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https://www.readbyqxmd.com/read/28213388/effects-of-dopamine-donor-pretreatment-on-graft-survival-after-kidney-transplantation-a-randomized-trial
#1
Peter Schnuelle, Wilhelm H Schmitt, Christel Weiss, Antje Habicht, Lutz Renders, Martin Zeier, Felix Drüschler, Katharina Heller, Przemyslaw Pisarski, Bernhard Banas, Bernhard K Krämer, Matthias Jung, Kai Lopau, Christoph J Olbricht, Horst Weihprecht, Peter Schenker, Johan W De Fijter, Benito A Yard, Urs Benck
BACKGROUND AND OBJECTIVES: Donor dopamine improves initial graft function after kidney transplantation due to antioxidant properties. We investigated if a 4 µg/kg per minute continuous dopamine infusion administered after brain-death confirmation affects long-term graft survival and examined the exposure-response relationship with treatment duration. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Five-year follow-up of 487 renal transplant patients from 60 European centers who had participated in the randomized, multicenter trial of dopamine donor pretreatment between 2004 and 2007 (ClinicalTrials...
February 17, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28207629/short-and-long-term-outcome-after-lung-transplantation-from-circulatory-dead-donors-a-single-center-experience
#2
David Ruttens, An Martens, Sofie Ordies, Stijn E Verleden, Arne P Neyrinck, Robin Vos, Marc Boada Collado, Bart M Vanaudenaerde, Geert M Verleden, Dirk Van Raemdonck
BACKGROUND: Donation after cardiac death (DCD) to overcome the donor organ shortage is well accepted in the clinical setting, although long-term outcome after DCD lung transplantation (LTx) remains largely unknown. METHODS: In this retrospective study, DCD LTx recipients (n=59) were compared with a cohort of donation after brain-death (DBD) LTx recipients (n=331) transplanted between February 2007 and September 2013; follow-up was until January 1st 2016. Short-term (duration of mechanical ventilation, ICU stay, hospital stay and highest PGD score within 72 hours) and long-term (CLAD-free and overall survival) follow-up were compared over a median follow-up of 50...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28194201/an-investigation-into-the-factors-effective-in-the-consent-of-families-with-brain-dead-patients-candidates-for-organ-donation-in-isfahan-iran-in-2012-13
#3
Maryam Khalifehsoltani Khajooei, Fereshteh Zamani, Asieh Maghami Mehr
BACKGROUND: Studies have shown that, with regard to social, cultural, and institutional contexts, several factors affect family decision-making on organ donation. This study aimed to investigate the effective factors in organ donation by family members with brain-dead patients. MATERIALS AND METHODS: This was a descriptive-comparative study in which a researcher-made questionnaire was used to collect data. The reliability of the questionnaire was obtained as 0.81 using Cronbach's alpha...
