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Organ procurement

Guya Piemonte, Maria L Migliaccio, Stefano Bambi, Marco Bombardi, Lorenzo D'antonio, Andrea Guazzini, Caterina Di Pasquale, Laura Tadini-Buoninsegni, Cristiana Guetti, Manuela Bonizzoli, Sara Bagatti, Paolo Lopane, Anna Nativi, Laura Rasero, Adriano Peris
BACKGROUND: Family refusal (FR) to heart beating donation (HBD) in Intensive Care Unit (ICU) is increasing in recent years with a significant impact on the number of transplantable organs. Fostering setting humanization, quality of relationships, respect for will and family reliance towards ICU could be relevant in containing FR to organ donation (OD) in ICU. Our aims were to highlight the effects of structural features of ICUs and humanization determinants on FR in HBD process, and to describe visiting policies, structure and modalities of support in ICUs...
May 14, 2018: Minerva Anestesiologica
B Chopra, K K Sureshkumar
BACKGROUND: Donor final serum creatinine (SCr) is a dynamic variable and is 1 of 10 factors used in calculating kidney donor profile index (KDPI). We hypothesize that deceased-donor kidneys (DDKs) with higher SCr were likely accepted for transplantation if procurement biopsy findings were favorable and with long-term outcomes no worse than kidneys with lower final SCr within a KDPI group. METHODS: Using the Organ Procurement and Transplant Network/United Network for Organ Sharing database, we identified DDK transplant recipients from 2000 to 2015 who received induction and calcineurin inhibitor/mycophenolate mofetil maintenance...
March 12, 2018: Transplantation Proceedings
Hassiba Smail, Diana Garcia Saez, Ulrich Stock, Hesham Ahmed Hassan, Christopher Bowles, Barlomiej Zych, Prashant N Mohite, Olaf Maunz, Andre R Simon
The most extended technique of Heart procurement from donors after circulatory death (DCD)involves direct procurement and reperfusion in ex situ normothermic platform using Organ Care System (OCS). We describe a modified technique at our institution with rapid donor blood drainage using a cell saver and synchronised perfusion on the OCS.
May 9, 2018: Annals of Thoracic Surgery
Jay A Fishman, Melissa Greenwald
This workshop targeted opportunities to stimulate transformative innovation in organ transplantation. Participants reached consensus regarding the following: 1) Mechanisms are needed to improve the coordination of policy and oversight activities, given overlapping responsibilities for transplantation and clinical investigation among federal agencies. Innovative clinical trials span traditional administrative boundaries and include stakeholders with diverse interests. Participants identified the need for a governmental inter-agency working group to coordinate nation-wide transplant-related activities...
May 9, 2018: American Journal of Transplantation
Helen Baker, Ana Fried, Allanise Cloete, Cody Sigel, Danielle Miranda, Jose Guillen, Roger Rochat, Aaron Siegler
Condom use has remained low in South Africa despite efforts by the government to make condoms accessible to all. We assessed condom availability, procurement/distribution, and education practices, and explored perceptions of and interest in an expanded array of condom options, including fitted male condoms in Cape Town, South Africa. We conducted 11 key informant interviews with staff members from two sexual health organizations and four state-owned clinics. Key informants (a) were interested in their organizations offering an expanded variety of male condom options including different sizes, colors, and flavors; and (b) substantiated the capacity that their organizations had to integrate alternative condom options into existing procurement, distribution, and education programs...
April 18, 2018: Journal of the Association of Nurses in AIDS Care: JANAC
Javad Hashemi, Parvin Pasalar, Masoud Soleimani, Ehsan Arefian, Reza Khorramirouz, Aram Akbarzadeh, Fariba Ghorbani, Seyed Ehsan Enderami, Abdol Mohammad Kajbafzadeh
INTRODUCTION: Diabetes is known as a worldwide disease with a great burden on society. Since therapeutic options cover a limited number of target points, new therapeutic strategies in the field of regenerative medicine are considered. Bioscaffolds along with islet cells would provide bioengineered tissue as a substitute for β-cells. The perfusion-decellularization technique is considered to create such scaffolds since they mimic the compositional, architectural, and biomechanical nature of a native organ...
May 9, 2018: Cells, Tissues, Organs
Sumit Mohan, Mariana C Chiles, Rachel E Patzer, Stephen O Pastan, S Ali Husain, Dustin J Carpenter, Geoffrey K Dube, R John Crew, Lloyd E Ratner, David J Cohen
The proportion of deceased donor kidneys procured for transplant but subsequently discarded has been growing steadily in the United States, but factors contributing to the rising discard rate remain unclear. To assess the reasons for and probability of organ discard we assembled a cohort of 212,305 deceased donor kidneys recovered for transplant from 2000-2015 in the SRTR registry that included 36,700 kidneys that were discarded. 'Biopsy Findings' (38.2%) was the most commonly reported reason for discard. The median Kidney Donor Risk Index of discarded kidneys was significantly higher than transplanted organs (1...
