Split liver transplant recipients do not have an increased frequency of acute kidney injury.

Small series have suggested that split liver transplantation (SLT) has an increased frequency of peri-operative acute kidney injury (AKI). However, the optimal donor selection in this setting could have a favourable impact on renal outcomes. This was a retrospective single-centre study of 76 adults who underwent SLT (right extended lobe) and 301 adults who underwent elective full-size donation after brain death liver transplantation (FSLT). SLT recipients were less likely than unmatched FSLT recipients to develop AKI (≥stage 1 KDIGO criteria) (40.3% vs. 56.1%, P = 0.016) and had a reduced frequency of renal replacement therapy (11.8% vs. 21.9%, P = 0.049). In 72 pairs of SLT patients and propensity risk score-matched FSLT controls the incidence of AKI was not significantly different (40.3% vs. 47.2%, P = 0.473). However, SLT patients were less likely to require renal replacement therapy (11.1% vs. 23.6%, P = 0.078; adjusted OR 0.32; 95% CI 0.11-0.87, P = 0.026). There was no association between SLT and the development of chronic kidney disease (eGFR<60 ml/min/1.73 m(2) , log rank P = 0.534). In conclusion, SLT is not associated with an increased frequency of AKI. These observations support the postulation that the optimal donor status of SLT may result in less graft injury with renal sparing effects.

Hepatic ischemia reperfusion injury is associated with acute kidney injury following donation after brain death liver transplantation.

Donation after cardiac death liver transplant recipients have an increased frequency of acute kidney injury (AKI). This suggests that hepatic ischemia-reperfusion injury may play a critical role in the pathogenesis of AKI after liver transplantation. The aim of this single-center study was to determine if hepatic ischemia-reperfusion injury, estimated by peak peri-operative serum amino-transferase (AST), is associated with AKI following donation after brain death (DBD) liver transplantation. A total of 296 patients received 298 DBD liver transplants from January 2007 to June 2011. The incidence of AKI was 35.9%. AKI was a risk factor for chronic kidney disease (P = 0.037) and mortality (P = 0.002). On univariate analysis, peak AST correlated with peak creatinine (P < 0.001) and peak change in creatinine from baseline (P < 0.001). Peak AST was higher in AKI patients (P < 0.001). The incidence of AKI in patients with a peak AST of <1500, 1500-2999 and ≥ 3000 U/l was 26.1%, 39.8% and 71.2%, respectively (P < 0.001). On multiple logistic regression analysis, peak AST was independently associated with the development of AKI (P < 0.001). In conclusion, hepatic ischemia-reperfusion injury demonstrates a strong relationship with peri-operative AKI in DBD liver transplant recipients.

Data on highway maintenance, rehabilitation, and mobility projects for integrated planning in Texas.

State Highway Agencies (SHAs) have different functional groups that work towards improving the functional and physical performance of highway assets. These functional groups often propose multiple inter-related highway projects on the same network. However, the respective information systems of such functional groups lack interoperability capabilities between them. This data article is related to an earlier study by France-Mensah et al. (France-Mensah et al., 2017) that explored the integrated visualization of highway projects proposed by different functional groups working in the same highway agency. This dataset provides a spatially integrated set of maintenance and capital planning projects which is rarely available due to organizational silos which often exist in highway agencies. The data includes approximately 700 highway projects with over 16 attributes that includes spatial, temporal, cost, and description attributes. The highway projects are located in the Fort Worth District of the Texas Department of Transportation (TxDOT) which is responsible for a large network (approximately 9000 lane miles) of highway assets. The agency currently oversees around $4 billion in construction projects and spends around $120 million annually for asset preservation. An analysis of the fund allocations categorized by different project types for pavement and bridge assets is presented. The data presented can be used to compare competing approaches or policies for cross-asset allocation, spatial-temporal projects coordination, and safety planning in the infrastructure management domain.

Integrating social equity in highway maintenance and rehabilitation programming: A quantitative approach.

With limited funds and an aging highway infrastructure network, agency decision-makers are tasked with making the most cost-effective decisions while accounting for the environment and social equity. Several studies have accounted for the economic and environmental considerations in infrastructure management decisions. However, there have been limited studies which have proposed quantitative approaches for integrating social equity as part of the highway Maintenance and Rehabilitation (M&R) decision-making process. To address this gap in the literature, this paper proposes four optimization models (corresponding to policies) for achieving social equity in highway M&R programming. The underlying rationales behind these models include combinations of egalitarian, utilitarian, socialism, and Rawlsian equity theories. The developed models were then implemented in a numerical case study consisting of a network of 500 pavement sections. The case study results were evaluated using average condition scores and adaptations of the Gini Coefficient and the Theil Index. An inter-policy analysis suggests that for a similar performance in network condition, different policies yield varying inequity levels over time. Furthermore, step changes in the budget size also suggest that a higher budget size generally leads to a reduction in inequity although some policies perform better than others.