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Impact of propofol and sevoflurane anesthesia on cognition and emotion in gastric cancer patients undergoing radical resection

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 79-89页

作者： Ao-Han Li Su Bu Ling Wang Ai-Min Liang Hui-Yu Luo Department of Anesthesiology Xiangyang No.1 People's HospitalHubei University of MedicineXiangyang 441000Hubei ProvinceChina Department of cardiothoracic surgery Xiangyang No.1 People's HospitalHubei University of MedicineXiangyang 441000Hubei ProvinceChina Department of Rehabilitation Xiangyang No.1 People's HospitalHubei University of MedicineXiangyang 441000Hubei ProvinceChina Department of Internal medicine-cardiovascular Xiangyang No.1 People's HospitalHubei University of MedicineXiangyang 441000Hubei ProvinceChina

BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric ***,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this *** To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric *** A total of 80 patients were involved in this *** subjects were divided into two groups:Propofol group and sevoflurane *** evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also *** The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane ***,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol *** sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol ***,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol *** Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric *** anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative *** anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental ***,the selection of anesthetic agents should be based on the individual patient's specific circumstances.

关键词： Propofol Sevoflurane Radical resection of gastric cancer Anesthetic effect Cognitive function Negative emotion

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A Comparative Analysis on Surgical Outcomes and Complications of Endoscopic and Open Vein Harvesting Techniques

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Open Journal of Thoracic surgery 2024年第2期14卷 29-39页

作者： Mohammed Fawzy Eltaweel Ismail N. El-Sokkary Ahmed Alherazi Mohamed Wael Badawi Mohammed G. Abdellatif Bahaa A. Elkhonezy Ibrahim K. Gamil Haytham Mohamed Abd El Moaty Sarra Sadmi Mahmoud Khalil Department of cardiothoracic surgery Faculty of Medicine Menoufia University Shibin El Kom Egypt Department of cardiovascular & Thoracic surgery Faculty of Medicine Al-Azhar University Cairo Egypt Department of cardiothoracic surgery Faculty of Medicine Alexandria University Alexandria Egypt Faculty of medicine University of Algiers Algiers Algeria Department of Cardiac surgery Sabah Al-Ahmed Cardiac Center Al-Amiri Hospital Kuwait City Kuwait

Objective: The great saphenous vein (GSV) is commonly used as a conduit for grafting during CABG surgery, and open GSV harvesting (OVH), commonly used with long incision to expose the vein. However, endoscopic vein harvesting (EVH) is an alternative approach, utilizing specialized instruments and small incisions to harvest the vein. Methods: A retrospective analysis was conducted on a cohort of patients who underwent Coronary artery bypass graft (CABG) requiring great saphenous vein (GSV) harvesting which was done by EVH or OVH procedures. Demographic variables, including age and gender, were assessed for both groups. Intraoperative variables such as the number of grafts, cardiopulmonary bypass time, X clamp time, and type of procedure were analyzed. Postoperative variables, including infection and bleeding rates, were also evaluated. Results: The study included 30 patients each undergoing Coronary artery bypass graft (CABG) with need of great saphenous vein harvesting which was done by EVH and OVH. Demographic variables were well-matched between the two groups in terms of age, while a significant difference in gender distribution was observed. Obesity and smoking were more prevalent in the OVH group, and EVH was associated with a higher mean number of grafts compared to OVH. Conversion to an open technique occurred in a portion of the EVH cases, and infection rates did not significantly differ between the EVH and OVH groups. However, the incidence of postoperative bleeding was significantly higher in the EVH group. Conclusion: This study provides valuable insights into the demographic, intraoperative, and postoperative variables associated with EVH and OVH techniques. EVH demonstrated advantages in terms of reduced infection rates compared to OVH. However, the higher incidence of postoperative bleeding associated with EVH raises concerns about potential risks.

