Liver paired exchange U.S. single center experience - pairs, chains, and use of compatible pairs'.

BACKGROUND: In the United States, the discrepancy between organ availability and need has persisted despite changes in allocation, innovations in preservation, and policy initiatives. Living donor liver transplant (LDLT) remains an underutilized means of improving access to timely liver transplantation and decreasing waitlist mortality. Liver paired exchange (LPE) represents an opportunity to overcome LDLT pair incompatibility due to size, anatomy, or blood type. METHODS: LPE was adopted as a strategy to augment access to liver transplantation at our institution. Specific educational materials, consent forms, and selection processes were developed to facilitate LPE. RESULTS: From 2019 through October 2023, our center performed 11 LPEs, resulting in 23 LDLT pairs. The series included several types of LPE: those combining complementary incompatible pairs, the inclusion of compatible pairs to overcome incompatibility, and the use of altruistic non-directed donors to initiate chains. These exchanges facilitated transplantation for 23 recipients, including 1 pediatric patient. CONCLUSIONS: LPE improved access to liver transplantation at our institution. The ethical application of LPE includes tailored patient education, assessment and disclosure of exchange balance, mitigation of risk and maximization of benefit for donors and recipients.

Replacing Plastics with Alternatives Is Worse for Greenhouse Gas Emissions in Most Cases.

Plastics are controversial due to their production from fossil fuels, emissions during production and disposal, potential toxicity, and leakage to the environment. In light of these concerns, calls to use less plastic products and move toward nonplastic alternatives are common. However, these calls often overlook the environmental impacts of alternative materials. This article examines the greenhouse gas (GHG) emission impact of plastic products versus their alternatives. We assess 16 applications where plastics are used across five key sectors: packaging, building and construction, automotive, textiles, and consumer durables. These sectors account for about 90% of the global plastic volume. Our results show that in 15 of the 16 applications a plastic product incurs fewer GHG emissions than their alternatives. In these applications, plastic products release 10% to 90% fewer emissions across the product life cycle. Furthermore, in some applications, such as food packaging, no suitable alternatives to plastics exist. These results demonstrate that care must be taken when formulating policies or interventions to reduce plastic use so that we do not inadvertently drive a shift to nonplastic alternatives with higher GHG emissions. For most plastic products, increasing the efficiency of plastic use, extending the lifetime, boosting recycling rates, and improving waste collection would be more effective for reducing emissions.

Feasible supply of steel and cement within a carbon budget is likely to fall short of expected global demand.

The current decarbonization strategy for the steel and cement industries is inherently dependent on the build-out of infrastructure, including for CO2 transport and storage, renewable electricity, and green hydrogen. However, the deployment of this infrastructure entails considerable uncertainty. Here we explore the global feasible supply of steel and cement within Paris-compliant carbon budgets, explicitly considering uncertainties in the deployment of infrastructure. Our scenario analysis reveals that despite substantial growth in recycling- and hydrogen-based production, the feasible steel supply will only meet 58-65% (interquartile range) of the expected baseline demand in 2050. Cement supply is even more uncertain due to limited mitigation options, meeting only 22-56% (interquartile range) of the expected baseline demand in 2050. These findings pose a two-fold challenge for decarbonizing the steel and cement industries: on the one hand, governments need to expand essential infrastructure rapidly; on the other hand, industries need to prepare for the risk of deployment failures, rather than solely waiting for large-scale infrastructure to emerge. Our feasible supply scenarios provide compelling evidence of the urgency of demand-side actions and establish benchmarks for the required level of resource efficiency.

Growing role of concrete in sand and climate crises.

