Biological basis of temperament: Respiratory sinus arrhythmia and inhibitory control across childhood.

Temperamental inhibitory control is a foundational capacity for children's social, emotional, and behavioral development. Even though temperament is suggested to have a biological basis, the physiological indicators of inhibitory control remain unclear amid mixed empirical results. In this study, we leveraged a multicohort longitudinal design to examine resting respiratory sinus arrhythmia (RSA) as a physiological correlate of inhibitory control across the early and middle childhood years. Data were collected annually across four time points from cohorts of 4- (n = 150, Mage = 4.53; SD = 0.30; 49.7% female) and 8- (n = 150; Mage = 8.53; SD = 0.29; 49.7% female) year-old children and their caregivers. There were weak, albeit significant, associations between resting RSA and caregiver-reported inhibitory control in middle childhood but not in early childhood. A stronger association was found for older children when latent trait assessments of RSA and inhibitory control were derived from commonalities across the four annual assessments. We conclude that using repeated measures to extract latent trait scores increases power to detect potential physiological indicators of temperament. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Empathy, sympathy, and emotion regulation: A meta-analytic review.

Empathy, sympathy, and emotion regulation are core components of social-emotional development. Regulating vicariously induced negative emotions is thought to support feeling empathy and sympathy for others in need, but empirical evidence for such effects is mixed. Moreover, despite the longstanding conceptual distinction between empathy and sympathy, most researchers refer to and measure these constructs interchangeably. This meta-analysis examined associations between emotion regulation and empathy and/or sympathy in childhood and adolescence, as well as potential methodological, study, and sample moderators. Analyses were conducted on 58 studies (75 effect sizes; N = 25,831). There was a significant and positive overall association between emotion regulation and empathy/sympathy (r = .19, p < .001); however, most scales assessing empathy were conflated with other constructs. Accounting for conflation, emotion regulation was related to sympathy (r = .24, p < .001) but not empathy (r = .04, p = .38). Moreover, the association between emotion regulation and empathy/sympathy was not significant when baseline respiratory sinus arrhythmia (RSA) and RSA reactivity were examined as proxies of emotion regulation. Results were largely similar across sample characteristics (e.g., age group, sex, and culture). Conceptual implications for differentiating empathy and sympathy are discussed, as well as methodological considerations to maximize the quality and clarity of research on emotion regulation, empathy, and sympathy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of titanium-prepared platelet-rich fibrin in type 1 fascia graft tympanoplasty on graft survival and hearing outcomes.

Background: Type 1 fascia graft tympanoplasty (T1FGT) is the mainstay surgical approach for the treatment of tympanic membrane perforations. The most widely used graft material is temporal muscle fascia, and graft take rates are reported differently. The methods to enhance graft take are still being investigated. Aim: The aim of our study was to investigate the effect of titanium-prepared platelet-rich fibrin (T-PRF) on graft take and hearing outcomes in T1FGT. Materials and Methods: Fifty-seven ears eligible for T1FGT were involved in the study and prospectively evaluated. T-PRF was applied with T1FGT in 27 ears. Thirty ears in the other group underwent only T1FGT. The patients underwent an otomicroscopic and audiometric examination in preoperative and postoperative 2nd week, 1st month, and 6th month. Both groups were evaluated in terms of hearing levels, infection, and graft take rates. Results: Two patients in the T1FGT + T-PRF group and seven patients in the T1FGT group had postoperative perforation (graft take rate: 92.6% versus 76.7%). The graft take rate was found to be increased in the T-PRF group although the difference was not statistically significant. In the T1FGT group, the percentage of infection was higher than in the T1FGT + T-PRF group. When the preoperative and postoperative 6th-month audiometry was compared, a statistically significant hearing gain was obtained for both groups. Conclusion: In the treatment of tympanic membrane perforations, T-PRF applied over the fascia graft was shown to increase graft take rates and decrease the probability of infection. Further studies with larger samples are needed to demonstrate the effects of PRF.

