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https://www.readbyqxmd.com/read/29128023/evaluation-and-management-of-the-potential-lung-donor
#1
REVIEW
Andrew Courtwright, Edward Cantu
The expansion of the donor lung pool has involved an evidence-driven redefinition of acceptable donors. Proceeding with transplantation with an acceptable rather than ideal donor depends on specific patient-related and organ-related risk factors as well as the severity of recipient illness. Although the physiologic optimization of brain-dead donors has not changed significantly in recent years, the use of donor management protocols has improved procurement rates. Ex vivo lung perfusion is an increasingly viable strategy to recondition lungs that would otherwise fall below the acceptable threshold for transplant...
December 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29110792/anesthetic-management-of-the-patient-undergoing-heart-transplantation
#2
REVIEW
Liem Nguyen, Dalia A Banks
Cardiac transplantation is the treatment of choice for patients with end-stage heart failure. Over the years, significant advances in patient selection, donor optimization and selection, and optimization of immunosuppression strategies have markedly improved outcomes. In this review, we highlight patient selection, donor management and procurement, heart transplantation procedure, and intraoperative and postoperative management of heart transplants.
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29026875/ethylene-glycol-poisoning-should-not-contraindicate-liver-donation
#3
Alisha Burman, Christopher J E Watson, Vasilis Kosmoliaptsis
As the number of patients waiting to receive transplants increases, there is a need to explore all possible donation opportunities. In this case report, we describe the transplantation of a liver from a donor who died after ethylene glycol poisoning into a woman with alcoholic liver disease with cirrhosis and associated ascites. Donor management, including ethanol, fomepizol and haemodialysis, hastened clearance of ethylene glycol from the circulation, and after liver transplantation, the recipient exhibited no adverse effects suggestive of ethylene glycol toxicity, although recipient hepatic artery dissection and thrombosis necessitated retransplantation...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28985863/early-declaration-of-death-by-neurologic-criteria-results-in-greater-organ-donor-potential
#4
Shelby Resnick, Mark J Seamon, Daniel Holena, Jose Pascual, Patrick M Reilly, Niels D Martin
BACKGROUND: Aggressive management of patients prior to and after determination of death by neurologic criteria (DNC) is necessary to optimize organ recovery, transplantation, and increase the number of organs transplanted per donor (OTPD). The effects of time management are understudied but potentially pivotal component. The objective of this study was to analyze specific time points (time to DNC, time to procurement) and the time intervals between them to better characterize the optimal timeline of organ donation...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28970681/evaluation-of-process-excellence-tools-in-improving-donor-flow-management-in-a-tertiary-care-hospital-in-south-india
#5
Divya Venugopal, Aboobacker Mohamed Rafi, Susheela Jacob Innah, Bibin T Puthayath
BACKGROUND: Process Excellence is a value based approach and focuses on standardizing work processes by eliminating the non-value added processes, identify process improving methodologies and maximize capacity and expertise of the staff. AIM AND OBJECTIVES: To Evaluate the utility of Process Excellence Tools in improving Donor Flow Management in a Tertiary care Hospital by studying the current state of donor movement within the blood bank and providing recommendations for eliminating the wait times and to improve the process and workflow...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28964417/continued-successful-evolution-of-extended-criteria-donor-lungs-for-transplantation
#6
Sakhee Kotecha, Jamie Hobson, Jeremy Fuller, Eldho Paul, Bronwyn J Levvey, Helen Whitford, Miranda Paraskeva, David McGiffin, Gregory I Snell, Glen P Westall
BACKGROUND: In an era of increasing ex vivo lung perfusion (EVLP) use, it remains important to describe what outcomes can be achieved without EVLP, by taking an aggressive approach to donor use to maximize lung transplantation. METHODS: Data for all lung transplant donor referrals to the Alfred Hospital in Melbourne, Australia were collected for 2012 to 2013. Donor variables were analyzed and calculated into a previously validated lung donor score. Lung transplant recipient outcome data included the following: primary graft dysfunction; duration of mechanical ventilation; need for cardiopulmonary bypass extracorporeal membrane oxygenation; intensive care and hospital length of stay; 30-day, 1-year, and 3- to 4-year survival rates; rates of acute rejection and chronic lung allograft dysfunction; and peak and 12-month lung function (forced expiratory volume in 1 second)...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28963316/canada-donate-study-protocol-a-prospective-national-observational-study-of-the-medical-management-of-deceased-organ-donors
#7
Frederick D'Aragon, Sonny Dhanani, Francois Lamontagne, Deborah J Cook, Karen Burns, Aemal Akhtar, Michaël Chassé, Anne-Julie Frenette, Sean Keenan, Jean-Francois Lize, Demetrios J Kutsogiannis, Andreas Kramer, Lori E Hand, Erika Arseneau, Marie-Helene Masse, Christine Ribic, Ian Ball, Andrew Baker, Gordon Boyd, Bram Rochwerg, Andrew Healey, Steven Hanna, Gordon H Guyatt, Maureen O Meade
INTRODUCTION: Research on the management of deceased organ donors aims to improve the number and quality of transplants and recipient outcomes. In Canada, this research is challenged by regionalisation of donation services within provinces and the geographical, clinical and administrative separation of donation from transplantation services. This study aims to build a national platform for future clinical trials in donor management. Objectives are to engage collaborators at donation hospitals and organ donation organisations (ODOs) across Canada, describe current practices, evaluate the effectiveness of donation-specific interventions and assess the feasibility of future clinical trials...