May 5, 2018: Kidney International
David J Blackley, Cara N Halldin, A Scott Laney
BACKGROUND: Severe coal workers' pneumoconiosis (CWP) is increasingly common, and sometimes requires lung transplantation. METHODS: Using Organ Procurement and Transplantation Network data, we updated the trend for CWP-related lung transplants, described CWP patients who have been waitlisted but not transplanted, and characterized the primary payer of medical costs for CWP-related and other occupational lung disease transplants. RESULTS: There have been at least 62 CWP-related lung transplants; 49 (79%) occurred in the last decade...
May 6, 2018: American Journal of Industrial Medicine
Hideya Kamei, Masahiko Komagome, Nobuhiko Kurata, Satoshi Ogiso, Yasuharu Onishi, Takanobu Hara, Mitsuhisa Takatsuki, Susumu Eguchi, Yasuhiro Ogura
INSTRUCTION: Organ transplantation from a brain death donor on mechanical circulatory support is rare. We report a case in which a brain death donor, supported by a left ventricular assist device (LVAD), unexpectedly displayed significant congestive fibrosis of the liver. PRESENTATION OF CASE: The potential organ donor was diagnosed 23 years previously as having dilated-phase of hypertrophic cardiomyopathy. He had undergone implantation of an LVAD as a bridge to heart transplantation...
April 30, 2018: International Journal of Surgery Case Reports
Shunji Nagai, Mohamed Safwan, Kelly Collins, Randolph E Schilke, Michael Rizzari, Dilip Moonka, Kimberly Brown, Anita Patel, Atsushi Yoshida, Marwan Abouljoud
The new Organ Procurement and Transplant Network/United Organ Sharing Network (OPTN/UNOS) simultaneous liver-kidney transplant (SLK) policy has been implemented. The aim of this study was to review liver transplant outcomes utilizing the new SLK policy. Liver transplant alone (LTA) and SLK patients between 2009 and 2015 were reviewed. Graft survival and post-transplant kidney function were investigated among LTA patients meeting the chronic kidney disease (CKD) criteria of the new policy (LTA-CKD group). In order to validate our findings, we reviewed and applied our analysis to the OPTN/UNOS registry...
May 2, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Gereltuya Dorj, Bruce Sunderland, Tsetsegmaa Sanjjav, Gantuya Dorj, Byambatsogt Gendenragchaa
BACKGROUND: The Essential Medicines List for Children (EMLc) was developed by the World Health Organization (WHO) to assist member countries to achieve Millennium Development Goals (MDG). The Government of Mongolia has adopted a National Essential Drug List (NEDL) with the seventh update published in 2014. The objective of this study was to determine the accessibility, availability and costs of essential pediatric medicines in Mongolia. METHODS: A standardized methodology developed by the WHO and Health Action International (HAI) was employed to conduct a study on the availability, costs and affordability of pediatric medicines in Mongolia...
May 2, 2018: BMC Pediatrics
Caterina Lonati, Giulia A Bassani, Daniela Brambilla, Patrizia Leonardi, Andrea Carlin, Alice Faversani, Stefano Gatti, Franco Valenza
Despite increasing clinical adoption, biologic influences of ex vivo lung perfusion (EVLP) remain insufficiently elucidated. The aim of the current study was to investigate biomolecular changes induced by EVLP in rat lungs. EVLP was maintained for 180 min. Hyaluronan, mediators, and cells were assessed in the perfusate. Gene expression, signaling pathways, and ATP content were investigated in lung tissue. EVLP induced the release of medium-high molecular weight hyaluronan and transcription of hyaluronan synthases ( P < 0...
May 2, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Jenny J Maisonneuve, Katherine E A Semrau, Pinki Maji, Vinay Pratap Singh, Kate A Miller, Ian Solsky, Neeraj Dixit, Jigyasa Sharma, Janaka Lagoo, Natalie Panariello, Brandon Neal, Tapan Kalita, Nabihah Kara, Vishwajeet Kumar, Lisa R Hirschhorn
Objective: Evaluate the impact of a World Health Organization Safe Childbirth Checklist coaching-based intervention (BetterBirth Program) on availability and procurement of essential childbirth-related supplies. Design: Matched pair, cluster-randomized controlled trial. Setting: Uttar Pradesh, India. Participants: 120 government-sector health facilities (60 interventions, 60 controls). Supply-availability surveys were conducted quarterly in all sites...
