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Donor management

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https://www.readbyqxmd.com/read/28108262/deceased-organ-donor-management-does-hospital-volume-matter
#1
Madhukar S Patel, Jahan Mohebali, Mitchell Sally, Tahnee Groat, Parsia A Vagefi, David C Chang, Darren J Malinoski
BACKGROUND: Identification of strategies to improve organ donor utilization remains imperative. Despite the association between hospital volume and outcomes for many common disease processes, there have been no studies to assess the impact of organ donor hospital volume on organ yield. STUDY DESIGN: A prospective observational study of all deceased organ donors managed by ten OPOs across UNOS Regions 4, 5, and 6 was conducted from February 2012-June 2015. In order to study the impact of hospital volume on organ yield, each donor was placed into a hospital volume quartile based on the number of donors managed by their hospital...
December 16, 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28107271/perioperative-care-of-the-patient-with-the-total-artificial-heart
#2
Jill Yaung, Francisco A Arabia, Michael Nurok
Advanced heart failure continues to be a leading cause of morbidity and mortality despite improvements in pharmacologic therapy. High demand for cardiac transplantation and shortage of donor organs have led to an increase in the utilization of mechanical circulatory support devices. The total artificial heart is an effective biventricular assist device that may be used as a bridge to transplant and that is being studied for destination therapy. This review discusses the history, indications, and perioperative management of the total artificial heart with emphasis on the postoperative concerns...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28104115/pretransplant-serum-hyaluronic-acid-can-be-a-biomarker-as-a-prognostic-predictor-in-adult-to-adult-living-donor-liver-transplantation
#3
S Mizuno, B C Das, Y Iizawa, H Kato, Y Murata, A Tanemura, N Kuriyama, Y Azumi, M Kishiwada, M Usui, H Sakurai, S Isaji
OBJECTIVE: The goal of this study was to evaluate whether pretransplant serum hyaluronic acid (HA) levels can predict outcomes after adult-to-adult living donor liver transplantation (LDLT). METHODS: In study I, 21 patients who underwent LDLT (March 2002-February 2004) were divided into 2 groups: the H-I group (HA ≥500 ng/mL; n = 12) and the L-I group (HA <500 ng/mL; n = 9). The influence of pretransplantation HA levels on short-term surgical outcome was investigated...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28103870/osteochondral-autograft-transplantation-with-biplanar-distal-tibial-osteotomy-for-patients-with-concomitant-large-osteochondral-lesion-of-the-talus-and-varus-ankle-malalignment
#4
Xingchen Li, Yuan Zhu, Yang Xu, Bibo Wang, Jinhao Liu, Xiangyang Xu
BACKGROUND: Osteochondral lesions of the talus (OLTs) are amongst the most common foot and ankle disorders. Varus ankle malalignment causes stress concentration on medial side of the joint, resulting in OLTs and osteoarthritis. For large symptomatic OLTs (>10 mm), Osteochondral autograft transplantation is usually recommended. This article highlights biplanar distal tibial osteotomy as an approach and management for patients with concomitant large OLTs and varus ankle malalignment...
January 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28103510/exo-organoplasty-interventions-a-brief-review-of-past-present-and-future-directions-for-advance-heart-failure-management
#5
REVIEW
Waqas Nawaz, Farhan Ullah Khan, Muhammad Zahid Khan, Wang Gang, Mengqi Yang, Xiaoqian Liao, Li Zhang, Awais Ullah Ihsan, Amjad Khan, Lei Han, Xiaohui Zhou
Heart failure (HF) is a debilitating disease in which abnormal function of the heart leads to imbalance of blood demand to tissues and organs. The pathogenesis of HF is very complex and various factors can contribute including myocardial infarction, ischemia, hypertension and genetic cardiomyopathies. HF is the leading cause of death and its prevalence is expected to increase in parallel with the population age. Different kind of therapeutic approaches including lifestyle modification, medication and pacemakers are used for HF patients in NYHA I-III functional class...