关键词： Endoscopic Vein Harvesting (EVH) Open Vein Harvesting (OVH) Coronary Artery Bypass Grafting (CABG) Great Saphenous Vein (GSV) Surgical Outcomes

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Animal Model of Aortic Valve Calcification: Their Methodology Helps Us Understand Aortic Valve Calcification

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Advances in Bioscience and Biotechnology 2024年第4期15卷 235-268页

作者： Yinze Wei Zhen Wang Miao Chen Liang Ma Departments of cardiothoracic surgery The Fourth Affiliated Hospital of Zhejiang University School of Medicine Yiwu China Departments of cardiothoracic surgery The First Affiliated Hospital of Zhejiang University School of Medicine Hangzhou China

Aortic valve calcification disease (CAVD) is the most prevalent degenerative valve disease in humans, leading to significant morbidity and mortality. Despite its common occurrence, our understanding of the underlying mechanisms remains incomplete, and available treatment options are limited and risky. A more comprehensive understanding of the biology of CAVD is essential to identify new therapeutic strategies. Animal models have played a crucial role in advancing our knowledge of CAVD and exploring potential treatments. However, these models have inherent limitations as they cannot fully replicate the complex physiological mechanisms of human CAVD. In this review, we examine various CAVD models ranging from pigs to mice, highlighting the unique characteristics of each model to enhance our understanding of CAVD. While these models offer valuable insights, they also have limitations and shortcomings. We propose that the guide wire model shows promise for future CAVD research, and streamlining the methodology could enhance our understanding and expand the research scope in this field.

关键词： Animal Model Aortic Valve Stenosis Calcification cardiovascular

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美国成人心脏移植现状与外科进展

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中国胸心血管外科临床杂志 2024年

作者：梁宏亮 Department of cardiothoracic surgery Stanford University School of Medicine

心脏移植是终末期心力衰竭患者最有效的治疗方式。近10年来，心脏移植外科领域取得了巨大进展，但供体心脏的严重不足始终是限制心脏移植广泛应用的关键问题。随着供心复苏、保存与评估技术的革新，扩展标准供体和循环死亡供体的应用日... 详细信息

心脏移植是终末期心力衰竭患者最有效的治疗方式。近10年来，心脏移植外科领域取得了巨大进展，但供体心脏的严重不足始终是限制心脏移植广泛应用的关键问题。随着供心复苏、保存与评估技术的革新，扩展标准供体和循环死亡供体的应用日益增加，供心缺血的安全时限和获取地域范围不断扩大，这都显著扩充了供体库，推动了心脏移植数量的迅速增长。同时，心脏移植外科技术和受体围手术期管理领域也涌现出许多新技术，特别是机械循环支持和人工智能的迅猛发展，有望为心脏移植领域带来革命性的变革。本文对近年来美国成人心脏移植的现状与外科主要进展进行综述和讨论，以期为读者提供启示，激发在该领域的持续探索与创新思路。

关键词：心脏移植脑死亡后捐献供体循环死亡后捐献供体扩展标准供体多器官联合移植原发性移植物功能障碍机械循环支持人工智能综述

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Peroxisome proliferator-activated receptor gamma coactivator-1(PGC-1)family in physiological and pathophysiological process and diseases

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Signal Transduction and Targeted Therapy 2024年第4期9卷 1249-1292页

作者： Lu Qian Yanli Zhu Chao Deng Zhenxing Liang Junmin Chen Ying Chen Xue Wang Yanqing Liu Ye Tian Yang Yang Xi'an Key Laboratory of cardiovascular and Cerebrovascular Diseases Xi'an No.3 HospitalThe Affiliated Hospital of Northwest UniversityNorthwest UniversityXi'an 710021China Xi'an Key Laboratory of Innovative Drug Research for Heart Failure Faculty of Life Sciences and MedicineNorthwest University229 Taibai North RoadXi'an 710069China Department of cardiovascular surgery The First Affiliated Hospital of Xi'an Jiaotong University277 Yanta West RoadXi'an 710061China Department of cardiothoracic surgery The First Affiliated Hospital of Zhengzhou University1 Jianshe EastZhengzhou 450052China Department of Hematology The First Affiliated Hospital of Xi'an JiaotongUniversity277 Yanta West RoadXi'an 710061China

Peroxisome proliferator-activated receptor gamma coactivator-1(PGC-1)family(PGC-1s),consisting of three members encompassing PGC-1a,PGC-1β,and PGC-1-related coactivator(PRC),was discovered more than a quarter-century ***-1s are essential coordinators of many vital cellular events,including mitochondrial functions,oxidative stress,endoplasmic reticulum homeostasis,and *** evidence has shown that PGC-1s are implicated in many diseases,such as cancers,cardiac diseases and cardiovascular diseases,neurological disorders,kidney diseases,motor system diseases,and metabolic *** the upstream modulators and co-activated partners of PGC-1s and identifying critical biological events modulated by downstream effectors of PGC-1s contribute to the presentation of the elaborate network of ***,discussing the correlation between PGC-1s and diseases as well as summarizing the therapy targeting PGC-1s helps make individualized and precise intervention *** this review,we summarize basic knowledge regarding the PGC-1s family as well as the molecular regulatory network,discuss the physio-pathological roles of PGc-1s in human diseases,review the application of PGC-1s,including the diagnostic and prognostic value of PGC-1s and several therapies in pre-clinical studies,and suggest several directions for future *** review presents the immense potential of targeting PGC-1s in the treatment of diseases and hopefully facilitates the promotion of PGC-1s as new therapeutic targets.

