Improved charge extraction in inverted perovskite solar cells with dual-site-binding ligands

Inverted (pin) perovskite solar cells (PSCs) afford improved operating stability in comparison to their nip counterparts but have lagged in power conversion efficiency (PCE). The energetic losses responsible for this PCE deficit in pin PSCs occur primarily at the interfaces between the perovskite and the charge-transport layers. Additive and surface treatments that use passivating ligands usually bind to a single active binding site: This dense packing of electrically resistive passivants perpendicular to the surface may limit the fill factor in pin PSCs. We identified ligands that bind two neighboring lead(II) ion (Pb2+) defect sites in a planar ligand orientation on the perovskite. We fabricated pin PSCs and report a certified quasi-steady state PCE of 26.15 and 24.74% for 0.05- and 1.04-square centimeter illuminated areas, respectively. The devices retain 95% of their initial PCE after 1200 hours of continuous 1 sun maximum power point operation at 65°C.

The dynamic adsorption affinity of ligands is a surrogate for the passivation of surface defects

Surface defects in semiconducting materials, though they have been widely studied, remain a prominent source of loss in optoelectronic devices; here we sought a new angle of approach, looking into the dynamic roles played by surface defects under atmospheric stressors and their chemical passivants in the lifetime of optoelectronic materials. We find that surface defects possess properties distinct from those of bulk defects. ab initio molecular dynamics simulations reveal a previously overlooked reversible degradation mechanism mediated by hydrogen vacancies. We find that dynamic surface adsorption affinity (DAA) relative to surface treatment ligands is a surrogate for passivation efficacy, a more strongly-correlated feature than is the static binding strength emphasized in prior reports. This guides us to design targeted passivator ligands with high molecular polarity: for example, 4-aminobutylphosphonic acid exhibits strong DAA and provides defect passivation applicable to a range of perovskite compositions, including suppressed hydrogen vacancy formation, enhanced photovoltaic performances and operational stability in perovskite solar cells.

Anion optimization for bifunctional surface passivation in perovskite solar cells

Pseudo-halide (PH) anion engineering has emerged as a surface passivation strategy of interest for perovskite-based optoelectronics; but until now, PH anions have led to insufficient defect passivation and thus to undesired deep impurity states. The size of the chemical space of PH anions (>106 molecules) has so far limited attempts to explore the full family of candidate molecules. We created a machine learning workflow to speed up the discovery process using full-density functional theory calculations for training the model. The physics-informed machine learning model allowed us to pinpoint promising molecules with a head group that prevents lattice distortion and anti-site defect formation, and a tail group optimized for strong attachment to the surface. We identified 15 potential bifunctional PH anions with the ability to passivate both donors and acceptors, and through experimentation, discovered that sodium thioglycolate was the most effective passivant. This strategy resulted in a power-conversion efficiency of 24.56% with a high open-circuit voltage of 1.19 volts (24.04% National Renewable Energy Lab-certified quasi-steady-state) in inverted perovskite solar cells. Encapsulated devices maintained 96% of their initial power-conversion energy during 900 hours of one-sun operation at the maximum power point.

Bilateral Gastrocnemius Tertius Muscles: Cadaveric Findings of a Rare Variant

The posterior compartment of the leg typically contains three muscles in the superficial flexor group: the gastrocnemius, plantaris, and soleus. The gastrocnemius has medial and lateral heads (MH and LH) that originate from the medial and lateral condyles of the femur, respectively. However, a third head (TH) of the gastrocnemius, is a rare accessory muscle bundle of the gastrocnemius muscle that covers the surface of the popliteal fossa. Bilateral THs of gastrocnemius were identified in a 67-year-old male during a routine educational cadaveric dissection. Both gastrocnemius TH muscles consisted of a superficial belly with distinct neurovasculature heads and originated from the lateral condyle of the femur and inserted into the Achilles tendon. To our knowledge, the co-existence of bilateral gastrocnemius TH muscles has only been reported once. The male donor was found to exhibit an anatomical anomaly and could be clinically underdiagnosed due to its clinically silent nature and the lack of reports. Insight into the potential implications of bilateral and unilateral gastrocnemius TH and identification during clinical evaluation offers a path for future research to better identify and manage cases of gastrocnemius TH and its effects.

