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https://www.readbyqxmd.com/read/28815385/stretching-the-boundaries-of-parental-responsibility-and-new-legal-guidelines-for-determination-of-brain-death
#1
Bernadette Richards, Thaddeus Mason Pope
No abstract text is available yet for this article.
August 16, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28814093/role-of-ischemic-modified-albumin-in-the-early-diagnosis-of-increased-intracranial-pressure-and-brain-death
#2
I Kara, H K Pampal, F Yildirim, E Dilekoz, G Emmez, F P U, M Kocabiyik, C B Demirel
AIM: Increased intracranial pressure following trauma and subsequent possible development of brain death are important factors for morbidity and mortality due to ischemic changes. We aimed to establish the role of ischemic modified albumin (IMA) in the early diagnosis of the process, starting with increased intracranial pressure and ending with brain death. MATERIALS AND METHODS: Eighteen Wistar-Albino rats were divided into three groups; control (CG, n = 6), increased intracranial pressure (ICPG, n = 6), and brain death (BDG, n = 6)...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28802764/factors-influencing-renal-graft-survival-7-year-experience-of-a-single-center
#3
Rūta Auglienė, Eglė Dalinkevičienė, Vytautas Kuzminskis, Mindaugas Jievaltas, Laima Peleckaitė, Agnė Gryguc, Edgaras Stankevičius, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: The demand for kidney transplants exceeds the existing supply. This leads to a recently growing interest of research in the area of factors that could prolong graft long-term outcomes and survival. In Lithuania, approximately 90% of kidney transplantations are from deceased donors. Donor organs are received and shared only inside the country territory in Lithuania; therefore, donor data is accurate and precise. This study was performed to present particularities of kidney transplantation data in Lithuania and to identify the effect of donor and recipient factors and histologic findings on renal graft outcomes...
July 29, 2017: Medicina
https://www.readbyqxmd.com/read/28801937/in-situ-split-liver-splitting-under-extra-corporeal-membrane-oxygenation-in-brain-dead-donor
#4
Assalino Michela, Pietro Majno, Christian Toso, Thierry Berney, Raphaël Giraud, Philipp Dutkowski, Axel Andres, Barbara Wildhaber, Laure Elkrief
Hemodynamic instability is generally considered as a contraindication to liver splitting, in particular when using an in-situ technique. We describe the cases of two young donors with brain death in whom refractory cardiac arrest and hemodynamic instability were supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO), allowing uneventful in situ splitting. Two adult and two pediatric liver recipients were successfully transplanted with immediate graft function. Favorable outcomes were also observed for the other transplanted organs, including one heart, two lungs and four kidneys...
August 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28795141/posttransplant-outcomes-of-kidneys-donated-after-brain-death-followed-by-circulatory-death-a-cohort-study-of-128-chinese-patients
#5
Ning Na, Ke Li, Zhengyu Huang, Bin Miao, Cheng Hu, Heng Li, Dejuan Wang, Jianguang Qiu
BACKGROUND: Donation after brain death followed by circulatory death (DBCD) is a new class in the unique Chinese donor classification system. Currently, in China, the organ transplantation of DBCD is rising. However, there is a dearth of research on the characteristics and outcomes of DBCD kidney transplantation. METHOD: We collected 128 DBCD renal transplant patients who underwent surgery between June 2013 and May 2016 at our center to analyze clinical outcomes and to share our experience to enhance perioperative management in DBCD kidney transplantation...
August 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28792681/long-term-outcome-of-renal-transplantation-from-octogenarian-donors-a-multicenter-controlled-study
#6
Piero Ruggenenti, Cristina Silvestre, Luigino Boschiero, Giovanni Rota, Lucrezia Furian, Annalisa Perna, Giuseppe Rossini, Giuseppe Remuzzi, Paolo Rigotti
To assess whether biopsy-guided selection of kidneys from very old brain-death donors enables more successful transplantations, this multicenter, observational study compared graft survival between 37 Recipients of one or two histologically evaluated kidneys from >80-years-old donors and 198 Reference-Recipients of non-histologically evaluated single grafts from ≤60-year-old donors (transplant period: 2006-2013 at three Italian Centers). Over a median (IQR) of 25 (13-42) months, two Recipients (5.4%) and 10 Reference-Recipients (5...
August 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28789990/descriptive-analysis-of-extracorporeal-cardiopulmonary-resuscitation-following-out-of-hospital-cardiac-arrest-an-elso-registry-study%C3%A2
#7
Nathan L Haas, Ryan A Coute, Cindy H Hsu, James A Cranford, Robert W Neumar
AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) is an emerging therapy for refractory cardiac arrest. The purpose of this study was to analyze and report characteristics and outcomes of adult patients treated with ECPR after out-of-hospital cardiac arrest (OHCA) in a large international registry. METHODS: The Extracorporeal Life Support Organization's Extracorporeal Life Support Registry was queried for adult cardiac arrests with arrest location of "EMT Transport" or "Outside Hospital...
