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"Brain death"

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https://www.readbyqxmd.com/read/28093562/factors-associated-with-a-family-s-delay-of-decision-for-organ-donation-after-brain-death
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
https://www.readbyqxmd.com/read/28027600/comparison-of-long-term-outcomes-and-quality-of-life-in-recipients-of-donation-after-cardiac-death-liver-grafts-with-a-propensity-matched-cohort
#8
K P Croome, D D Lee, D K Perry, J M Burns, J H Nguyen, A P Keaveny, C B Taner
BACKGROUND: The use of liver grafts from donation after cardiac death donors (DCD LT) has been limited due to the increased rate of graft failure, mostly related to ischemic cholangiopathy(IC). It is our hypothesis that long term outcomes and quality of life similar to patients undergoing liver transplantation with donation after brain death donors (DBD LT) can be achieved. METHODS: Clinical outcomes of all patients undergoing DCD LT (n = 300) between 1998-2015 were compared to a propensity score matched cohort of patients undergoing DBD LT (n = 300)...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28024551/end-of-life-issues-in-cardiac-critical-care-the-option-of-organ-donation
#9
REVIEW
Karim Serri, Pierre Marsolais
Despite important advances in the care of postcardiac arrest patients, severe brain injury remains one of the major causes of death in the cardiac intensive care unit. Neurological prognostication after cardiac arrest has evolved significantly since the introduction of therapeutic hypothermia. It now relies on a multimodal approach and a minimal observation period of 72 hours is usually advocated. However, when brain injury is severe and the prognosis considered dismal, patients become eligible for organ donation...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28003943/envisioning-and-leading-organizational-transformation-one-organ-procurement-organization-s-journey
#10
Jeffrey P Orlowski
BACKGROUND:  In 2012, one organ procurement organization (OPO) welcomed a new President and Chief Executive Officer (CEO). This OPO, LifeShare Transplant Donor Services of Oklahoma (LifeShare), had just celebrated its 25th anniversary in 2011. While LifeShare was well-established chronologically, growth in organ donors and organs transplanted from these donors had occurred at a much slower rate during the collaborative era and afterward (2003-2011) than the donor/transplant growth the United States (US), as a whole, had experienced...
November 15, 2016: Curēus
https://www.readbyqxmd.com/read/27993450/predictive-patterns-of-sensory-evoked-potentials-in-comatose-brain-injured-patients-evolving-to-brain-death
#11
Maenia Scarpino, Giovanni Lanzo, Riccardo Carrai, Francesco Lolli, Maria Luisa Migliaccio, Maddalena Spalletti, Adriano Peris, Aldo Amantini, Antonello Grippo
OBJECTIVE: To assess whether Somatosensory Evoked Potentials (SEPs), recorded within 24h after ICU admission, are reliable predictors of brain death (BD) in comatose patients with acquired brain injury of various aetiologies. METHODS: SEPs were classified as absent (A), pathological (P), and normal (N). Considering SEP recordings from both hemispheres, 6 patterns were identified: NN, NP, PP, NA, AP, and AA. The final endpoint was BD. RESULTS: Of the 203 patients included in the study, 70 (34%) evolved toward BD...
December 16, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27989433/complement-mediated-inflammation-and-injury-in-brain-dead-organ-donors
#12
Felix Poppelaars, Marc A Seelen
The importance of the complement system in renal ischemia-reperfusion injury and acute rejection is widely recognized, however its contribution to the pathogenesis of tissue damage in the donor remains underexposed. Brain-dead (BD) organ donors are still the primary source of organs for transplantation. Brain death is characterized by hemodynamic changes, hormonal dysregulation, and immunological activation. Recently, the complement system has been shown to be involved. In BD organ donors, complement is activated systemically and locally and is an important mediator of inflammation and graft injury...
December 15, 2016: Molecular Immunology
https://www.readbyqxmd.com/read/27987378/in-vitro-differentiation-of-neural-stem-cells-derived-from-human-olfactory-bulb-into-dopaminergic-like-neurons
#13
Rafieh Alizadeh, Gholamreza Hassanzadeh, Mohammad Taghi Joghataei, Mansoureh Soleimani, Fatemeh Moradi, Shahram Mohammadpour, Jahangir Ghorbani, Ali Safavi, Maryam Sarbishegi, Vahid Pirhajati Mahabadi, Leila Alizadeh, Mahmoudreza Hadjighassem
Obtaining new accessible source of neuronal stem cells that can be used in Parkinson's disease cell transplant is the aim of this research. The human olfactory bulb contains neural stem cells (NSCs) that are responsible for the neurogenesis in the brain and the replacement of damaged cellular components throughout life. NSCs are capable of differentiating into neuronal and glial cells. We isolated NSCs from brain-death donor's olfactory bub and differentiate them to dopaminergic neurons. The obtained olfactory bulb tissues were cultured in DMEM12, B27 supplemented with bFGF, EGF, and LIF...
