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Donor management

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https://www.readbyqxmd.com/read/28739153/active-donor-management-during-the-hospital-phase-of-care-is-associated-with-more-organs-transplanted-per-donor
#1
Madhukar S Patel, Salvador De La Cruz, Mitchell B Sally, Tahnee Groat, Darren J Malinoski
BACKGROUND: Meeting donor management goals (DMGs) while caring for potential organ donors has been associated with more organs transplanted per donor (OTPD). Concern persists, however, as to whether this reflects that younger/healthier donors are more likely to meet DMGs or whether active management affects outcomes. STUDY DESIGN: A prospective observational study of all standard criteria donors (SCDs) was conducted by 10 organ procurement organizations across UNOS Regions 4, 5, and 6...
July 21, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28737659/summary-of-kidney-disease-improving-global-outcomes-kdigo-clinical-practice-guideline-on-the-evaluation-and-care-of-living-kidney-donors
#2
Krista L Lentine, Bertram L Kasiske, Andrew S Levey, Patricia L Adams, Josefina Alberú, Mohamed A Bakr, Lorenzo Gallon, Catherine A Garvey, Sandeep Guleria, Philip Kam-Tao Li, Dorry L Segev, Sandra J Taler, Kazunari Tanabe, Linda Wright, Martin G Zeier, Michael Cheung, Amit X Garg
Kidney Disease: Improving Global Outcomes (KDIGO) engaged an evidence review team and convened a work group to produce a guideline to evaluate and manage candidates for living kidney donation. The evidence for most guideline recommendations is sparse and many "ungraded" expert consensus recommendations were made to guide the donor candidate evaluation and care before, during, and after donation. The guideline advocates for replacing decisions based on assessments of single risk factors in isolation with a comprehensive approach to risk assessment using the best available evidence...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28737658/regulation-of-clinical-xenotransplantation-time-for-a-reappraisal
#3
David K C Cooper, Richard N Pierson, Bernhard J Hering, Muhammad M Mohiuddin, Jay A Fishman, Joachim Denner, Curie Ahn, Agnes M Azimzadeh, Leo H Buhler, Peter J Cowan, Wayne J Hawthorne, Takaaki Kobayashi, David H Sachs
The continual critical shortage of organs and cells from deceased human donors has stimulated research in the field of cross-species transplantation (xenotransplantation), with the pig selected as the most suitable potential source of organs. Since the US Food and Drug Administration concluded a comprehensive review of xenotransplantation in 2003, considerable progress has been made in the experimental laboratory to improve cell and organ xenograft survival in several pig-to-nonhuman primate systems that offer the best available models to predict clinical outcomes...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28736994/intraoperative-hemodynamic-factors-predicting-early-postoperative-renal-function-in-pediatric-kidney-transplantation
#4
Daphné Michelet, Christopher Brasher, Lucile Marsac, Nabil Zanoun, Mona Assefi, Alaa Elghoneimi, Stephane Dauger, Souhayl Dahmani
BACKGROUND: The anesthetic management of kidney transplantation in children remains somewhat empirical. The goal of the present study was to investigate intraoperative hemodynamic factors affecting posttransplantation kidney function. METHODS: We performed a retrospective analysis of data from patients undergoing kidney transplantation in our pediatric teaching hospital from 2000 to 2014. Data collected included: donor and recipient demographic data, recipient comorbidities, fluids administered intraoperatively, and intraoperative blood pressure and central venous pressure...
