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Organ donor management

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https://www.readbyqxmd.com/read/27928705/semi-quantitative-assessments-of-dextran-toxicity-on-corneal-endothelium-conceptual-design-of-a-predictive-algorithm
#1
Filip Filev, Ceprail Oezcan, Jana Feuerstacke, Stephan J Linke, Birgit Wulff, Olaf J C Hellwinkel
Dextran is added to corneal culture medium for at least 8 h prior to transplantation to ensure that the cornea is osmotically dehydrated. It is presumed that dextran has a certain toxic effect on corneal endothelium but the degree and the kinetics of this effect have not been quantified so far. We consider that such data regarding the toxicity of dextran on the corneal endothelium could have an impact on scheduling and logistics of corneal preparation in eye banking. In retrospective statistic analyses, we compared the progress of corneal endothelium (endothelium cell loss per day) of 1334 organ-cultured corneal explants in media with and without dextran...
December 7, 2016: Cell and Tissue Banking
https://www.readbyqxmd.com/read/27910193/use-of-organs-from-donors-with-bloodstream-infection-pneumonia-and-influenza-results-of-a-survey-of-infectious-diseases-practitioners
#2
Sanjay R Mehta, Cathy Logan, Camille N Kotton, Deepali Kumar, Saima Aslam
BACKGROUND: Potential organ donors may be admitted with an infection to an intensive care unit, or contract a nosocomial infection during their stay, increasing the risk of potential transmission to the recipient. Because of a lack of practice guidelines and large-scale data on this topic, we undertook a survey to assess the willingness of transplant infectious diseases (ID) physicians to accept such organs. METHODS: We performed a 10-question survey of ID providers from the American Society of Transplantation Infectious Disease Community of Practice to determine the scope of practice regarding acceptance of organs from donors with bloodstream infection, pneumonia, and influenza prior to organ procurement, as well as management of such infections following transplantation...
December 2, 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/27902502/zika-virus-and-patient-blood-management
#3
Lawrence T Goodnough, Marisa B Marques
Sporadic Zika virus infections had only occurred in Africa and Asia until an outbreak in Micronesia (Oceania) in 2007. In 2013 to 2014, several outer Pacific Islands reported local outbreaks. Soon thereafter, the virus was likely introduced in Brazil from competing athletes from French Polynesia and other countries that participated in a competition there. Transmission is thought to have occurred through mosquito bites and spread to the immunologically naive population. Being also a flavivirus, the Zika virus is transmitted by the Aedes mosquito that is endemic in South and Central America that is also the vector of West Nile virus, dengue, and chikungunya...
November 29, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27896782/mixed-method-versus-full-top-down-microcosting-for-organ-recovery-cost-assessment-in-a-french-hospital-group
#4
Abdelbaste Hrifach, Coralie Brault, Sandrine Couray-Targe, Lionel Badet, Pascale Guerre, Christell Ganne, Hassan Serrier, Vanessa Labeye, Pierre Farge, Cyrille Colin
BACKGROUND: The costing method used can change the results of economic evaluations. Choosing the appropriate method to assess the cost of organ recovery is an issue of considerable interest to health economists, hospitals, financial managers and policy makers in most developed countries. OBJECTIVES: The main objective of this study was to compare a mixed method, combining top-down microcosting and bottom-up microcosting versus full top-down microcosting to assess the cost of organ recovery in a French hospital group...
December 2016: Health Economics Review
https://www.readbyqxmd.com/read/27873477/telemedically-supported-case-management-of-living-donor-renal-transplant-recipients-to-optimize-routine-evidence-based-aftercare-a-single-center-randomized-controlled-trial
#5
A Schmid, S Hils, A Kramer-Zucker, L Bogatyreva, D Hauschke, S De Geest, P Pisarski
Improving mid-term and long-term outcomes after solid organ transplantation is imperative, and requires both state-of-the-art transplant surgery and optimization of routine, evidence-based aftercare. This randomized, controlled trial assessed the effectiveness of standard aftercare versus telemedically-supported case management, an innovative aftercare model, in 46 living-donor renal transplant recipients during the first post-transplant year. The model includes three components: (a) chronic care case management initiated after discharge, (b) case management initiated in emerging acute care situations, and (c) a telemedically-equipped team comprising a transplant nurse case manager and two senior transplant physicians (nephrologist, surgeon)...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27873446/the-first-two-years-of-activity-of-a-specialized-organ-procurement-centre-report-of-an-innovative-approach-to-improve-organ-donation
#6
Pierre Marsolais, Philippe Durand, Emmanuel Charbonney, Karim Serri, Anne-Marie Lagacé, Francis Bernard, Martin Albert
The number of patients requiring organ transplants continues to outgrow the number of organs donated each year. In an attempt to improve the organ donation process and increase the number of organs available, we created a specialized multidisciplinary team within a specialized Organ Procurement Centre (OPC) with dedicated intensive care unit beds and operating rooms. The OPC was staffed with ICU nurses, operating room nurses, organ donor management ICU physicians and multidisciplinary staff. All organ donors within a designated geographic area were transferred and managed within the OPC...
