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Organ procurement

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https://www.readbyqxmd.com/read/28222055/ex-situ-perfusion-of-human-limb-allografts-for-24-hours
#1
Nicole L Werner, Fares Alghanem, Stephanie L Rakestraw, Dylan C Sarver, Bruce Nicely, Richard E Pietroski, Paul Lange, Steven M Rudich, Christopher L Mendias, Alvaro Rojas-Pena, John C Magee, Robert H Bartlett, Kagan Ozer
BACKGROUND: Vascularized composite allografts, particularly hand and forearm, have limited ischemic tolerance after procurement. In bilateral hand transplantations, this demands a 2 team approach and expedited transfer of the allograft, limiting the recovery to a small geographic area. Ex situ perfusion may be an alternative allograft preservation method to extend allograft survival time. This is a short report of 5 human limbs maintained for 24 hours with ex situ perfusion. METHODS: Upper limbs were procured from brain-dead organ donors...
March 2017: Transplantation
https://www.readbyqxmd.com/read/28219584/outcomes-of-kidney-transplantation-in-patients-exposed-to-hepatitis-b-virus-analysis-by-phase-of-infection
#2
B Chopra, K K Sureshkumar
BACKGROUND: In kidney transplant recipients (KTRs) with hepatitis B virus (HBV) infection, immunosuppression may increase viral replication with increased risk for liver disease progression and HBV-related kidney diseases, factors that could adversely influence graft and patient outcomes. We aimed to analyze the impact of different phases of HBV infection on the outcomes in KTRs. METHODS: Using the Organ Procurement and Transplant Network/United Network for Organ Sharing database, we selected adult KTRs from 2001 to 2011 who received peri-operative antibody induction followed by calcineurin inhibitor/mycophenolate mofetil maintenance with/without steroid...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28218989/liver-transplantation-from-donors-with-positive-blood-cultures-increased-risk-of-graft-failure-or-opportunity-to-expand-the-donor-pool
#3
Paolo Antonio Grossi
Organ transplantation is considered the therapy of choice for end-stage organ failure. However, the growing gap between the number of patients waiting for transplantation and available organs continue to be the number one issue facing the transplant community. As a consequence the major focus in liver transplantation has been developing strategies to increase available donors, including the use of live donor liver segments, splitting deceased donor grafts for two patients and the use of organs procured from donors after circulatory death (DCD)...
February 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28216236/elimination-of-false-reactivity-results-in-a-commercially-available-west-nile-virus-igm-capture-enzyme-linked-immunosorbent-assay-by-heterophilic-antibody-blocking-reagents
#4
Harry E Prince, Mary Lapé-Nixon, Tara S Givens, Tiffany Bradshaw, Marek J Nowicki
All sera initially reactive in the Focus Diagnostics West Nile virus IgM capture enzyme-linked immunosorbent assay (WNV IgM ELISA) must be retested with background subtraction to identify falsely-reactive (FR) samples due to antibodies that bind to immunoglobulins of other animal species (heterophilic antibodies). In some settings, such as pre-transplant testing of organ donors, the reporting delay associated with retesting can have an adverse impact on donor procurement and organ placement. We sought to determine if inclusion of heterophilic antibody blockers in assay conjugate could eliminate the nonspecific reactivity of FR samples...
February 16, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28207639/predictors-of-waitlist-mortality-in-portopulmonary-hypertension
#5
Hilary M DuBrock, David S Goldberg, Norman L Sussman, Sonja D Bartolome, Zakiyah Kadry, Reena J Salgia, David C Mulligan, Walter K Kremers, Steven M Kawut, Michael J Krowka, Richard N Channick
BACKGROUND: The current Organ Procurement Transplantation Network (OPTN) policy grants Model for End Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH. METHODS: We performed a retrospective cohort study of patients in the OPTN database with hemodynamics consistent with POPH [defined as mean pulmonary arterial pressure (mPAP) >25mmHg and pulmonary vascular resistance (PVR) ≥240 dynes-s-cm] who were approved for a POPH MELD exception between 2006 and 2014...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28207635/kidney-transplantation-rates-across-glomerulonephritis-subtypes-in-the-united-states
#6
Michelle M O'Shaughnessy, Sai Liu, Maria E Montez-Rath, Richard A Lafayette, Wolfgang C Winkelmayer
BACKGROUND: Whether kidney transplantation rates differ by glomerulonephritis (GN) subtype remains largely unknown. METHODS: Using the US Renal Data System, we identified all adult patients with ESRD attributed to 1 of 6 GN subtypes who initiated dialysis in the US (1996-2013). Patients with diabetic nephropathy (DN) and autosomal-dominant polycystic kidney disease (ADPKD) served as "external" non-GN comparators. Using Cox proportional hazards regression, with death considered a competing risk, we estimated hazard ratios [HRs (95% confidence intervals)] for first kidney transplantation, controlling for year, demographics, comorbidities, socioeconomic factors, and Organ Procurement Organization (OPO)...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28201928/movie-piracy-networks-at-alaba-international-market-lagos-nigeria
#7
Oludayo Tade, Okoro Paul Mmahi
This study examined the veiled chain of film piracy, a major crime in the Nigeria entertainment industry. Studies on film piracy in Nigeria have focused on its economic implications, both on the copyright owners and on the Nigerian economy. The organization of the activities of the film pirates has, however, been neglected. Narratives were extracted through in-depth interviews with pirates, "marketers," and "producers." Data indicated that pirates were insiders in the film marketing industry and included importers of foreign movies, registered and nonregistered retailers of Nigerian films, as well as marketers appointed by copyright owners to distribute their films...
