Browsing by Author "Mall, AS"

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    Open Access
    Hypoalbuminaemia in brain-dead donors for liver transplantation
    (Health and Medical Publishing Group, 2005) Ibirogba, SB; Spearman, W; Mall, AS; Shephard, EG; Kahn, D
    Liver transplantation has become established as the treatment of choice for most patients with end-stage liver disease and is performed on a routine basis in most major centres throughout the world. The majority of donors for liver transplantation are brain-dead cadaver donors following either a severe head injury or a massive intracranial haemorrhage. Potential liver donors undergo a rigid screening process before being accepted. This includes a thorough clinical examination to assess the haemodynamic status of the donor and to exclude any overt evidence of liver disease. Blood samples are also taken for viral studies to exclude HIV infection and hepatitis B and C infection, and for liver function tests to exclude liver disease or liver injury. Over the years we have noted that our liver donors often had low serum albumin levels, although this has not been formally documented. A review of the literature revealed that hypoalbuminaemia associated with severe head injury has been documented previously. However the impact of brain death on serum albumin levels has not been studied previously. The present study was therefore undertaken to document serum albumin levels in brain-dead cadaver donors.
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    Risk of blood splashes to the eye during surgery
    (2009) de, Silva R; Kahn, D; Mall, AS; Panieri, E; Stupart, D J
    Background. With the advent of a new infectious era involving the HIV and hepatitis B and C viruses, concern has arisen about transmission of these viruses through ocular blood splashes during surgery. The purpose of the study was to determine the risk of ocular blood splashes to surgeons and their assistants during surgery. Method. Surgeons and assistants in several surgical disciplines were requested to wear facemasks with a transparent plastic visor. The visors were collected postoperatively and inspected for macroscopic and microscopic blood splashes. Results. Fifty-nine per cent of the surgeons and assistants refused to wear facemasks with a visor. The incidence of blood splashes in those who participated was 45%. There was a trend for blood splashes to be more common during major surgery and during elective surgery. Surgeons and assistants were subject to similar risk. Conclusion. This study confirms the significant risk of ocular blood splashes during surgery, while also suggesting that both surgeons and assistants lack appreciation of the risk.