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Best practices tissue Procurement

L R Copeland-Halperin, A J Kaminsky, N Bluefeld, R Miraliakbari
OBJECTIVE: Identifying the responsible pathogen is required in order to select optimum antimicrobial therapy for infected wounds, but the best techniques to use remain the subject of debate. Our aim was to assess the evidence on the value of wound swabs compared with biopsies. METHOD: We conducted a systematic literature review with the terms 'wound infection', 'wound swab', 'wound swab technique', 'wound biopsy', 'wound culture', 'wound swab comparison', 'Levine swab technique', 'microbiological technique', 'specimen handling', 'bacterial load', 'perioperative care', 'swab', and 'culture'...
April 2016: Journal of Wound Care
Miranda A Paraskeva, Glen P Westall, David Pilcher, David McGiffin, Bronwyn J Levvey, Trevor J Williams, Gregory I Snell
The management of patients undergoing lung transplantation has continued to evolve, leading to improvements in 90-day and 1-year survival. The significant advancements in donor management and utilization at our center have led to significant increases in lung transplant activity without any compromise in recipient outcomes. Through the use of a patient-centered multidisciplinary model of care involved in all aspects of recipient management, from assessment and waitlisting to pre-, peri- and post-operative care, our lung transplant outcomes represent 2015 world's best lung transplant practice...
2014: Clinical Transplants
Sarah Faeder, Darcy Moschenross, Emily Rosenberger, Mary Amanda Dew, Andrea DiMartini
PURPOSE OF REVIEW: Psychiatrists and other mental health professionals typically assist with evaluating and treating psychiatric and behavioral issues in transplant candidates, recipients, and living organ donors. In this review recent findings on specific psychiatric issues in adult solid organ transplant candidates and recipients, as well as living donors are discussed as well as their relevance to clinical practice. RECENT FINDINGS: Patients with complex mental health and addiction histories can have outcomes similar to patients without these disorders but may require specialized pretransplant preparation or posttransplant interventions to optimize their outcomes...
September 2015: Current Opinion in Psychiatry
Jennifer A Frontera, J Randall Curtis, Judith E Nelson, Margaret Campbell, Michelle Gabriel, Anne C Mosenthal, Colleen Mulkerin, Kathleen A Puntillo, Daniel E Ray, Rick Bassett, Renee D Boss, Dana R Lustbader, Karen J Brasel, Stefanie P Weiss, David E Weissman
OBJECTIVES: To describe unique features of neurocritical illness that are relevant to provision of high-quality palliative care; to discuss key prognostic aids and their limitations for neurocritical illnesses; to review challenges and strategies for establishing realistic goals of care for patients in the neuro-ICU; and to describe elements of best practice concerning symptom management, limitation of life support, and organ donation for the neurocritically ill. DATA SOURCES: A search of PubMed and MEDLINE was conducted from inception through January 2015 for all English-language articles using the term "palliative care," "supportive care," "end-of-life care," "withdrawal of life-sustaining therapy," "limitation of life support," "prognosis," or "goals of care" together with "neurocritical care," "neurointensive care," "neurological," "stroke," "subarachnoid hemorrhage," "intracerebral hemorrhage," or "brain injury...
September 2015: Critical Care Medicine
Dominique E Martin, Thomas A Nakagawa, Marion J Siebelink, Katrina A Bramstedt, Joe Brierley, Fabienne Dobbels, James R Rodrigue, Minnie Sarwal, Ron Shapiro, Beatriz Dominguez-Gil, Gabriel Danovitch, Stuart C Sweet, Richard S Trompeter, Farhat Moazam, Michael A Bos, Francis L Delmonico
The Ethics Committee of The Transplantation Society convened a meeting on pediatric deceased donation of organs in Geneva, Switzerland, on March 21 to 22, 2014. Thirty-four participants from Africa, Asia, the Middle East, Oceania, Europe, and North and South America explored the practical and ethical issues pertaining to pediatric deceased donation and developed recommendations for policy and practice. Their expertise was inclusive of pediatric intensive care, internal medicine, and surgery, nursing, ethics, organ donation and procurement, psychology, law, and sociology...
July 2015: Transplantation
Sonny Dhanani, Sam D Shemie
There is an increasing burden of responsibility for intensivists to optimize donation potential after the declaration of brain death in patients with catastrophic brain injury. Best practice for donor management, if present, has been formed on low quality and mainly observational studies or consensus. In particular, research into the use of corticosteroids has shown varied benefit. The specific and limited results of the CORTICOME study are less important than the systematic methodology and the development of rigour in the study of deceased organ donation...
