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Deceased donor

Louise Barbier, Manuela Cesaretti, Federica Dondero, François Cauchy, Linda Khoy-Ear, Takeshi Aoyagi, Emmanuel Weiss, Olivier Roux, Safi Dokmak, Claire Francoz, Catherine Paugam-Burtz, Ailton Sepulveda, Jacques Belghiti, François Durand, Olivier Soubrane
BACKGROUND: Older liver grafts have been considered in the past decade due to organ shortage. The aim was to compare outcomes after liver transplantation with either younger or older donors. METHODS: Patients transplanted in our center between 2004 and 2014 with younger donors (younger than 60 years; n = 253) were compared with older donors (older than 75 years; n = 157). Multiorgan transplantations, split grafts, or non-heart-beating donors were not included. RESULTS: Donors in the older group were mostly women deceased from stroke, and only 3 patients had experienced cardiac arrest...
November 2016: Transplantation
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
S Mittal, A Adamusiak, C Horsfield, I Loukopoulos, N Karydis, N Kessaris, M Drage, J Olsburgh, Cje Watson, C J Callaghan
BACKGROUND: A significant proportion of procured deceased donor kidneys are subsequently discarded. The UK Kidney Fast-Track Scheme (KFTS) was introduced in 2012, enabling kidneys at risk of discard to be simultaneously offered to participating centres. We undertook an analysis of discarded kidneys to determine if unnecessary organ discard was still occurring since the KFTS was introduced. METHODS: Between April and June 2015, senior surgeons independently inspected 31 consecutive discarded kidneys from throughout the UK...
October 25, 2016: Transplantation
Jia Loon Chong
Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation...
October 2016: Singapore Medical Journal
C Y Cheung, M L Pong, S F Au Yeung, K F Chau
INTRODUCTION: The number of actual donors per million population is the most commonly used metric to measure organ donation rates worldwide. It is deemed inadequate, however, because it does not take into account the potential donor pool. The aim of this study was to determine the true potential for solid organ donation from deceased brain-dead donors and the reasons for non-donation from potential donors in the Chinese community. METHODS: Medical records of all hospital deaths between 1 January and 31 December 2014 at a large regional hospital in Hong Kong were reviewed...
October 24, 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Mani Nagarajan, Sakthirajan Ramanathan, Jeyachandran Dhanapriya, Thanigachalam Dineshkumar, T Bala Subramaniyan, Natarajan Gopalakrishnan
BACKGROUND: Acute kidney injury (AKI) is one of the major determinants of graft survival in kidney transplantation (KTx). Renal Transplant recipients are more vulnerable to develop AKI than general population. AKI in the transplant recipient differs from community acquired, in terms of risk factors, etiology and outcome. Our aim was to study the incidence, risk factors, etiology, outcome and the impact of AKI on graft survival. METHODS: A retrospective analysis of 219 renal transplant recipients (both live and deceased donor) was done...
October 24, 2016: Renal Failure
Ronald F Parsons, Jayme E Locke, Robert R Redfield, Garrett R Roll, Matthew H Levine
Deceased donor kidney allocation was reorganized in the United States to address several problems, including the highly sensitized patients disadvantaged with large, diverse repertoires of antibodies. Here, five transplant surgeons review their center's experience with the new allocation changes: highlighting areas of accomplishment, opportunities for improvement and, in some cases, stark differences in practice. Across these five centers the highly sensitized patients (CPRA ⩾98%) range from 5.5 to 9.2% of the 12,364 candidates on their collective waitlist...
October 20, 2016: Human Immunology
Darren E Stewart, Victoria C Garcia, John D Rosendale, David K Klassen, Bob J Carrico
BACKGROUND: The proportion of deceased donor kidneys recovered for transplant but discarded increased steadily in the U.S. over 2 decades, from 5.1% in 1988 to 19.2% by 2009. Over 100,000 patients are waiting for a kidney transplant, yet 3,159 kidneys were discarded in 2015. METHODS: We evaluated trends in donor characteristics, discard reasons, and OPO-specific discard rates. Multivariable regression and propensity analysis were used to estimate the proportion of the discard rate rise in the 2000's attributable to changes in donor factors and decisions to biopsy and pump kidneys...