Parental warmth predicts more child pro-social behaviour in children with better emotion regulation.

Parental warmth and child emotion regulation have each been implicated in the development of child pro-social behaviours; however, their interactive benefits remain unclear. In this multi-method, multi-cohort longitudinal study, we examined the effect of parental warmth on child pro-social behaviours at different levels of child emotion regulation. We collected data from 6- and 10-year-olds in Canada (NT1  = 233; Mage  = 8.41; SD = 2.08) and their parents. Parental warmth, child emotion regulation, and child pro-social behaviours were assessed via parent report. Children's baseline respiratory sinus arrhythmia (RSA; an indicator of cardiac regulatory capacity) was assessed as a correlate of emotion regulation. Child pro-social behaviours were assessed concurrently and 1 year later. Results showed that higher parental warmth was related to higher concurrent prosocial behaviours and greater increases in prosocial behaviours over 1 year. These effects were strengthened for children with higher emotion regulation whether measured by parent report or RSA. We discuss implications for understanding pro-social development in middle childhood from a strengths-based perspective.

Assessing social-emotional development: Reliability and validity of the social-emotional responding task.

The Social-Emotional Responding Task (SERT) assesses children's anticipated emotions in the contexts of transgressions (Malti, The Social-Emotional Responding Task. Unpublished tool by T. Malti, 2017.). We present a systematic psychometric evaluation of the SERT using data from two different samples of 4-8-year-old children from Canada (N = 291, Mage = 6.55 years, SDs = 2.02, 50% boys in Sample 1 and N = 282, Mage = 6.57 years, SDs = 1.56, 49% boys in Sample 2). Children reported their anticipated emotions in six vignettes describing three domains of transgressions [aggressive acts (AA), prosocial omission (PO), and social exclusion (SE)]. Caregivers rated children's sympathy and prosocial and aggressive behaviors. Results supported a one-factor ("domain-general") model over a three-factor ("domain-specific") model, indicating convergence of anticipated emotions across vignettes and domains. Measurement invariance was established across gender and age groups, indicating the robustness of the assessment. Construct validity was supported by associations with sympathy and less robustly, with prosocial and aggressive behavior. We discuss the use of SERT as an assessment tool for children's social-emotional capacities in research and practice settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Culturally shared and unique meanings and expressions of maternal control across four cultures.

Maternal control is a major dimension of parenting and has different meanings, practices, and potential consequences across cultures. The present study aimed to identify and compare mothers' conceptualizations of parenting control across four cultures to reveal a more nuanced understanding regarding the meaning and practices of control: European American, Chinese immigrant, Korean immigrant, and Turkish. Using a semistructured open-ended interview, 100 European American, 102 U.S. Chinese immigrant, 103 U.S. Korean immigrant, and 109 Turkish mothers of preschool-aged children reported the ratings of importance, specific reasons, and strategies for exerting control over their children in daily life. Results revealed both shared and unique conceptualizations of maternal control across four cultures. Specifically, all mothers reported that it is important to express maternal control over their children in order to set behavioral norms/standards, maintain child safety, support social relations and respect for others, provide guidance, and guide moral development. Moreover, mothers discussed utilizing nonphysical punishment, setting and maintaining rules, reasoning/negotiating, consistency, physical punishment and verbal control, showing parents' serious/stern attitude, correction, and psychological control forms of control. However, the levels at which mothers emphasize the different reasons and strategies varied across cultures, reflecting culturally emphasized values. The findings of the present study further enrich our understanding of the complexities of maternal control across cultures. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A founder nonsense variant in NUDT2 causes a recessive neurodevelopmental disorder in Saudi Arab children.

We identified the homozygous p.Arg12* variant in 5 patients with neurodevelopmental delay, but variation databases list many truncating heterozygous variants for this small 2-exon gene. As most of these affect the protein's C-terminus, loss-of-function mediated pathogenicity may be confined to bi-allelic truncating variants in exon 1 (nonsense-mediated decay!) or in the catalytically active Nudix box.