November 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28187804/decompressive-craniectomy-in-acute-brain-injury
#4
D A Brown, E F M Wijdicks
Decompressive surgery to reduce pressure under the skull varies from a burrhole, bone flap to removal of a large skull segment. Decompressive craniectomy is the removal of a large enough segment of skull to reduce refractory intracranial pressure and to maintain cerebral compliance for the purpose of preventing neurologic deterioration. Decompressive hemicraniectomy and bifrontal craniectomy are the most commonly performed procedures. Bifrontal craniectomy is most often utilized with generalized cerebral edema in the absence of a focal mass lesion and when there are bilateral frontal contusions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28182115/organ-donation-and-elective-ventilation-a-necessary-strategy
#5
REVIEW
Dolores Escudero, Jesus Otero, Begoña Menéndez de León, Marcos Perez-Basterrechea
Organ transplantation is the sole treatment to improve or save the life of patients with final-stage organ failure. The shortage of available organs for transplantation constitutes a universal problem, estimating that 10% of patients on waiting lists die. Brain death is an undesirable result; nevertheless, it has beneficial side-effects since it is the most frequent source of organs for transplantation. However, this phenomenon is relatively uncommon and has a limited potential. One of the options that focuses on increasing organ donation is to admit patients with catastrophic brain injuries (with a high probability of brain death and nontreatable) to the Intensive Care Unit, with the only purpose of donation...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28176180/prevention-of-hypoxemia-during-apnea-testing-a-comparison-of-oxygen-insufflation-and-continuous-positive-airway-pressure
#6
Andreas H Kramer, Philippe Couillard, Ryan Bader, Peter Dhillon, Demetrios J Kutsogiannis, Christopher J Doig
BACKGROUND: Apnea testing is an essential step in the clinical diagnosis of brain death. Current international guidelines recommend placement of an oxygen (O2) insufflation catheter into the endotracheal tube to prevent hypoxemia, but use of a continuous positive airway pressure (CPAP) valve may be more effective at limiting arterial partial pressure of O2 (PO2) reduction. METHODS: We performed a multicenter study assessing consecutive apnea tests in 14 intensive care units (ICUs) in two cities utilizing differing protocols...
February 7, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28141909/improving-the-outcomes-of-organs-obtained-from-controlled-donation-after-circulatory-death-donors-using-abdominal-normothermic-regional-perfusion
#7
Eduardo Miñambres, Borja Suberviola, Beatriz Dominguez-Gil, Emilio Rodrigo, Juan Carlos Ruiz-San Millan, Juan Carlos Rodríguez-San Juan, Maria Angeles Ballesteros
Donation after circulatory death (DCD) has experienced a significant expansion over the last decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared to donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow prior to organ recovery in cDCD has been proposed as a better alternative than rapid recovery to reverse the effect of ischemia and improve recipients' outcome...
January 31, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28127623/regulation-of-cannabinoid-cb2-receptor-constitutive-activity-in-vivo-repeated-treatments-with-inverse-agonists-reverse-the-acute-activation-of-jnk-and-associated-apoptotic-signaling-in-mouse-brain
#8
Glòria Salort, María Álvaro-Bartolomé, Jesús A García-Sevilla
RATIONALE: CB2 receptors express constitutive activity and inverse agonists regulate receptor basal activity, which might be involved in death mechanisms. This study assessed the effects of a selective CB2 agonist (JWH133) and different CB2 inverse agonists (AM630, JTE907, raloxifene) on death pathways in brain. OBJECTIVES: The acute (JWH13) and the acute/chronic effects (AM630, JTE907, raloxifene) of CB2 ligands regulating pro-apoptotic c-Jun NH2-terminal kinase (p-JNK/JNK ratio) and associated signaling of extrinsic (Fas receptor, Fas-Associated death domain protein, FADD) and intrinsic (Bax, cytochrome c) death pathways (nuclear poly (ADP-ribose) polymerase PARP) were investigated in mouse brain...
January 26, 2017: Psychopharmacology
https://www.readbyqxmd.com/read/28117941/donor-preconditioning-after-the-onset-of-brain-death-with-dopamine-derivate-n-octanoyl-dopamine-improves-early-posttransplant-graft-function-in-the-rat
#9
Shiliang Li, Sevil Korkmaz-Icöz, Tamás Radovits, Mihály Ruppert, Rahel Spindler, Sivakkanan Loganathan, Péter Hegedűs, Paige Brlecic, Bastian Theisinger, Sonja Theisinger, Simone Höger, Maik Brune, Felix Lasitscha, Matthias Karck, Benito Yard, Gábor Szabó
Heart transplantation is the therapy of choice for end-stage heart failure. However, hemodynamic instability, which has been demonstrated in brain-dead donors (BDD), could also affect the posttransplant graft function. We tested the hypothesis that treatment of the BDD with the dopamine derivate n-octanoyl-dopamine (NOD) improves donor cardiac and graft function after transplantation. Donor rats were given a continuous intravenous infusion of either NOD (0.882mg/kg/h, BDD+NOD, n=6) or a physiological saline vehicle (BDD, n=9) for 5h after the induction of brain death by inflation of a subdural balloon catheter...