Engineering ligand reactivity enables high-temperature operation of stable perovskite solar cells

Perovskite solar cells (PSCs) consisting of interfacial two- and three-dimensional heterostructures that incorporate ammonium ligand intercalation have enabled rapid progress toward the goal of uniting performance with stability. However, as the field continues to seek ever-higher durability, additional tools that avoid progressive ligand intercalation are needed to minimize degradation at high temperatures. We used ammonium ligands that are nonreactive with the bulk of perovskites and investigated a library that varies ligand molecular structure systematically. We found that fluorinated aniliniums offer interfacial passivation and simultaneously minimize reactivity with perovskites. Using this approach, we report a certified quasi-steady-state power-conversion efficiency of 24.09% for inverted-structure PSCs. In an encapsulated device operating at 85°C and 50% relative humidity, we document a 1560-hour T₈₅ at maximum power point under 1-sun illumination.

Sterically Suppressed Phase Segregation in 3D Hollow Mixed-Halide Wide Band Gap Perovskites

Band gap tuning in mixed-halide perovskites enables efficient multijunction solar cells and LEDs. However, these wide band gap perovskites, which contain a mixture of iodide and bromide ions, are known to phase segregate under illumination, introducing voltage losses that limit stability. Previous studies have employed inorganic perovskites, halide alloys, and grain/interface passivation to minimize halide segregation, yet photostability can be further advanced. By focusing on the role of halide vacancies in anion migration, one expects to be able to erect local barriers to ion migration. To achieve this, we employ a 3D "hollow" perovskite structure, wherein a molecule that is otherwise too large for the perovskite lattice is incorporated. The amount of hollowing agent, ethane-1,2-diammonium dihydroiodide (EDA), varies the density of the hollow sites. Photoluminescence measurements reveal that 1% EDA in the perovskite bulk can stabilize a 40% bromine mixed-halide perovskite at 1 sun illumination intensity. These, along with capacitance-frequency measurements, suggest that hollow sites limit the mobility of the halide vacancies.

Suppressed phase segregation for triple-junction perovskite solar cells

The tunable band gaps and facile fabrication of perovskites make them attractive for multi-junction photovoltaics^1,2. However, light-induced phase segregation limits their efficiency and stability^3-5: this occurs in wide band gap (> 1.65 eV) I/Br mixed perovskite absorbers, and becomes even more acute in the top cells of triple-junction solar photovoltaics that requires a fully 2.0 eV band gap absorber^2,6. We report herein that lattice distortion in I/Br mixed perovskites is correlated with the suppression of phase segregation, generating an increased ion migration energy barrier arising from the decreased average interatomic distance between A-site cation and iodide. Using a ~2.0 eV Rb/Cs mixed-cation inorganic perovskite with large lattice distortion in the top subcell, we fabricated all-perovskite triple-junction solar cells and achieved an efficiency of 24.3% (23.3% certified quasi-steady-state efficiency) with an open-circuit voltage of 3.21 V. This is, to our knowledge, the first reported certified efficiency for perovskite-based triple-junction solar cells. The triple-junction devices retain 80% of their initial efficiency following 420 hours of operation at the maximum power point.

Regulating surface potential maximizes voltage in all-perovskite tandems

The open-circuit voltage (V_OC) deficit in perovskite solar cells is greater in wide-bandgap (over 1.7 eV) cells than in perovskites of roughly 1.5 eV (refs. ^1,2). Quasi-Fermi-level-splitting measurements show V_OC-limiting recombination at the electron-transport-layer contact^3-5. This, we find, stems from inhomogeneous surface potential and poor perovskite-electron transport layer energetic alignment. Common monoammonium surface treatments fail to address this; as an alternative, we introduce diammonium molecules to modify perovskite surface states and achieve a more uniform spatial distribution of surface potential. Using 1,3-propane diammonium, quasi-Fermi-level splitting increases by 90 meV, enabling 1.79 eV perovskite solar cells with a certified 1.33 V V_OC and over 19% power conversion efficiency (PCE). Incorporating this layer into a monolithic all-perovskite tandem, we report a record V_OC of 2.19 V (89% of the detailed balance V_OC limit) and over 27% PCE (26.3% certified quasi-steady state). These tandems retained more than 86% of their initial PCE after 500 h of operation.

