Raymond J. Lynch

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BACKGROUND Surgeons frequently struggle to determine patient suitability for liver transplantation. Objective and comprehensive measures of overall burden of disease, such as sarcopenia, could inform clinicians and help avoid futile transplantations. STUDY DESIGN The cross-sectional area of the psoas muscle was measured on CT scans of 163 liver transplant(More)
OBJECTIVE We sought to understand whether obesity imparts detriment in outcome beyond risk of developing surgical site infection (SSI). SUMMARY BACKGROUND DATA Obesity is a risk factor for SSI following renal transplantation, and has been implicated in inferior patient and graft survival postoperatively. METHODS We conducted a retrospective review of(More)
OBJECTIVE Most studies on variant forms of aortic dissection--penetrating ulcer and intramural hematoma--have focused on the initial presenting episode, with scant follow-up. This investigation provides midterm follow-up of penetrating ulcer and intramural hematoma to determine whether the aorta shows healing according to radiography, goes on to dilate, or(More)
Surgical site infections cause significant morbidity and mortality in the postoperative period. Opening of the operating room door disrupts its filtered atmosphere, increasing contamination above the wound. We conducted a study of traffic in the operating room as a risk for infections. This is an observational study of recorded behaviors in the operating(More)
BACKGROUND Complications after liver transplantation are common and expensive. The incremental costs of adult posttransplantation liver transplantation complications and who pays for these complications (center or payor) is unknown. STUDY DESIGN We reviewed the medical and financial records (first 90 postoperative days) of all adult liver transplant(More)
The effects of occlusive portal vein thrombosis (PVT) on the survival of patients with cirrhosis are unknown. This was a retrospective cohort study at a single center. The main exposure variable was the presence of occlusive PVT. The primary outcome measure was time-dependent mortality. A total of 3295 patients were analyzed, and 148 (4.5%) had PVT.(More)
Over the past several years we have noted a marked decrease in this profitability of our kidney transplant program. Our hypothesis is that this reduction in kidney transplant institutional profitability is related to aggressive donor and recipient practices. The study population included all adults with Medicare insurance who received a kidney transplant at(More)
OBJECTIVE To determine whether controlling for differences in the use of invasive therapy affects racial/ethnic differences in survival of early-stage hepatocellular carcinoma (HCC). DESIGN A retrospective cohort study using Surveillance, Epidemiology, and End Results (SEER) HCC data. Invasive therapy was defined as tumor ablation, hepatectomy, or liver(More)
PURPOSE OF REVIEW We review recent insights into the mechanisms and prevalence of accommodation. Accommodation refers to an acquired resistance of an organ graft to humoral injury and rejection. RECENT FINDINGS Accommodation has been postulated to reflect changes in antibodies, control of complement and/or acquired resistance to injury by antibodies,(More)
Four cases of patients in whom graft vs. host disease developed after liver transplantation are described. The clinical course of each patient was similar with fever, pancytopenia, diarrhea and a skin rash developing 1 or 2 mo after liver transplantation. The clinical diagnosis was made from skin or colon biopsy specimens. Liver dysfunction did not occur in(More)