate your organs is one of the most generous gifts you can give. 59ce067264
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