July 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28736009/beliefs-of-living-donors-about-recipients-end-stage-liver-failure-and-surgery-for-organ-donation
#5
M R Krespi, A Tankurt, K Acarli, T Kanmaz, Y Yankol, M Kalayoglu
BACKGROUND: The concept of beliefs could provide a basis for how donors may perceive recipients' end-stage liver failure (ESLF) and surgery for organ donation. However, there is no such quantitative study. Therefore, the objective of this study was to explore beliefs of living donors about recipients' ESLF and surgery for organ donation. METHODS: The sample comprised 16 living donors who donated a part of their liver to a patient who had ESLF. The data were analyzed by following established procedures for inductive qualitative analysis...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28736006/advantages-of-epidural-analgesia-on-pulmonary-functions-in-liver-transplant-donors
#6
H K Atalan, B Gucyetmez, R Donmez, A Kargi, K Y Polat
OBJECTIVE: Epidural analgesia (EA) has positive effects on anesthetic requirement, blood loss, postoperative analgesia, and pulmonary function tests (PFTs). The purpose of the present study was to investigate the effect of EA on postoperative PFTs in liver transplant donors (LTDs). METHODS: In the present study, 66 LTDs were classified as total intravenous anesthesia (TIVA) and TIVA+EA groups. Patient's age, sex, body mass index, induction and maintenance dose of propofol (IDP and MDP), operation duration, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, visual analog scale (VAS), atelectasis scores, and lengths of intensive care unit (ICU) and hospital stays were recorded...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28735842/angled-bio-rsa-bony-increased-offset-reverse-shoulder-arthroplasty-a-solution-for-the-management-glenoid-bone-loss-and-erosion
#7
Pascal Boileau, Nicolas Morin-Salvo, Marc-Olivier Gauci, Brian L Seeto, Peter N Chalmers, Nicolas Holzer, Gilles Walch
BACKGROUND: Glenoid deficiency and erosion (excessive retroversion/inclination) must be corrected in reverse shoulder arthroplasty (RSA) to avoid prosthetic notching or instability and to maximize function, range of motion, and prosthesis longevity. This study reports the results of RSA with an angled, autologous glenoid graft harvested from the humerus (angled BIO-RSA). METHODS: A trapezoidal bone graft, harvested from the humerus and fixed with a long-post baseplate and screws, was used to compensate for residual glenoid bone loss/erosion...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28734064/extensive-seed-and-pollen-dispersal-and-assortative-mating-in-the-rain-forest-tree-entandrophragma-cylindricum-meliaceae-inferred-from-indirect-and-direct-analyses
#8
F K Monthe, O J Hardy, J L Doucet, J Loo, J Duminil
Pollen and seed dispersal are key processes affecting the demographic and evolutionary dynamics of plant species, and are also important considerations for the sustainable management of timber trees. Through direct and indirect genetic analyses we studied the mating system and the extent of pollen and seed dispersal in an economically-important timber species, Entandrophragma cylindricum (Meliaceae). We genotyped adult trees, seeds and saplings from a 400-ha study plot in a natural forest from East Cameroon using eight nuclear microsatellite markers...
July 22, 2017: Molecular Ecology
https://www.readbyqxmd.com/read/28734023/how-do-we-manage-blood-donors-and-recipients-after-a-positive-zika-screening-result
#9
Alexandra Jimenez, Beth H Shaz, Debra Kessler, Evan M Bloch
Zika virus (ZIKV) is a mosquito-borne flavivirus that is the focus of an ongoing pandemic. ZIKV is notable for its severe neurologic sequelae in babies born to infected mothers. High rates of subclinical infection, as evidenced by the finding of ZIKV RNA in asymptomatic donors, raise concerns of risk to the blood supply. To date, a total of four suspected cases of transfusion-transmitted ZIKV have been reported (all in Brazil), none of which were associated with clinical infection in the transfusion recipients...
July 21, 2017: Transfusion
https://www.readbyqxmd.com/read/28729548/multiplex-polymerase-chain-reaction-for-pathogen-detection-in-donor-recipient-corneal-transplant-tissue-and-donor-storage-solution
#10
Takehiro Hariya, Kazuichi Maruyama, Sunao Sugita, Masayo Takahashi, Shunji Yokokura, Kota Sato, Yasuhiro Tomaru, Norio Shimizu, Toru Nakazawa
Corneal transplantation is a safe, reliable method of restoring visual acuity in patients with corneal disorders. Although it has a very high success rate, rejection can still occur, especially if the site is infected. Therefore, seeking to find better ways to manage infection risk, this study investigated a new technique, based on multiplex polymerase chain reaction (mPCR), to identify pathogens, including viruses, bacteria, and fungi, in corneal transplantation recipient sites, donor corneas and the donor cornea storage solution...
