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"Brain death"

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https://www.readbyqxmd.com/read/29342477/-new-challenges-diagnosis-of-brain-death-in-newborn-children-and-adolescents
#1
Florian Masuhr, Christof Dame, Alexander Gratopp, Olaf Hoffmann
BACKGROUND: According to the current update of the German guideline on brain death (BD), participation of paediatricians is now mandatory for the examination of BD in patients younger than 14 years. The present analysis focuses on the previous practice and highlights the challenges that arise from the current update. METHODS: Retrospective evaluation of the patient registry of the German organ procurement organisation (north-eastern bureau) between January, 2001 and December, 2010 with specified paediatric age groups according to the 4th update of the German guideline on BD from the 1st of July 2015...
January 17, 2018: Klinische Pädiatrie
https://www.readbyqxmd.com/read/29338388/novel-fusion-protein-targeting-mitochondrial-dna-improves-pancreatic-islet-functional-potency-and-islet-transplantation-outcomes
#2
Juan S Danobeitia, Peter J Chlebeck, Inna Shokolenko, Xiaobo Ma, Glenn Wilson, Luis A Fernandez
Long-term graft survival is an ongoing challenge in the field of islet transplantation. With the growing demand for transplantable organs, therapies to improve organ quality and reduce the incidence of graft dysfunction are of paramount importance. We evaluated the protective role of a recombinant DNA repair protein targeted to mitochondria (Exscien I-III), as a therapeutic agent using a rodent model of pancreatic islet transplantation. We first investigated the effect of therapy on isolated rat islets cultured with pro-inflammatory cytokines (interleukin-1 β, interferon γ, and tumor necrosis factor α) for 48 h and documented a significant reduction in apoptosis by flow cytometry, improved viability by immunofluorescence, and conserved functional potency in vitro and in vivo in Exscien I-III-treated islets...
November 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29333823/brain-death-and-organ-donation-in-argentine-pediatric-intensive-care-units-a-multicenter-study
#3
Germán Bonetto, Pedro Taffarel, Melisa Gamerman, Facundo Jorro Barón, Carolina Gaviña, Laura Flores, Emanuel Fernández, Andrea Zifferman, Gustavo Debaisi, Marcelo Acerenza, Jorge Selandari, Luis Landry, Ariel Cacciamano, Alfredo Clavel, Patricia Capocasa, Bernardo Calvo, Marcial Angos
Brain death (BD) is a condition determined by the complete and irreversible absence of brain functions. Maintenance of vital functions creates an opportunity for organ donation. A retrospective study was carried out in 7 pediatric intensive care units of Argentina (from 1/1/2013 to 9/30/2016) to determine the incidence of clinical and certified BD, and the proportion of effective transplantations. Among deceased patients, 19.14% (147/768) met the clinical requirements for BD, and the main cause of BD was multiple trauma...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29331874/thyroid-hormone-resuscitation-after-brain-death-in-potential-organ-donors-a-primer-for-neurocritical-care-providers-and-narrative-review-of-the-literature
#4
REVIEW
Ian A Buchanan, Vivek A Mehta
Solid organ transplantation has become a mainstay in the contemporary management of end-stage organ failures fueled by advances in immunosuppression, intensive care and surgical technology. Every year, a vast number of transplantable organs is lost on account of hemodynamic instability in potential brain-dead organ donors. Because of a growing organ shortage, measures that increase total donor supply pools are desperately needed. Thyroid hormone has been identified as an adjunctive therapy in donor management due to its potential for increasing organ supply and is currently endorsed by transplant organizations such as United Network for Organ Sharing (UNOS)...
January 8, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29329407/transplant-buccaneers-p-k-sen-and-india-s-first-heart-transplant-february-1968
#5
David S Jones, Kavita Sivaramakrishnan
On 17 February 1968, Bombay surgeon Prafulla Kumar Sen transplanted a human heart, becoming the fourth surgeon in the world to attempt the feat. Even though the patient survived just three hours, the feat won Sen worldwide acclaim. The ability of Sen's team to join the ranks of the world's surgical pioneers raises interesting questions. How was Sen able to transplant so quickly? He had to train a team of collaborators, import or reverse engineer technologies and techniques that had been developed largely in the United States, and begin conversations with Indian political authorities about the contested concept of brain death...