关键词： diseases life precise

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Prognostic Role of Preoperative Tricuspid Annular Plane Systolic Excursion (TAPSE) in Mitral Valve Replacement (MVR) for Rheumatic Mitral Stenosis Patients

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World Journal of cardiovascular surgery 2024年第8期14卷 115-130页

作者： Satyajit Sharma Muhit Abdullah Md. Noor-E-Elahi Mozumder Munjerin Refat Synthee Md. Zafar-Al-Nimari Anowarul Azim Saikat Das Gupta Dewan Iftakher Raza Chowdhury Siddhartha Shankar Howlader Noel Crypian Gomes Saleh Ahmed Samir Kumar Biswas Department of Cardiac surgery National Heart Foundation Hospital & Research Institute (NHFH & RI) Dhaka Bangladesh Department of Cardiac surgery National Institute of Cardiovascular Diseases & Hospital Dhaka Bangladesh Department of cardiothoracic and Vascular surgery Square Hospital Dhaka Bangladesh Department of cardiothoracic and Vascular surgery Evercare Hospital Chattogram Bangladesh

Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAPSE in patients with mitral valve replacement for rheumatic mitral stenosis patients is still under focused. Therefore, the objective of the study was to predict the outcome after MVR in rheumatic mitral stenosis patients in relation to preoperative TAPSE. This comparative cross-sectional study was conducted at the Department of Cardiac surgery, National Heart Foundation Hospital and Research Institute. A total of 72 patients of rheumatic mitral stenosis patients who underwent mitral valve replacement were included in the study. They were divided into two groups: Group A and B. Group A included 36 patients with TAPSE 0.05) except for the preoperative TAPSE. Mean TAPSE of Group A was 13.17 (±1.40) and Group B was 18.61 (±1.57), the difference was statistically significant (p 0.05). Among the postoperative complications, including postoperative atrial fibrillation was higher in Group A (30.56%) than Group B (11.11%), mean ventilation time was higher in Group A (27.78%) than Group B (5.56%), length of intensive care was higher in Group A (33.33%) than Group B (11.12%), and hospital stay was higher in Group A (25.0%) than Group B (5.56%), (p < 0.05). Higher preoperative TASPE could be used as a prognostic tool for MVR in rheumatic mitral stenosis patients in our settings.

关键词： Tricuspid Annular Plane Systolic Excursion Mitral Valve Replacement Rheumatic Heart Disease Mitral Stenosis Right Ventricular Ejection Fraction Postoperative Complications

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Clinical application and management of temporary mechanical circulatory support:A clinical consensus

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Chinese Medical Journal 2024年第10期137卷 1135-1139页

