Cases Of Severe Injury Research Articles

Urinary α 1-microglobulin and β 2-microglobulin as markers of early kidney injury in HIV-positive male patients on tenofovir-based antiretroviral therapy.

A retrospective study was conducted to explore the urinary expression of α 1-microglobulin (α1MG) and β2-microglobulin (β2MG) in patients with human immunodeficiency virus (HIV) infection, aiming to evaluate their predictive capability for renal injury. One hundred and five male HIV-infected patients treated with Tenofovir (TDF) regimen (TDF+3TC or the third drug TDF/FTC+) were selected between March 1, 2021, and March 1, 2022, in Wuhan Jinyintan Hospital. Three months after TDF treatment, the renal function injury was evaluated with the standard creatinine clearance rate. The urinary levels of α1MG and β2MG were compared between the initiation of TDF treatment and three months thereafter. Spearman correlation was utilized to analyze the correlation between the urinary expression of α1MG and β2MG and renal injury in HIV patients. The logistic regression was used to analyze the predictive value of urinary α1MG and β 2-microglobulin expression in renal injury. Up to the first follow-up, 29 (27.6%) cases of the 105 male HIV patients had varying degrees of renal function injury, including 14 (13.3%) mild injury, 9 (8.6%) moderate injury, and 6 (5.7%) severe injury cases. Patients with severe renal injury had the highest levels of urinary α1MG and β2MG expression while those with mild injury demonstrated higher levels compared to the non-injury group (P < 0.05). Spearman correlation analysis indicated that urinary α1MG and β2MG were positively correlated with renal impairment in HIV patients (Rho = -0.568, and -0.732; P < 0.001). The ROC curve analysis demonstrated that the area under the curve (AUC) for urine α1MG and β2MG in predicting kidney damage among HIV patients were 0.928, 0.916, and 0.889, respectively. The sensitivity values were 96.55%, 82.76%, and 89.66% while the specificity values were 84.07%, 94.51%, and 89.29% for urine α1MG and β2MG, respectively. The expression level of urinary α1MG and β2MG in HIV patients was significantly higher compared to normal people. Detection of these two indexes can enable early determination of renal injury and its severity in HIV patients.

Comprehensive Assessment of Mid-Regional Proadrenomedullin, Procalcitonin, Neuron-Specific Enolase and Protein S100 for Predicting Pediatric Severe Trauma Outcomes.

The development of multiple organ failure and septic complications increases the cumulative risk of mortality in children with severe injury. Clinically available biochemical markers have shown promise in assessing the severity and predicting the development of complications and outcomes in such cases. This study aimed to determine informative criteria for assessing the severity and outcome prediction of severe injury in children based on levels of mid-regional proadrenomedullin (MR-proADM) procalcitonin (PCT), neuron-specific enolase (NSE), and protein S100. Biomarker levels were measured in 52 children with severe injury (ISS ≥ 16) on the 1st, 3rd, 7th, and 14th days after admission to the ICU. The children were divided into groups based on their favorable (n = 44) or unfavorable (n = 8) outcomes according to the Severe Injury Outcome Scale, as well as their favorable (n = 35) or unfavorable (n = 15) outcomes according to the Glasgow Coma Outcome Scale (GOS). The study also evaluated the significance of biomarker levels in predicting septic complications (with SC (n = 16) and without SC (n = 36)) and diagnosing and stratifying multiple organ failure (with MOF (n = 8) and without MOF (n = 44)). A comprehensive assessment of MR-proADM and PCT provided the highest diagnostic and prognostic efficacy for early diagnosis, risk stratification of multiple organ failure, and outcome prediction in severe injury cases involving children. Additionally, the inclusion of the S100 protein in the study allowed for further assessment of brain damage in cases of traumatic brain injury (TBI), contributing to the overall prognostic model.