September 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28870982/understanding-the-effect-of-corticosteroid-pretreatment-in-brain-dead-organ-donors-new-mechanistic-insights-for-improvement-of-organ-quality-in-liver-transplantation
#8
Carola Dahrenmöller, Raymond Reding
Transplant surgeons are currently faced with the challenge to accept marginal liver transplants due to steatosis or old age. Improving organ quality by implementing a selective organ protective donor management could be the first step towards a graft of enhanced quality. However, the molecular mechanisms of such treatments are still poorly understood. Glucocorticoid medication in donor medicine has been carried out and discussed for a long time. In a recent study published in Clinical Science, Jiménez-Castro et al...
September 15, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28859788/outcomes-after-transplantation-of%C3%A2-donor%C3%A2-hearts-with-improving-left%C3%A2-ventricular-systolic%C3%A2-dysfunction
#9
MULTICENTER STUDY
Shivank Madan, Omar Saeed, Peter Vlismas, Ioanna Katsa, Snehal R Patel, Julia J Shin, William A Jakobleff, Daniel J Goldstein, Daniel B Sims, Ulrich P Jorde
BACKGROUND: Left ventricular systolic dysfunction (LVSD) accounts for almost 25% of nonacceptance of potential donor hearts. Previous smaller, single-center studies showed that LVSD following brain death may be transient, and such hearts can be successfully resuscitated with resolution of LVSD, then transplanted. OBJECTIVES: This study evaluated outcomes of donor hearts with LVSD on initial transthoracic echocardiogram (TTE) that resolved during donor management...
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28739153/active-donor-management-during-the-hospital-phase-of-care-is-associated-with-more-organs-transplanted-per-donor
#10
Madhukar S Patel, Salvador De La Cruz, Mitchell B Sally, Tahnee Groat, Darren J Malinoski
BACKGROUND: Meeting donor management goals when caring for potential organ donors has been associated with more organs transplanted per donor (OTPD). Concern persists, however, as to whether this indicates that younger/healthier donors are more likely to meet donor management goals or whether active management affects outcomes. STUDY DESIGN: A prospective observational study of all standard criteria donors was conducted by 10 organ procurement organizations across United Network for Organ Sharing Regions 4, 5, and 6...
October 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28686151/individual-contextual-and-network-characteristics-of-blood-donors-and-non-donors-a-systematic-review-of-recent-literature
#11
REVIEW
Tjeerd W Piersma, René Bekkers, Elisabeth F Klinkenberg, Wim L A M De Kort, Eva-Maria Merz
BACKGROUND: The ageing population and recent migration flows may negatively affect the blood supply in the long term, increasing the importance of targeted recruitment and retention strategies to address donors. This review sought to identify individual, network and contextual characteristics related to blood donor status and behaviour, to systematically discuss differences between study results, and to identify possible factors to target in recruitment and retention efforts. METHODS: The systematic review was conducted in accordance with a predefined PROSPERO protocol (CRD42016039591)...
