A5008501127- Liver Disease and Transplantation
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Organ Transplantation Techniques and Outcomes
- Blood transfusion and management
- Blood donation and transfusion practices
- Acute Kidney Injury Research
- Research in Social Sciences
- Liver Disease Diagnosis and Treatment
- Renal Transplantation Outcomes and Treatments
- Cardiac and Coronary Surgery Techniques
- Blood Coagulation and Thrombosis Mechanisms
- Blood groups and transfusion
- Cardiac, Anesthesia and Surgical Outcomes
- Blood properties and coagulation
- Drug-Induced Hepatotoxicity and Protection
- Hemoglobinopathies and Related Disorders
- Health, Medicine and Society
- Genetic Syndromes and Imprinting
- Iron Metabolism and Disorders
- Extracellular vesicles in disease
- Mass Spectrometry Techniques and Applications
- Transplantation: Methods and Outcomes
- Romani and Gypsy Studies
- Atrial Fibrillation Management and Outcomes
- Neurological Complications and Syndromes
Helsinki University Hospital
2008-2025
University of Helsinki
2009-2025
Finnish Red Cross
2023-2025
Hospital District of Helsinki and Uusimaa
2013
Mary och Georg C. Ehrnrooths Stiftelse
2006
Scripps Research Institute
2004-2006
Jorvi Hospital
2006
Ella and Georg Ehrnrooth Foundation
2006
Abstract Background In patients with cirrhosis, the synthesis of coagulation factors can fall short, reflected by a prolonged prothrombin time. Although anticoagulants are decreased as well, blood loss during orthotopic liver transplantation still be excessive. Blood is currently managed transfusion red cell concentrates, platelet fresh frozen plasma, and fibrinogen concentrate. Transfusion these products may paradoxically result in an increased bleeding tendency due to aggravated portal...
High mobility group box 1 protein (HMGB1), a cytokine actively secreted by phagocytes and passively released from necrotic cells, is an inflammatory mediator in experimental hepatic ischemia/reperfusion injury. We characterized its expression human liver transplantation. In 20 patients, addition to systemic samples, blood was drawn portal veins during after reperfusion assess changes within the graft. Plasma HMGB1, tumor necrosis factor α (TNF-α), interleukin-6 (IL-6) levels were measured,...
Abstract Background Enhanced recovery protocols (ERPs) accelerate patient and shorten hospital stay by optimization of perioperative care. However, experience with ERPs is still limited in liver surgery. Methods The implementation a multimodal ERP was studied patients who underwent open laparoscopic An opioid-sparing pain treatment chosen together early mobilization oral feeding, as well restricted use abdominal drains catheters. Date to discharge, postoperative complications satisfaction...
Abstract Background Prehospital low‐titer group O whole blood (LTOWB) used for patients with life‐threatening hemorrhage is often RhD positive. The most important complication following alloimmunization hemolytic disease of the fetus and newborn (HDFN). Preceding clinical use positive LTOWB, we estimated risk HDFN due to LTOWB prehospital transfusion in Finnish population. Study Design Methods We collected data on transfusions Tampere Helsinki University Hospital areas. Using mean reported...
Abstract Background Extracellular vesicles (EVs) have procoagulative properties. As EVs are known to accumulate in stored blood products, we compared the EV content and coagulation capacity of leukoreduced cold‐stored whole (CSWB) with current prehospital in‐hospital component therapies understand role haemostatic ageing CSWB. Materials Methods Blood was obtained from 12 O RhD‐positive male donors. CSWB therapy red cells (RBCs), OctaplasLG buffy‐coat platelets RBC lyophilized plasma. Samples...
Abstract Background Non‐refrigerated whole blood can be used for bleeding emergencies when cold‐stored is unavailable. Storage time in room temperature usually limited to 24 h although there little evidence supporting this practice. We studied the quality of stored 5 days investigate effects prolonged storage time. Study Design and Methods Non‐leukoreduced CPDA‐1 from 10 group O or A RhD positive male donors was +22°C 120 h. Samples were taken daily assess cultures, count metabolic...
To study the association between bleeding and acute kidney injury (AKI). Post-hoc of a randomized trial 4% albumin versus Ringer's acetate for cardiopulmonary bypass priming perioperative volume replacement. Single-center study. 1,386 on-pump cardiac surgical patients. AKI was defined by Kidney Disease: Improving Global Outcomes creatinine criteria, Universal Definition Perioperative Bleeding (UDPB) classification. With univariably independent factors, two logistic regression analyses (Model...
Abstract Background and Objectives Efficient blood supply chain requires accurate demand estimates. Blood is created by clinicians making transfusion decisions based on patient status. To better understand the use of units, we tracked their hourly across a large hospital organization. Materials Methods We analysed in adult patients over 2021–2022 at HUS Helsinki University Hospital, serving population 1.7 million consuming third units used Finland. utilized electronic health records (EHR) to...
