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Organ donor management

Martin I Montenovo, Ryan N Hansen, André A S Dick, Jorge Reyes
OBJECTIVES: Individuals older than 60 years represent a large proportion of the organs available for orthotopic liver transplant. However, the use of organs from older donors remains controversial. We hypothesized that the use of older donors would not affect patient and graft survival due to significant improvements in donor-recipient management. MATERIALS AND METHODS: We conducted a retrospective cohort analysis using the United Network for Organ Sharing database from February 2002 through December 2012, including non-HCV-infected adults (18 and older) who underwent primary orthotopic liver transplant...
October 14, 2016: Experimental and Clinical Transplantation
Rafael Bello Corassa, Carmen Aceijas, Paula Aryane Brito Alves, Hemda Garelick
AIMS: This article aimed to provide a critical review of the evolution of Chagas' disease (ChD) in Brazil, its magnitude, historical development and management, and challenges for the future. METHODS: A literature search was performed using PubMed, SciELO and Google Scholar and throughout collected articles' references. Narrative analysis was structured around five main themes identified: vector transmission, control programme, transfusion, oral and congenital transmission...
October 10, 2016: Perspectives in Public Health
J H Kang, B H Choi, K M Moon, Y M Park, K H Yang, J H Ryu, C W Chu
It is well known that the quality of organs retrieved from brain-dead donors (DBDs) is better than those retrieved from circulatory death donors. However, in situations of organ retrieval from marginal DBDs, who are unstable despite intensive care, transplantation outcomes are not good. Organ ischemia is the most important determining factor in decreased organ quality in circulatory death donors and in some DBDs. Extracorporeal membrane oxygenation (ECMO) for management of DBDs can be an emergency countermeasure...
September 2016: Transplantation Proceedings
R Sarlo, G Pereira, M Surica, D Almeida, C Araújo, O Figueiredo, E Rocha, E Vargas
Establishing an organization to promote organ donation and a good organ procurement team assure quality and improve performance on organ donation rates. Brazil's organ procurement structure is based on 2 models disseminated worldwide: the "Spanish model," based on in-house coordinators, and the "American organ procurement organization (OPO) model," with extra-hospital coordinators. In 2006, Brazil's Federal Government had formally introduced the in-house coordination model for every hospital equipped with a mechanical ventilator bed...
September 2016: Transplantation Proceedings
Britt M Blokker, Annick C Weustink, M G Myriam Hunink, J Wolter Oosterhuis
INTRODUCTION: Hospital autopsies, vanishing worldwide, need to be requested by clinicians and consented to by next-of-kin. The aim of this prospective observational study was to examine how often and why clinicians do not request an autopsy, and for what reasons next-of-kin allow, or refuse it. METHODS: Clinicians at the Erasmus University Medical Centre were asked to complete a questionnaire when an adult patient had died. Questionnaires on 1000 consecutive naturally deceased adults were collected...
2016: PloS One
R Thuret, F Kleinclauss, N Terrier, M O Timsit
OBJECTIVES: To review epidemiologic data's and medical results of deceased donation in renal transplantation. MATERIAL AND METHODS: Relevant publications were identified through Medline ( and Embase ( database using the following keywords, alone or in association, "brain death; cardiac arrest; deceased donation; organ procurement; transplantation". Articles were selected according to methods, language of publication and relevance...
October 7, 2016: Progrès en Urologie
Lauren B Cooper, Carmelo A Milano, Melissa Williams, Wendy Swafford, Donna Croezen, Adrian B Van Bakel, Joseph Rogers, Chetan B Patel
BACKGROUND: Acute hypothyroidism after brain death results in hemodynamic impairments that limit availability of donor hearts. Thyroid hormone infusions can halt that process and lead to increased utilization of donor organs, but prolonged used of thyroid replacement has not been well studied. METHODS: We developed a 15 question survey regarding policies, procedures, and reporting of thyroid hormone use by OPOs. The survey was posted for five weeks on the Association of OPOs Portal...