作者： Nianguo Dong Liangwan Chen Xin Chen Huishan Wang Yingbin Xiao Xianqiang Wang Jinsong Huang Yang Yan Pramod Bonde Neel Sodha Pavan Atluri Juan Pablo Maureira AndréVincentelli Masanobu Yanase Yixuan Wang Haitao Zhang Xiaotong Hou Yoshijuki Takami Pascal Leprince Thierry Folliguet Frank W Sellke Chinese Society for Thoracic and cardiovascular surgery Chinese Association of cardiovascular Surgeons Cardiac Critical Care Professional Committee of Chinese Medical Association Chinese Society of Extracorporeal Life Support European Society of cardiovascular and Endovascular surgery French Society of Thoracic and cardiovascular surgery Japanese Society for cardiovascular surgery Japanese Society of Artificial Organs Department of cardiovascular surgery Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China Department of cardiovascular surgery Fujian Medical University Union HospitalFuzhouFujian 350000China Department of Thoracic and cardiovascular surgery Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210000China Department of cardiovascular surgery General Hospital of Northern Theater CommandShenyangLiaoning 110000China Department of cardiovascular surgery Xinqiao HospitalThird Military Medical UniversityChongqing 400037 China Department of cardiovascular surgery Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100000 China Department of cardiovascular surgery Guangdong Provincial Cardiovascular InstituteGuangdong General HospitalGuangdong Academy of Medical SciencesGuangzhouGuangdong 510000 China Department of cardiovascular surgery First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710061China Department of Cardiac surgery Yale School of Medicine330 Cedar St204 BoardmanNew HavenCT 06510USA Department of cardiothoracic surgery Alpert Medical SchoolBrown University Rhode Island HospitalProvidenceRI 02912USA Department of cardiovascular surgery Department of SurgeryUniversity of PennsylvaniaPhiladelphiaPA 19113USA Department of cardiovascular surgery and Transplantation University Hospital of NancyUniversity of LorraineVandoeuvre-lès-Nancy 54500France Department of cardiovascular surgery University Hospital of LilleUniversity of LilleLille 59037France Department of Cardiology Fujita Health University School of MedicineToyoakeAichi 470-1192Japan Department of Adult Surgical Intensive Care Unit Fuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100000China Department of Cardiac Intensive Care Beijing Institute of HeartLung and B

Temporary mechanical circulatory support(tMCS)plays a pivotal role in managing severe or refractory cardiogenic shock(CS),furnishing essential hemodynamic support,and sustaining organ perfusion from hours to weeks,or to even *** the past decade,the utilization of tMCS has witnessed a signicant increase in American and European *** in Asia,the newly developed concepts and devices constituting tMCS have also made rapid ***,the absence of a consensus or standardized guidelines,especially for the Asian population considering inherited polymorphism,is *** address this knowledge gap,eight associations/societies and experts in thiseld came up with the present consensus after repeated discussions,more specically for the Asian *** comprehensively elucidates the commonly employed tMCS devices,criteria for patient selection,indications and contraindications,clinical management,and the optimal timing for implantation and *** goal of this statement is to promote the standardized application of tMCS and make reasonable decisions in clinical ***-length version of the consensus can be seen in Supplementary File,http://***/CM9/B883.

关键词： application statement discussions

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An in vitro demonstration of a passive,acoustic metamaterial as a temperature sensor with mK resolution for implantable applications

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Microsystems & Nanoengineering 2024年第1期10卷 41-54页

作者： Lucrezia Maini Vicente Genovés Roman Furrer Nikola Cesarovic Christofer Hierold Cosmin Roman Micro-and Nanosystems Department of Mechanical and Process EngineeringETH ZurichTannenstrasse 38092 ZurichSwitzerland. Translational cardiovascular Technology Department of Health Science and TechnologyETH ZurichLeopold-Ruzicka-Weg 48093 ZurichSwitzerland. Transport at Nanoscale Interfaces Swiss Federal Laboratories for Materials Science and TechnologyEMPAÜberlandstrasse 1298600 DübendorfSwitzerland Department of cardiothoracic and Vascular surgery Deutsches Herzzentrum der Charite(DHZC)13353 BerlinGermany

Wireless medical sensors typically utilize electromagnetic coupling or ultrasound for energy transfer and sensor *** transfer and management is a complex aspect that often limits the applicability of implantable sensor *** this work,we report a new passive temperature sensing scheme based on an acoustic metamaterial made of silicon embedded in a polydimethylsiloxane *** to other approaches,this concept is implemented without additional electrical components in situ or the need for a customized receiving unit.A standard ultrasonic transducer is used for this demonstration to directly excite and collect the reflected *** metamaterial resonates at a frequency close to a typical medical value(5 MHz)and exhibits a high-quality *** the design features of the metamaterial with the high-temperature sensitivity of the polydimethylsiloxane matrix,we achieve a temperature resolution of 30 *** value is below the current standard resolution required in infrared thermometry for monitoring postoperative complications(0.1 K).We fabricated,simulated,in vitro tested,and compared three acoustic sensor designs in the 29-43℃(~302-316 K)temperature *** this concept,we demonstrate how our passive metamaterial sensor can open the way toward new zero-power smart medical implant concepts based on acoustic interrogation.