Atypical Leiomyomas of the Uterus: A Clinicopathologic Study of 54 Cases and an Immunohistochemical Analysis of Ki-67 and p53 / Leiomiomas atípicos del útero: un estudio clínico-patológico de 54 casos y un análisis inmunohistoquímico de Ki-67 y p53

ABSTRACT Objective: Uterine atypical leiomyomas (ALs) are extremely rare and occur in an age group almost one decade earlier than that for leiomyosarcomas. According to the literature, extensive clinicopathologic studies on ALs were limited to only two studies (2, 8). Atypical leiomyomas of the uterus are well-defined neoplasms with smooth muscle cells. The aim of this study was to investigate clinicopathologic findings in 54 cases diagnosed with ALs as well as Ki-67 and p53 expressions immunohistochemically. Methods: Fifty-four cases diagnosed between 2000 and 2013 were included. The histological and clinical features of the cases were reviewed, and their medical records were examined. Ki-67 and p53 were performed on all cases immunohistochemically. Results: The average age of the patients was 41.8 years. The average clinical follow-up period was 57 months. Hysterectomy was performed in 31 patients, and myomectomy in 21 patients, while resection of the mass was performed in two patients due to the intraligamentary mass. The average size of the neoplasms was 6.2 cm. Severe cellular atypia was noticed in 25 patients. While the number of mitoses was 1/10 high power field in 30 patients, it was 4/10 high power field in six patients. Ki67 was found to be positive in 50 patients at the rate of 1-5% immunohistochemically, while p53 demonstrated staining at the ratio of 10-15% staining in four patients. Conclusion: The differentiation of ALs from leiomyosarcomas is crucial. The recurrence rate after follow-up is 2%. In our opinion, the patients diagnosed with 'AL with limited experience' before should be correctly diagnosed as AL. We recommend that Ki-67 and p53 can be used as adjuvant markers immunohistochemically in the patients where a problem in differential diagnosis from leiomyosarcoma exists.

RESUMEN Objetivo: Los leiomiomas atípicos uterinos (LA) son extremadamente raros y se presentan en un grupo de edad casi una década antes que los leiomiosarcomas. De acuerdo con la literatura, los extensos estudios clínico-patológicos en los LA se limitaron a sólo dos estudios (2, 8). Los leiomiomas atípicos del útero son neoplasmas bien definidos con células de músculo liso. El objetivo de este estudio fue investigar los hallazgos clínico-patológicos en 54 casos diagnosticados con LA, así como las expresiones Ki-67 y p53, de forma inmunohistoquímica. Métodos: Se incluyeron cincuenta y cuatro casos diagnosticados entre 2000 y 2013. Se revisaron las características histológicas y clínicas de los casos y se examinaron sus historias clínicas. Ki-67 y p53 se realizaron en todos los casos de forma inmunohistoquímica. Resultados: La edad promedio de los pacientes fue de 41.8 años. El período promedio de seguimiento clínico fue de 57 meses. Se realizaron histerectomías a 31 pacientes, y miomectomías a 21 pacientes, en tanto que a dos pacientes se les realizó resección de la masa debido a la situación intraligamentosa. El tamaño promedio de los neoplasmas fue de 6.2 cm. Se observó atipia celular severa en 25 pacientes. El número de mitosis fue de 1/10 campos de gran aumento en 30 pacientes, en contraste con el número de mitosis de 4/10 campos de gran aumento en seis pacientes. Se encontró que Ki67 fue positivo en 50 pacientes a razón de 1-5% inmunohistoquímicamente, mientras que p53 mostró tinción a razón de 10-15% de tinción en cuatro pacientes. Conclusión: La diferenciación de LA entre los leiomiosarcomas es crucial. La tasa de recurrencia después del seguimiento es de 2%. En nuestra opinión, los pacientes diagnosticados con 'LA con experiencia limitada ' antes, deben ser diagnosticados correctamente como LA. Recomendamos que Ki-67 y p53 sean usados como marcadores adyuvantes inmunohistoquímicamente en los pacientes con un diagnóstico diferencial de leiomiosarcoma.