Concrete production poses multiple sustainability challenges, including resource over-exploitation and climate change. Here we show that growing global demand for buildings and infrastructure over the past three decades has quadrupled concrete production, reaching ∼26 Gt/year in 2020. As a result, annual requirements for virgin concrete aggregates (∼20 Gt/year) exceeded the extraction of all fossil fuels (∼15 Gt/year), exacerbating sand scarcity, ecosystem destruction, and social conflict. We also show that despite industry efforts to reduce CO2 emissions by ∼20% per unit of production, mainly through clinker substitution and improved thermal efficiency, increased production has outweighed these gains. Consequently, concrete-related CO2 emissions have tripled between 1990 and 2020, and its contribution to global emissions has risen from 5% to 9%. We propose that the policy agenda should focus more on limiting production growth by changing how concrete structures are designed, constructed, used, and disposed of to address the sand and climate crises.

Designing a zero-order energy transition model: How to create a new Starter Data Kit.

The Paris Agreement was signed by 192 Parties, who committed to reducing emissions. Reaching such commitments by developing national decarbonisation strategies requires significant analyses and investment. Analyses for such strategies are often delayed due to a lack of accurate and up-to-date data for creating energy transition models. The Starter Data Kits address this issue by providing open-source, zero-level country datasets to accelerate the energy planning process. There is a strong demand for replicating the process of creating Starter Data Kits because they are currently only available for 69 countries in Africa, Asia, and South America. Using an African country as an example, this paper presents the methodology to create a Starter Data Kit made of tool-agnostic data repositories and OSeMOSYS-specific data files. The paper illustrates the steps involved, provides additional information for conducting similar work in Asia and South America, and highlights the limitations of the current version of the Starter Data Kits. Future development is proposed to expand the datasets, including new and more accurate data and new energy sectors. Therefore, this document provides instructions on the steps and materials required to develop a Starter Data Kit.•The methodology presented here is intended to encourage practitioners to apply it to new countries and expand the current Starter Data Kits library.•It is a novel process that creates data pipelines that feed into a single Data Collection and Manipulation Tool (DaCoMaTool).•It allows for tool-agnostic data creation in a consistent format ready for a modelling analysis using one of the available tools.

What to Do about Plastics? Lessons from a Study of United Kingdom Plastics Flows.

Plastics are one of the most widely used materials on the planet, owing to their usefulness, durability, and relatively low cost. Yet, making, using, and disposing of plastics create important environmental impacts, most notably greenhouse gas emissions and waste pollution. Reducing these impacts while still enjoying the benefits of plastic use requires an integrated assessment of all of the life cycles of plastics. This has rarely been attempted due to the wide variety of polymers and the lack of knowledge on the final uses and applications of plastics. Using trade statistics for 464 product codes, we have mapped the flows of the 11 most widely used polymers from production into six end-use applications for the United Kingdom (UK) in 2017. With a dynamic material flow analysis, we have anticipated demand and waste generation until 2050. We found that the demand for plastics seems to have saturated in the UK, with an annual demand of 6 Mt, responsible for approximately 26 Mt CO2e/a. Owing to a limited recycling capacity in the UK, only 12% of UK plastic waste is recycled domestically, leading to 21% of the waste being exported, labeled as recycling, but mostly to countries with poor practices of waste management. Increasing recycling capacity in the UK could both reduce GHG emissions and prevent waste pollution. This intervention should be complemented with improved practices in the production of primary plastics, which currently accounts for 80% of UK plastic emissions.

Criteria for Assessing Sustainability of Lignocellulosic Wastes: Applied to the Cellulose Nanofibril Packaging Production in the UK.

Extensive use of petrochemical plastic packaging leads to the greenhouse gas emission and contamination to soil and oceans, posing major threats to the ecosystem. The packaging needs, hence, are shifting to bioplastics with natural degradability. Lignocellulose, the biomass from forest and agriculture, can produce cellulose nanofibrils (CNF), a biodegradable material with acceptable functional properties, that can make packaging among other products. Compared to primary sources, CNF extracted from lignocellulosic wastes reduces the feedstock cost without causing an extension to agriculture and associated emissions. Most of these low value feedstocks go to alternative applications, making their use in CNF packaging competitive. To transfer the waste materials from current practices to the packaging production, it is imperative to assess their sustainability, encompassing environmental and economic impacts along with the feedstock physical and chemical properties. A combined overview of these criteria is absent in the literature. This study consolidates thirteen attributes, delineating sustainability of lignocellulosic wastes for commercial CNF packaging production. These criteria data are gathered for the UK waste streams, and transformed into a quantitative matrix, evaluating the waste feedstock sustainability for CNF packaging production. The presented approach can be adopted to decision scenarios in bioplastics packaging conversion and waste management.

