The use of livers from donation after circulatory death (DCD) is increasing, but concerns exist regarding outcomes following use of grafts from "marginal" donors. To compare outcomes in transplants using DCD and donation after brain death (DBD), propensity score matching was performed for 973 patients with chronic liver disease and/or malignancy who underwent primary whole-liver transplant between 2004 and 2014 at University Hospitals Birmingham NHS Foundation Trust. Primary end points were overall graft and patient survival. Secondary end points included postoperative, biliary and vascular complications. Over 10 years, 234 transplants were carried out using DCD grafts. Of the 187 matched DCDs, 82.9% were classified as marginal per British Transplantation Society guidelines. Kaplan-Meier analysis of graft and patient survival found no significant differences for either outcome between the paired DCD and DBD patients (p = 0.162 and p = 0.519, respectively). Aspartate aminotransferase was significantly higher in DCD recipients until 48 h after transplant (p < 0.001). The incidences of acute kidney injury and ischemic cholangiopathy were greater in DCD recipients (32.6% vs. 15% [p < 0.001] and 9.1% vs. 1.1% [p < 0.001], respectively). With appropriate recipient selection, the use of DCDs, including those deemed marginal, can be safe and can produce outcomes comparable to those seen using DBD grafts in similar recipients.

Trainee research collaboratives (TRCs) have been revolutionary changes to the delivery of high-quality, multicentre research. The aim of this study was to define common roles in the conduct of collaborative research, and map these to academic competencies as set out by General Medical Council (GMC) in the United Kingdom. This will support trainers and assessors when judging academic achievements of those involved in TRC projects, and supports trainees by providing guidance on how to fulfil their role in these studies. A modified Delphi process was followed. Electronic discussion with key stakeholders was undertaken to identify and describe common roles. These were refined and mapped to GMC educational domains and International Committee of Medical Journal Editors authorship (ICJME) guidelines. The resulting roles and descriptions were presented to a face-to-face consensus meeting for voting. The agreed roles were then presented back to the electronic discussion group for approval. Electronic discussion generated six common roles. All of these were agreed in face-to-face meetings, where two further roles identified and described. All eight roles required skills that map to part of the academic requirements for surgical training in the UK. This paper presents a standardised framework for reporting authorship in collaborative group authored research publications. Linkage of collaborator roles to the ICMJE guidelines and GMC academic competency guidelines will facilitate incorporation into relevant training curricular and journal publication policies.

Arterial blood gas (ABG) machines are vital tools in the assessment of critically ill patients. Current ABG point-of-care (POC) analysers provide information on concentrations of haemoglobin, glucose and electrolytes in addition to acid-base balance. Awaiting results from venous analysers may present a significant delay in diagnosis and management, thus reliance on arterial blood gas determination of these parameters is increasing. However, published data on the concordance between the two modalities are limited. This study aims to assess the concordance of ABG machines in analysing haemoglobin, glucose and electrolyte concentrations compared to standard venous analysers as the gold standard. Results from 100 patients undergoing ABG analysis and simultaneous venous sampling without therapeutic intervention between sampling were compared. Differences in haemoglobin, glucose, sodium and potassium concentrations were determined and analysed using statistical software (Statview). There was a significant difference (P<0.02, paired signed test) in the mean haemoglobin concentration between the two modalities of 0.91 g/dL (range: 0–4.3 g/dL). Mean discrepancy in glucose concentrations was 1.16 mmol/L (range: 0-10.5 mmol/L; P5 mmol/L), ABG readings varied significantly (P5 mmol/L) obtained from such machines should be interpreted with caution and confirmed using standard venous samples.