September 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28667204/effect-of-corticosteroid-administration-on-neurologically-deceased-organ-donors-and-transplant-recipients-a-systematic-review-and-meta-analysis
#12
Frédérick D'Aragon, Emilie Belley-Cote, Arnav Agarwal, Anne-Julie Frenette, Francois Lamontagne, Gordon Guyatt, Sonny Dhanani, Maureen O Meade
OBJECTIVES: This review investigates the impact of corticosteroids on donation rates and transplant outcomes in light of findings from randomised controlled trials (RCTs) and to highlight the sources of uncertainty in this unresolved donor management issue. DATA SOURCES: We searched electronic databases, trial registries and conference proceedings for RCTs evaluating corticosteroid therapy in neurologically deceased donors. STUDY SELECTION AND DATA EXTRACTION: Independent reviewers assessed eligibility, evaluated risk of bias and abstracted data, including donor haemodynamic data, number of organs recovered and transplant outcomes...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#13
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
November 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28617162/the-use-of-stroke-volume-variation-to-guide-donor-management-is-associated-with-increased-organs-transplanted-per-donor
#14
Benjamin Bergstrom, J Salvador de la Cruz, Mitch Sally, Scott Louis, Melissa Friedman, Floyd Petersen, Darren Malinoski
BACKGROUND: There is a national shortage of organs available for transplantation, and utilization rates for thoracic organs are less than 40%. In addition, the optimal method of assessing cardiovascular status during donor management is uncertain. FloTrac is a noninvasive hemodynamic technique that measures cardiac output and fluid responsiveness. Our objective was to measure the impact of using this technique to guide management on fluid balance, vasopressor usage, thyroid hormone usage, and pulmonary function...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28489438/surgical-issues-in-retrieval-and-implantation
#15
REVIEW
James Ra Skipworth, Gabriele Spoletini, Charles Imber
With increasing demand for organ transplantation and patients deteriorating or dying on the waiting list, organs are now being increasingly used from donors previously considered too marginal. This requires improvements to donor management during the retrieval process, and of the organ during transport and subsequent implantation, in order to maintain outcomes.
May 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28447929/five-year-follow-up-on-transplanted-organs-from-donors-after-brain-death-after-acute-stroke
#16
Vera Spatenkova, Eva Pokorna, Petr Suchomel
OBJECTIVES: Efficient intensive care donor management can help alleviate the shortage of organs for transplant. The aim of this study was to investigate the efficiency of management of donors after brain death from our neurointensive care unit. MATERIALS AND METHODS: We conducted a prospective observational 5-year follow-up on 29 transplanted organs from 14 brain-dead donors after acute stroke (7 subarachnoid and 4 intracerebral hemorrhages, 3 ischemic strokes)...
April 27, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28318674/organ-donor-management-eight-common-recommendations-and-actions-that-deserve-reflection
#17
C Chamorro-Jambrina, M R Muñoz-Ramírez, J L Martínez-Melgar, M S Pérez-Cornejo
Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis...
March 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28260484/impact-of-a-full-time-donor-management-protocol-on-donors-liver-biopsy-findings-progress-to-date
#18
COMPARATIVE STUDY
Meysam Mojtabaee, Alireza Shamsaeefar, Siavash Gholami, Mojtaba Mohsenzadeh, Farahnaz Sadegh Beigee
OBJECTIVES: This study investigated a fixed coordinator-directed donor management strategy's impact on donated liver quality, as determined by definitive biopsy results. MATERIALS AND METHODS: We collected donated liver biopsy results from donations both before and after implementing a fixed coordinator-directed donor management strategy. This strategy involved full-time attendance by a donor coordinator and continued resuscitation of brain-dead donors. All donations took place in a single organ procurement unit...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260449/living-kidney-donor-cancellation-at-king-hussein-medical-center
#19
Katibh Al-Rabadi, Reham Issa Almardini, Mysoon Hajeer, Mahmood Hendawi, Aiham Hadad
OBJECTIVES: Living-related kidney donation is the main source of renal grafts in Jordan, since kidneys from deceased donors are scarce. Although the Jordanian community accepts the idea of kidney donation to family members, not all potential donors manage to complete the required psychologic and medical evaluations. We review the causes of kidney-donation cancellation and suggest options to increase the number of available organs. MATERIALS AND METHODS: We performed a retrospective chart review of all potential living-related kidney donors at King Hussein Medical Center between January 2008 and June 2016...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28240643/heart-allograft-preservation-an-arduous-journey-from-the-donor-to-the-recipient
#20
Michiel Erasmus, Arne Neyrink, Mario Sabatino, Luciano Potena
PURPOSE OF REVIEW: The discrepancy between needs and availability of organs for heart transplantation may be partially reduced by improving the utilization of organs currently deemed unsuitable. Strategies to achieve this goal need optimization of the entire process of organ procurement, transportation, and functional recovery after transplant. RECENT FINDINGS: In the latest years, several studies reported improvements in organ utilization after appropriate donor management, and management of heart transportation is approaching a new era...
February 24, 2017: Current Opinion in Cardiology
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