关键词： passive resolution utilize

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Exploring the Role of Serum Cystatin C in Early Detection of Acute Kidney Injury among On-Pump Cardiac surgery Patients: A Single-Center Investigation in Bangladesh

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World Journal of cardiovascular Diseases 2024年第6期14卷 363-373页

作者： Md. Ahaduzzaman Md. Abir Tazim Chowdhury Munama Magdum Md. Saiful Islam Khan Satyajit Sharma Monoj Tiwari Md. Abul Bashar Maruf Md. Alauddin Omar Sadeque Khan Md. Mostafizur Rahman Mirza Md. Nazmus Saquib Department of cardiothoracic and Vascular surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Preventive and Social medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of Cardiac surgery National Heart Foundation Hospital & Research Institute Dhaka Bangladesh Department of cardiovascular and Thoracic surgery B.P. Koirala Memorial Cancer Hospital Bharatpur Chitwan Nepal Department of Cardiac surgery United Hospital Limited Dhaka Bangladesh Department of Cardiac surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac surgery Ibrahim Cardiac Hospital & Research Institute Dhaka Bangladesh

Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analy

关键词： Acute Kidney Injury (AKI) On-Pump Cardiac surgery Serum Cystatin C Serum Creatinine Diagnostic Biomarkers Early Detection Cardiopulmonary Bypass Single-Center Study Bangladesh

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The Dallas Donation after Circulatory Death Transplantation Summit:expanding donation after circulatory death procedures through process improvement,broader utilization,and innovation

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Hepatobiliary surgery and Nutrition 2024年第5期13卷 824-836,I0009页

作者： Michele Finotti Anji Wall Anthony D’Alessandro Gary Schwartz Chris Sonnenday David Goldberg Ashish Shah Peter Friend Jeff P.Orlowski Greg McKenna Steve Newton Brad Adams William C.Chapman Amit Mathur Marwan Abouljoud Tim Pruett Amelia Hessheimer James F.Trotter Sumeet K.Asrani Giuliano Testa Simmons Transplant Institute Baylor University Medical CenterDallasTXUSA Hepatobiliary and General surgery Unit Regional Hospital TrevisoDISCOGUniversity of PaduaPaduaItaly Division of Transplantation Department of SurgeryUniversity of Wisconsin School of Medicine and Public HealthMadisonWIUSA Department of Thoracic surgery and Lung Transplantation Baylor University Medical CenterCenter for Advanced Heart and Lung DiseaseDallasTXUSA Department of surgery University of MichiganAnn ArborMIUSA Division of Digestive Health and Liver Diseases Department of MedicineUniversity of Miami Miller School of MedicineMiamiFLUSA Department of Cardio-Thoracic surgery Vanderbilt University Medical CenterNashvilleTNUSA Nuffield Department of Surgical Sciences University of OxfordOxfordUK LifeShare Transplant Donor Services of Oklahoma Oklahoma CityOKUSA Administration Baylor University Medical CenterDallasTXUSA Southwest Transplant Alliance DallasTXUSA Department of surgery/Transplantation Washington UniversitySt.LouisMOUSA Division of Transplant surgery Department of SurgeryMayo Clinic ArizonaAlix School of MedicinePhoenixAZUSA divisions of Transplant and Hepatobiliary surgery Henry Ford HospitalDetroitMIUSA Department of surgery University of MinnesotaMinneapolisMNUSA General and Digestive surgery Hospital Universitario La PazIdiPAZMadridSpain

Despite a significant increase in utilization over the past decade,the number of donation after circulatory death(DCD)organs that are procured and transplanted in the United States(US)remains well below its *** is still room for expansion,as utilizing DCD organs to the fullest extent is currently the most viable solution to the persistent mismatch between supply and demand in *** convened a multidisciplinary transplantation summit to examine various aspects of DCD,with faculty members from around the world with clinical and academic interest in DCD donation and transplantation,including abdominal and cardiothoracic surgeons,organ procurement organization directors,hepatologists,and *** conference focused on identifying barriers to DCD organ utilization and strategies to overcome these *** divide the barriers to DCD utilization into three mains categories:(Ⅰ)policy and process variation;(II)logistical and transportation challenges;and(Ⅲ)higher risk perceptions related to DCD *** each barrier,we proposed a variety of solutions,providing an overview of the status of DCD donation in the US and suggestions on how to increase the use of *** is a specific focus on ex situ machine perfusion,normothermic regional perfusion,and other opportunities to expand DCD utilization without negatively impacting recipient outcomes.

关键词： Donation after circulatory death donation(DCD donation) marginal graft donor pool machine perfusion(MP)

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