К вопросу о суицидальном поведении подростков - реалии скоропомощного стационара

&lt;p style="text-align: justify;"&gt;The issue of suicidal behavior in adolescents is one of the most disturbing and complex. The present work is aimed to draw attention to the problem of suicidal behavior in adolescents in modern Russian reality. While analyzing cases of severe injuries due to suicidal behavior in adolescents who were admitted to the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma (CRIEPST) in Moscow (Russia) , the authors stated their significant increase in recent years . In 2016-2023, 58 children after suicidal attempts were hospitalized to CRIEPST. All children were teenagers (11-17 years old). The authors not only noted an increased risk of suicide in 14-16 age group of teenagers, but they also noted gender features in this group. Two groups of suicide causation were defined as well: psychopathological processes and affective, impulsive reactions. After summarizing findings obtained in CRIEPST , the researchers have stated an increase in the number of psychopathological predispositions in children in the recent years. An increased number of cases with suicidal behavior in adolescents and predominance of psychopathological processes as risk factors should make adults be more attentive to tendencies in suicide causation and their prevention. The data presented in the article are preliminary and incomplete, as they do not cover cases that did not lead to severe somatic consequences.&lt;/p&gt;

Comparison of pathological findings in head computed to-mography with clinical presentation of pediatric patients in the Emergency Department

Pediatric trauma is a cause for over 750.000 visits to emergency departments each year. Of all types of traumas, head injuries represent the group at most risk. Computed tomography (CT) is still the most frequently used advanced imaging method to distinguish cases of severe injuries out of thousands of mild or apparently trivial injuries. The aim of this study was to review the results of CT in terms of clinical prediagnosis and radiological findings in children categorized into four age groups, who underwent a CT scan in the Pediatric Emergency Department (ED). Among all CT studies, no findings were found in 552 (80.23%) patients, whereas CT findings were detected in 98 (14.2%) boys and 38 (5.5%) girls from all participants. The incidence of lesions in the male group is 2 times higher than in the female group. The most common abnormality was hematoma representing 26.47% of all confirmed lesions and 5.23% among all head CTs performed from the ED. Head CT is an incredibly useful tool in the evaluation of some head emergencies. However, in the majority of cases, the clinical presentation with which children present to the ED does not correlate with the severity of neuroimaging results.

The role of tourism in road traffic accidents: the case of Greece

ABSTRACT The increase in the number of tourists visiting many destinations in Greece could lead to spillover effects on the safety of tourists with road traffic accidents being the major contributor to the morbidity and mortality of travellers worldwide. We employ data from 51 Greek regions (NUTS-3) during the period 2000–2017 to investigate the role of tourism in road accidents. We examine whether road accidents are affected by factors such as tourism, economic, demographic, meteorological, and risk exposure variables. We reveal that tourism affects road accidents in Greece, and that foreign tourists have a significant influence in this regard. Domestic tourists have a significant effect on non-fatal accidents, unlike foreign travellers, who covary more with cases of severe injuries and fatalities. There is a positive relationship between the number of road traffic accidents and tourism; more and longer stays of tourists coincide with increased vehicular collisions. Our findings suggest that domestic and foreign tourists are important to the national road safety policy plan, and that policymakers should be aware of this.

Multifactor Logistic Analysis to Explore the Risk Factors of Safety Risks in the Transport of Critically Ill Patients with ICU and the Improvement of Nursing Strategies.

Objective Multivariate logistic analysis was employed to explore the risk factors of safety risks in the transport of critically ill patients with ICU and the improvement of nursing strategies. Methods Two hundred critical transport patients with ICU treated in our hospital from January 2019 to April 2021 were enrolled. According to the occurrence of unsafe events in transit, the patients were assigned to the control group (165 cases without unsafe events, n = 165) and the study group (35 cases with safety incidents, n = 35). Multivariate logistic analysis was employed to explore the risk factors of safety risks in the transport of critically ill patients with ICU and to enhance nursing strategies. Results (1) General data of the subjects: among the 200 critically ill patients with ICU who needed in-hospital transport, the age ranged from 18 to 85 years with an average age of 52.48 ± 3.31, including 89 males and 111 females. There were 35 cases of gastrointestinal bleeding, 16 cases of respiratory failure, 23 cases of heart failure, 43 cases of myocardial infarction, 26 cases of cerebrovascular accident, 14 cases of ectopic pregnancy, 25 cases of severe injury, and 18 cases of mechanical ventilation. There were 35 cases in the study group with accidents and 45 cases in group B without accidents. (2) Among the 200 patients, 35 patients had complications during the transit process in the intermediate people's court, with an incidence rate of 17.5%. It included blood pressure fluctuation (n = 6), artificial airway obstruction (n = 6), decrease in blood oxygen saturation (n = 10), dyspnea (n = 5), fall pain (n = 3), elevated intracranial pressure (n = 2), and other factors (n = 3). There exhibited no significant difference in blood oxygen saturation at each time point during transport (P > 0.05). There exhibited no significant difference in SpO2 before transport. The comparison of 5 min and 10 min blood oxygen saturation during transit in the study group was lower compared to the control group (P < 0.05). (3) In a univariate analysis of safety risks for critically ill ICU patients, home escorts did not show significant differences in hospital transport for critically ill ICU patients (P > 0.05). There were significant differences in terms of age, patient's condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline (P < 0.05). The results of multivariate logistic regression analysis indicated that age, patient's condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline were the risk factors affecting the safe transport of critically ill patients (P < 0.05). Conclusion Age, patient's condition, transport escort, auxiliary ventilation, means of transport, uncarried drugs and goods, and carrying pipeline are the independent risk factors that affect the safe transport of emergency or ICU critically ill patients. Therefore, in order to reduce the risk of transshipment, we must enhance the safety awareness of escorts, strengthen the management and training of escorts, promote rules and regulations, and formulate dangerous plans, so as to eliminate the occurrence of unsafe factors.