Binding Affinity of Concanavalin A to Native and Acid-Hydrolyzed Phytoglycogen Nanoparticles

Phytoglycogen (PG) is a polysaccharide produced in the kernels of sweet corn as soft, highly branched, compact nanoparticles. Its tree-like or dendritic architecture, combined with a high-safety profile, makes PG nanoparticles attractive for use in biological applications, many of which rely on the association or binding of small biomolecules. We have developed a methodology to functionalize surface plasmon resonance (SPR) sensor surfaces with PG nanoparticles, and we demonstrate the utility of the PG-functionalized SPR sensor by measuring the binding affinity of the tetrameric concanavalin A (ConA) protein to both native PG nanoparticles and smaller, softer acid-hydrolyzed PG nanoparticles. We measure comparable values of the equilibrium association constant K for native and acid-hydrolyzed PG, with a slightly smaller value for the acid-hydrolyzed particles that we attribute to unfavorable lateral interactions between the tetrameric subunits of ConA due to the increase in surface curvature of the smaller acid-hydrolyzed PG particles. We also use infrared reflection-absorption spectroscopy (IRRAS) to show that ConA maintains a large fraction of its native conformation, and thus its bioactivity, upon binding to PG, representing an important step toward the realization of PG as a novel bioactive delivery vehicle.

A dimensional investigation of error-related negativity (ERN) and self-reported psychiatric symptoms

Alterations in error processing are implicated in a range of DSM-defined psychiatric disorders. For instance, obsessive-compulsive disorder (OCD) and generalised anxiety disorder show enhanced electrophysiological responses to errors-i.e. error-related negativity (ERN)-while others like schizophrenia have an attenuated ERN. However, as diagnostic categories in psychiatry are heterogeneous and also highly intercorrelated, the precise mapping of ERN enhancements/impairments is unclear. To address this, we recorded electroencephalograms (EEG) from 196 participants who performed the Flanker task and collected scores on 9 questionnaires assessing psychiatric symptoms to test if a dimensional framework could reveal specific transdiagnostic clinical manifestations of error processing dysfunctions. Contrary to our hypothesis, we found non-significant associations between ERN amplitude and symptom severity of OCD, trait anxiety, depression, social anxiety, impulsivity, eating disorders, alcohol addiction, schizotypy and apathy. A transdiagnostic approach did nothing to improve signal; there were non-significant associations between all three transdiagnostic dimensions (anxious-depression, compulsive behaviour and intrusive thought, and social withdrawal) and ERN magnitude. In these same individuals, we replicated a previously published transdiagnostic association between goal-directed learning and compulsive behaviour and intrusive thought. Possible explanations discussed are (i) that associations between the ERN and psychopathology might be smaller than previously assumed, (ii) that these associations might depend on a greater level of symptom severity than other transdiagnostic cognitive biomarkers, or (iii) that task parameters, such as the ratio of compatible to incompatible trials, might be crucial for ensuring the sensitivity of the ERN to clinical phenomena.

Idiopathic Pulmonary Arterial Hypertension Unmasked by Pregnancy

A 31-year old woman presented to the acute medical unit 9 days post-partum with shortness of breath and peripheral oedema. Initially suspected to have either a pulmonary embolism or post-partum cardiomyopathy, she proceeded to have imaging including a CT Pulmonary angiogram and echocardiogram, which were suggestive of pulmonary hypertension and severe right heart failure. Her history and other investigations did not reveal any obvious cause for this. She was transferred to a specialist centre where she was diagnosed with Idiopathic Pulmonary Arterial Hypertension (IPAH), previously known as primary pulmonary hypertension. Shortness of breath during pregnancy and in the postpartum period is a relatively common acute medical presentation. Whilst IPAH is a rare diagnosis, it carries a high mortality rate, particularly in pregnancy, and requires prompt specialist investigation, diagnosis and management.

Proceedings of the First International Conference on Stepped Wedge Trial Design

I1 Introduction

Mona Kanaan, Noreen Dadirai Mdege, Ada Keding

O1 The HiSTORIC trial: a hybrid before-and-after and stepped wedge design

RA Parker, N Mills, A Shah, F Strachan, C Keerie, CJ Weir

O2 Stepped wedge trials with non-uniform correlation structure

Andrew Forbes, Karla Hemming

O3 Challenges and solutions for the operationalisation of the ENHANCE study: a pilot stepped wedge trial within a general practice setting

Sarah A Lawton, Emma Healey, Martyn Lewis, Elaine Nicholls, Clare Jinks, Valerie Tan, Andrew Finney, Christian D Mallen, on behalf of the ENHANCE Study Team