February 1, 2017: International Journal of Offender Therapy and Comparative Criminology
https://www.readbyqxmd.com/read/28197039/surgical-illustration-of-en-bloc-dual-kidney-transplant-from-a-16-month-old-brain-dead-donor-to-an-adult-recipient
#8
Vikas Jain, Saurabh Jain, Paras Singhal, Suman Lata Nayak, Rajendra P Mathur
Transplantable organs from pediatric donors have been contributing significantly to donor pool worldwide. Pediatric donors are excellent resources that should be procured whenever available, and with the recent increase in deceased donations in India, more pediatric donors will be available for organ harvesting. We share a rare instance of multi-organ harvesting from a 16-month old brain dead donor and implanting both kidneys en-bloc in an adult male, while liver went to a 4-year old child. The report provides the surgical illustration of salient steps of transplanting both kidneys from pediatric donor into an adult, in an en-bloc manner...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28196048/the-phs-increased-risk-label-is-associated-with-nonutilization-of-hundreds-of-organs-per-year
#9
Michael L Volk, Amber R Wilk, Cameron Wolfe, Daniel R Kaul
BACKGROUND: The Public Health Service "Increased Risk" (PHS IR) designation identifies donors at increased risk of transmitting hepatitis B, C, and human immunodeficiency virus. Although the risk remains very low in the era of nucleic acid testing, we hypothesized that this label may result in decreased organ utilization. METHODS: Organ Procurement and Transplantation Network (OPTN) data were used to compare utilization rates between PHS-IR and non-PHS-IR donors, as well as to compare export rates and variation in utilization...
February 11, 2017: Transplantation
https://www.readbyqxmd.com/read/28185740/vaccine-adverse-events-in-a-safety-net-healthcare-system-and-a-managed-care-organization
#10
Komal J Narwaney, Kristin Breslin, Colleen A Ross, Jo Ann Shoup, Kris F Wain, Eric S Weintraub, Michael M McNeil, Simon J Hambidge
BACKGROUND: The Institute of Medicine, in a 2013 report, recommended that the Vaccine Safety Datalink (VSD) expand collaborations to include more diversity in the study population. Kaiser Permanente Colorado (KPCO), an established VSD site, partnered with Denver Health (DH), an integrated safety net healthcare system, to demonstrate the feasibility of integrating DH data within the VSD. Prior to incorporating the data, we examined the identification of specific vaccine associated adverse events (VAEs) in these two distinct healthcare systems...
February 6, 2017: Vaccine
https://www.readbyqxmd.com/read/28183854/linguistic-isolation-and-access-to-the-active-kidney-transplant-waiting-list-in-the-united-states
#11
Efrain Talamantes, Keith C Norris, Carol M Mangione, Gerardo Moreno, Amy D Waterman, John D Peipert, Suphamai Bunnapradist, Edmund Huang
BACKGROUND AND OBJECTIVES: Waitlist inactivity is a barrier to transplantation, because inactive candidates cannot receive deceased donor organ offers. We hypothesized that temporarily inactive kidney transplant candidates living in linguistically isolated communities would be less likely to achieve active waitlist status. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We merged Organ Procurement and Transplantation Network/United Network for Organ Sharing data with five-digit zip code socioeconomic data from the 2000 US Census...
February 9, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28178953/human-rights-violations-in-organ-procurement-practice-in-china
#12
Norbert W Paul, Arthur Caplan, Michael E Shapiro, Charl Els, Kirk C Allison, Huige Li
BACKGROUND: Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China's organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained. DISCUSSION: We have collected and analysed available evidence on human rights violations in the organ procurement practice in China...
February 8, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28168823/opo-strategies-to-prevent-unintended-use-of-kidneys-exported-for-high-pra-98-cpra-recipients
#13
A S Paramesh, N Neidlinger, M Salvatore, A Smith, A Friedman, W Payne, T Taber, C Wright
Since the advent of the Kidney Allocation System (KAS), matched candidates with high (>98%) panel reactive antibody (hPRA) are given priority over local candidates with lower PRA. This often leads to exporting of kidneys. Data for these kidneys is not detailed on routine reports. Twenty two organ procurement organizations prospectively submitted data from 8/2015 - 7/2016, describing allocation practices of kidneys to hPRA patients and outcomes of these kidneys. 520 out of 6924 procured kidneys were exported for hPRA recipients...