October 11, 2016: Clinical Transplantation
Glauco A Westphal, Elisabeth Coll, Rafael L de Souza, Silvana Wagner, Artur Montemezzo, Fernanda Carolina Cani de Souza, Gabriel Torres, Stefan Halla, Tiago C Carnin, Míriam C Machado, Eduardo Berbigier, Fernando Busetto, Ivonei Bittencourt, Karine Gerent, Bruno S de Souza, Manoel Tassinari, Joel de Andrade
BACKGROUND: The disproportion between the large organ demand and the low number of transplantations performed represents a serious public health problem worldwide. Reducing the loss of transplantable organs from deceased potential donors as a function of cardiac arrest (CA) may contribute to an increase in organ donations. Our purpose was to test the hypothesis that a goal-directed protocol to guide the management of deceased donors may reduce the losses of potential brain-dead donors (PBDDs) due to CA...
October 11, 2016: Critical Care: the Official Journal of the Critical Care Forum
Thomas Kerforne, Frédéric Favreau, Raphaël Thuillier, Thierry Hauet, Michel Pinsard
The increased number of patients in waiting list for renal transplantation requires the establishment of recommendations regarding graft preservation techniques. The preservation method impacts graft function and survival particularly in case of extended criteria donors. Based on our experience, the aim of this review is to establish a decisional diagram to draw graft management to 5years in relation to donor type and graft quality. Novel biomarkers are necessary to evaluate graft quality. Nuclear magnetic resonance or transcriptomic analyses are promising...
October 3, 2016: Néphrologie & Thérapeutique
Dilek Colak, Ayodele A Alaiya, Namik Kaya, Nzioka P Muiya, Olfat AlHarazi, Zakia Shinwari, Editha Andres, Nduna Dzimiri
AIMS: The disease pathways leading to idiopathic dilated cardiomyopathy (DCM) are still elusive. The present study investigated integrated global transcriptional and translational changes in human DCM for disease biomarker discovery. METHODS: We used identical myocardial tissues from five DCM hearts compared to five non-failing (NF) donor hearts for both transcriptome profiling using the ABI high-density oligonucleotide microarrays and proteome expression with One-Dimensional Nano Acquity liquid chromatography coupled with tandem mass spectrometry on the Synapt G2 system...
2016: PloS One
Heimir Thorisson, James H Lambert, John J Cardenas, Igor Linkov
Infrastructure development of volatile regions is a significant investment by international government and nongovernment organizations, with attendant requirements for risk management. Global development banks may be tasked to manage these investments and provide a channel between donors and borrowers. Moreover, various stakeholders from the private sector, local and international agencies, and the military can be engaged in conception, planning, and implementation of constituent projects. Emergent and future conditions of military conflict, politics, economics, technology, environment, behaviors, institutions, and society that stress infrastructure development are prevalent, and funding mechanisms are vulnerable to fraud, waste, and abuse...
September 30, 2016: Risk Analysis: An Official Publication of the Society for Risk Analysis
Michael Nasr, Tara Sigdel, Minnie Sarwal
Identification of allograft injury, including acute clinical and subclinical injury, is vital in increasing the longevity of the transplanted organ. Acute rejection, which occurs as a result of a variety of immune and non-immune factors including the infiltration of immune cells and antibodies to the donor specific epitopes, poses a significant risk to the organ. Recent years have marked an increase in the discovery of new genomic, transcriptomic, and proteomic biomarkers in molecular diagnostics, which offer better potential for personalized management of the transplanted organ by providing earlier detection of rejection episodes...
October 2016: Expert Review of Molecular Diagnostics
May Griffith, Mohammad M Islam, Joel Edin, Georgia Papapavlou, Oleksiy Buznyk, Hirak K Patra
Biomaterials are now being used or evaluated clinically as implants to supplement the severe shortage of available human donor organs. To date, however, such implants have mainly been developed as scaffolds to promote the regeneration of failing organs due to old age or congenital malformations. In the real world, however, infection or immunological issues often compromise patients. For example, bacterial and viral infections can result in uncontrolled immunopathological damage and lead to organ failure. Hence, there is a need for biomaterials and implants that not only promote regeneration but also address issues that are specific to compromised patients, such as infection and inflammation...