O4 Early lessons from the implementation of a stepped wedge trial design investigating the effectiveness of a training intervention in busy health care settings: the Thistle study

Erik Lenguerrand, Graeme MacLennan, John Norrie, Siladitya Bhattacharya, Tim Draycott, on behalf of the Thistle group

O5 Sample size calculation for longitudinal cluster randomised trials: a unified framework for closed cohort and repeated cross-section designs

Richard Hooper, Steven Teerenstra, Esther de Hoop, Sandra Eldridge

O6 Restricted randomisation schemes for stepped-wedge studies with a cluster-level covariate

Alan Girling, Monica Taljaard

O7 A flexible modelling of the time trend for the analysis of stepped wedge trials: results of a simulation study

Gian Luca Di Tanna, Antonio Gasparrini

P1 Tackling acute kidney injury – a UK stepped wedge clinical trial of hospital-level quality improvement interventions

Anna Casula, Fergus Caskey, Erik Lenguerrand, Shona Methven, Stephanie MacNeill, Margaret May, Nicholas Selby

P2 Sample size considerations for quantifying secondary bacterial transmission in a stepped wedge trial of influenza vaccine

Leon Danon, Hannah Christensen, Adam Finn, Margaret May

P3 Sample size calculation for time-to-event data in stepped wedge cluster randomised trials

Fumihito Takanashi, Ada Keding, Simon Crouch, Mona Kanaan

P4 Sample size calculations for stepped-wedge cluster randomised trials with unequal cluster sizes

Caroline A. Kristunas, Karen L. Smith, Laura J. Gray

P5 The design of stepped wedge trials with unequal cluster sizes

John N.S. Matthews

P6 Promoting Recruitment using Information Management Efficiently (PRIME): a stepped wedge SWAT (study-within-a-trial)

R Al-Shahi Salman, RA Parker, A Maxwell, M Dennis, A Rudd, CJ Weir

P7 Implications of misspecified mixed effect models in stepped wedge trial analysis: how wrong can it be?

Jennifer A Thompson, Katherine L Fielding, Calum Davey, Alexander M Aiken, James R Hargreaves, Richard J Hayes

S1 Stepped Wedge Designs with Multiple Interventions

Vivian H Lyons, Lingyu Li, James Hughes, Ali Rowhani-Rahbar

S2 Analysis of the cross-sectional stepped wedge cluster randomised trial

Karla Hemming, Monica Taljaard, Andrew Forbes

Adult zebrafish intestine resection: a novel model of short bowel syndrome, adaptation, and intestinal stem cell regeneration

Loss of significant intestinal length from congenital anomaly or disease may lead to short bowel syndrome (SBS); intestinal failure may be partially offset by a gain in epithelial surface area, termed adaptation. Current in vivo models of SBS are costly and technically challenging. Operative times and survival rates have slowed extension to transgenic models. We created a new reproducible in vivo model of SBS in zebrafish, a tractable vertebrate model, to facilitate investigation of the mechanisms of intestinal adaptation. Proximal intestinal diversion at segment 1 (S1, equivalent to jejunum) was performed in adult male zebrafish. SBS fish emptied distal intestinal contents via stoma as in the human disease. After 2 wk, S1 was dilated compared with controls and villus ridges had increased complexity, contributing to greater villus epithelial perimeter. The number of intervillus pockets, the intestinal stem cell zone of the zebrafish increased and contained a higher number of bromodeoxyuridine (BrdU)-labeled cells after 2 wk of SBS. Egf receptor and a subset of its ligands, also drivers of adaptation, were upregulated in SBS fish. Igf has been reported as a driver of intestinal adaptation in other animal models, and SBS fish exposed to a pharmacological inhibitor of the Igf receptor failed to demonstrate signs of intestinal adaptation, such as increased inner epithelial perimeter and BrdU incorporation. We describe a technically feasible model of human SBS in the zebrafish, a faster and less expensive tool to investigate intestinal stem cell plasticity as well as the mechanisms that drive intestinal adaptation.

The clinical effectiveness and cost-effectiveness of different surveillance mammography regimens after the treatment for primary breast cancer: systematic reviews registry database analyses and economic evaluation

BACKGROUND

Following primary breast cancer treatment, the early detection of ipsilateral breast tumour recurrence (IBTR) or ipsilateral secondary cancer in the treated breast and detection of new primary cancers in the contralateral breast is beneficial for survival. Surveillance mammography is used to detect these cancers, but the optimal frequency of surveillance and the length of follow-up are unclear.