Grafting of iPS cell-derived tenocytes promotes motor function recovery after Achilles tendon rupture

Tendon self-renewal is a rare occurrence because of the poor vascularization of this tissue; therefore, reconstructive surgery using autologous tendon is often performed in severe injury cases. However, the post-surgery re-injury rate is relatively high, and the collection of autologous tendons leads to muscle weakness, resulting in prolonged rehabilitation. Here, we introduce an induced pluripotent stem cell (iPSC)-based technology to develop a therapeutic option for tendon injury. First, we derived tenocytes from human iPSCs by recapitulating the normal progression of step-wise narrowing fate decisions in vertebrate embryos. We used single-cell RNA sequencing to analyze the developmental trajectory of iPSC-derived tenocytes. We demonstrated that iPSC-tenocyte grafting contributed to motor function recovery after Achilles tendon injury in rats via engraftment and paracrine effects. The biomechanical strength of regenerated tendons was comparable to that of healthy tendons. We suggest that iPSC-tenocytes will provide a therapeutic option for tendon injury.

Accident typology comparisons between pedelecs and conventional bicycles

The data from the years 2009 until 2015, collected by a scientific research team at the Hannover Medical School for the GIDAS project (German In-Depth Accident Study), were used as the study sample. Results: Injuries do not occur more often or more seriously in pedelec accidents than in conventional bicycle accidents. For accidents involving pedelec riders, almost exclusively injury severities of MAIS 1 and 2 (slight/moderate) can be observed and only one case of severe injury (MAIS 3), whereas for accidents with conventional bicyclists (Maximal Accident Injury Severity) MAIS 3+ occurs more often with 4.3%. The statistical analysis shows that head injuries occur more often in pedelec accidents (42.2%) compared to conventional bicycle accidents (35.7%). In addition, there are 21.8% more driving accidents (i.e., single-vehicle accidents such as collisions against objects or falls) involving pedelecs compared to 12.0% for conventional bicycle accidents. Finally, this study shows that pedelec riders tend to be much older than bicyclists, and the injury pattern of bicyclists and pedelec riders seems to depend on the age of the rider: with increasing age a rising risk of head injuries occurs and, therefore, the use of bicycle helmets is an important factor for injury prevention.

The Woes of Economic Burden of Traumatic Brain Injury (TBI) Cases Borne by Public Sector Hospital of Pakistan

Objectives: To highlight the role of public sector hospitals in sharing the major burden of severely head injured patients in a resource constrained economically striving countryMaterials and Methods: The study was conducted in the Neurosurgery department of Jinnah Hospital, Lahore, Pakistan. 70 patients with moderate to severe TBI cases above one year of age were included. The data was analyzed for the cost estimation for the period of six months, for the following heads: 1) hospital cost per day, 2) ICU setup cost per day, and 3) salaries of hospital staff per day.Results: There were 53 cases of moderate injury and 17 cases of severe injury. Mean hospital stay was 14 days, minimum number of stay was 2 days and the maximum number of stay was 124 days in six months. Overall, in six months, per day cost of hospital bills head was Rs. 42,333/$ 263/€ 238. For the ICU setup head, the total cost was Rs. 17,9923/$1130/€ 1016 per day. The salary head’s total cost was Rs. 2573/$16.06/€ 14.44. The grand total of all heads, (bills, ICU setup &amp; salaries) was Rs. 22,482,29/$1409/€ 1270.Conclusion: We evaluated the cost effectiveness of the Neurocritical care unit of a public sector hospital who provides the best possible health care facilities at a cheaper rate as compared to developed countries. We are highlighting the economic burden borne by the developing country’s government.