January 16, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28099402/transplant-center-volume-and-the-risk-of-pancreas-allograft-failure
#6
Tarek Alhamad, Andrew F Malone, Daniel C Brennan, Robert J Stratta, Su-Hsin Chang, Jason R Wellen, Timothy A Horwedel, Krista L Lentine
BACKGROUND: Successful pancreas transplantation requires surgical expertise and multidisciplinary medical management. The impact of transplant center volume on pancreas allograft survival remains unclear. METHODS: We examined Organ Procurement and Transplantation Network (OPTN) data on 11,568 simultaneous pancreas-kidney (SPK) and 4308 solitary pancreas (pancreas transplant alone and pancreas after kidney) transplants between 2000 and 2013. RESULTS: Average annual transplant center volume was categorized by tertiles into low, medium and high volume, respectively, as follows: 1-6 (n=3,861), 7-13 (n=3,891), and 14-34 (n=3,888) for SPK, and 1-3 (n=1,417), 4-10 (n=1,518), and 11-33 (n=1,377) for solitary pancreas transplants...
January 17, 2017: Transplantation
https://www.readbyqxmd.com/read/28097804/adult-living-donor-liver-transplantation-for-acute-on-chronic-liver-failure-in-high-model-for-end-stage-liver-disease-score-patients
#7
D-B Moon, S-G Lee, W-H Kang, G-W Song, D-H Jung, G-C Park, H-D Cho, E-K Jwa, W-J Kim, T-Y Ha, H-J Kim
The large volume of adult living donor liver transplantations (ALDLTs) at our center affords a unique opportunity to examine the impact of acute-on-chronic liver failure (ACLF) among high-MELD score patients. From February 1998 to March 2010, 1958 cirrhotic recipients were analyzed to study the relationship between MELD scores and ALDLT outcomes. A total of 327 high-MELD score recipients were categorized into ACLF and non-ACLF groups, and their outcomes were compared. The five-year graft and patient survival in the high MELD group were 75...
January 17, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28092012/results-of-a-randomized-controlled-trial-analyzing-telemedically-supported-case-management-in-the-first-year-after-living-donor-kidney-transplantation-a-budget-impact-analysis-from-the-healthcare-perspective
#8
Klaus Kaier, Silvia Hils, Stefan Fetzer, Philip Hehn, Anja Schmid, Dieter Hauschke, Lioudmila Bogatyreva, Bernd Jänigen, Przemyslaw Pisarski
: ᅟ: We analyze one-year costs and savings of a telemedically supported case management program after kidney transplantation from the perspective of the German Healthcare System. Recipients of living donor kidney transplantation (N = 46) were randomly allocated to either (1) standard aftercare or (2) standard aftercare plus additional telemedically supported case management. A range of cost figures of each patient's medical service utilization were calculated at month 3, 6 and 12 and analyzed using two-part regression models...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28089410/microparticle-detection-to-guide-platelet-management-for-the-reduction-of-platelet-refractoriness-in-children-a-study-proposal
#9
REVIEW
Peter Kanzler, Andrew Mahoney, Gerda Leitner, Volker Witt, Elisabeth Maurer-Spurej
Microparticles have been shown to shed from a variety of viable cells as a consequence of inflammatory processes, activation or physical stress. Seventy to 90% of circulating microparticles are thought to be platelet-derived. The content of microparticles in blood collected from normal blood donors is highly variable and transfers into the final blood component. Elevated microparticle content (MPC) in donor blood might indicate an asymptomatic clinical condition of the donor which might affect the transfusion recipient, particularly pediatric patients...