Planet-compatible pathways for transitioning the chemical industry.

Chemical products, such as plastics, solvents, and fertilizers, are essential for supporting modern lifestyles. Yet, producing, using, and disposing of chemicals creates adverse environmental impacts which threaten the industry's license to operate. This study presents seven planet-compatible pathways toward 2050 employing demand-side and supply-side interventions with cumulative total investment costs of US$1.2-3.7 trillion. Resource efficiency and circularity interventions reduce global chemicals demand by 23 to 33% and are critical for mitigating risks associated with using fossil feedstocks and carbon capture and sequestration, and constraints on available biogenic and recyclate feedstocks. Replacing fossil feedstocks with biogenic/air-capture sources, shifting carbon destinations from the atmosphere to ground, and electrifying/decarbonizing energy supply for production technologies could enable net negative emissions of 0.5 GtCO2eq y-1 across non-ammonia chemicals, while still delivering essential chemical-based services to society.

Regional characteristics and spatial correlation of haze pollution: Interpretative system analysis in cities of Fenwei Plain in China.

Urban agglomeration is an important model for promoting global economic development and has made important contributions to global economic integration. However, as the core area of urbanization and industrialization, urban agglomerations also contribute to air pollutant emissions primarily due to the agglomeration of population and industry. The mutual influence of air pollution between different cities in urban agglomerations has brought significant challenges to global environmental governance. The Fenwei Plain is one of the most severely polluted areas in China. We collected daily average PM2.5 concentration data of 11 cities in the Fenwei Plain, China in 2019. We then developed an interpretive structural model to statistically analyze the spatial correlation and hierarchical transmission of haze pollution between the 11 cities. The results showed that haze pollution has a strong systematic correlation between the 11 cities, and a regional haze pollution community has formed throughout the region. Haze pollution also exhibits evident transmission and spatial correlations between the cities. The transmission starts from Baoji and ends at Sanmenxia, with mutual interactions between the cities of Xi'an, Xianyang, Weinan, Tongchuan, Jinzhong, Lvliang, Linfen, Yuncheng, and Luoyang. Thus, air pollution prevention and control in the Fenwei Plain should consider the spatial correlation of haze pollution between different cities, especially in autumn and winter, and should rationally be implemented in key urban cluster areas. We recommend building a coordinated governance between cities to improve the overall air quality. Our findings shed a light for coordinated pollution management in urban agglomerations worldwide.

Wind Turbine Blades Using Recycled Carbon Fibers: An Environmental Assessment.

Polymers reinforced with virgin carbon fibers (VCF) are being used to make spar caps of wind turbine (WT) blades and polymers with glass fibers (GF) to make skins of the blade components. Here, we assess the life cycle environmental performance of the hybrid blades with spar caps based on VCF and the shells and shear webs based on RCF (recycled CF) composites (RCF-hybrid). The production of the WT blades and associated reinforced polymers is assumed to occur in Sweden, with their uses and end-of-life management in the European region. The functional unit is equivalent to three blades in an offshore WT with the market incumbent blades solely based on the GF composite or the hybrid option. The RCF-hybrid blades offer 12-89% better environmental performance in nine out of 10 impact categories and 6-26% better in six out of 10 impact categories. The RCF-hybrid blades exhibit optimum environmental performance when the VCF manufacturing facilities are equipped with pollution abatement systems including regenerative thermal oxidizers to reduce ammonia and hydrogen cyanide emissions; spar caps are made using VCF epoxy composites through pultrusion and resin infusion molding, and the blade scrap is mechanically recycled at the end of life. The energy and carbon payback times for the RCF-hybrid blades were found to be 5-13% lower than those of the market incumbents.