2016: Frontiers in Bioengineering and Biotechnology
Pratim Sengupta, Sumanta Biswas, Shiuli Chowdhury, Atish Ratan Nandi
New onset anaemia within three months after renal transplantation though not very common sometimes present as diagnostic challenge to the renal physicians. Understanding the etiology is necessary for correct management and avoiding adverse graft outcome. Passenger lymphocyte syndrome (PLS) is a rare entity of immune haemolytic anaemia that sometimes occurs in recipient of minor ABO mismatched renal transplantation. In this case report we present an AB positive renal allograft recipient who received organ from an O positive donor and developed acute haemolytic anaemia and jaundice, 19 days after renal transplantation due to PLS...
December 2015: Journal of the Association of Physicians of India
Catherine Korte, Jennifer L Garber, Jillian L Descourouez, Katelyn R Richards, Karen Hardinger
PURPOSE: This article reviews organ donor pathophysiology as it relates to medication use with the goal of maximizing the successful procurement and transplantation of donor organs. SUMMARY: The number of patients requiring organ transplantation continues to grow, yet organ donation rates remain flat, making it critical to appropriately manage each organ donor in order to ensure viability of all transplantable organs. The care given to one organ donor is tantamount to the care of several transplant recipients...
September 23, 2016: American Journal of Health-system Pharmacy: AJHP
Joseph A R Englert, Jennifer A Davis, Selim R Krim
BACKGROUND: Heart transplantation remains the definitive therapy for patients with advanced heart failure; however, owing to limited donor organ availability and long wait times, continuous-flow left ventricular assist devices (LVADs) have become standard therapy. METHODS: This review summarizes the history, progression, function, and basic management of LVADs. Additionally, we provide some clinical pearls and important caveats for managing this unique patient population...
2016: Ochsner Journal
Hiroshi Date
Lung transplantation has been performed worldwide and recognized as an effective treatment for patients with various end-stage lung diseases. Shortage of lung donors is one of the main obstacles in most of the countries, especially in Japan. Every effort has been made to promote organ donation during the past 20 years. In 2010, Japanese transplant low was revised so that the family of the brain dead donors can make a decision for organ donation. Since then, the number of cadaveric lung donor has increased by 5-fold...
August 2016: Journal of Thoracic Disease
Kathene C Johnson-Henry, Thomas R Abrahamsson, Richard You Wu, Philip M Sherman
Necrotizing enterocolitis (NEC) is a devastating intestinal disease in preterm infants characterized by barrier disruption, intestinal microbial dysbiosis, and persistent inflammation of the colon, which results in high mortality rates. Current strategies used to manage this disease are not sufficient, although the use of human breast milk reduces the risk of NEC. Mother's milk is regarded as a fundamental nutritional source for neonates, but pasteurization of donor breast milk affects the composition of bioactive compounds...
September 2016: Advances in Nutrition
Jamshed Dalal, Pradeep Kumar Deb, Sameer Shrivastava, Maddury Srinivas Rao, Jagdish Chander Mohan, Arramraju Sreenivas Kumar
Dyslipidemia is an established risk factor for cardiovascular disease (CVD). Atherosclerosis begins early in life as suggested by "fatty streaks" observed in coronaries of healthy organ donors aged 20-29 years. Premature occurrence of coronary heart disease (CHD) in Indians, increases the risk for young individuals. Management of Dyslipidemia in the young Indian poses several challenges. In this article we provide in-depth review of prevalence, guidelines' perspective and expert comments on management of Dyslipidemia in the young (20-40 years) Indian...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
M L Nogueira, C F Estofolete, A C B Terzian, E P B Mascarin do Vale, R C M A da Silva, R F da Silva, H J Ramalho, I M M Fernandes Charpiot, M Abbud-Filho
Public health concerns exist surrounding the epidemic of the Zika virus (ZIKV) and the rapid growth of transplantation in developing countries, including endemic zones of active arbovirus transmission, as well as travel to such regions by potential organ donors and recipients. Few data exist regarding the clinical characteristics of ZIKV infection in immunocompromised hosts. Laboratory screening protocols for transplantation to differentiate ZIKV infections from other endemic viral diseases and for the detection of possible donor-derived infection have not been stated...
September 15, 2016: American Journal of Transplantation
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