Child and adolescent bicycling injuries involving motor vehicle collisions

BackgroundBicycle-related injuries are among the most common recreational injuries for children in Canada; moreover, bicycle-motor vehicle collisions often result in serious injuries. This study seeks to examine environmental, motorist, and bicyclist characteristics of bicycle-motor vehicle collisions that resulted in police reported severe injuries in youth (< 18 years old) bicyclists, in Alberta, Canada.FindingsUsing Calgary and Edmonton police collision reports, 423 youth bicycle-motor vehicle collisions were identified from 2010 to 2014. Forty-three (10.2%) of these collisions resulted in major/fatal (severe) injuries. These severe injury cases were compared with the 380 youth bicycle-motor vehicle collisions resulting in minor or no injury (controls) using classification tree and logistic regression analyses. There were no driver or bicyclist characteristics with a significant effect on the odds of severe injury to youth bicyclists; however, lower odds were found on each of: divided roads with no barrier (aOR = 0.36; 95% CI: 0.13–0.97) or during peak traffic time (aOR = 0.44; 95% CI: 0.16–0.99).ConclusionPersonal and environment characteristics should be considered in future research and interventions focused on reducing severe youth bicycle-motor vehicle collision injuries.

Epidemiology and Natural History of Psychiatric Disorders After TBI.

This article outlines the epidemiology of psychiatric disorders in individuals with traumatic brain injury (TBI), with a focus on DSM axis I disorders diagnosed on the basis of structured clinical interview. The epidemiology of psychiatric disorders in the general population is described as a basis for understanding the disorders that occur before and after TBI. For each disorder category, including mood disorders, anxiety disorders, acute stress disorder, posttraumatic stress disorder (PTSD), substance use disorders, psychotic disorders, eating disorders, somatoform disorders, and adjustment disorders, the evidence from retrospective, cross-sectional and prospective studies is reviewed, showing the frequency, time course, and predictors of the disorders. Studies show elevated rates of depressive and anxiety disorders after TBI, most commonly major depressive disorder and PTSD, usually emerging in the first year postinjury but with delayed onset in severe injury cases. Although individuals with a preinjury history are more likely to develop these disorders, the nature of the disorders may change after injury, and novel psychiatric disorders are also common. Even though the frequency of anxiety disorders diminishes over the years postinjury, depressive disorders are more persistent during postinjury years. Substance use-while high before injury-declines after injury. The frequency of psychotic, eating, somatoform, and adjustment disorders do not exceed population rates.

Prevalence and outcome of injury in patients visiting the emergency Department of Yirgalem General Hospital, Southern Ethiopia

BackgroundTraumatic injuries continue to be an important cause of morbidity and mortality in the developing world. Despite the high burden of injury in Ethiopia, the occurrence and health impact have not received due attention. The aim of the study was to assess the prevalence and outcome of injury among patients visiting the Emergency Department (ED) of Yirgalem General Hospital, southern Ethiopia.MethodsA facility-based prospective cross sectional study was conducted from March, 27 – April, 30/2017. The final calculated sample size was 353 and all eligible trauma patients who visited the ED of Yirgalem General Hospital during the study period were included in the study. Data was collected using a checklist which was adapted from the WHO injury surveillance guideline. The data were entered and analyzed using SPSS version 19.ResultsA total of 346 patients, who visited the ED during the study period, participated in the study and of them, 171 (49.4%) were injury cases. Unintentional injuries accounted 123 (71.9%) of the total injuries and the age group ≤24 years (48.2%) was the most commonly affected age group. More than half (51.4%) of unintentional injury cases were due to Road Traffic Injuries (RTIs) and 48 (28%) of the cases were attributed to interpersonal violence (assault). The majority of patients, 97 (56.7%), had a minor or superficial injury (like bruises and minor cuts), 44 (25.7%) had a moderate injury and 16 (9.3%) had severe type of injury requiring intensive medical/surgical management; and RTIs accounted for 11 (68%) of all severe injuries.ConclusionThe prevalence of injury was considerably high in Yirgalem General Hospital. Road Traffic Injuries (RTIs) accounted for the majority of severe injury cases; therefore, appropriate prevention strategies should be strengthened and implemented against RTIs. We also suggest that children and young adults should be educated in schools and work environments to prevent injuries/accidents.