April 30, 2018: International Journal for Quality in Health Care
Raffaella Ravinetto, Tim Roosen, Catherine Dujardin
Today, a combination of globalization of pharmaceutical production, lack of regulatory harmonization, and weakness of Medicines Regulatory Authorities, creates the "perfect conditions" for poor-quality medicine to circulate in the global market and to penetrate the less-regulated countries. Medicines regulation is the responsibility of the national regulatory authorities in the recipient country, but in the poorer countries, in practice, the responsibility of supply of quality-assured medicines is often taken by Non-Governmental Organizations and other implementers...
2018: Journal of Pharmaceutical Policy and Practice
David Harimbola Rakotonandrasana, Takahiro Tsukahara, Noriko Yamamoto-Mitani
Background: Despite the World Health Organization and the National Malaria Program of Madagascar recommending that antimalarial drugs only be prescribed for patients with positive results on malaria rapid diagnostic tests, healthcare workers continue to prescribe these drugs for cases with negative test results. We explored why and how primary healthcare workers in Madagascar continue to prescribe antimalarial drugs despite this guidance. Methods: We purposively selected 14 medical doctors and 2 nurses from 11 primary health facilities (6 public, 5 private) in Toliara, Madagascar, and interviewed them regarding their antimalarial prescribing behaviors...
2018: Tropical Medicine and Health
David Schenck, George V Mazariegos, J Richard Thistlethwaite, Lainie Friedman Ross
Due to the widening gap between supply and demand, patients who need a liver transplant due to metabolic disease may be asked to serve as domino liver donors-to have their native liver transplanted into another candidate. We here analyze the ethical problems surrounding informed consent for the implant and explant procedures in transplant candidates who will serve as domino donors, using the case of a child with maple syrup urine disease. We discuss the need for 2 distinct consent processes separated in time to ensure that potential domino donors (or their surrogates) give a truly voluntary consent...
May 2018: Transplantation
Konstantin Tretyakov
In this article, I critically examine the principle of national solidarity in organ sharing across national borders. More specifically, I analyse the policy foundations of solidarity in the transnational allocation of organs and its implementation in the system of national balance points adopted in Europe. I argue that the system of national balance points is based on statist collectivism and therefore is oriented more toward collective, rather than individual welfare. The same collective welfare rationale is also evident from leading policy statements about self-sufficiency in organ donation that seem to assume that cross-border organ sharing can be wrong if collective welfare is violated...
May 2018: Journal of Law and the Biosciences
Antonio Franco Ravioli, Patrícia Coelho De Soárez, Mário César Scheffer
The current study aimed to systematically analyze trends and priorities in the theoretical and conceptual approaches and empirical studies on specific health services management modalities in the Brazilian Unified National Health System. A narrative review of the literature identified, in 33 publications, the location and nature of services, management models, methodological procedures, and study outcomes. The research deals mainly with the models' conceptual and legal characteristics and management practices, in addition to addressing contracts, procurement, human resources, financing, and control mechanisms...
2018: Cadernos de Saúde Pública
Jorge S López, Maria Soria-Oliver, Begoña Aramayona, Rubén García-Sánchez, José M Martínez, María J Martín
Organ transplantation remains currently limited because the demand for organs far exceeds the supply. Though organ procurement is a complex process involving social, organizational, and clinical factors, one of the most relevant limitations of organ availability is family refusal to donate organs of a deceased relative. In the past decades, a remarkable corpus of evidence about the factors conditioning relatives' consent has been generated. However, research in the field has been carried out mainly by means of merely empirical approaches, and only partial attempts have been made to integrate the existing empirical evidence within conceptual and theoretically based frameworks...
2018: Frontiers in Psychology
Napat Leeaphorn, Jeremy Ryan A Pena, Natanong Thamcharoen, Eliyahu V Khankin, Martha Pavlakis, Francesca Cardarelli
BACKGROUND AND OBJECTIVES: Recent evidence suggests that HLA epitope-mismatching at HLA-DQ loci is associated with the development of anti-DQ donor-specific antibodies and adverse graft outcomes. However, the clinical significance of broad antigen HLA-DQ mismatching for graft outcomes is not well examined. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using the United Network Organ Sharing/the Organ Procurement and Transplantation Network (UNOS/OPTN) data, patients with primary kidney transplants performed between 2005 and 2014 were included...
April 23, 2018: Clinical Journal of the American Society of Nephrology: CJASN
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