August 5, 2017: Resuscitation
https://www.readbyqxmd.com/read/28780193/is-brain-computed-tomography-combined-with-somatosensory-evoked-potentials-useful-in-the-prediction-of-brain-death-after-cardiac-arrest
#8
Maenia Scarpino, Giovanni Lanzo, Francesco Lolli, Marco Moretti, Riccardo Carrai, Maria Luisa Migliaccio, Maddalena Spalletti, Manuela Bonizzoli, Adriano Peris, Aldo Amantini, Antonello Grippo
BACKGROUND: Brain death (BD) in coma after cardiac arrest (CA) is difficult to predict. Basal ganglia gray matter/white matter (GM/WM) ratio density and somatosensory evoked potentials (SEPs) may differentiate patients evolving toward BD. METHODS: We used SEPs and brain computed tomography (CT) after coma onset, within the first 24hours. RESULTS: Of the 160 patients included in the study, 22 (14%) evolved toward BD. SEP patterns predicted BD (ROC area=0...
August 2, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/28777134/retrospective-analysis-of-transcranial-doppler-patterns-in-veno-arterial-extracorporeal-membrane-oxygenation-patients-feasibility-of-cerebral-circulatory-arrest-diagnosis
#9
Marinella Marinoni, Giovanni Cianchi, Sara Trapani, Maria L Migliaccio, Manuela Bonizzoli, Letizia Gucci, Antonella Cramaro, Andrea Gallerini, Fabio Picciafuochi, Serafina Valente, Adriano Peris
Transcranial Doppler (TCD) is able to detect cerebral hemodynamic changes in real-time. Impairment of cerebral blood flow during veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) treatment is referred to in the literature. Several cerebrovascular complications can affect VA ECMO patients, eventually leading to brain death (BD). Transcranial Doppler is a worldwide accepted technique for cerebral circulatory arrest (CCA) diagnosis for BD confirmation, and in Italy, it is mandatory in certain clinical conditions...
August 1, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28768153/effects-of-mechanical-ventilation-on-gene-expression-profiles-in-renal-allografts-from-brain-dead-rats
#10
Maximilia C Hottenrott, Joerg Krebs, Paolo Pelosi, Thomas Luecke, Patricia R M Rocco, Carsten Sticht, Annette Breedijk, Benito Yard, Charalambos Tsagogiorgas
Pathophysiological changes of brain death (BD) are impairing distal organ function and harming potential renal allografts. Whether ventilation strategies influence the quality of renal allografts from BD donors has not been thoroughly studied. 28 adult male Wistar rats were randomly assigned to four groups: 1) no brain death (NBD) with low tidal volume/low positive endexpiratory pressure (PEEP) titrated to minimal static elastance of the respiratory system (LVT/OLPEEP); 2) NBD with high tidal volume/low PEEP (HVT/LPEEP); 3) brain death (BD) with LVT/OLPEEP; and 4) BD with HVT/LPEEP...
July 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28759682/contemporary-legal-updates-to-the-definition-of-brain-death-in-nevada
#11
Ariane Lewis
No abstract text is available yet for this article.
July 31, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28756900/evaluation-of-early-kidney-damage-caused-by-brain-death-using-real-time-ultrasound-elastography-in-a-bama-pig-model
#12
Ying Tang, Jingwen Zhao, Dongyang Liu, Ningning Niu, Huimin Yu
The aim of this study was to investigate the value of real-time tissue elastography (RTE) in the evaluation of early graft damage resulting from brain death. We performed RTE before and 0, 3, 6 and 9 h after brain death in a Bama pig model. Eleven RTE parameters were compared among time groups, and their correlations with electron microscopic findings were analyzed. Receiver operating characteristic curve analysis was used to find the RTE parameter cutoff values. The mean relative strain value within the region of interest (MEAN), standard deviation of the relative strain value within the region of interest (SD), percentage area of low strain within the region of interest (%AREA), complexity of low-strain area within the region of interest (COMP), kurtosis (KURT), skewness (SKEW), contrast (CONT) and entropy (ENT) and inverse difference moment (IDM) differed statistically significantly between groups (p < 0...
July 27, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28753621/mechanical-versus-humoral-determinants-of-brain-death-induced-lung-injury
#13
Asmae Belhaj, Laurence Dewachter, Sandrine Rorive, Myriam Remmelink, Birgit Weynand, Christian Melot, Emeline Hupkens, Céline Dewachter, Jacques Creteur, Kathleen Mc Entee, Robert Naeije, Benoît Rondelet
BACKGROUND: The mechanisms of brain death (BD)-induced lung injury remain incompletely understood, as uncertainties persist about time-course and relative importance of mechanical and humoral perturbations. METHODS: Brain death was induced by slow intracranial blood infusion in anesthetized pigs after randomization to placebo (n = 11) or to methylprednisolone (n = 8) to inhibit the expression of pro-inflammatory mediators. Pulmonary artery pressure (PAP), wedged PAP (PAWP), pulmonary vascular resistance (PVR) and effective pulmonary capillary pressure (PCP) were measured 1 and 5 hours after Cushing reflex...