OBJECTIVES

To identify feasible management strategies for surveillance and follow-up of women after treatment for primary breast cancer in a UK setting, and to determine the effectiveness and cost-effectiveness of differing regimens.

METHODS

A survey of UK breast surgeons and radiologists to identify current surveillance mammography regimens and inform feasible alternatives; two discrete systematic reviews of evidence published from 1990 to mid 2009 to determine (i) the clinical effectiveness and cost-effectiveness of differing surveillance mammography regimens for patient health outcomes and (ii) the test performance of surveillance mammography in the detection of IBTR and metachronous contralateral breast cancer (MCBC); statistical analysis of individual patient data (West Midlands Cancer Intelligence Unit Breast Cancer Registry and Edinburgh data sets); and economic modelling using the systematic reviews results, existing data sets, and focused searches for specific data analysis to determine the effectiveness and cost-utility of differing surveillance regimens.

RESULTS

The majority of survey respondents initiate surveillance mammography 12 months after breast-conserving surgery (BCS) (87%) or mastectomy (79%). Annual surveillance mammography was most commonly reported for women after BCS or after mastectomy (72% and 53%, respectively). Most (74%) discharge women from surveillance mammography, most frequently 10 years after surgery. The majority (82%) discharge from clinical follow-up, most frequently at 5 years. Combining initiation, frequency and duration of surveillance mammography resulted in 54 differing surveillance regimens for women after BCS and 56 for women following mastectomy. The eight studies included in the clinical effectiveness systematic review suggest surveillance mammography offers a survival benefit compared with a surveillance regimen that does not include surveillance mammography. Nine studies were included in the test performance systematic review. For routine IBTR detection, surveillance mammography sensitivity ranged from 64% to 67% and specificity ranged from 85% to 97%. For magnetic resonance imaging (MRI), sensitivity ranged from 86% to 100% and specificity was 93%. For non-routine IBTR detection, sensitivity and specificity for surveillance mammography ranged from 50% to 83% and from 57% to 75%, respectively, and for MRI from 93% to 100% and from 88% to 96%, respectively. For routine MCBC detection, one study reported sensitivity of 67% and specificity of 50% for both surveillance mammography and MRI, although this was a highly select population. Data set analysis showed that IBTR has an adverse effect on survival. Furthermore, women experiencing a second tumour measuring >20 mm in diameter were at a significantly greater risk of death than those with no recurrence or those whose tumour was <10 mm in diameter. In the base-case analysis, the strategy with the highest net benefit, and most likely to be considered cost-effective, was surveillance mammography alone, provided every 12 months at a societal willingness to pay for a quality-adjusted life-year of either £20,000 or £30,000. The incremental cost-effectiveness ratio for surveillance mammography alone every 12 months compared with no surveillance was £4727.

LIMITATIONS

Few studies met the review inclusion criteria and none of the studies was a randomised controlled trial. The limited and variable nature of the data available precluded any quantitative analysis. There was no useable evidence contained in the Breast Cancer Registry database to assess the effectiveness of surveillance mammography directly. The results of the economic model should be considered exploratory and interpreted with caution given the paucity of data available to inform the economic model.

CONCLUSIONS

Surveillance is likely to improve survival and patients should gain maximum benefit through optimal use of resources, with those women with a greater likelihood of developing IBTR or MCBC being offered more comprehensive and more frequent surveillance. Further evidence is required to make a robust and informed judgement on the effectiveness of surveillance mammography and follow-up. The utility of national data sets could be improved and there is a need for high-quality, direct head-to-head studies comparing the diagnostic accuracy of tests used in the surveillance population.

FUNDING

The National Institute for Health Research Health Technology Assessment programme.

MeCP2 controls an epigenetic pathway that promotes myofibroblast transdifferentiation and fibrosis

BACKGROUND & AIMS

Myofibroblast transdifferentiation generates hepatic myofibroblasts, which promote liver fibrogenesis. The peroxisome proliferator-activated receptor gamma (PPARgamma) is a negative regulator of this process. We investigated epigenetic regulation of PPARgamma and myofibroblast transdifferentiation.