Expanding the clinical and genetic spectra of NKX6-2-related disorder.

Hypomyelinating leukodystrophies (HLDs) affect the white matter of the central nervous system and manifest as neurological disorders. They are genetically heterogeneous. Very recently, biallelic variants in NKX6-2 have been suggested to cause a novel form of autosomal recessive HLD. Using whole-exome or whole-genome sequencing, we identified the previously reported c.196delC and c.487C>G variants in NKX6-2 in 3 and 2 unrelated index cases, respectively; the novel c.608G>A variant was identified in a sixth patient. All variants were homozygous in affected family members only. Our patients share a primary diagnosis of psychomotor delay, and they show spastic quadriparesis, nystagmus and hypotonia. Seizures and dysmorphic features (observed in 2 families each) represent an addition to the phenotype, while developmental regression (observed in 3 families) appears to be a notable and previously underestimated clinical feature. Our findings extend the clinical and mutational spectra associated with this novel form of HLD. Comparative analysis of our 10 patients and the 15 reported previously did, however, not reveal clear evidence for a genotype-phenotype correlation.

Predictors of obesity and overweight in preschoolers: The role of parenting styles and feeding practices.

Childhood obesity/overweight (OB/OW) displayed a rapid increase and high prevalence in the last few decades in preschool-aged children, which raised health concerns across the world and motivated researchers to investigate the factors that underlie childhood obesity. The current study examined parenting styles and child-feeding practices as potential predictors for OB/OW in preschool children, controlling for child's temperament, which has been shown to be linked with OB/OW. The sample included 61 normal weight (NW) and 61 obese/overweight (OB/OW) Turkish pre-schoolers (M age = 62.2 months; SD = 7.64, range = 45-80 months). Parenting styles (authoritarian, authoritative), child-feeding practices (restriction, pressure to eat, monitoring), and child's temperament (negative affectivity) were measured with mothers' reports. Results showed that authoritarian parenting and maternal pressure to eat were the two parenting variables that significantly predicted child's weight status; the odds of being OB/OW was 4.71 times higher in children whose mothers used higher authoritarian parenting style, and was 0.44 times lower when mothers pressured their child to eat. These findings suggest that understanding the unique role of different aspects of parenting in the risk of early OB/OW status of children would be important in developing more effective interventions from early years in life.

Not just a sum of its parts: How tasks of the theory of mind scale relate to executive function across time.

There is a well-established relationship between theory of mind (ToM) and executive function (EF) during the preschool years. However, less is known about the concurrent and longitudinal relations between EF and specific tasks tapping different aspects of ToM. The current study investigated the ToM-EF relationship across 1 year in 3- to 5-year-old Turkish children using the ToM battery of Wellman and Liu (2004), which measures understanding of diverse desires (DD), diverse beliefs (DB), knowledge access (KA), contents false belief (CFB), explicit false belief (EFB), and hidden emotion (HE). This battery has not yet been used in its entirety to test the predictive relations between ToM and EF. We used peg-tapping and day-night tasks to measure EF. Our sample comprised 150 Turkish preschool children (69 girls) aged 36-60 months at Time 1 (T1) and 49-73 months at Time 2 (T2). Using the ToM composite with all six tasks, when child's age, receptive language, and T1 ability level (EF or ToM) were controlled, T1 EF significantly predicted T2 ToM, whereas T1 ToM did not predict T2 EF. Among DD, DB, KA, false belief understanding (FBU: the composite score of CFB and EFB), and HE, only KA and FBU were significantly associated with EF at T1 and T2. Further regression analyses showed that KA did not have a predictive relationship with EF. Instead, FBU drove the predictive EF-ToM relationship across time. Thus, in Turkish children, earlier EF predicts later ToM, but especially the FBU component, in this well-validated battery.