Correlation of CYP2C19 genotypes and Helicobacter pylori infection in children

Objective To evaluate CYP2C19 genotypes distribution in children with Helicobacter pylori (Hp) infection and to know its correlation with gender, age, severity and frequency of clinical symptoms, pathological classification of gastric antral mucosa. Methods Antral mucosas of 214 Hp infection patients who were hospitalized at Beijing Children′s Hospital of Capital Medical University from July 2013 to December 2015 were collected.Genotypes were determined by PCR-sequence specific primer method, which were classified as homozygous extensive metabolizer (HomEM), heterozygous extensive metabolizer (HetEM) and poor metabolizer (PM). The differences in CYP2C19 genotype distribution in gender, age, severity and frequency of clinical symptoms, pathological classification of gastric antral mucosa were analyzed. Results (1)Among 214 Hp infected children, the percentage of HomEM was 48.1%(103/214 cases), HetEM was 46.3%(99/214 cases), and PM was 5.6%(12/214 cases). PM in the CYP2C19 infection patients was lower than that in the normal Han nationality in China, and the difference was statistically significant (P 0.05). (3)There was no statistical difference in severity and frequency of clinical symptoms of CYP2C19 genotypes(all P>0.05). (4)In HomEM group, according to pathological classification of gastric mucosa, there were 14 cases of mild injury, 36 cases of moderate injury and 53 cases of severe injury, respectively.In HetEM group, there were 17 cases of mild injury, 29 cases of moderate injury and 53 cases of severe injury, respectively.In PM group, there were 2 cases of mild injury, 3 cases of moderate injury and 7 cases of severe injury, respectively.There was no statistical difference in the pathological degree of inflammation changes in gastric antral mucosa of CYP2C19 genotypes(all P>0.05). (5)Thirty-five cases didn′t receive treatment, 78 cases received Hp eradication one time and failed, 101 cases received no less than 2 times of unsuccessful Hp eradication.The number of Hp unsuccessful eradications were positively correlated with the degree of pathological inflammation changes(r=0.219, P<0.01). There was obvious difference between the number of Hp unsuccessful eradication and the pathological degree of inflammation changes in gastric antral mucosa (χ2=12.414, P<0.05). Conclusions There was no statistical difference in CYP2C19 genotypes distribution as for different gender, age, severity and frequency of clinical symptoms, pathological classification of gastric antral mucosa and CYP2C19 genotypes.The number of Hp unsuccessful eradication was positively correlated with the degree of pathological inflammation changes. Key words: Helicobacter pylori; CYP2C19 gene; Child

Comprehensive safety management and assessment at rugby football competitions.

The present study aims to improve medical systems by designing objective safety assessment criteria for rugby competitions. We evaluated 195 competitions between 2002 and 2011 using an original safety scale comprising the following sections: 1) competence of staff such as referees, medical attendants and match day doctor; 2) environment such as weather, wet bulb globe temperature and field conditions; and 3) emergency medical care systems at the competitions. Each section was subdivided into groups A, B and C according to good, normal or fair degrees of safety determined by combinations of the results.Overall safety was assessed as A, B and C for 110, 78 and 7 competitions, respectively. The assessments of individual major factors were mostly favorable for staff, but the environment and medical care systems were assessed as C in 25 and 70, respectively, of the 195 competitions. Medical management involves not having a match day doctor, but also comprehensive management including preventive factors and responses from the staff, environment and medical-care systems. 6 cases of severe injuries and accidents occurred between 2002 and 2011, which were observed in Grade A competition. These cases revealed better prognosis without obvious impairment, thus confirming the value of the present assessment scale.

RISK FACTORS FOR BODY REGION SPECIFIC INJURIES IN SKIERS AND SNOWBOARDERS

BackgroundLittle is known about risk factors (e.g., wrist guards, binding adjustment, equipment ownership) for body region specific skiing/snowboarding injuries.ObjectiveIdentify risk factors for body region specific injuries and severe injuries in...