December 29, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28088950/-risk-factors-for-acute-rejection-in-living-donor-kidney-transplant-recipients-in-china-a-subgroup-analysis-of-a-multi-center-registry-study
#10
X P Hu, Y Tian, T Y Zhu, J H Chen, C X Wang, X T Li, W J Xue, T Lin, L K Peng, J M Tan, G W Feng, Z S Chen, W K Han, J Dong, Y Fan, X D Zhang
Objective: To evaluate pre-and early post-transplantation risk factors for acute rejection(AR) in kidney recipients. Methods: This subgroup analysis of a multi-center registry study was conducted on living-donor kidney transplant recipients in China with 10 years of follow-up. This study analyzed 1 255 recipients including 921 males(73.4%) and with a mean age of (33±10)years. Data from patients were first analyzed with univariate analysis and then multivariate analysis was used for finding out the potential risk factors of AR...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28087657/european-consensus-conference-on-faecal-microbiota-transplantation-in-clinical-practice
#11
Giovanni Cammarota, Gianluca Ianiro, Herbert Tilg, Mirjana Rajilić-Stojanović, Patrizia Kump, Reetta Satokari, Harry Sokol, Perttu Arkkila, Cristina Pintus, Ailsa Hart, Jonathan Segal, Marina Aloi, Luca Masucci, Antonio Molinaro, Franco Scaldaferri, Giovanni Gasbarrini, Antonio Lopez-Sanroman, Alexander Link, Pieter de Groot, Willem M de Vos, Christoph Högenauer, Peter Malfertheiner, Eero Mattila, Tomica Milosavljević, Max Nieuwdorp, Maurizio Sanguinetti, Magnus Simren, Antonio Gasbarrini
Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance...
January 13, 2017: Gut
https://www.readbyqxmd.com/read/28077132/foxn1-deficient-nude-severe-combined-immunodeficiency
#12
REVIEW
Ioanna A Rota, Fatima Dhalla
Nude severe combined immunodeficiency is a rare inherited disease caused by autosomal recessive loss-of-function mutations in FOXN1. This gene encodes a transcription factor essential for the development of the thymus, the primary lymphoid organ that supports T-cell development and selection. To date nine cases have been reported presenting with the clinical triad of absent thymus resulting in severe T-cell immunodeficiency, congenital alopecia universalis and nail dystrophy. Diagnosis relies on testing for FOXN1 mutations, which allows genetic counselling and guides therapeutic management...
January 11, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28074434/lessons-learned-from-the-world-s-first-successful-penis-allotransplantation
#13
REVIEW
Andre van der Merwe, Amir Zarrabi, Alexander Zühlke, Nicola Barsdorf, Rafique Moosa
We performed a successful penis allotransplantation on 11 December 2014. Sharing the lessons learned might help more patients in need to be treated this way. We divided the project into manageable segments that was each overseen by an expert. The ethical review and conduct paved the way for a publically acceptable and successful project. Screening for a psychological stable recipient is important. The most difficult part of the project was finding a donor penis. This was successfully negotiated with the family of a brain dead donor by creating a neo-phallus for the donor, thereby maintaining the dignity of the donor...
February 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28074234/-biological-downsizing-acetabular-defect-reconstruction-in-revision-total-hip-arthroplasty
#14
S Koob, S Scheidt, T M Randau, M Gathen, M D Wimmer, D C Wirtz, S Gravius
BACKGROUND: Periacetabular bony defects remain a great challenge in revision total hip arthroplasty. After assessment and classification of the defect and selection of a suitable implant the primary stable fixation and sufficient biological reconstitution of a sustainable bone stock are essential for long term success in acetabular revision surgery. Biological defect reconstruction aims for the down-sizing of periacetabular defects for later revision surgeries. TECHNIQUE: In the field of biological augmentation several methods are currently available...
January 10, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28073361/sustainability-of-health-information-systems-a-three-country-qualitative-study-in-southern-africa
#15
Corrina Moucheraud, Amee Schwitters, Chantelle Boudreaux, Denise Giles, Peter H Kilmarx, Ntolo Ntolo, Zwashe Bangani, Michael E St Louis, Thomas J Bossert
BACKGROUND: Health information systems are central to strong health systems. They assist with patient and program management, quality improvement, disease surveillance, and strategic use of information. Many donors have worked to improve health information systems, particularly by supporting the introduction of electronic health information systems (EHIS), which are considered more responsive and more efficient than older, paper-based systems. As many donor-driven programs are increasing their focus on country ownership, sustainability of these investments is a key concern...