2014: Critical Care: the Official Journal of the Critical Care Forum
Zivko Popov, Pivko Kolevski, Ninoslav Ivanovski
Renal transplantation is surely the best treatment for Chronic Kidney Disease (CKD) patients in both developed and developing countries. Due to the tragic events in former Yugoslavia at the beginning of the nineties, it was not possible to develop a really good clinical practice in the field of transplantation. Facing the lack of Deceased Donor Donation Transplantation and any organ-sharing among the Balkan countries, we introduced a large and very ambitious living donor transplant programme including what were called expanded criteria living donors...
2014: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
M C Cavallo, V Sepe, F Conte, M Abelli, E Ticozzelli, A Bottazzi, P M Geraci
INTRODUCTION: Kidney transplantation represents the best therapeutic option for patients with end-stage renal disease (ESRD), providing the best outcomes for survival, quality of life, and cost-effectiveness. To increase kidney donations, in 2007, the Italian IRCCS Policlinico San Matteo Foundation in Pavia designed and conducted Programma Alba, a protocol for organ donation after cardiac death (DCD). This study evaluated the costs and health outcomes of DCD transplantation and in all types of transplants compared with current clinical practice...
December 2014: Transplantation Proceedings
J A de Graauw, S Mihály, O Deme, H S Hofker, A G Baranski, O P Gobée, C Krikke, I Fehérvari, R M Langer, R J Ploeg, R Marazuela, B Domínguez-Gil, B J J M Haase-Kromwijk, C Font-Sala
Considering the growing organ demand worldwide, it is crucial to optimize organ retrieval and training of surgeons to reduce the risk of injury during the procedure and increase the quality of organs to be transplanted. In the Netherlands, a national complete trajectory from training of surgeons in procurement surgery to the quality assessment of the procured organs was implemented in 2010. This mandatory trajectory comprises training and certification modules: E-learning, training on the job, and a practical session...
July 2014: Transplantation Proceedings
Umberto Maggiore, Paolo Cravedi
PURPOSE OF REVIEW: The current era of organ shortage has necessitated a widening of criteria for donation, considering donors who would have been considered unsuitable before. This review summarizes the recent advances in strategies to maximize the use of marginal kidneys without compromising the outcomes. RECENT FINDINGS: Various strategies have been studied and implemented to optimize procurement and allocation of marginal kidneys, and to preserve their function...
August 2014: Current Opinion in Organ Transplantation
Robert S Brown, Abigail R Smith, Mary Amanda Dew, Brenda W Gillespie, Peg Hill-Callahan, Daniela P Ladner
Donor safety in living liver donation is of paramount importance; however, information on long-term outcomes is limited by incomplete follow-up. We sought to ascertain factors that predicted postdonation follow-up in 456 living liver donors in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study. Completed donor follow-up was defined as physical, phone, or laboratory contact at a given time point. Univariate and multivariate mixed effects logistic regression models, using donor and recipient demographic and clinical data and donor quality-of-life data, were developed to predict completed follow-up...
August 2014: Liver Transplantation
Leslie Mataya, Andrew Aronsohn, J Richard Thistlethwaite, Lainie Friedman Ross
The liver donor risk index (LDRI), originally developed in 2006 by Feng et al. and since modified, is a method of evaluating liver grafts from deceased donors through the determination of the relative risk of graft failure after transplantation. Online and paper surveys about attitudes and practices regarding decision making in liver transplantation and the role of the LDRI were sent to liver transplant physicians. One hundred forty-seven of 401 eligible respondents (37%) returned partial or complete surveys...
July 2014: Liver Transplantation
Martin Barr, Lina Souan, Peadar MacGabhann, Jeanette Müller, Maxim Al Ashhab, Mohammed Jasser, Khetam Hamza, Sallam Al Hassoon, Uwe Kuhn, Daniela Infante, Denise Lawlor, Kathy Gately, Eyad Amireh, Kenneth O'Byrne, Maher A Sughayer
Research studies aimed at advancing cancer prevention, diagnosis, and treatment depend on a number of key resources, including a ready supply of high-quality annotated biospecimens from diverse ethnic populations that can be used to test new drugs, assess the validity of prognostic biomarkers, and develop tailor-made therapies. In November 2011, KHCCBIO was established at the King Hussein Cancer Center (KHCC) with the support of Seventh Framework Programme (FP7) funding from the European Union (khccbio.khcc...