Numbers of Brain Deaths and Deceased Donors in Hospitals in Istanbul Region That Have Transplantation Units: A Retrospective Analysis Between the Years 2005 and 2015.

BACKGROUND: Turkey is one of the countries facing a serious organ shortage problem, with thousands of patients with end-stage organ failure. The Social Security Institution started to increase the reimbursement for transplantation operations in 2007 to solve this problem, and this policy has continued since then. Although the number of transplantation centers and operations in Turkey increased in this term, according to organ donation and transplantation statistics from the Ministry of Health, the rate of organ retrieval from deceased organ donors has decreased. METHODS: This study was performed with the purpose of retrospectively analyzing (between the years 2005 and 2015) the number of brain deaths and donors after brain death in hospitals that are affiliated with the Istanbul Regional Coordination Office and have transplantation units. Data were collected via the website of the Ministry of Health. Hospitals were categorized as those directly affiliated with the Ministry of Health, university hospitals, and private hospitals. RESULTS: This study found that the number of transplantation centers has increased >3 times since 2005, and the number of private transplantation centers has increased 9 times for the same period. We also found that the number of brain deaths, donors after brain death in hospitals, and number of brain deaths and donors after brain death per hospital had varied throughout the study years. CONCLUSIONS: Although the number of transplantation centers has increased since 2005, the number of brain deaths and donors after brain death has not increased to the same extent for this period in these hospitals that have transplantation units.

Feelings of burden among family caregivers of people with spinal cord injury in Turkey.

STUDY DESIGN: The study was designed as a cross-sectional survey. OBJECTIVES: The purpose of the study was to examine the level of feelings of burden in family caregivers of people with spinal cord injury (SCI) in Turkey, and to explore its predictors. SETTING: Turkey. METHODS: One hundred family caregivers of people with SCI completed measures of burden of caregiving, depression, social support and physical health. The SCI participants completed a measure of functional independence. Multivariate statistics and structural equation modeling (SEM) were conducted to identify significant predictors of caregiver burden. RESULTS: Caregiver burden was significantly related to caregivers' feelings of depression. SEM analysis showed that social support from family and from friends predicted caregiver burden via depression. Caregivers' age, sex, educational level, physical health and household income did not significantly predict their feelings of depression or burden. CONCLUSIONS: Our findings revealed that support received from both families and friends is an important source for alleviating the depressive feelings of caregivers and, in return, their burden in the caregiving. In Turkey, high support from family members is expected and is important for psychological well-being, yet the current study showed that the support received from friends also has unique contribution to the well-being of the caregivers of persons with SCI. Overall, our findings highlight the importance of supportive relationships between family as well as friends for the caregivers who may have to provide lifetime care for their family member with special needs.

Social competence in children with autism.

Objectives: This paper investigates the associations of social competence with cognitive representation and communication skills in children with Autism Spectrum Disorders (ASD), by measuring these skills in an expansive way through assessing both mental and internal-state understanding, and verbal and non-verbal communication. Methods: The data were collected from 45 Turkish children (M age=8.52 years, SD=3.05, min-max=3-14) with a diagnosis of ASD. Individual assessments were used to measure mental- and internal-state understanding. Teacher-rated scales were used to assess child's verbal and non-verbal communication skills, and social competence. Results: The results showed that social competence, cognitive representation, verbal and non-verbal communication skills were all significantly associated, but over and above cognitive representation skills and verbal communication, non-verbal communication had a salient role in adaptive social relationships of children with ASD. Conclusions: These findings have important applied implications for intervention studies and suggest that improvements of non-verbal communication skills in children with ASD might be important for increasing their positive social relations.

Kidney Transplantation From Elderly Donor.