Increased use of split liver grafts in adult recipients following implementation of a pediatric liver transplant program.

BACKGROUND: Split liver transplantation (SLT) is a strategy to address organ shortage, but is a technically more demanding procedure than whole graft liver transplantation (LT). We aimed to determine the outcomes following SLT in adult recipients as well as to highlight the impact that having a pediatric LT program has on SLT implementation. METHODS: All SLTs conducted at a single-center from 2010 to 2019 were identified. Patient data was obtained through retrospective review of the electronic medical record. Kaplan-Meier analysis assessed primary outcomes of 1-,3-, and 5-year graft and patient survival. RESULTS: We identified 37 SLTs performed at our institution from 2010 to 2019. Twenty-four donated livers resulted in 21 extended right lobes and 16 left lateral segments for adults and pediatrics recipients, respectively. Eighty-one percent (30/37) of the SLTs were performed after introduction of the combined pediatric program in 2016. 13/24 donor livers were split with both grafts allocated and used at our institution and 92% occurred after introduction of the pediatric program. Graft survival rates at 1-, 3-, and 5-years were 94% in adult recipients and 100% for all time periods in pediatric recipients. Actuarial post-transplant patient survival was 100% at 1-, 3-, and 5-years in both. CONCLUSIONS: The introduction of a pediatric liver transplantation program resulted in more than a fourfold increase in the number of SLTs performed at our center. Increase in allocation and use of both grafts at our institution was also seen.

The sponge effect and carbon emission mitigation potentials of the global cement cycle.

Cement plays a dual role in the global carbon cycle like a sponge: its massive production contributes significantly to present-day global anthropogenic CO2 emissions, yet its hydrated products gradually reabsorb substantial amounts of atmospheric CO2 (carbonation) in the future. The role of this sponge effect along the cement cycle (including production, use, and demolition) in carbon emissions mitigation, however, remains hitherto unexplored. Here, we quantify the effects of demand- and supply-side mitigation measures considering this material-energy-emissions-uptake nexus, finding that climate goals would be imperiled if the growth of cement stocks continues. Future reabsorption of CO2 will be significant (~30% of cumulative CO2 emissions from 2015 to 2100), but climate goal compliant net CO2 emissions reduction along the global cement cycle will require both radical technology advancements (e.g., carbon capture and storage) and widespread deployment of material efficiency measures, which go beyond those envisaged in current technology roadmaps.

Mapping Global Flows of Chemicals: From Fossil Fuel Feedstocks to Chemical Products.

Chemical products are ubiquitous in modern society. The chemical sector is the largest industrial energy consumer and the third largest industrial emitter of carbon dioxide. The current portfolio of mitigation options for the chemical sector emphasizes upstream "supply side" solutions, whereas downstream mitigation options, such as material efficiency, are given comparatively short shrift. Key reasons for this are the scarcity of data on the sector's material flows, and the highly intertwined nature of its complex supply chains. We provide the most up to date, comprehensive and transparent data set available publicly, on virgin production routes in the chemical sector: from fossil fuel feedstocks to chemical products. We map global mass flows for the year 2013 through a complex network of transformation processes, and by taking account of secondary reactants and by-products, we maintain a full mass balance throughout. The resulting data set partially addresses the dearth of publicly available information on the chemical sector's supply chain, and can be used to prioritise downstream mitigation options.

Designing climate change mitigation plans that add up.

Mitigation plans to combat climate change depend on the combined implementation of many abatement options, but the options interact. Published anthropogenic emissions inventories are disaggregated by gas, sector, country, or final energy form. This allows the assessment of novel energy supply options, but is insufficient for understanding how options for efficiency and demand reduction interact. A consistent framework for understanding the drivers of emissions is therefore developed, with a set of seven complete inventories reflecting all technical options for mitigation connected through lossless allocation matrices. The required data set is compiled and calculated from a wide range of industry, government, and academic reports. The framework is used to create a global Sankey diagram to relate human demand for services to anthropogenic emissions. The application of this framework is demonstrated through a prediction of per-capita emissions based on service demand in different countries, and through an example showing how the "technical potentials" of a set of separate mitigation options should be combined.