February 2014: Biopreservation and Biobanking
J O'Rourke, J A Zimmermann, W Shields, D McLaughlin, P Cunningham, C Magee, D P Hickey
Organ Donation following the Circulatory determination of Death was introduced in Beaumont Hospital during 2011. The Intensive Care Society of Ireland formally endorsed a national DCD clinical practice guideline in 2012. This retrospective audit covers a 2-year period during which eleven patients were considered suitable for DCD and where consent was obtained. Nine patients died within the ninety-minute period following the withdrawal of life sustaining therapies and subsequently donated organs (82%). Eighteen kidneys were recovered and seventeen patients received renal transplants--one patient received a nephron-dosing dual renal transplant...
January 2014: Irish Medical Journal
Dermot W McKeown, Jonathan Ball
PURPOSE OF REVIEW: Current pressures of organ supply and demand require maximization of potential for organ donation. The donor population is older and has more significant comorbidity than in the past.Optimal management of the donor after brain death (DBD) is essential to ensure that the greatest number of organs can be transplanted per donor. Defining evidence-based drugs and techniques to assist this has never been more important. RECENT FINDINGS: Care of patients with catastrophic brain injury incorporating supportive therapy targeted at specific goals and delivered by experienced specialists provides the best donation outcomes...
April 2014: Current Opinion in Organ Transplantation
Claudie Laprise, Helen Trottier, Patricia Monnier, François Coutlée, Marie-Hélène Mayrand
STUDY QUESTION: What is the prevalence of human papillomavirus (HPV) in semen? SUMMARY ANSWER: HPV is present in the semen of asymptomatic men, with a pooled prevalence in a random effects meta-analysis of populations seeking fertility evaluation/treatment of 16%, versus 10% in other populations. WHAT IS KNOWN ALREADY: The main risk of donor insemination (DI) is known to be contamination with an infectious agent. HPV is the necessary cause of cervical cancer, and plays an etiologic role in other anogenital cancers...
April 2014: Human Reproduction
Goce Spasovski, Saso Dohcev, Oliver Stankov, Sotir Stavridis, Skender Saidi, Aleksandar Josifov, Jelka Masin-Spasovska
Kidney transplantation (KTx) is the best treatment option in patients with chronic kidney disease (CKD). Health-economics data favour the KTx in comparison with any type of dialysis procedure, but the multidisciplinary approach and required high level of organisational infrastructure are frequent impediments for its availability in the majority of developing countries. A living donor kidney transplant (LDKTx) programme has been developed in the Republic of Macedonia since 1977 but without a real continuum in the following years...
2013: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Prashant Kedia, Monica Gaidhane, Michel Kahaleh
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is one of the least invasive and most effective modality in diagnosing pancreatic adenocarcinoma in solid pancreatic lesions, with a higher diagnostic accuracy than cystic tumors. EUS-FNA has been shown to detect tumors less than 3 mm, due to high spatial resolution allowing the detection of very small lesions and vascular invasion, particularly in the pancreatic head and neck, which may not be detected on transverse computed tomography. Furthermore, this minimally invasive procedure is often ideal in the endoscopic procurement of tissue in patients with unresectable tumors...
September 2013: Clinical Endoscopy
Ji Young Bang, Shyam Varadarajulu
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is routinely performed for establishing tissue diagnosis in patients with gastrointestinal tumors. The concept of delivering chemotherapy based on molecular markers and the ability to establish a reliable diagnosis in lieu of an onsite cytopathologist has fuelled the recent trend in procuring core tissue by means of EUS-guided fine needle biopsy. To overcome the technical limitations induced by the rigidity of the Trucut biopsy needle, a new ProCore needle with reverse bevel technology has been developed...
September 2013: Clinical Endoscopy
Ciara Kierans, Jessie Cooper
Organ donation is constructed in the UK as a public responsibility, but more particularly as an obligation for members of minority ethnic communities. This paper draws attention to the ways in which 'ethnicity' has been made problematic by the allocation practices of transplant medicine, health promotion discourses and policy developments. Taken together, they have served to culturalise and racialise the procurement of organs. As the problem of organ donation is as much made inside medicine as outside it, this paper argues greater attention ought to be paid to these institutional practices and processes...
2013: Anthropology & Medicine
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