July 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28727227/long-term-outcomes-of-simultaneous-heart-and-kidney-transplantation-in-pediatric-recipients
#11
Patricia L Weng, Juan Carlos Alejos, Nancy Halnon, Qiuheng Zhang, Elaine F Reed, Eileen Tsai Chambers
Pediatric sHKTx has become an effective therapy for patients with combined cardiac and renal failure. Often, these patients develop human leukocyte antigen antibodies from their previous allografts and are therefore more difficult to re-transplant. We describe the largest case series of a predominantly sensitized pediatric sHKTx with emphasis on medical management and patient outcomes. Demographics, clinical characteristics, antibody, and biopsy data were retrospectively collected from University of California, Los Angeles database and correlated with short- and long-term patient and allograft outcomes of all sHKTx performed between 2002 and 2015...
July 20, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28723742/liver-transplantation-using-the-otherwise-discarded-partial-liver-resection-graft-with-hepatic-benign-tumor-analysis-of-a-preliminary-experience-on-15-consecutive-cases
#12
Guoqiang Li, Xiaoxin Mu, Xinli Huang, Xiaofeng Qian, Jianjie Qin, Zhongming Tan, Wenjie Zhang, Xiaoliang Xu, Shanbai Tan, Zhijun Zhu, Wei Li, Xuan Wang, Xuehao Wang, Beicheng Sun
RATIONALE: The shortage of available donor organs limits the development of liver transplantation. This case-serial study presents a novel way to expand the donor pool by using the other-wise discarded partial liver resection graft with hepatic benign tumor. PATIENT CONCERNS: From 2012 to 2016, 15 patients with hepatic lesions were admitted to our hospital. 12 patients suffered from right epigastric discomfort and 3 patients worried about uncertain diagnosis. INTERVENTIONS: Regular hepatic lobectomy was performed for all patients and after back-table management the resected partial liver grafts were used for patients with end-stage liver disease for liver transplantation...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28719965/living-donor-liver-transplantation-for-giant-hepatic-hemangioma-with-diffuse-hemangiomatosis-in-an-adult-a-case-report
#13
Ju Hyun Lee, Chang Jin Yoon, Young Hoon Kim, Ho-Seong Han, Jai Young Cho, Jai Young Cho, Haeryoung Kim, Eun Sun Jang, Jin-Wook Kim, Sook-Hyang Jeong
Hepatic hemangioma represents the most common benign primary hepatic neoplasm. Although most such tumors are small and asymptomatic, giant hepatic hemangioma is frequently symptomatic, and requires intervention. Moreover, diffuse multiple hepatic hemangiomatosis occupying almost the entire liver is extremely rare in adults, and the optimal management for this condition is unclear. We report a case of a rapidly growing, symptomatic giant hepatic hemangioma with diffuse hepatic hemangiomatosis in a 50-year-old female patient who was treated by living-donor liver transplantation...
July 19, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28719070/sirtuin-1-attenuates-inflammation-and-hepatocellular-damage-in-liver-transplant-ischemia-reperfusion-from-mouse-to-human
#14
Kojiro Nakamura, Shoichi Kageyama, Bibo Ke, Takehiro Fujii, Rebecca A Sosa, Elaine F Reed, Nakul Datta, Ali Zarrinpar, Ronald W Busuttil, Jerzy W Kupiec-Weglinski
Hepatic ischemia-reperfusion injury (IRI), an inevitable antigen-independent inflammation response in cadaveric liver transplantation, correlates with poor early graft function, rejection episodes, and contributes to donor organ shortage. Sirtuin 1 (SIRT1) is a histone deacetylase which may regulate inflammatory cell activity and manage liver function in IRI, though its functional role and clinical relevance remains to be elucidated. We investigated the efficacy of SIRT1 activation in murine liver IRI model and verified the concept of putative SIRT1-mediated hepatoprotection in clinical liver transplantation...
