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https://www.readbyqxmd.com/read/28074702/operative-technique-and-pitfalls-in-donor-heart-procurement
#1
Yasuhiro Shudo, William Hiesinger, Philip E Oyer, Y Joseph Woo
We describe a simple and reproducible donor heart procurement technique in sequential steps. A detailed understanding of procurement and organ preservation techniques should be an essential part of a heart transplant training program.
January 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28073574/massive-donor-transfusion-potentially-increases-recipient-mortality-after-lung-transplantation
#2
Catherine F Borders, Yoshikazu Suzuki, Jared Lasky, Christian Schaufler, Djamila Mallem, James Lee, Kevin Carney, Scarlett L Bellamy, Christian A Bermudez, A Russell Localio, Jason D Christie, Joshua M Diamond, Edward Cantu
OBJECTIVE: Donor blood transfusion has been identified as a potential risk factor for primary graft dysfunction and by extension early mortality. We sought to define the contributing risk of donor transfusion on early mortality for lung transplant. METHODS: Donor and recipient data were abstracted from the Organ Procurement and Transplantation Network database updated through June 30, 2014, which included 86,398 potential donors and 16,255 transplants. Using the United Network for Organ Sharing 4-level designation of transfusion (no blood, 1-5 units, 6-10 units, and >10 units, massive), we analyzed all-cause mortality at 30-days with the use of logistic regression adjusted for confounders (ischemic time, donor age, recipient diagnosis, lung allocation score and recipient age, and recipient body mass index)...
December 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28072757/organ-procurement-organization-survey-of-practices-and-beliefs-regarding-prerecovery-percutaneous-liver-biopsy-in-donation-after-neurologic-determination-of-death
#3
Joseph Benton Oliver, Andrea Fleisch Marcus, Mark Paster, Joseph Nespral, Advaith Bongu, George Dikdan, Lloyd Brown, Nikole Neidlinger, Baburao Koneru
BACKGROUND: Prerecovery liver biopsy (PLB) allows histological evaluation of the organ prior to procurement. The opinions and what factors might influence PLB use within Organ Procurement Organizations (OPOs) are unknown. METHODS: A survey instrument was distributed by the Association of OPOs to the clinical directors of all 58 OPOs. Descriptive statistics were calculated. Results were also stratified based on OPO characteristics. RESULTS: 84...
January 9, 2017: Transplantation
https://www.readbyqxmd.com/read/28071246/family-perspectives-on-organ-and-tissue-donation-for-transplantation-a-principlist-analysis
#4
Marcelo José Dos Santos, Lydia Feito
BACKGROUND: The family interview context is permeated by numerous ethical issues which may generate conflicts and impact on organ donation process. OBJECTIVE: This study aims to analyze the family interview process with a focus on principlist bioethics. METHOD: This exploratory, descriptive study uses a qualitative approach. The speeches were collected using the following prompt: "Talk about the family interview for the donation of organs and tissues for transplantation, from the preparation for the interview to the decision of the family to donate or not...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28062942/what-money-cannot-buy-and-what-money-ought-not-buy-dignity-motives-and-markets-in-human-organ-procurement-debates
#5
Ryan Gillespie
Given the current organ shortage, a prevalent alternative to the altruism-based policy is a market-based solution: pay people for their organs. Receiving much popular and scholarly attention, a salient normative argument against neoliberal pressures is the preservation of human dignity. This article examines how advocates of both the altruistic status quo and market challengers reason and weigh the central normative concept of dignity, meant as inherent worth and/or rank. Key rhetorical strategies, including motivations and broader social visions, of the two positions are analyzed and evaluated, and the separation of morally normative understandings of dignity from market encroachment is defended...
January 6, 2017: Journal of Medical Humanities
https://www.readbyqxmd.com/read/28058213/face-transplantation-anesthetic-challenges
#6
REVIEW
Aparna Dalal
Face transplantation is a complex vascular composite allotransplantation (VCA) surgery. It involves multiple types of tissue, such as bone, muscles, blood vessels, nerves to be transferred from the donor to the recipient as one unit. VCAs were added to the definition of organs covered by the Organ Procurement and Transplantation Network Final Rule and National Organ Transplant Act. Prior to harvest of the face from the donor, a tracheostomy is usually performed. The osteotomies and dissection of the midface bony skeleton may involve severe hemorrhagic blood loss often requiring transfusion of blood products...