January 24, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28114163/doppler-ultrasonography-of-the-central-retinal-vessels-in-children-with-brain-death
#10
Becky J Riggs, Joanna S Cohen, Bhavana Shivakumar, Carmelina Trimboli-Heidler, Jason T Patregnani, Marijean M Miller, Michael C Spaeder, Nathan P Dean
OBJECTIVE: The purpose of this observational study is to explore if bedside Doppler ultrasonography of the central retinal vessels has the potential to become an ancillary study to support the timely diagnosis of brain death in children. DESIGN: Seventeen-month prospective observational cohort. SETTING: Forty-four bed pediatric medical and surgical ICU in an academic teaching hospital. PATIENTS: All children 0-18 years old who were clinically evaluated for brain death at Children's National Health Systems were enrolled and followed until discharge or death...
January 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28111805/ureteric-complications-in-recipients-of-kidneys-from-donation-after-circulatory-death-donors
#11
Trina-Jo Mah, Dermot H Mallon, Oliver Brewster, Kourosh Saeb-Parsy, Andrew J Butler, J Andrew Bradley, Vasilis Kosmoliaptsis
A large increase in the use of kidneys from donation after circulatory death (DCD) donors prompted us to examine the impact of donor type on the incidence of ureteric complications (UCs; ureteric stenosis, urinary leak) after kidney transplantation. We studied 1072 consecutive kidney transplants [DCD n=494, live-donor (LD) n=273, donation after brain death (DBD) n=305] performed during 2008 to 2014. Overall, there was a low incidence of UCs after kidney transplantation (3.5%). Despite a trend towards higher incidence of UCs in DCD (n=22, 4...
January 23, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28104145/a-case-report-of-successful-kidney-donation-after-brain-death-following-nicotine-intoxication
#12
M Räsänen, I Helanterä, J Kalliomäki, J Savikko, M Parry, M Lempinen
Nicotine intoxication is a rare cause of death and can lead to brain death after respiratory arrest and hypoxic-ischemic encephalopathy. To our knowledge, no previous reports regarding organ donation after nicotine intoxication have been described. We present a successful case of kidney donation after brain death caused by subcutaneous nicotine overdose from liquid nicotine from an e-cigarette cartridge in an attempted suicide. Both kidneys were transplanted successfully with immediate graft function, and both recipients were discharged at postoperative day 9 with normal plasma creatinine levels...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28103768/authors-response-to-sensory-input-and-motor-responses-after-brain-death-diagnosis
#13
Abhay Kumar, Rajat Dhar
No abstract text is available yet for this article.
February 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28093562/factors-associated-with-a-family-s-delay-of-decision-for-organ-donation-after-brain-death
#14
Sang Youb Han, Jae Il Kim, Eun-Woo Lee, Hye-Yeon Jang, Kum Hyun Han, Se Won Oh, Young-Nam Roh
BACKGROUND This study aimed to explore the factors associated with a family's delay of decision for organ donation after brain death, and to investigate the effect of such a delay on organ donation. MATERIAL AND METHODS Medical records and data on counseling about organ donation with the families of 107 brain-dead potential donors between September 2012 and March 2016 at a single tertiary medical center were retrospectively reviewed. RESULTS The final consent rate was 58% (62/107), and successful donation was performed in 40% (43/107)...
