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The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

Mi, Z and Novitzky, D and Collins, JF and Cooper, DK (2014) The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors. Clinical Epidemiology, 7. 17 - 27.

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Abstract

The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy) is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA), are statistically conservative. Hsu’s multiple comparisons with the best (MCB)-adapted from the Dunnett’s multiple comparisons with control (MCC)-has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM) or generalized linear mixed models (GLMM), and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS), among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mi, Z
Novitzky, D
Collins, JF
Cooper, DKcooperdk@pitt.eduCOOPERDK
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 22 December 2014
Date Type: Publication
Journal or Publication Title: Clinical Epidemiology
Volume: 7
Page Range: 17 - 27
DOI or Unique Handle: 10.2147/clep.s71403
Refereed: Yes
Date Deposited: 09 Apr 2015 20:27
Last Modified: 30 Mar 2021 14:55
URI: http://d-scholarship.pitt.edu/id/eprint/24691

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