July 18, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28717289/comparison-of-extended-nasolabial-flap-versus-buccal-fat-pad-graft-in-the-surgical-management-of-oral-submucous-fibrosis-a-prospective-pilot-study
#15
Sandeep B Patil, D Durairaj, G Suresh Kumar, D Karthikeyan, D Pradeep
AIM: To evaluate the application of extended nasolabial flap versus buccal fat pad graft in the surgical management of oral submucous fibrosis. SETTINGS AND DESIGN: This prospective study was carried out in the Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai. MATERIAL AND METHODS: A total of 8 patients (6 men and 2 women) with age range from 21 to 65 years were selected for study. These 8 patients were randomly divided into two groups of four namely group 1 and group 2...
September 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28717279/cystitis-glandularis-management-and-challenges-in-a-renal-transplant-recipient
#16
Himanshu Agarwal, Mukund G Andankar, Viswanath Billa
Cystitis cystica or glandularis is a clinical and pathological entity of the bladder mucosa occurring secondary to inflammation or chronic obstruction. Its premalignant nature remains controversial, especially in an immunocompromised transplant recipient. We present a rare case where a chronic kidney disease patient was found to have cystitis glandularis while being worked up for living-related donor renal transplant and describe its subsequent management.
July 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28717244/trail-regulatory-receptors-constrain-human-hepatic-stellate-cell-apoptosis
#17
Harsimran D Singh, Itziar Otano, Krista Rombouts, Kasha P Singh, Dimitra Peppa, Upkar S Gill, Katrin Böttcher, Patrick T F Kennedy, Jude Oben, Massimo Pinzani, Henning Walczak, Giuseppe Fusai, William M C Rosenberg, Mala K Maini
The TRAIL pathway can mediate apoptosis of hepatic stellate cells to promote the resolution of liver fibrosis. However, TRAIL has the capacity to bind to regulatory receptors in addition to death-inducing receptors; their differential roles in liver fibrosis have not been investigated. Here we have dissected the contribution of regulatory TRAIL receptors to apoptosis resistance in primary human hepatic stellate cells (hHSC). hHSC isolated from healthy margins of liver resections from different donors expressed variable levels of TRAIL-R2/3/4 (but negligible TRAIL-R1) ex vivo and after activation...
July 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28716239/acquired-transthyretin-amyloidosis-after-domino-liver-transplant-phenotypic-correlation-implication-of-liver-retransplantation
#18
Eli Muchtar, Martha Grogan, Surendra Dasari, Paul J Kurtin, Morie A Gertz
Reports of acquired ATTRm in domino liver transplant (DLT) recipients are infrequent and the approach to management is unknown. We describe two patients, an inherited ATTRm patient who underwent liver transplant and his liver recipient who developed acquired ATTRm 8years following transplantation. The clinical manifestations of amyloidosis were similar between patients and consisted of peripheral neuropathy, diarrhea and weight loss. Following liver transplantation, the DLT donor went into remission for 4years, but eventually progressed and died...
August 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28716143/the-factors-affecting-the-institutionalisation-of-two-policy-units-in-burkina-faso-s-health-system-a-case-study
#19
Andre Zida, John N Lavis, Nelson K Sewankambo, Bocar Kouyate, Kaelan Moat
BACKGROUND: This paper is one of three linked studies that attempts to understand the process of institutionalisation of policy units within Burkina Faso's health system. It examines the relationships between the existence of an institutional framework, data production capacity and other resource availability in the institutionalisation of policy units in health systems. It therefore contributes to our understanding of the dynamics linking the key drivers and indicators of institutionalisation...
July 17, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28715721/pushing-the-boundaries-in-liver-graft-utilisation-in-transplantation-case-report-of-a-donor-with-previous-bile-duct-injury-repair
#20
Asma Sultana, James J Powell, Gabriel C Oniscu
INTRODUCTION: Liver transplantation is a recognised treatment for extensive bile duct injuries with secondary biliary cirrhosis or recurring sepsis. However, there have been no reports of successful liver transplantation from a donor who sustained a previous bile duct injury. PRESENTATION OF CASE: Here we discuss the case of a liver transplant from a 51-year-old brain dead donor who had suffered a Strasberg E1 bile duct injury and had undergone a Roux-en-Y hepaticojejunostomy 24 years prior to donation...
June 29, 2017: International Journal of Surgery Case Reports
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