Prehospital injury deaths—Strengthening the case for prevention

To determine the frequency and characteristics of prehospital deaths compared with hospital deaths in different subpopulations with severe injuries. Population-based cohort study using person-based linkage of the Swedish nationwide hospital discharge register with death certificate data. In all, 28,715 injury deaths were identified among 419,137 cases of severe injury during 1998 to 2004. Prehospital deaths were defined as autopsied out-of-hospital deaths with injury as the underlying cause. Their impact on mortality prediction was assessed using the International Classification of Disease Injury Severity Score with the C statistic as a measure of discrimination. The majority of all injury deaths occurred either at the scene or before hospitalization. Among persons younger than 65 years, for each hospital death there were nine prehospital deaths. A high proportion of deaths from drowning, suffocation, and firearm injuries were prehospital (85, 82, and 67% of all cases, respectively). More than 90% of hospital deaths resulted from unintentional injuries, while only 43% of prehospital deaths were unintentional. The largest increase in a cause-specific case fatality risk estimate was seen for poisoning, where inclusion of prehospital deaths increased the risk estimate from 1.6% to 22.8%. Injury mortality prediction based on International Classification of Disease Injury Severity Score improved when prehospital deaths were added to hospital data (C statistic increased from 0.86 to 0.93). Prehospital deaths constitute the majority of trauma deaths and differ in major characteristics from hospital deaths. The high proportion of prehospital deaths among young and middle aged people highlights the potential impact of preventive efforts. III.

Skin injuries in interventional procedures

Radiation-induced skin injuries to patients in interventional procedures have been reported since the early 1990s, but the number reported is far less than what might be occurring around the world. There is a gross lack of awareness resulting in patients suffering. A case of severe injury observed in multiple percutaneous coronary interventions for chronic total occlusion is reported in this paper. Further, the paper summarises the existing knowledge on radiation dosimetry in interventional procedures, factors involved in skin injury, guidance on detection, and avoidance and management of injury when it occurs. Information on a recently launched international anonymous reporting system of the International Atomic Energy Agency is also included.

Severe brachial plexus injuries in rugby

We describe the mechanisms, pattern of injuries, management and outcomes of severe injuries to the brachial plexus sustained during the play of rugby.Thirteen cases of severe injury to the brachial plexus caused by tackles in rugby had detailed clinical assessment, and operative exploration of the brachial plexus. Seventeen spinal nerves were avulsed, two were ruptured and there were traction lesions in continuity of 24 spinal nerves. The pattern of nerve lesion was related to the posture of the neck and the forequarter at the moment of impact. Early repair by nerve transfer enabled some functional recovery, and decompression of lesions in continuity was followed by recovery of nerve function and relief of pain.

The diagnosis and treatment of the close renal trauma (a report 129 cases)

Objective To evaluate the diagnostic rate and treatment effect of close renal trauma.Methods The clinical data of 129 cases of close renal trauma were analyzed retrospectively. Results Lumbago or bellyache occurred in 109 cases,hematuria 113 cases,coexistent injuries of other organs 81 cases. 129 cases were examined by type B-ultrasonography, 102 cases by CT scan open operation on 17 cases and others were treated non-operatively. 118 cases have been followed up for 3 months to 56 months with normal urine routine and IVU.Conclusions Usually urine inspection and B-ultrasonography were simple,instant reliable and safe. The accurate diagnosis rate was higher with CT scanning,CT scan was helpful in detecting the degree of renal injury and any coexistent injuries,and to estimate the treatment effect. Laparotomy should undertaken for the case of severe injury or with coexistent injuries in rime. Key words: Wounds and Injuries; Kidney; Nephrectomy

Hepatocellular Calcification in Severe Ischemia–Reperfusion Injury in a Liver Allograft

Ischemia–reperfusion injury (IR) of solid organ allografts is a consequence of ischemia resulting from disruption of blood flow during organ harvest and transportation. Histologically, this manifests as variable necrosis in a pattern similar to that seen in systemic hypoperfusion. Calcification of hepatocytes has been rarely observed in ischemic injury due to systemic shock and in two cases of severe IR, both of which were associated with graft loss and death. The authors present another case of dystrophic calcification within hepatocytes occurring in a liver allograft affected by severe IR. Biochemical stains revealed that the mineralized material was calcium phosphate (likely hydroxyapatite). By electron microscopy, the hepatocyte cytoplasm was filled with variably calcified vacuoles, a subset of which likely represented swollen mitochondria. When encountered in hepatic allograft biopsies, hepatocellular calcification is associated with ischemic injury and a poor prognosis.