Mapping the global flow of aluminum: from liquid aluminum to end-use goods.

Demand for aluminum in final products has increased 30-fold since 1950 to 45 million tonnes per year, with forecasts predicting this exceptional growth to continue so that demand will reach 2-3 times today's levels by 2050. Aluminum production uses 3.5% of global electricity and causes 1% of global CO2 emissions, while meeting a 50% cut in emissions by 2050 against growing demand would require at least a 75% reduction in CO2 emissions per tonne of aluminum produced--a challenging prospect. In this paper we trace the global flows of aluminum from liquid metal to final products, revealing for the first time a complete map of the aluminum system and providing a basis for future study of the emissions abatement potential of material efficiency. The resulting Sankey diagram also draws attention to two key issues. First, around half of all liquid aluminum (~39 Mt) produced each year never reaches a final product, and a detailed discussion of these high yield losses shows significant opportunities for improvement. Second, aluminum recycling, which avoids the high energy costs and emissions of electrolysis, requires signification "dilution" (~ 8 Mt) and "cascade" (~ 6 Mt) flows of higher aluminum grades to make up for the shortfall in scrap supply and to obtain the desired alloy mix, increasing the energy required for recycling.

Mapping the global flow of steel: from steelmaking to end-use goods.

Our society is addicted to steel. Global demand for steel has risen to 1.4 billion tonnes a year and is set to at least double by 2050, while the steel industry generates nearly a 10th of the world's energy related CO2 emissions. Meeting our 2050 climate change targets would require a 75% reduction in CO2 emissions for every tonne of steel produced and finding credible solutions is proving a challenge. The starting point for understanding the environmental impacts of steel production is to accurately map the global steel supply chain and identify the biggest steel flows where actions can be directed to deliver the largest impact. In this paper we present a map of global steel, which for the first time traces steel flows from steelmaking, through casting, forming, and rolling, to the fabrication of final goods. The diagram reveals the relative scale of steel flows and shows where efforts to improve energy and material efficiency should be focused.

Reducing energy demand: what are the practical limits?

Concern over the global energy system, whether driven by climate change, national security, or fears of shortage, is being discussed widely and in every arena but with a bias toward energy supply options. While demand reduction is often mentioned in passing, it is rarely a priority for implementation, whether through policy or through the search for innovation. This paper aims to draw attention to the opportunity for major reduction in energy demand, by presenting an analysis of how much of current global energy demand could be avoided. Previous work led to a "map" of global energy use that traces the flow of energy from primary sources (fuels or renewable sources), through fuel refinery, electricity generation, and end-use conversion devices, to passive systems and the delivery of final energy services (transport, illumination, and sustenance). The key passive systems are presented here and analyzed through simple engineering models with scalar equations using data based on current global practice. Physically credible options for change to key design parameters are identified and used to predict the energy savings possible for each system. The result demonstrates that 73% of global energy use could be saved by practically achievable design changes to passive systems. This reduction could be increased by further efficiency improvements in conversion devices. A list of the solutions required to achieve these savings is provided.

Options for achieving a 50% cut in industrial carbon emissions by 2050.

Carbon emissions from industry are dominated by production of goods in steel, cement plastic, paper, and aluminum. Demand for these materials is anticipated to double at least by 2050, by which time global carbon emissions must be reduced by at least 50%. To evaluate the challenge of meeting this target the global flows of these materials and their associated emissions are projected to 2050 under five technical scenarios. A reference scenario includes all existing and emerging efficiency measures but cannot provide sufficient reduction. The application of carbon sequestration to primary production proves to be sufficient only for cement The emissions target can always be met by reducing demand, for instance through product life extension, material substitution, or "light-weighting". Reusing components shows significant potential particularly within construction. Radical process innovation may also be possible. The results show that the first two strategies, based on increasing primary production, cannot achieve the required emissions reductions, so should be balanced by the vigorous pursuit of material efficiency to allow provision of increased material services with reduced primary production.