December 24, 2016: World Journal of Transplantation
https://www.readbyqxmd.com/read/28052608/optn-srtr-2015-annual-data-report-deceased-organ-donation
#7
A K Israni, D Zaun, C Bolch, J D Rosendale, C Schaffhausen, J J Snyder, B L Kasiske
SRTR uses data collected by OPTN to calculate metrics such as donation/conversion rate, organ yield, and rate of organs recovered for transplant but not transplanted. In 2015, 1,072,828 death and imminent death referrals were made to Organ Procurement Organizations, of which 21,559 met the definition of eligible (9793) or imminent (11,766) deaths per OPTN policy. The number of deceased donors was 9080, and this number has been increasing since 2010. The number of organs authorized for recovery increased slightly to 65,086 in 2015, and the number recovered increased slightly to 25,762...
January 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28032366/permanence-can-be-defended
#8
Andrew Mcgee, Dale Gardiner
In donation after the circulatory-respiratory determination of death (DCDD), the dead donor rule requires that the donor be dead before organ procurement can proceed. Under the relevant limb of the Uniform Determination of Death Act 1981 (USA), a person is dead when the cessation of circulatory-respiratory function is 'irreversible'. Critics of current practice in DCDD have argued that the donor is not dead at the time organs are procured, and so the procurement of organs from these donors violates the dead donor rule...
December 28, 2016: Bioethics
https://www.readbyqxmd.com/read/28030433/the-case-against-imminent-death-donation
#9
Grace S Lee, Vishnu S Potluri, Peter P Reese
PURPOSE OF REVIEW: Imminent death donation (IDD) is a proposal to procure organs from patients prior to the withdrawal of life support, which is anticipated to lead to death. In this review, we outline substantial concerns that the transplant community should consider when deliberating the possibility of practicing IDD. RECENT FINDINGS: Although there are several compelling theoretical and intuitive reasons to support IDD, its application has been hindered because of inadequate definitions or protocols...
December 26, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28029219/defining-the-tipping-point-in-surgical-performance-for-laparoscopic-donor-nephrectomy-among-transplant-surgery-fellows-a-risk-adjusted-cumulative-summation-learning-curve-analysis
#10
O K Serrano, A S Bangdiwala, D M Vock, D Berglund, T B Dunn, E B Finger, T L Pruett, A J Matas, R Kandaswamy
UNOS recommends that fellowship-trained surgeons participate in 15 LDN to be considered proficient. ASTS mandates 12 LDN during abdominal transplant surgery fellowship (ATSF). We performed a retrospective intraoperative case analysis to create a risk-adjusted cumulative summation (RACUSUM) model to assess the learning curve (LC) of novice TSF (nTSF). Between January 2000 and December 2014, 30 nTSF rotated on the Organ Procurement Rotation (OPR) of our ASTS-approved ATSF. Measures of surgical performance included: 1) intraoperative time (ORT), 2) estimated blood loss (EBL), and 3) incidence of intraoperative complications (IOC)...
December 28, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/28027592/outcomes-of-liver-retransplantation-in-patients-with-primary-sclerosing-cholangitis
#11
Jacqueline B Henson, Yuval A Patel, Lindsay Y King, Jiayin Zheng, Shein-Chung Chow, Andrew J Muir
: Liver retransplantation in patients with primary sclerosing cholangitis (PSC) has not been well studied. The aims of this study were to characterize patients with PSC listed for and undergoing retransplantation and to describe the outcomes in these patients. The United Network for Organ Sharing/Organ Procurement and Transplantation Network database was used to identify all primary liver transplantations and subsequent relistings and first retransplantations in adults with PSC between 1987 and 2015...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28026108/outcomes-utilizing-imported-liver-grafts-for-recipients-with-hepatocellular-carcinoma
#12
Narendra Battula, Trevor W Reichman, Yamah Amiri, Ian C Carmody, Gretchen Galliano, John Seal, Emily Ahmed, Humberto Bohorquez, David Bruce, Ari Cohen, George E Loss
BACKGROUND: Liver transplantation (LT) offers the best chance of survival in selected patients with hepatocellular carcinoma (HCC). Wait list mortality or dropout due to tumor progression can be significant and therefore timely transplantation is critical. Liver grafts discarded by outside organ procurement organizations are a potential source of grafts for low MELD tumor patients. The primary aim of this study was to assess the disease-free and overall survival of patients with HCC transplanted with imported liver grafts (ILG)...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28024676/ageing-and-healthy-sexuality-among-women-living-with-hiv
#13
Manjulaa Narasimhan, Caitlin Payne, Stephanie Caldas, John R Beard, Caitlin E Kennedy
Populations around the world are rapidly ageing and effective treatment for HIV means women living with HIV (WLHIV) can live longer, healthier lives. HIV testing and screening programmes and safer sex initiatives often exclude older sexually active WLHIV. Systematically reviewing the literature to inform World Health Organization guidelines on the sexual and reproductive health and rights (SRHR) of WLHIV, identified four studies examining healthy sexuality among older WLHIV. In Uganda, WLHIV reported lower rates of sexual activity and rated sex as less important than men...