Objective Ischaemia/reperfusion-injury degrades endothelial glycocalyx. Graft glycocalyx degradation was studied in human liver transplantation. Methods To assess changes within the graft, blood drawn from portal and hepatic veins addition to systemic samples 10 patients. Plasma syndecan-1, heparan sulfate chondroitin sulfate, were measured with enzyme-linked immunosorbent assay. Results During reperfusion, syndecan-1 levels higher graft caval effluent [3118 (934–6141) ng/ml, P = 0.005] than...
Cold-stored whole blood (CSWB) is increasingly used in damage control resuscitation. Haemostatic function of CSWB seems superior to that reconstituted blood, and it sufficiently preserved for 14-21 days. To provide evidence a yet insufficiently studied aspect prehospital use, we compared vitro haemostatic properties currently in-hospital component therapies.Blood was obtained from 24 O RhD positive male donors. Three products were prepared: CSWB, therapy (red cells [RBCs], OctaplasLG...
In experimental models, brain death induces inflammatory cascades, leading to reduced graft survival. Thus far, factors prior preservation have gained less attention in clinical setting. We studied pre-preservation response and its effects on function 30 dead liver donors the respective recipients. Before donor perfusion, portal hepatic venous blood samples were drawn for phagocyte adhesion molecule expression plasma cytokine determinations. Donor intensive care unit stay correlated with...
Activated protein C (APC) exhibits anticoagulant and antiinflammatory properties. We studied the kinetics magnitude of activation in clinical liver transplantation interaction this with neutrophil monocyte activation.In 10 patients undergoing transplantation, we measured plasma APC levels, CD11b L-selectin expression, leukocyte differential counts pre-, intra-, postoperatively. Samples blood entering leaving were obtained simultaneously to assess changes across liver.Protein level was low...
Plasma proteome is widely used in studying changes occurring human body during disease or other disturbances. Immunological methods are commonly such studies. In recent years, mass spectrometry has gained popularity high-throughput analysis of plasma proteins. this study, we tested whether and iTRAQ-based protein quantification might be proteomic liver transplantation surgery to characterize abundances early graft reperfusion. We sampled blood from systemic circulation as well entering...
Abstract Background In experimental liver transplantation, endogenous protease inhibitors alleviate ischemia–reperfusion (I/R) injury by inhibiting proteolysis and direct anti‐inflammatory actions. We described the kinetics of explored their potential during reperfusion effects on graft function in human transplantation. Methods measured circulating levels (secretory leukocyte proteinase inhibitor, SLPI; tissue inhibitor metalloproteinases‐1, TIMP‐1) proteolytic enzymes (elastase; matrix...
To explore the potential anti-inflammatory role of protein C pathway in ischemia-reperfusion injury during liver transplantation.Prospective, observational clinical study.Tertiary teaching hospital.Fifty adult patients undergoing transplantation for acute failure or chronic disease.To assess changes occurring across transplanted liver, samples blood entering and leaving graft were obtained simultaneously from portal hepatic veins. Plasma activated levels, neutrophil monocyte CD11b L-selectin...
Despite declining transfusion rates, overuse of O RhD-negative red blood cells (RBCs) risks the secure supply this limited resource. A nationwide prospective audit was performed in Finland to understand clinical use and inventory management units. Our aim identify areas where policy changes could help alleviate shortage RBCs.The every unit during a period 1 month reviewed. For each issued (n = 1105), age, urgency transfusion, hospital patient demographics, specific reasons for issuing units...
Acute Kidney Injury (AKI) is a common clinical complication. Plasma/serum neutrophil gelatinase-associated lipocalin (NGAL) has been proposed as rapid marker of AKI. However, NGAL not kidney-specific. It exists in three isoforms (monomeric, homo-dimeric and hetero-dimeric). Only the monomeric isoform produced by renal tubular cells plasma levels are confounded release all from neutrophils. Our aim was to investigate whether released into blood injured tubules.Kidney transplantation (n = 28)...
Abstract Background Whole blood (WB) collections can occur downrange for immediate administration. An important aspect of these is determining when the unit sufficiently full. This project tested a novel method field collection complete. Methods The amount empty space at top WB units, destined to become LTOWB or separated into components, that were collected centers hospitals was measured by holding off ground and placing piece string where donor tubing entered bag. marked it intersected...
ABSTRACT BACKGROUND AND OBJECTIVES Efficient blood supply chain requires accurate demand estimates. Blood is created by clinicians making transfusion decisions based on patient status. To better understand the use of units, we tracked their hourly and across a large hospital organization. MATERIALS METHODS We analyzed in adult patients over 2021-2022 at HUS Helsinki University Hospital, serving population 1.7 million consuming third units used Finland. utilized electronic health records...