January 10, 2018: Journal of the History of Medicine and Allied Sciences
https://www.readbyqxmd.com/read/29326416/strategies-to-restore-adenosine-triphosphate-atp-level-after-more-than-20-hours-of-cold-ischemia-time-in-human-marginal-kidney-grafts
#6
Matteo Ravaioli, Maurizio Baldassare, Francesco Vasuri, Gianandrea Pasquinelli, Maristella Laggetta, Sabrina Valente, Vanessa De Pace, Flavia Neri, Antonio Siniscalchi, Chiara Zanfi, Valentina R Bertuzzo, Paolo Caraceni, Davide Trerè, Pasquale Longobardi, Antonio D Pinna
BACKGROUND The persisting organ shortage in the field of transplantation recommends the use of marginal kidneys which poorly tolerate ischemic damage. Adenosine triphosphate (ATP) depletion during cold ischemia time (CIT) is considered crucial for graft function. We tested different strategies of kidney perfusion before transplantation in the attempt to improve the technique. MATERIAL AND METHODS Twenty human discarded kidneys from donors after brain death and with at least 20 hours of CIT were randomized to the following experimental groups (treatment time three-hours at 4°C): a) static cold storage (CS); b) static cold hyperbaric oxygenation (Hyp); c) hypothermic perfusion (PE); d) hypothermic perfusion in hyperbaric oxygenation (PE-Hyp); and e) hypothermic oxygenated perfusion (PE-O2)...
January 12, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29317989/erythropoietin-therapy-after-out-of-hospital-cardiac-arrest-a-systematic-review-and-meta-analysis
#7
Rahul Chaudhary, Jalaj Garg, Parasuram Krishnamoorthy, Kevin Bliden, Neeraj Shah, Nayan Agarwal, Rahul Gupta, Abhishek Sharma, Karl B Kern, Nainesh C Patel, Paul Gurbel
AIM: To assess safety and efficacy of early erythropoietin (Epo) administration in patients with out-of-hospital cardiac arrest (OHCA). METHODS: A systematic literature search was performed using PubMed, MEDLINE, EMBASE, EBSCO, CINAHL, Web of Science and Cochrane databases, of all studies published from the inception through October 10, 2016. Inclusion criteria included: (1) Adult humans with OHCA and successful sustained return of spontaneous circulation; and (2) studies including mortality/brain death, acute thrombotic events as their end points...
December 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29314286/the-impact-of-kidney-donor-profile-index-kdpi-on-delayed-graft-function-and-transplant-outcomes-a-single-center-analysis
#8
Tiffany J Zens, Juan S Danobeitia, Glen Leverson, Peter J Chlebeck, Laura J Zitur, Robert R Redfield, Anthony M D'Alessandro, Scott Odorico, Dixon B Kaufman, Luis A Fernandez
INTRODUCTION: Renal transplant outcomes result from a combination of factors. Traditionally, donor factors were summarized by classifying kidneys as extended criteria or standard criteria. In 2014, the nomenclature changed to describe donor factors with the kidney donor profile index (KDPI). We aim to evaluate the relationship between KDPI and delayed graft function, and the impact KDPI on transplant outcomes for both donor after cardiac death (DCD) and donor after brain death (DBD) ...
January 3, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29312561/therapeutic-effects-of-adipose-derived-mesenchymal-stem-cells-against-brain-death-induced-remote-organ-damage-and-post-heart-transplant-acute-rejection
#9
Hon-Kan Yip, Mel S Lee, Cheuk-Kwan Sun, Kuan-Hung Chen, Han-Tan Chai, Pei-Hsun Sung, Kun-Chen Lin, Sheung-Fat Ko, Chun-Man Yuen, Chu-Feng Liu, Pei-Lin Shao, Fan-Yen Lee
We tested the hypothesis that allogenic adipose-derived mesenchymal stem cells (ADMSCs) alleviated brain death (BD)-induced remote organ damage and events of post heart-transplant acute rejection. To determine the impact of BD on remote organ damage, adult-male F344 rats (n=24) were categorized sham-control (SC), BD and BDMSC (allogenic ADMSC/1.2 × 106 cells/derived from F344 by intravenous transfusion 3 h after BD procedure). To determine the protective effect of allogenic ADMSCs, animals (n=8/each group in F344/Lewis) were categorized into groups BD-T(F344 heart transplanted into Lewis by 6h after BD), BD-TMSC(D1/3) (BD induction for 6h then heart transplantation, and allogenic ADMSCs transfusion at days 1 and 5 after heart transplantation), BD-TMSC(3h) (BD + ADMSC/1...