December 17, 2016: European Journal of Neuroscience
https://www.readbyqxmd.com/read/27982363/-efficiency-indicators-to-assess-the-organ-donation-and-transplantation-process-systematic-review-of-the-literature
#14
Marina Martins Siqueira, Claudia Affonso Araujo, Bartira de Aguiar Roza, Janine Schirmer
Objective: To search the literature and identify indicators used to monitor and control the organ donation and transplantation process and to group these indicators into categories. Method: In November 2014, a systematic review of the literature was carried out in the following databases: Biblioteca Virtual em Saúde (BVS), EBSCO, Emerald, Proquest, Science Direct, and Web of Science. The following search terms (and the corresponding terms in Brazilian Portuguese) were employed: "efficiency," "indicators," "organ donation," "tissue and organ procurement," and "organ transplantation...
August 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/27979629/estimation-of-potential-donors-after-cardiocirculatory-death-in-elche-university-general-hospital-alicante-spain
#15
E Tenza, R Valero, V Arraez
OBJECTIVE: To evaluate the number and characteristics of potential organ donors among cardiocirculatory death cases. DESIGN AND SETTING: A retrospective observational study was made of individuals between 15-65 years of age who died in the period 2006-2014 in Elche University General Hospital (Alicante, Spain). INTERVENTION: A univariate analysis and binary logistic regression predictive model were performed to discriminate factors related to donation contraindication...
December 12, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27932184/intrapancreatic-splenule-in-a-pancreas-allograft-case-report
#16
K Yadav, O K Serrano, R Kandaswamy
A 16-year-old white man was involved in a motor vehicle collision and suffered head, chest, and abdominal trauma. Despite initial resuscitative efforts, he progressed to brain death and was designated to be an organ donor by his family. He had no earlier medical or surgical history and no high-risk behaviors. Blood work revealed normal creatinine, liver function tests, lipase, and amylase. Viral serologies were negative except for cytomegalovirus IgG and Epstein-Barr virus nucleic acid. Imaging revealed a right kidney contusion, a manubrial fracture, and fractures of right first rib and bilateral scapulae...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932147/case-report-demonstrating-the-safe-and-effective-means-of-expanding-the-donor-pool-with-livers-recovered-from-brain-dead-donors-after-ethylene-glycol-toxicity
#17
M H Fujii, J Gierlach, S Alami, C Ericksen, R Kashyap, M S Orloff, C E Marroquin
The growing disparity between organ supply and demand has become the greatest hurdle facing transplant professionals and life-saving transplants. Because the organ shortage has become the rate-limiting step to effective transplants, it is critical for the transplant community to identify viable mechanisms to expand the donor pool and use every available allograft. Although using kidneys from deceased donors whose demise was secondary to ethylene glycol (EG) toxicity requires great deliberation and precise timing as described by Barbas et al [5], using hepatic allografts in this setting involves far less risk...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932094/non-heart-beating-donor-kidney-transplantation-survival-is-similar-to-donation-after-brain-death-comparative-study-with-controls-in-a-regional-program
#18
M A Gentil, P Castro de la Nuez, C Gonzalez-Corvillo, M C de Gracia, M Cabello, M A Mazuecos, A Rodriguez-Benot, L Ballesteros, A Osuna, M Alonso
Non-heart-beating donors (NHBD) are an increasing source of organs for kidney transplantation (KT) compared with donation after brain death (DBD), but the results in each regional transplantation program require local analysis. We compared 164 KT from NHBD (83 Maastrich type II A-B [T2] and 81 type III [T3]) with 328 DBD controls. NHBD kidneys were implanted with less cold ischemia, mean time on renal replacement therapy for NHBD recipients before transplantation was less too, and a higher proportion of thymoglobulin was also used...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27932093/midterm-results-of-renal-transplantation-from-controlled-cardiac-death-donors-are-similar-to-those-from-brain-death-donors
#19
O Lafuente, B Sánchez-Sobrino, M Pérez, P López-Sánchez, D Janeiro, E Rubio, A Huerta, M Marques, M R Llópez-Carratala, J J Rubio, J Portolés
BACKGROUND: The systematic use of grafts from controlled donors after cardiac death (cDCD) started in our country in 2012 and expanded with the strategic support of National Transplant Organization. We present our experience in kidney transplantation with organs from cDCD donors with a mean follow-up of 3 years. METHODS: Observational prospective study of all transplants performed in our center in 2012-2013 followed to 2016. The immunosuppression protocols were triple therapy for low-risk recipients from a standard brain death donor (DBD), adding basiliximab or thymoglobulin induction for extended-criteria donor or high-risk recipient, respectively, and thymoglobulin induction plus triple therapy for all cDCD recipients...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931564/taking-care-of-relationships-in-the-intensive-care-unit-positive-impact-on-family-consent-for-organ-donation
#20
M G Bocci, C D'Alò, R Barelli, S Inguscio, A Prestifilippo, S Di Paolo, S Lochi, M Fanfarillo, D L Grieco, R Maviglia, A Caricato, G Mistraletti, S Pulitanò, M Antonelli, C Sandroni
BACKGROUND: Organ donation refusal from relatives of potential donors with brain death significantly reduces organ availability. The need for organ donation has increased over time, but the shortage of available donors is the major limiting factor in transplantation. We analyzed the impact of a new systematic communication approach between medical staff and patients' relatives on the rate of consent to organ donation. METHODS: The study was conducted as a single-center, non-randomized, controlled, before-and-after study at an 18-bed intensive care unit (ICU) of a university hospital...
December 2016: Transplantation Proceedings
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