November 22, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27847799/clinical-importance-of-congenital-anomalies-of-the-inferior-vena-cava-in-organ-procurement-surgery-from-a-deceased-donor-two-case-reports
#7
Mi-Hyeong Kim, Kang-Woong Jun, In-Sung Moon, Ji-Il Kim
Congenital anomalies of the inferior vena cava (IVC) are rare but important problems in living donors for kidney transplantation, especially in cases of a short left renal vein and accompanying vascular and urological anatomic variations. However, the clinical impacts of IVC anomalies in deceased donors have yet to be reported. The unexpected presence of an IVC in an unusual position poses challenges to surgeons and increases the risk of bleeding during organ removal. Accompanying vascular variations can cause unexpected bleeding and injury and therefore technical complications in procurement and subsequent implantation...
November 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27818660/unraveling-the-role-of-allo-antibodies-and-transplant-injury
#8
REVIEW
Yoshiko Matsuda, Minnie M Sarwal
Alloimmunity driving rejection in the context of solid organ transplantation can be grossly divided into mechanisms predominantly driven by either T cell-mediated rejection (TCMR) and antibody-mediated rejection (ABMR), though the co-existence of both types of rejections can be seen in a variable number of sampled grafts. Acute TCMR can generally be well controlled by the establishment of effective immunosuppression (1, 2). Acute ABMR is a low frequency finding in the current era of blood group and HLA donor/recipient matching and the avoidance of engraftment in the context of high-titer, preformed donor-specific antibodies...
2016: Frontiers in Immunology
https://www.readbyqxmd.com/read/27809952/tuberculosis-and-transplantation
#9
José M Aguado, José Tiago Silva, Palash Samanta, Nina Singh
Mycobacterium tuberculosis is a major opportunistic pathogen in transplant recipients. Compared to that in the general population, the frequency of tuberculosis (TB) is 10 to 40 times higher in hematopoietic stem cell transplant (HSCT) recipients and 20 to 74 times higher in solid-organ transplant (SOT) recipients. Transplant recipients with TB are also more likely to develop disseminated disease, have longer time to definitive diagnosis, require more invasive diagnostic procedures, and experience greater anti-TB treatment-related toxicity than the general population...
November 2016: Microbiology Spectrum
https://www.readbyqxmd.com/read/27809862/the-challenge-of-bridging-the-gap-between-researchers-and-policy-makers-experiences-of-a-health-policy-research-group-in-engaging-policy-makers-to-support-evidence-informed-policy-making-in-nigeria
#10
Benjamin Uzochukwu, Obinna Onwujekwe, Chinyere Mbachu, Chinenye Okwuosa, Enyi Etiaba, Monica E Nyström, Lucy Gilson
BACKGROUND: Getting research into policy and practice (GRIPP) is a process of going from research evidence to decisions and action. To integrate research findings into the policy making process and to communicate research findings to policymakers is a key challenge world-wide. This paper reports the experiences of a research group in a Nigerian university when seeking to 'do' GRIPP, and the important features and challenges of this process within the African context. METHODS: In-depth interviews were conducted with nine purposively selected policy makers in various organizations and six researchers from the universities and research institute in a Nigerian who had been involved in 15 selected joint studies/projects with Health Policy Research Group (HPRG)...
November 4, 2016: Globalization and Health
https://www.readbyqxmd.com/read/27805507/transplant-ethics
#11
Nur Altınörs, Mehmet Haberal
OBJECTIVES: The aim of this study was to review and discuss the great variety of ethical issues related to organ donation, organ procurement, transplant activities, and new ethical problems created as a result of technologic and scientific developments. MATERIALS AND METHODS: An extensive literature survey was made, and expert opinions were obtained. RESULTS: The gap between demand and supply of organs for transplant has yielded to organ trafficking, organ tourism, and commercialism...
November 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27801541/leishmaniasis-in-solid-organ-and-hematopoietic-stem-cell-transplant-recipients
#12
REVIEW
Kiran Gajurel, Reshika Dhakal, Stan Deresinski
Leishmaniasis occurs in <1% of solid organ and hematopoietic stem cell transplant (SOT, HSCT) recipients in endemic countries in which transplants are performed. Visceral leishmaniasis (VL) makes up the bulk of reported cases. The onset generally occurs months after transplantation and the mode of acquisition is often impossible to determine, but de novo vector-borne infection and reactivation of inapparent infection are thought to be the principal means. The potential role of clinically inapparent donor infection is uncertain and screening is not currently recommended, nor is it recommended for recipients from endemic areas, some of whom may have detectable circulating protozoan nucleic acid...