AIM: In recent years, there has been an increase in usage of grafts from advanced-age donors because of the shortage of organ availability. Acceptance of elderly living-kidney donors remains controversial due to the higher incidence of comorbidity and greater risk of postoperative complications. The objective of this study was to evaluate the graft function and patient survival using kidneys from living-related and unrelated donors who were older than 65 years of age. MATERIALS AND METHODS: From December 2008 until December 2013 we compared the outcomes of 294 patients (mean age, 47.67 ± 12.4 years; range, 16 to 74 years old) who received grafts from donors ≥ 65 years old to 2339 patients who received grafts from donors who were younger than 65 years old. RESULTS: We observed no significant differences in sex, time on dialysis, or cold ischemia time between the groups. The recipient ages between two groups were similar. For survival analysis we used the Kaplan-Meier survival estimator. Patient survival at 1, 2, and 3 years was 91.1%, 89.1%, and 88.5%, respectively, for patients transplanted with kidneys from donors ≥ 65-years-old vs 96.7%, 95.9%, and 95.0%, respectively, in the <65-year-old donor group. Multivariate analysis showed the variables associated with patient survival to be donor age at time of transplantation in years (hazard ratio [HR], 1.65; 95% confidence interval [CI], 1.59-1.71; P < .05), time on dialysis in months (HR, 1.22; 95% CI, 1.21-1.23; P = .002). Graft survival rates at 1, 2, and 3 years censored for death with functional graft at was 97.6%, 96.4%, and 94.1%, respectively, for patients transplanted with kidneys from donors older than 65 years vs 97.5%, 96.8%, and 95.2%, respectively, in the <65-year-old donor group. Multivariate analysis, HLA-DR mismatches (HR, 1.23; 95% CI, 1.12-1.55; P = .050), delayed graft function (HR, 1.77; 95% CI, 1.53-2.07; P = .021), and perhaps acute rejection (HR 1.14; 95% CI, 0.82-1.95; P = .093) were the variables associated with graft survival. CONCLUSION: We concluded that the use of kidneys from donors older than 65 years of age allows us to increase the rate of renal transplantation to approximately 15 to 20 per million population, with good graft and patient survivals provided that the protocol for expanded criteria organs ensured proper macroscopic and microscopic evaluation of the organ for transplantation.

Donors With Hepatitis B Surface Antigen Positivity.

OBJECTIVE: There is a still controversy among transplantation centers regarding acceptance of hepatitis B surface antigen (HBsAg)-positive donors for renal transplantation. However, some reports show that these donors can be used under a special protocol. In this study, we compared the clinical and biochemical parameters of patients who received kidneys from HBsAg-positive (group 1) versus other living-related kidney donors (group 2). MATERIALS AND METHODS: We retrospectively analyzed the outcomes of 2168 living-related renal transplantations performed between December 2008 and April 2014 at Medical Park Hospital Transplantation Center, Antalya, Turkey. One hundred eleven donors were HbsAg-positive (group 1), and 2057 donors were HbsAg-negative (group 2). Group 1 kidney transplantations were undertaken only if the recipient displayed a hepatitis B antibody titer >10 mIU/mL and donor hepatitis B virus DNA was negative. RESULTS: Demographic characteristics; 1-, 2- and 4-year serum creatinine levels; glomerular filtration rates; and liver function test results were similar between the two groups. There were no new hepatitis B virus infections throughout the study period. Acute rejection rates (26/111 in group 1 vs 375/2168 in group 2; P = .887), graft loss (4/111 in group 1 vs 123/2168 in group 2; P = .546), and patient loss (6/111 in group 1 vs 102/2168; P = .132) were similar between the two groups. CONCLUSION: Our study showed that hepatitis B surface antigen positivity was not a contraindication to living-kidney donation.

Simultaneous Cardiac Surgery and Renal Transplantation Compared With Renal Transplantation After Cardiac Surgery.