METHODS

Chromatin immunoprecipitation (ChIP) assays assessed the binding of methyl-CpG binding protein 2 (MeCP2) to PPARgamma and chromatin modifications that silence this gene. MeCP2(-/y) mice and an inhibitor (DZNep) of the epigenetic regulatory protein EZH2 were used in the carbon tetrachloride model of liver fibrosis. Liver tissues from mice were assessed by histologic analysis; markers of fibrosis were measured by quantitative polymerase chain reaction (qPCR). Reverse transcription PCR detected changes in expression of the microRNA miR132 and its target, elongated transcripts of MeCP2. Myofibroblasts were transfected with miR132; PPARgamma and MeCP2 expressions were analyzed by qPCR or immunoblotting.

RESULTS

Myofibroblast transdifferentiation of hepatic stellate cells is controlled by a combination of MeCP2, EZH2, and miR132 in a relay pathway. The pathway is activated by down-regulation of miR132, releasing the translational block on MeCP2. MeCP2 is recruited to the 5' end of PPARgamma, where it promotes methylation by H3K9 and recruits the transcription repressor HP1alpha. MeCP2 also stimulates expression of EZH2 and methylation of H3K27 to form a repressive chromatin structure in the 3' exons of PPARgamma. Genetic and pharmacologic disruptions of MeCP2 or EZH2 reduced the fibrogenic characteristics of myofibroblasts and attenuated fibrogenesis.

CONCLUSIONS

Liver fibrosis is regulated by an epigenetic relay pathway that includes MeCP2, EZH2, and miR132. Reagents that interfere with this pathway might be developed to reduce fibrogenesis in chronic liver disease.

Lesion size is a major determinant of the mammographic features of ductal carcinoma in situ: findings from the Sloane project

AIM

To assess the radiological features of calcific ductal carcinoma in situ (DCIS) in a large, multicentre dataset according to grade and size, and to investigate the possibility that DCIS has different mammographic features when small.

MATERIALS AND METHODS

The dataset consisted of all Sloane Project DCIS cases where calcification was present mammographically and histological grade and size were available. The radiology data form classifies calcific DCIS as casting/linear, granular/irregular, or punctate. The pathology dataset includes cytonuclear grade and microscopic tumour size. Correlations were sought between the radiological findings and DCIS grade and size. The significance of differences was assessed using the chi-square test and chi-square test for trend.

RESULTS

One thousand, seven hundred and eighty-three cases were included in the study. Of these, 1128, 485, and 170 had high, intermediate, and low-grade DCIS, respectively. Casting calcification was more frequently seen the higher the grade of DCIS, occurring in 58% of high grade, 38% of intermediate grade, and 26% of low-grade cases, respectively (p<0.001). Casting calcification was also increasingly common with increasing lesion size, irrespective of the histological grade (p<0.001). Thus casting calcifications in small (<10mm) high-grade DCIS lesions were seen with a similar frequency (50%) to those in moderate-sized (21-30 mm) intermediate-grade lesions (48%), and to those in large (>30 mm) low-grade lesions (46%).

CONCLUSION

Lesion size has a strong influence on the radiological features of calcific DCIS; small, high-grade lesions often show no casting calcifications, whereas casting calcifications are seen in nearly half of large, low-grade lesions. As small clusters of punctate or granular calcifications may represent high-grade DCIS, an aggressive clinical approach to the diagnosis of such lesions is recommended as the adequate treatment of high-grade DCIS will prevent the occurrence of potentially life-threatening high-grade invasive disease.

EULID project: European living donation and public health

The choice of transplantation from a living donor offers advantages over a deceased donor. However, it also carries disadvantages related to donor risks in terms of health and safety. Furthermore, there are several controversial ethical aspects to be taken into account. Several national and international institutions and the scientific community have stated standards that have great influence on professional codes and legislations. Living organ donation and transplantation are to some extent regulated by parliamentary acts in most European countries. It is necessary to take a step forward to develop a legal framework to regulate all of these processes to guarantee the quality and to prevent illegal and nonethical practices. It is also necessary to develop and implement living donor protection practices not only in terms of physical health, but also to minimize potential impacts on the psychological, social, and economic spheres. Finally, an additional effort should be made to create a database model with recommendations for registration practices as part of the standardized follow-up care for the living donor. The European Living Donation (EULID) project's (http://www.eulivingdonor.eu/) main objective was to contribute to a European consensus to set standards and recommendations about legal, ethical, and living donor protection practices to guarantee the health and safety of living donors.