1.Recent innovations in renal replacement technology and potential applications to transplantation and dialysis patients: a review of current methods
Calista L DOMINY ; Ethan B. SHAMSIAN ; Kennedy E. OKHAWERE ; Talia G. KORN ; Kirolos MEILIKA ; Ketan BADANI
Kidney Research and Clinical Practice 2023;42(1):53-62
The current standard of care for patients with end-stage renal disease (ERSD) is a kidney transplant or dialysis when a donor organ isnot available. The growing gap between patients who require a kidney transplant and the availability of donor organs as well as thenegative effects of long-term dialysis, such as infection, limited mobility, and risk of cancer development, drive the impetus to developalternative renal replacement technology. The goal of this review is to assess the potential of two of the most recent innovations inkidney transplant technology—the implantable bioartificial kidney (BAK) and kidney regeneration technology—in addressing the aforementionedproblems related to kidney replacement for patients with ERSD. Both innovations are fully implantable, autologous, personalizedwith patient cells, and can replace all aspects of kidney function. Not only do these new innovations have the potential toimprove the possibility of transplantation for more patients, they also have potential to improve the outcome of transplantation or dialysis-related renal cancer diagnosis. A major limitation of the current technology is that both implantable BAK and kidney regenerationtechnology are still in preclinical stages, and thus their potential effects cannot be comprehensively generalized to human patients.
2.Trends in the Charges and Utilization of Computer-Assisted Navigation in Cervical and Thoracolumbar Spinal Surgery
Calista L. DOMINY ; Justin E. TANG ; Varun ARVIND ; Brian H. CHO ; Stephen SELVERIAN ; Kush C. SHAH ; Jun S. KIM ; Samuel K. CHO
Asian Spine Journal 2022;16(5):625-633
Methods:
Relevant data from the National Readmission Database in 2015–2018 were analyzed, and the computer-assisted procedures of cervical and thoracolumbar spinal surgery were identified using International Classification of Diseases 9th and 10th revision codes. Patient demographics, surgical data, readmissions, and total charges were examined. Comorbidity burden was calculated using the Charlson and Elixhauser comorbidity index. Complication rates were determined on the basis of diagnosis codes.
Results:
A total of 48,116 cervical cases and 27,093 thoracolumbar cases were identified using computer-assisted navigation. No major differences in sex, age, or comorbidities over time were found. The utilization of computer-assisted navigation for cervical and thoracolumbar spinal fusion cases increased from 2015 to 2018 and normalized to their respective years’ total cases (Pearson correlation coefficient=0.756, p =0.049; Pearson correlation coefficient=0.9895, p =0.010). Total charges for cervical and thoracolumbar cases increased over time (Pearson correlation coefficient=0.758, p =0.242; Pearson correlation coefficient=0.766, p =0.234).
Conclusions
The use of computer-assisted navigation in spinal surgery increased significantly from 2015 to 2018. The average cost grossly increased from 2015 to 2018, and it was higher than the average cost of nonnavigated spinal surgery. With the increased utilization and standardization of computer-assisted navigation in spinal surgeries, the cost of care of more patients might potentially increase. As a result, further studies should be conducted to determine whether the use of computer-assisted navigation is efficient in terms of cost and improvement of care.