Patients with end-stage renal disease (ESRD) have a high prevalence of coronary artery disease and cardiovascular death. The mortality and the morbidity rates of cardiac surgery are particularly high in these patients with end-stage renal disease. Performing cardiac surgery and kidney transplantation in the same session can reduce these complications in the early postoperative period by normalizing renal function. We compared the mortality and morbidity rates between patients who had undergone cardiac surgery and kidney transplantation separately and patients who had combined surgeries. This retrospective study consisted of 75 patients. One group of 60 patients underwent cardiac surgery and kidney transplantation in separate sessions, and the other group of 15 patients had combined surgeries in the same session, between March 2008 and September 2012. Patients who had combined surgeries achieved fluid electrolytic balance more easily, had shorter extubation times, used less blood and blood products, and had fewer major complications. The patients recovered faster and thus had shorter stays in the intensive care unit and hospital. This combined surgical approach allows normalized kidney function in patients with end-stage renal disease, so mortality and morbidity in the early postoperative period could be significantly reduced.

Renal Transplantation in Recipients Older Than 65 Years: Retrospective Analysis of the Results of a 4-year (2008-2012) Experience.

BACKGROUND: We analyze the results of renal transplantation among recipients older than 65 years old over a 4-year period (2008-2012) from a single renal transplantation unit and compare results with younger recipients. METHODS: We retrospectively analyzed the outcomes of 2018 renal transplantations performed between November 2008 and December 2012. The χ(2) test was used for the comparison of categorical data, and the Student t test was used for the analysis of continuous variables. Patient and graft cumulative actuarial survivals were calculated using the Kaplan-Meier analysis and we tested for differences with the Mantel-Cox log-rank test. RESULTS: Seventy-five (3.7%) recipients were aged ≥ 65 years with a median age of 68 (range, 65 to 82) years. Actuarial graft survivals at 1, 2, and 3 years were 93.8%, 92.5%, and 90.3%, respectively, for the <65 group and 89.7%, 88.1%, and 83.1%, respectively, for the ≥ 65 group (P < .03). Actuarial patient survivals at 1, 2, and 3 years were 96.3%, 95.5%, and 94.7%, respectively, for the younger and 91.8%, 90.2%, and 88%, respectively, for the older samples (P < .03). When graft survival was censored for patient death with a functioning kidney at 1, 2, and 3 years, the results were similar between groups with 95.5%, 94%, and 92.8%, respectively, for recipients aged <65 years and 94.7%, 89.2%, and 89.2%, respectively, for recipients aged ≥ 65 years (P = .213). CONCLUSIONS: Our results showed that renal transplantation in selected patients older than 65 years was associated with good outcomes; this indicates that it seems safe and effective to treat end-stage renal disease in the elderly knowing there are acceptable rates of graft and patient survival.

Middle Hepatic Vein Tributary Reconstruction of a Right Hepatic Graft in Adult Living Donor Liver Transplantation: A Case Report.

In adult living donor (right liver) lobe transplantations (LDLT), the removal of the middle hepatic vein (MHV) with the graft and reconstruction carried out in the donor are of great importance. Here a 44-year-old male patient with hepatitis B-related end-stage liver failure is reported of whom his 34-year-old brother was evaluated as a donor candidate. At routine preoperative screening tests, neither the patient nor the donor candidate was found to have any pathological findings that might interfere with the transplantation. The donor candidate was assessed using multislice computed tomography for a standard liver volume measurement and anatomical structure evaluation and extended right hepatectomy including MHV was planned. MHV of the donor removed together with the graft was reconstructed to the common orifice of MHV-left hepatic vein using a cryopreserved aortic graft. In conclusion, if the MHV is removed with the graft in adult LDLT, appropriate reconstruction in the donor is also an important issue. Reconstruction carried out without creating tension and folding in the right hepatic vein is crucial for avoiding congestion and of great importance for the prevention of graft dysfunction.