February 6, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28168821/metrics-and-data-analysis-in-transplantation-quality-improvement-via-transparency
#14
EDITORIAL
J A Fishman
Transparency in clinical data has been identified as a driver of improved clinical outcomes in transplantation by many including Porter (1). Transparency in this context includes the broad availability of outcomes data including clinical outcomes adjusted for risk, the costs of care, and the experience of the center in providing those services - as a basis for comparing the "value" of healthcare services at various clinical centers. At the same time, and perhaps of greater importance, dramatic advances in transplant immunology and immunosuppression, microbiologic diagnosis and therapy, surgical techniques, organ procurement and allocation, and in clinical management of complex patients have been major drivers of improved transplant outcomes...
February 6, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28161481/munich-anatomy-and-the-distribution-of-bodies-from-the-stadelheim-execution-site-during-national-socialism
#15
Mathias Schütz, Jens Waschke, Georg Marckmann, Florian Steger
During the reign of National Socialism (NS) anatomical institutes regularly received bodies of executed prisoners in steadily increasing numbers. After 1939, the execution site at Stadelheim prison in Munich supplied not only Munich anatomy but also the institutes in Erlangen, Innsbruck and Würzburg. Due to the disappearance of the Munich body journals, the exact dimension and procedure of body procurement from Stadelheim remained unknown for 70 years. After consultation of a wide range of sources, including rediscovered fragments of the body journals, it is now possible to give an almost comprehensive account of the developments...
February 2, 2017: Annals of Anatomy, Anatomischer Anzeiger: Official Organ of the Anatomische Gesellschaft
https://www.readbyqxmd.com/read/28160784/assistive-technology-pricing-in-australia-is-it-efficient-and-equitable
#16
Michael P Summers, George Verikios
Objective To examine available systematically collected evidence regarding prices for assistive technology (AT; e.g. disability aids and equipment) in Australia with other comparable countries. Issues of appropriate AT pricing are coming to the fore as a consequence of efforts to move to consumer-centric purchasing decisions with the National Disability Insurance Scheme (NDIS) and also in the recent aged care reforms.Methods We identified and present three sets of AT price comparisons. Two comparisons were based solely on the lowest prices advertised on the internet, and one comparison examined recommended retail prices...
February 6, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28140515/external-validation-of-the-donor-risk-index-and-the-eurotransplant-donor-risk-index-on-the-french-liver-transplantation-registry
#17
Audrey Winter, Cyrille Féray, Etienne Audureau, René Écochard, Christian Jacquelinet, Françoise Roudot-Thoraval, Christophe Duvoux, Jean-Pierre Daurès, Paul Landais
BACKGROUND & AIMS: A major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant-Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis...
January 31, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28135779/risk-of-tumor-transmission-after-thoracic-allograft-transplantation-from-adult-donors-with-central-nervous-system-neoplasm-a-unos-database-study
#18
C F Hynes, K Ramakrishnan, F A Alfares, K M Endicott, K Hammond-Jack, D Zurakowski, R A Jonas, D S Nath
BACKGROUND: We analyzed the UNOS database to better define the risk of transmission of CNS tumors from donors to adult recipients of thoracic organs. METHODS: Data were procured from the Standard Transplant Analysis and Research dataset files. Donors with CNS tumors were identified, and recipients from these donors comprised the study group (Group I). The remaining recipients of organs from donors who did not have CNS tumors formed the control group (Group II). Incidence of recipient CNS tumors, donor related malignancies, and overall survival was calculated and compared in addition to multivariable logistic regression...
January 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28131666/the-utility-of-6-minute-walk-distance-in-predicting-waitlist-mortality-for-lung-transplant-candidates
#19
Anthony Castleberry, Michael S Mulvihill, Babatunde A Yerokun, Brian C Gulack, Brian Englum, Laurie Snyder, Mathias Worni, Asishana Osho, Scott Palmer, R Duane Davis, Matthew G Hartwig
BACKGROUND: The lung allocation score (LAS) has led to improved organ allocation for transplant candidates. At present, the 6-minute walk distance (6MWD) is treated as a binary categorical variable of whether or not a candidate can walk more than 150 feet in 6 minutes. In this study, we tested the hypothesis that 6MWD is presently under-utilized with respect to discriminatory power, and that, as a continuous variable, could better prognosticate risk of waitlist mortality. METHODS: A retrospective cohort analysis was performed using the Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) transplant database...
December 30, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28125163/shuttle-catalysis-new-strategies-in-organic-synthesis
#20
Benjamin N Bhawal, Bill Morandi
Shuttle catalysis has recently emerged as a powerful new concept that provides a platform for performing both functionalization and defunctionalization reactions. In this concept article, applications of shuttle catalysis as a novel strategy in organic synthesis are discussed. This includes using forward shuttle catalysis reactions for challenging bond-forming processes that avoid the use of hazardous chemicals. Shuttle catalysis also facilitates the transfer of reactive functionality as a route to procure a broad range of compounds using one simple procedure...
January 26, 2017: Chemistry: a European Journal
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