2017: PloS One
https://www.readbyqxmd.com/read/28752363/inhibition-of-endoplasmic-reticulum-stress-alleviates-lung-injury-induced-by-brain-death
#14
Hongwei Tang, Jiakai Zhang, Shengli Cao, Bing Yan, Hongbo Fang, Huapeng Zhang, Wenzhi Guo, Shuijun Zhang
Brain death (BD) can induce inflammation and injury of organs. Endoplasmic reticulum (ER) stress is associated with a variety of diseases. However, little is known about how ER stress is implicated in brain death (BD)-induced lung injury. In this study, a stable BD rat model was constructed to investigate the role of ER stress on BD-induced lung injury. H&E staining demonstrated that BD can induce lung injury in rats. The results of Western blot and immunohistochemistry showed that apoptosis was observed in the lung tissues of BD rats...
July 27, 2017: Inflammation
https://www.readbyqxmd.com/read/28749083/evidence-of-bone-marrow-downregulation-in-brain-dead-rats
#15
Laura Menegat, Rafael Simas, Julia M Caliman, Fernando L Zanoni, Jacqueline F Jacysyn, Luiz Fernando F da Silva, Primavera Borelli, Luiz Felipe P Moreira, Paulina Sannomiya
Experimental findings support the evidence of a persistent leucopenia triggered by brain death (BD). This study aimed to investigate leucocyte behaviour in bone marrow and blood after BD in rats. BD was induced using intracranial balloon catheter inflation. Sham-operated (SH) rats were trepanned only. Thereafter bone marrow cells were harvested every six hours from the femoral cavity and used for total and differential counts. They were analysed further by flow cytometry to characterize lymphocyte subsets, granulocyte adhesion molecules expression and apoptosis/necrosis [annexin V/propidium iodide (PI) protocol]...
July 27, 2017: International Journal of Experimental Pathology
https://www.readbyqxmd.com/read/28748278/-therapy-escalation-for-the-potential-organ-donor-are-all-intensive-care-measures-also-ethically-justifiable
#16
REVIEW
S-O Kuhn, K Hahnenkamp
The gap between the number of organs needed and the number available has dramatically increased in Germany in the last decade-for intensivists and transplantation specialists, it is challenging to cover the demand responsibly. It is therefore increasingly important to identify potential organ donors in order to realize organ donation. An escalation of intensive care measures is often required, which raises critical ethical questions. In Germany, organ donation is only allowed after brain death with prior informed consent from the deceased or his/her relatives...
July 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28743344/-experimental-animal-study-of-cerebral-oxygen-metabolism-changes-during-the-process-of-brain-death
#17
Huaying Qi, Chenguang Wan, Xuequan Feng, Mu Li, Li Chen, Yongqiang Wang, Yuan Shi, Lei Liu, Zhongyang Shen
OBJECTIVE: To reproduce a stable animal model of brain death in pigs, observe the change regularity of cerebral oxygen metabolism during the process of brain death, and to evaluate the significance and value of cerebral oxygen metabolism parameters for the diagnosis of brain death. METHODS: Twelve landrace pigs were used to create the brain death models using modified method of increasing epidural intracranial pressure (ICP). The mean arterial pressure (MAP) and ICP were monitored continuously during the process...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28742817/temporal-profile-of-intracranial-pressure-and-cerebrovascular-reactivity-in-severe-traumatic-brain-injury-and-association-with-fatal-outcome-an-observational-study
#18
Hadie Adams, Joseph Donnelly, Marek Czosnyka, Angelos G Kolias, Adel Helmy, David K Menon, Peter Smielewski, Peter J Hutchinson
BACKGROUND: Both intracranial pressure (ICP) and the cerebrovascular pressure reactivity represent the dysregulation of pathways directly involved in traumatic brain injury (TBI) pathogenesis and have been used to inform clinical management. However, how these parameters evolve over time following injury and whether this evolution has any prognostic importance have not been studied. METHODS AND FINDINGS: We analysed the temporal profile of ICP and pressure reactivity index (PRx), examined their relation to TBI-specific mortality, and determined if the prognostic relevance of these parameters was affected by their temporal profile using mixed models for repeated measures of ICP and PRx for the first 240 hours from the time of injury...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742700/comparison-of-postoperative-outcomes-between-donation-after-circulatory-death-and-donation-after-brain-death-liver-transplantation-using-the-comprehensive-complication-index
#19
Marit Kalisvaart, Jubi E de Haan, Wojciech G Polak, Herold J Metselaar, Bas P L Wijnhoven, Jan N M IJzermans, Jeroen de Jonge
OBJECTIVE: To test the total burden of complications in the early postoperative period after liver transplantation (LT) between donation after circulatory death (DCD) and donation after brain death (DBD) grafts with the novel Comprehensive Complication Index (CCI). BACKGROUND: LT is complex surgery and the increasing use of high-risk grafts is pressuring current postoperative outcomes. DCD grafts in particular are associated with ischemic-type biliary lesions (ITBL) with subsequent impaired graft survival rates...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28739153/active-donor-management-during-the-hospital-phase-of-care-is-associated-with-more-organs-transplanted-per-donor
#20
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
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