October 19, 2016: Transplantation
David Shaw, Denie Georgieva, Bernadette Haase, Dale Gardiner, Penney Lewis, Nichon Jansen, Tineke Wind, Undine Samuel, Maryon McDonald, Rutger Ploeg
Millions of people want to donate their organs after they die for transplantation, and many of them have registered their wish to do so or told their family and friends about their decision. For most of them, however, this wish is unlikely to be fulfilled, as only a small number of deaths (1% in the United Kingdom) occur in circumstances where the opportunity to donate organs is possible. Even for those who do die in the 'right' way and have recorded their wishes or live in a jurisdiction with a 'presumed consent' system, donation often does not go ahead because of another issue: their families refuse to allow donation to proceed...
October 19, 2016: Transplantation
Shadi Shafaghi, Azizollah Abbasi Dezfuli, Zahra Ansari Aval, Kambiz Sheikhy, Behrooz Farzanegan, Esmaeil Mortaz, Habib Emami, Clemens Aigner, Fatemeh Sadat Hosseini-Baharanchi, Katayoun Najafizadeh
OBJECTIVES: Although the number of lung transplants is limited because of general shortage of organ donors, ex vivo lung perfusion is a novel method with 2 main benefits, including better evaluation of lung potential and recovery of injured lungs. The main aim of this study was to establish and operationalize ex vivo lung perfusion as the first experience in Iran. MATERIALS AND METHODS: This was a prospective operational research study on 5 cases, including 1 pig from Vienna Medical University and 4 patients from Masih Daneshvari Hospital...
October 14, 2016: Experimental and Clinical Transplantation
Abbas Rana, Eileen D Brewer, Brandi B Scully, Michael L Kueht, Matt Goss, Karim J Halazun, Hao Liu, N Thao N Galvan, Ronald T Cotton, Christine A O'Mahony
BACKGROUND: Low case volume has been associated with worse survival outcomes in solid organ transplantation. Our aim was to analyze wait-list outcomes in conjunction with posttransplant outcomes. METHODS: We studied a cohort of 11,488 candidates waitlisted in the Organ Procurement and Transplantation Network (OPTN) for pediatric kidney transplant between 2002 and 2014, including both deceased- and living-donor transplants; 8757 (76 %) candidates received a transplant...
October 18, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Benjamin M Anderson, Jemma L Mytton, Felicity Evison, Charles J Ferro, Adnan Sharif
INTRODUCTION: Outcomes for weekend hospital admissions or emergency procedures have become a topical and controversial issue for the UK National Health Service (NHS). Deceased-donor kidney transplantation is frequently performed at weekends and evidence for its relative safety are lacking. METHODS: We undertook a population-based cohort analysis, obtaining data from every deceased-donor kidney-alone transplant procedure performed in England between January 2003 and December 2014...
October 17, 2016: Transplantation
Ali A Al Bshabshe, Javed Iqbal Wani, Imran Rangreze, Mohammed Ali M Asiry, Haitham Mansour, Alhassan Gaba'n Ahmed, Jabber Madi Assiri
The gap between demand and supply of organs continues. No country has found a concrete solution for tackling this problem. We attempted to evaluate the general information and attitude of university students in their primary basic science stage, when they did not receive special education regarding brain death and organ donation in Saudi Arabia. Since they were from different cities with different cultures and values, we believe that we could assess the educational needs of future doctors and paramedical staff, to help them gain enough competence for solving the concerns of the population at large...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Raquel Núñez-Ramos, Soledad Montoro, Marcello Bellusci, María Rosa Del Fresno-Valencia, Marta Germán-Díaz, Pedro Urruzuno, Enrique Medina, Javier Manzanares
PURPOSE: The aims of this study were to analyze the characteristics of patients with acute liver failure (ALF) in our center and evaluate the prognostic value of the Pediatric End-Stage Liver Disease (PELD) score calculated at admission. PATIENTS AND METHODS: A retrospective analysis of patients with ALF younger than 15 years between 2005 and 2013 was performed. Information collected included age, sex, etiology of ALF, laboratory tests, PELD score, stage of encephalopathy, and need for liver support devices such as MARS and/or liver transplant (LT) and survival...