November 1, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27788788/primum-non-nocere-organ-donation-after-electrocution-and-transplantation-of-electricity-damaged-livers-report-of-2-cases
#13
E Giorgakis, M Tedeschi, E Bonaccorsi-Riani, S E Korshandi, H Vilca-Melendez, N Heaton
Liver transplantation remains the treatment of choice for patients with end-stage liver disease. However, allograft availability continues to be a problem, and extending the criteria for organ acceptance is key. Deceased donors after electrical accidents, as well as electricity-traumatized allografts, are not common but should be considered suitable. This study describes 2 cases of heart-beating organ donors with electrical injury to the liver. In 1 case, the electric shock was the cause of death; in the second case, the injury was caused by defibrillation at organ procurement...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27782890/pediatric-small-bowel-transplantation-a-single-center-experience-from-turkey
#14
Cem Tuğmen, Maşallah Baran, İsmail Sert, Ayşe Berna Anıl, Eyüp Kebapçı, Sait Murat Doğan, Selçuk Kılınç, Gaye Aydın, Ayşe Gülden Diniz, Mustafa Ölmez, İbrahim Pirim, Cezmi Karaca
BACKGROUND/AIMS: Small bowel transplantation (SBTx) is a treatment option for patients with serious parenteral nutrition-related problems in intestinal failure. İzmir Tepecik Training Research Hospital Organ Transplantation Center is still the only pediatric intestinal transplant center in Turkey. MATERIAL AND METHODS: This study was approved by the local ethics committee. Patients' data were analyzed from the medical charts and the hospital digital database. Seven isolated SBTxs were performed in six children between 2010 and 2016...
September 2016: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/27778091/delayed-graft-function-and-its-management-in-children
#15
Ryszard Grenda
Delayed graft function (DGF) is commonly defined as the requirement for dialysis within the first 7 days following renal transplantation. The major underlying mechanism is related to ischaemia/reperfusion injury, which includes microvascular inflammation and cell death and apoptosis, and to the regeneration processes. Several clinical factors related to donor, recipient and organ procurement/transplantation procedures may increase the risk of DGF, including donor cardiovascular instability, older donor age, donor creatinine concentration, long cold ischaemia time and marked body mass index of both the donor and recipient...
October 24, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27777432/case-of-24-week-fetus-delivered-from-mother-on-life-support-with-brain-death-from-suicide-attempt-ethical-issues-associated-with-severe-complications
#16
Takeshi Nishimura, Keisuke Kohama, Takaaki Osako, Taihei Yamada, Hiroyuki Tanaka, Atsunori Nakao, Joji Kotani
Advances in critical care medicine have made it possible to sustain vital organ systems in brain-dead patients. One clinical scenario besides donor organ retrieval in which a benefit may be gained from continuing life support is pregnancy. A pregnant woman in her late 30's at 23 weeks gestation exhibiting worsening depression was referred to the Department of Psychiatry. One day after admission she attempted suicide by hanging and suffered a cardiopulmonary arrest. A fetal heart beat and fetal motion was confirmed immediately after resuscitation...
October 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27777298/management-of-systemic-right-ventricular-failure-in-patients-with-congenitally-corrected-transposition-of-the-great-arteries
#17
Aleksei A Filippov, Pedro J Del Nido, Nikolay V Vasilyev
In recent decades, significant progress has been made in the diagnosis and management of congenitally corrected transposition of the great arteries (ccTGA). Nevertheless, gradual dysfunction and failure of the right ventricle (RV) in the systemic circulation remain the main contributors to mortality and disability for patients with ccTGA, especially after adolescence. Anatomic repair of ccTGA effectively resolves the problem of failure of the systemic RV and has good early and midterm results. However, this strategy is applicable primarily in infants and children up to their teens and has associated risks and limitations, and new challenges can arise in the late postoperative period...
October 25, 2016: Circulation
https://www.readbyqxmd.com/read/27776143/defining-priorities-for-future-research-results-of-the-uk-kidney-transplant-priority-setting-partnership
#18
Simon R Knight, Leanne Metcalfe, Katriona O'Donoghue, Simon T Ball, Angela Beale, William Beale, Rachel Hilton, Keith Hodkinson, Graham W Lipkin, Fiona Loud, Lorna P Marson, Peter J Morris
BACKGROUND: It has been suggested that the research priorities of those funding and performing research in transplantation may differ from those of end service users such as patients, carers and healthcare professionals involved in day-to-day care. The Kidney Transplant Priority Setting Partnership (PSP) was established with the aim of involving all stakeholders in prioritising future research in the field. METHODS: The PSP methodology is as outlined by the James Lind Alliance...
2016: PloS One
https://www.readbyqxmd.com/read/27759559/donor-age-still-matters-in-liver-transplant-results-from-the-united-network-for-organ-sharing-scientific-registry-of-transplant-recipients-database
#19
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
https://www.readbyqxmd.com/read/27758973/evolution-of-chagas-disease-in-brazil-epidemiological-perspective-and-challenges-for-the-future-a-critical-review
#20
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
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