January 17, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28079146/nitrosative-stress-induced-disruption-of-baroreflex-neural-circuits-in-a-rat-model-of-hepatic-encephalopathy-a-dti-study
#15
Ching-Yi Tsai, Chia-Hao Su, Julie Y H Chan, Samuel H H Chan
The onset of hepatic encephalopathy (HE) in liver failure is associated with high mortality; the underlying mechanism is undecided. Here we report that in an acute liver failure model employing intraperitoneal administration of thioacetamide in Sprague-Dawley rats, diffusion weighted imaging revealed a progressive reduction in apparent diffusion coefficient in the brain stem. Diffusion tensor imaging further showed that the connectivity between nucleus tractus solitarii (NTS), the terminal site of baroreceptor afferents in brain stem and rostral ventrolateral medulla (RVLM), the origin of sympathetic innervation of blood vessels, was progressively disrupted until its disappearance, coincidental with the irreversible cessation of baroreflex-mediated sympathetic vasomotor tone signifying clinically the occurrence of brain death...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28078616/physician-power-to-declare-death-by-neurologic-criteria-threatened
#16
Ariane Lewis, Thaddeus Mason Pope
BACKGROUND: Three recent lawsuits that address declaration of brain death (BD) garnered significant media attention and threaten to limit physician power to declare BD. METHODS: We discuss these cases and their consequences including: the right to refuse an apnea test, accepted medical standards for declaration of BD, and the irreversibility of BD. RESULTS: These cases warrant discussion because they threaten to: limit physicians' power to determine death; incite families to seek injunctions to continue organ support after BD; and force hospitals to dispense valuable resources to dead patients in lieu of patients with reparable illnesses or injuries...
January 11, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28077490/improving-uniformity-in-brain-death-determination-policies-over-time
#17
Hilary H Wang, Panayiotis N Varelas, Galen V Henderson, Eelco F M Wijdicks, David M Greer
OBJECTIVE: To demonstrate that progress has been made in unifying brain death determination guidelines in the last decade by directly comparing the policies of the US News and World Report's top 50 ranked neurologic institutions from 2006 and 2015. METHODS: We solicited official hospital guidelines in 2015 from these top 50 institutions, generated summary statistics of their criteria as benchmarked against the American Academy of Neurology Practice Parameters (AANPP) and the comparison 2006 cohort in 5 key categories, and statistically compared the 2 cohorts' compliance with the AANPP...
January 11, 2017: Neurology
https://www.readbyqxmd.com/read/28066980/how-spain-reached-40-deceased-organ-donors-per-million-population
#18
REVIEW
R Matesanz, B Domínguez-Gil, E Coll, B Mahíllo, R Marazuela
With 40 donors and more than 100 transplant procedures per million population in 2015, Spain holds a privileged position worldwide in providing transplant services to its patient population. The Spanish success derives from a specific organizational approach to ensure the systematic identification of opportunities for organ donation and their transition to actual donation and to promote public support for the donation of organs after death. The Spanish results are to be highlighted in the context of the dramatic decline in the incidence of brain death and the changes in end-of-life care practices in the country since the beginning of the century...
January 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28031256/organ-donation-after-medical-assistance-in-dying-or-cessation-of-life-sustaining-treatment-requested-by-conscious-patients-the-canadian-context
#19
Julie Allard, Marie-Chantal Fortin
In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many implications, including the possibility of combining this practice with organ donation through the controlled donation after cardiac death (cDCD) protocol. cDCD most often occurs in cases where the patient has a severe neurological injury but does not meet all the criteria for brain death...
December 28, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28027614/decision-modelling-in-donation-after-circulatory-death-dcd-liver-transplantation
#20
K A McLean, J Camilleri-Brennan, S R Knight, T Drake, R Ots, C A Shaw, S J Wigmore, E M Harrison
INTRODUCTION: Donation after circulatory death (DCD) liver allografts are increasingly used for transplantation. However, the post-transplantation clinical and quality of life outcomes of DCD recipients are traditionally considered to be inferior compared with donation after brain death (DBD) allograft recipients. Decision making for such marginal organs can be difficult. This study investigated the optimal decision to accept or decline a DCD liver allograft for a patient based on their current health...
December 27, 2016: Liver Transplantation
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