January 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28072550/rotational-advancement-in-cleft-nose-rhinoplasty-buccal-mucosal-grafts-serve-as-a-powerful-tool
#16
Andreas Kehrer, Tim H J Nijhuis, Pál Pesthy, Sten Willemsen, René Poublon, Jacques J J N M van der Meulen
OBJECTIVE:   Our aim was to analyze our technique of a modified rotational advancement in conjunction with buccal mucosal grafts (BMGs) in a subgroup of severe cleft cases. DESIGN:   A retrospective clinical and photographic evaluation was conducted. Columella angle (CA) and tip projection (TPR) served as instruments in a photometric analysis. SETTING:   Academic university hospital and specialized craniofacial cleft center. PATIENTS:   At the time of the secondary rhinoplasty, 61 cleft patients were included, all 17 years or older...
January 10, 2017: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/28070117/re-transplantation-higher-creatinine-levels-in-hepatitis-c-virus-patients-and-donor-age-are-predictors-of-mortality-in-long-term-analysis-of-late-acute-rejection-in-liver-transplantation
#17
Lucas Souto Nacif, Rafael Soares Pinheiro, Rafael Antônio de Arruda Pécora, Ryan Yukimatsu Tanigawa, Vinicius Rocha-Santos, Wellington Andraus, Venancio Avancini Ferreira Alves, Luiz Carneiro D'Albuquerque
BACKGROUND Late acute rejection (LAR) differs in its clinical and histological presentation and management from early acute rejection. This clinical entity is not completely understood; thus, we aimed to identify significant prognostic factors that can influence post-transplant survival in LAR patients. The purpose of this study was to evaluate the incidence and post-transplant survival of patients from a single center with a focus on late acute rejection. MATERIAL AND METHODS From January 2002 to June 2013, all liver biopsies from patients with rejection were scored using the Banff criteria...
January 10, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28069900/impact-of-donor-and-recipient-adiposity-on-feto-placental-growth-in-adolescent-sheep
#18
Jacqueline M Wallace, John S Milne, Clare L Adam, Raymond P Aitken
The influence of maternal obesity during oocyte development and its putative interaction with nutrient reserves at conception on pregnancy outcome were examined in an adolescent sheep model. Donor ewes were nutritionally managed to achieve contrasting adiposity (control [CD]/obese [ObD]) for 6 weeks prior to superovulation, and inseminated by a non-obese sire. Morulae from 6 CD and 7 ObD were transferred in singleton into adolescent recipients of identical age but differing adiposity, classified as relatively fat or thin, respectively...
January 9, 2017: Reproduction: the Official Journal of the Society for the Study of Fertility
https://www.readbyqxmd.com/read/28065763/the-kidd-jk-blood-group-system
#19
REVIEW
Shaun Lawicki, Randal B Covin, Amy A Powers
The Kidd blood group system was discovered in 1951 and is composed of 2 antithetical antigens, Jk(a) and Jk(b), along with a third high-incidence antigen, Jk3. The Jk3 antigen is expressed in all individuals except those with the rare Kidd-null phenotype. Four Kidd phenotypes are therefore possible: Jk(a+b-), Jk(a-b+), Jk(a+b+), and Jk(a-b-). The glycoprotein carrying the Kidd antigens is a 43-kDa, 389-amino acid protein with 10 membrane-spanning domains which functions as a urea transporter on endothelial cells of the renal vasa recta as well as erythrocytes...
November 9, 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28062320/melanised-fungal-infections-in-kidney-transplant-recipients-contributions-to-optimize-the-clinical-management
#20
Daniel Wagner de Castro Lima Santos, Luis Fernando Aranha Camargo, Sarah Santos Gonçalves, Marília Marufuji Ogawa, Jane Tomimori, Milvia Maria Simões E Silva Enokihara, José Osmar Medina Pestana, Arnaldo Lopes Colombo
OBJECTIVES: This is a retrospective and observational study addressing clinical and therapeutic aspects of melanised fungal infections in kidney transplant recipients. METHODS: We retrospectively reviewed medical records of all patients admitted between January 1996 and December 2013 in a single institution who developed infections by melanised fungi. RESULTS: We reported 56 patients aging between 30 and 74 years with phaeohyphomycosis or chromoblastomycosis (0...
January 3, 2017: Clinical Microbiology and Infection
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