December 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29290899/a-lazarus-effect-a-case-report-of-bupropion-overdose-mimicking-brain-death
#10
Douglas Stranges, Alan Lucerna, James Espinosa, Neveen Malik, Marc Mongeau, Kelly Schiers, Syed Omar Shah, Joan Wiley, Philip Willsie
No abstract text is available yet for this article.
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29287260/design-and-validation-of-an-automated-solid-phase-extraction-liquid-chromatography-coupled-mass-spectrometry-method-for-the-quantification-of-propofol-in-plasma
#11
Felix Maurer, Teodora Shopova, Beate Wolf, Daniel Kiefer, Tobias Hüppe, Thomas Volk, Daniel I Sessler, Sascha Kreuer
Propofol concentration in human plasma can be quantified by liquid chromatography coupled mass spectrometry. Sample preparation usually requires solid phase extraction to remove matrix components and enrich the analyte. To facilitate user-independent measurements and speed extraction, we developed and validated a fully automated high throughput in-line sample preparation system with direct injection into liquid chromatography coupled mass spectrometry. We assessed linearity of each method over the clinically relevant concentration range from 0...
December 21, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29276852/organ-donor-management-part-1-toward-a-consensus-to-guide-anesthesia-services-during-donation-after-brain-death
#12
Michael J Souter, E Eidbo, James Y Findlay, Daniel J Lebovitz, Marina Moguilevitch, Nikole A Neidlinger, Gerhard Wagener, Anil S Paramesh, Claus U Niemann, Pamela R Roberts, Ernesto A Pretto
Worldwide 715 482 patients have received a lifesaving organ transplant since 1988. During this time, there have been advances in donor management and in the perioperative care of the organ transplant recipient, resulting in marked improvements in long-term survival. Although the number of organs recovered has increased year after year, a greater demand has produced a critical organ shortage. The majority of organs are from deceased donors; however, some are not suitable for transplantation. Some of this loss is due to management of the donor...
December 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29262441/imaging-in-neurocritical-care-practice
#13
Craig Williamson, Larry Morgan, Joshua P Klein
The use of neuroimaging in conjunction with serial neurological examinations is a core component of modern neurocritical care practice. Although there is a growing role for other neuromonitoring techniques, the ability to quickly and accurately interpret images in the context of a patient's clinical status arguably remains the indispensable skill for neurocritical care practitioners. Due to its rapid acquisition time and excellent ability to detect intracerebral hemorrhage (ICH), cerebral edema, and signs of elevated intracranial pressure, computed tomography (CT) remains the most useful neuroimaging technique for intensive care unit (ICU) patients...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29251586/knowledge-of-the-concept-of-brain-death-among-the-latin-american-population-residing-in-spain
#14
Antonio Ríos, Ana Isabel López-Navas, Laura Martínez-Alarcón, Gregorio Garrido, Marco Antonio Ayala-García, Pablo Ramírez, Antonio Miguel Hernández, Pascual Parrilla
OBJECTIVES: The knowledge of brain death is fundamental for being able to understand the organ donation process and for ensuring its acceptance or rejection. Here, we analyzed the level of knowledge of the concept of brain death among Latin-American individuals who are residents of Spain to determine the factors affecting this knowledge. MATERIALS AND METHODS: Our patient group was a sample of 1314 Latin-American residents of Spain, obtained randomly and stratified according to the respondent's nationality, age, and sex...
December 18, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29241598/organ-donation-after-controlled-cardiac-death-under-maastricht-category-iii-ethical-implications-and-end-of-life-care
#15
M Isabel González-Méndez, Luís López-Rodríguez
The decrease in potential donation after brain death has resulted in a need to evaluate alternative sources. Donation after cardiac death is a good option. The objectives of this article were to describe the Maastricht type iii controlled organ donation characteristics and to determine end-of-life care and the role of nurses in the donation process. In this type of donation, cardiocirculatory arrest is predictable after the limitation of life sustaining treatments. These are patients for whom there are no effective therapy options and, in the context of an organised and planned practice involving all the professionals involved in the care of the patient, the decision is made, in consultation with the family, to withdraw life support measures...
