Background The UK has implemented a national strategy for organ donation that includes a centrally coordinated network of specialist nurses in organ donation embedded in all intensive care units and a national organ retrieval service for deceased organ donors. We aimed to determine whether despite the national approach to donation there is significant regional variation in deceased donor kidney donation rates. Methods The UK prospective audit of deaths in critical care was analysed for a cohort of patients who died in critical care between April 2010 and December 2011. Multivariate logistic regression was used to identify the factors associated with kidney donation. The logistic regression model was then used to produce risk-adjusted funnel plots describing the regional variation in donation rates. Results Of the 27 482 patients who died in a critical care setting, 1528 (5.5%) became kidney donors. Factors found to influence donation rates significantly were: type of critical care [e.g. neurointensive vs general intensive care: OR 1.53, 95% confidence interval (CI) 1.34–1.75, P<0.0001], patient ethnicity (e.g. ‘Asian’ vs ‘white’: OR 0.17, 95% CI 0.11–0.26, P<0.0001), age (e.g. age >69 vs age 18–39 yr: OR 0.2, 0.15–0.25, P<0.0001), and cause of death [e.g. ‘other’ (excluding ‘stroke’ and ‘trauma’) vs ‘trauma’: OR 0.04, 95% CI 0.03–0.05, P<0.0001]. Despite correction for these variables, kidney donation rates for the 20 UK kidney donor regions showed marked variation. The overall standardized donation rate ranged from 3.2 to 7.5%. Four regions had donation rates of >2 standard deviations (sd) from the mean (two below and two above). Regional variation was most marked for donation after circulatory death (DCD) kidney donors with 9 of the 20 regions demonstrating donation rates of >2 sd from the mean (5 below and 4 above). Conclusions The marked regional variation in kidney donation rates observed in this cohort after adjustment for factors strongly associated with donation rates suggests that there is considerable scope for further increasing kidney donation rates in the UK, particularly DCD.

Hudson, A. J.; Mumford, L. L.; Johnson, R. J.; Fuggle, S. V.; Watson, C. J.E. Author Information

1Statistics And Clinical Audit, NHS Blood and Transplant (UK), BS34 8RR/UNITED KINGDOM, 2Statistics And Clinical Audit, NHS Blood and Transplant (UK), Bristol/UNITED KINGDOM, 3Scientific Advisor, NHS Blood and Transplant (UK), Bristol/UNITED KINGDOM, 4Transplant Surgery, Addenbrooke's Hospitals NHS Trust, Cambridge/UNITED KINGDOM

Torque measurements, which can be related to viscous dissipation, were made in a simulated disk drive consisting of a single or multiple corotating disk stack enclosed in an axisymmetric shroud. The effects of rotational velocity, axial and radial spacing, and the position and thickness of simulated read/write arms between disks on torque were studied. Correlations are presented to describe the results of the unobstructed cases and the cases with the read/write arms at their innermost position, and a method is introduced to calculate the torque at intermediate arm positions.

The effect of various substrates upon the respiratory activity of cord slices has been investigated. Glucose was observed to support spinal cord respiration while fructose was not as effective a substrate as glucose. Sodium L-glutamate and α-ketoglutarate were poor substrates. With each substrate a higher respiratory activity was observed in the lumbar than in the cervical region of the cord. Since white matter constitutes a considerable part of spinal cord tissue, some of the metabolic characteristics observed with spinal cord may have been due to the high proportion of neuroglial elements present in white matter. However, the excessive thickness of the slices (0.3–0.9 mm) may also have been a cause of the low [Formula: see text] and poor stimulating effect of potassium.