November 2016: Reproductive Health Matters
https://www.readbyqxmd.com/read/28018761/improving-donor-conversion-rates-at-a-level-one-trauma-center-impact-of-best-practice-guidelines
#14
Rodrigo F Alban, Bobby L Gibbons, Vanessa L Bershad
BACKGROUND: Organ availability is a consistently limiting factor in transplant surgery. A primary driver of this limitation is donor conversion rate, which is defined as the percentage of eligible donors for whom procurement is actually performed. An alternative way to increase organ availability is through improved utilization of organs from donors after cardiac death (DCD). Recently, a concerted, multidisciplinary effort has been made within our system to improve conversion rates and DCD utilization, thus increasing organ availability...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28013117/hepatocellular-carcinoma-is-the-most-common-indication-for-liver-transplantation-and-placement-on-the-waitlist-in-the-united-states
#15
Ju Dong Yang, Joseph J Larson, Kymberly D Watt, Alina M Allen, Russell H Wiesner, Gregory J Gores, Lewis R Roberts, Julie A Heimbach, Michael D Leise
BACKGROUND & AIMS: Management strategies for patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) have changed, along with liver allocation policies based on model for end-stage liver disease (MELD) score. We investigated etiologic-specific trends in liver transplantation in the United States (US) during different time periods. METHODS: We performed a retrospective study, using the United Network for Organ Sharing/ Organ Procurement and Transplantation Network registry data to identify all adult patients registered for liver transplantation in the US from January 1, 2004 through December 31, 2015...
December 21, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28004463/duty-and-dilemma-perioperative-nurses-hiding-an-objection-to-participate-in-organ-procurement-surgery
#16
Zaneta Smith
Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study exploring the experiences of perioperative nurses participating in multi-organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses' experiences...
December 21, 2016: Nursing Inquiry
https://www.readbyqxmd.com/read/28003943/envisioning-and-leading-organizational-transformation-one-organ-procurement-organization-s-journey
#17
Jeffrey P Orlowski
BACKGROUND:  In 2012, one organ procurement organization (OPO) welcomed a new President and Chief Executive Officer (CEO). This OPO, LifeShare Transplant Donor Services of Oklahoma (LifeShare), had just celebrated its 25th anniversary in 2011. While LifeShare was well-established chronologically, growth in organ donors and organs transplanted from these donors had occurred at a much slower rate during the collaborative era and afterward (2003-2011) than the donor/transplant growth the United States (US), as a whole, had experienced...
November 15, 2016: Curēus
https://www.readbyqxmd.com/read/27992973/abdominal-organ-procurement-in-the-netherlands-an-analysis-of-quality-and-clinical-impact
#18
J D de Boer, W H Kopp, K Ooms-de Vries, B J J M Haase-Kromwijk, C Krikke, J de Jonge, L W E Van Heurn, A G Baranski, J A Van der Vliet, A E Braat
Between March 2012 and August 2013, 591 quality forms were filled out for abdominal organs in The Netherlands. In 133 cases (23%) there was a discrepancy between the evaluation from the procuring and transplanting surgeons. Injuries were seen in 148 (25%) organs of which 12 (2%) led to discarding of the organ; 1/133 (0.8%) livers, 5/38 (13%) pancreata and 6/420 (1.4%) kidneys (p<0.001). Higher donor BMI was a risk factor for procurement related injury in all organs (OR 1.06, p=0.011) and DCD donation in liver procurement (OR 2...
December 19, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27987369/procurement-professionalization-a-mandatory-step-to-improve-the-availability-and-quality-of-whole-pancreas-grafts
#19
Axel Andres, Michela Assalino, Graziano Oldani, Christian Toso, Thierry Berney
The lack of available organs remains one of the main limitations in the field of solid organ transplantation. Most transplant organizations work on improving donation rate through public information programs, and by exploring new organ sources, such as Donors after Cardio-circulatory Death (DCD). This article is protected by copyright. All rights reserved.
December 17, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27982508/regional-differences-in-communication-process-and-outcomes-of-requests-for-solid-organ-donation
#20
H M Traino, A J Molisani, L A Siminoff
Although federal mandate prohibits the allocation of solid organs for transplantation based on "accidents of geography," geographic variation of transplantable organs is well documented. This study explores regional differences in communication in requests for organ donation. Administrative data from 9 partnering Organ Procurement Organizations and interview data from 1,339 family decision makers (FDMs) were compared across 8 geographically distinct US donor service areas (DSA). Authorization to organ donation ranged from 60...
December 16, 2016: American Journal of Transplantation
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