December 11, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/29227984/microrna-146b-5p-identified-in-porcine-liver-donation-model-is-associated-with-early-allograft-dysfunction-in-human-liver-transplantation
#16
Cheukfai Li, Qiang Zhao, Wei Zhang, Maogen Chen, Weiqiang Ju, Linwei Wu, Ming Han, Yi Ma, Xiaofeng Zhu, Dongping Wang, Zhiyong Guo, Xiaoshun He
BACKGROUND Poor transplant outcome was observed in donation after brain death followed by circulatory death (DBCD), since the donor organs suffered both cytokine storm of brain death and warm ischemia injury. MicroRNAs (miRNAs) have emerged as promising disease biomarkers, so we sought to establish a miRNA signature of porcine DBCD and verify the findings in human liver transplantation. MATERIAL AND METHODS MiRNA expression was determined with miRNA sequencing in 3 types of the porcine model of organ donation, including donation after brain death (DBD) group, donation after circulatory death (DCD) group, and DBCD group...
December 11, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29226765/never-declared-brain-dead-potential-organ-donors-an-additional-source-of-donor-organs
#17
Patricia A Webster, Lori E Markham
CONTEXT: Patients never declared brain dead may represent an additional source of donor organs. OBJECTIVE: To determine the number of likely brain dead potential donors who are never declared brain dead and to compare them with brain dead and donation after cardiac death potential organ donors. DESIGN, SETTING, AND PARTICIPANTS: This study was a retrospective chart review of all catastrophically brain-injured patients referred to a single-organ procurement organization (OPO) over a 4-year period...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29216295/alpha-1-antichymotrypsin-is-involved-in-astrocyte-injury-in-concert-with-arginine-vasopressin-during-the-development-of-acute-hepatic-encephalopathy
#18
Jonghyuk Park, Takahiro Masaki, Yoshihiro Mezaki, Hiroshi Yokoyama, Mariko Nakamura, Haruka Maehashi, Takahiko J Fujimi, Sabine S Gouraud, Keisuke Nagatsuma, Madoka Nakagomi, Naofumi Kimura, Tomokazu Matsuura
BACKGROUND AND AIMS: We developed a bio-artificial liver (BAL) using a radial-flow bioreactor and rescued mini-pig models with lethal acute liver failure (ALF). The point of the rescue is the recovery from hepatic encephalopathy (HE). HE on ALF has sometimes resulted in brain death following brain edema with astrocyte swelling. Several factors, including ammonia and glutamine, have been reported to induce astrocyte swelling and injury. However, many clinicians believe that there are any other factors involved in the development of HE...
2017: PloS One
https://www.readbyqxmd.com/read/29206661/the-need-and-opportunity-for-donation-after-circulatory-death-worldwide
#19
Martí Manyalich, Helen Nelson, Francis L Delmonico
PURPOSE OF REVIEW: The global shortage of organ donors will not be resolved solely by relying on deceased donation following a brain death determination (DBD). Expansion of deceased donation after circulatory death (DCD) will be needed to address the shortfall of organs for transplantation. Approximately 120 000 organ transplants are performed each year; however, the WHO estimates that this number of transplants only resolves 10% of the annual worldwide transplant need. RECENT FINDINGS: The report addresses the opportunity of DCD expansion by evaluating the DCD potential that is not being realized, the utility of DCD enabling DBD to emerge in some clinical situations, by the effectiveness of a donor registry in achieving DCD, and by the current clinical research of heart, lung, and liver transplantation from DCD...
December 4, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29202255/patterns-of-organ-donation-in-children-in-australia-and-new-zealand
#20
Tarryn Corkery-Lavender, Johnny Millar, Elena Cavazzoni, Ben Gelbart
OBJECTIVES: Paediatric organ donation (OD) represents a small proportion of total OD in Australia and New Zealand. Our aim was to describe the patterns of paediatric OD, specifically, the demographic characteristics and donation outcomes over two time periods. DESIGN: We performed a retrospective study using national OD and intensive care registry data from intensive care units in Australia and New Zealand from 1 January 2000 to 31 December 2015. Data were analysed between two time periods...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
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