September 30, 2016: Pediatric Emergency Care
Ahmer M Hameed, Henry C Pleass, Germaine Wong, Wayne J Hawthorne
BACKGROUND: The two main options for renal allograft preservation are static cold storage (CS) and machine perfusion (MP). There has been considerably increased interest in MP preservation of kidneys, however conflicting evidence regarding its efficacy and associated costs have impacted its scale of clinical uptake. Additionally, there is no clear consensus regarding oxygenation, and hypo- or normothermia, in conjunction with MP, and its mechanisms of action are also debated. The primary aims of this article were to elucidate the benefits of MP preservation with and without oxygenation, and/or under normothermic conditions, when compared with CS prior to deceased donor kidney transplantation...
October 2016: Medicine (Baltimore)
Dmitri Bezinover, Shigekazu Sugino, Yuka Imamura-Kawasawa, Matthew S Bell, Zakiyah Kadry, Piotr K Janicki
We describe a case of fulminant intraoperative thrombosis during deceased donor liver transplantation. Despite significant medical bleeding, the patient suddenly developed diffuse thrombosis in all chambers of the heart and pulmonary vasculature resulting in intraoperative death. The patient's postmortem genetic analysis demonstrated a deleterious missense mutation in a coagulation pathway gene, SERPINC1, which codes for antithrombin III. The level of antithrombin III was not available to directly prove the causality of thrombosis, but our findings suggest that this mutation, in combination with antifibrinolytic administration in a hypercoagulable cirrhotic patient, might have contributed to the development of this catastrophic thrombotic event...
October 5, 2016: A & A Case Reports
M H Park, S Kim, H Hwang, H Park, J Kwak, E K Kwon, H Y Sung, B Han
OBJECTIVE: For deceased-donor organ transplantations, negative T cell crossmatches (XMs) are mandatory for kidney and pancreas allocation in the Korean Network for Organ Sharing (KONOS) organ allocation system. Submission and periodic renewal of serum to the KONOS is required for all transplantation candidates of kidney or pancreas and these sera are distributed to 23 laboratories for preliminary XMs. We have investigated how sensitization status varies among transplantation candidates waitlisted for different organs...
September 2016: Transplantation Proceedings
S H Song, J G Lee, J Lee, K H Huh, M S Kim, S I Kim, Y S Kim
The effects of pretransplantation dialysis modality on graft function are key issues in end-stage renal disease patients. The aim of this study was to evaluate post-transplantation outcomes according to pretransplantation renal replacement therapy modality in deceased-donor kidney transplantation. Among 444 deceased-donor kidney transplant recipients in Severance Hospital between April 1993 and Dec 2014, 275 who maintained a unique dialysis modality (hemodialysis [HD; n = 178] or peritoneal dialysis [PD; n = 97]) until transplantation were enrolled...
September 2016: Transplantation Proceedings
K Pabisiak, M Ostrowski, A Kram, K Safranow, M Słojewski, K Ciechanowski
BACKGROUND: Due to demographic projections, and lack of an algorithm in the case of a prostate specific antigen (PSA)-positive donor, the loss of organ recovery may occur more frequently in the near future without approved procedures. In Poland in recent years it has been recommended to determine tumor markers in potential donors. In the first year of the recommendation 10% of potential deceased donors were disqualified in our transplantation center on the basis of the elevated PSA levels (high PSA >10 ng/mL)...
September 2016: Transplantation Proceedings
J Czerwiński, P Malanowski, M Kosieradzki, M Jonas, A Jakubowska-Winecka
BACKGROUND: Monitoring of attitudes toward deceased donation gives the general view of the acceptance of this treatment but does not allow for precise prediction of single person's behavior. Consistency of actions and attitudes has many determinants, personal and situational. The idea of this study was to assess and compare relationships between behaviors and attitudes toward postmortem organ donation in single districts and between larger regions of the country (west and east). METHODS: Indicators calculated for the years 1996-2014 included the number of potential deceased donors (per million population [pmp]/y), the number of objections registered in the refusal registry (pmp), and the number and percentage of family refusals to donation...
September 2016: Transplantation Proceedings
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