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Organ donor management

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https://www.readbyqxmd.com/read/29021960/relapsing-ebv-encephalitis-in-a-renal-transplant-recipient
#1
Joshua A Stone, Bettina M Knoll, Dimitrios Farmakiotis
In solid organ transplant recipients, Epstein-Barr virus (EBV) can cause active central nervous system (CNS) infection or malignant transformation of latently infected cells in the CNS, known as post-transplant lymphoproliferative disease (PTLD). Reduction of T-cell immunosuppression is the cornerstone of management. The role of antivirals with in-vitro activity against herpesviruses in EBV-related CNS syndromes is controversial, as they have no effect on latent virus. We report an unusual case of relapsing EBV encephalitis in a donor-positive, EBV-negative renal transplant recipient, with response to valganciclovir...
2017: IDCases
https://www.readbyqxmd.com/read/28993303/the-lived-experience-of-being-evaluated-for-organ-donation-focus-groups-with-living-kidney-donors
#2
Camilla S Hanson, Angelique F Ralph, Karine E Manera, John S Gill, John Kanellis, Germaine Wong, Jonathan C Craig, Jeremy R Chapman, Allison Tong
BACKGROUND AND OBJECTIVES: Comprehensive evaluations are required to safeguard voluntarism and minimize harm to living kidney donors. This process is lengthy, invasive, and emotionally challenging, with up to one fifth of potential donors opting out. We aimed to describe donors' experiences of the evaluation process. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted 14 focus groups involving 123 kidney donors who completed donation from three transplant centers (Australia and Canada)...
October 9, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28985863/early-declaration-of-death-by-neurologic-criteria-results-in-greater-organ-donor-potential
#3
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/28975176/deformability-based-microfluidic-separation-of-pancreatic-islets-from-exocrine-acinar-tissue-for-transplant-applications
#4
Walter B Varhue, Linda Langman, Molly Kelly-Goss, Morgan Lataillade, Kenneth L Brayman, Shayn Peirce-Cottler, Nathan S Swami
The long-term management of type-1 diabetes (T1D) is currently achieved through lifelong exogenous insulin injections. Although there is no cure for T1D, transplantation of pancreatic islets of Langerhans has the potential to restore normal endocrine function versus the morbidity of hypoglycemic unawareness that is commonly associated with sudden death among fragile diabetics. However, since endocrine islet tissues form a small proportion of the pancreas, sufficient islet numbers can be reached only by combining islets from multiple organ donors and the transplant plug contains significantly high levels of exocrine acinar tissue, thereby exacerbating immune responses...
October 4, 2017: Lab on a Chip
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/28963316/canada-donate-study-protocol-a-prospective-national-observational-study-of-the-medical-management-of-deceased-organ-donors
#6
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/28958963/lean-management-and-medical-laboratory-application-in-transfusionnal-immuno-hematology
#7
Jean-Baptiste Thibert, Françoise Le Vacon, Bruno Danic
Despite a common use in industrial applications, only a few studies describe the lean management methods in medical laboratory. These tools have been evaluated in analysis laboratory of blood donors, especially in immuno-hematology sector. The aim was to optimize the organization and maintain team cohesion and strong staff involvement in a restructuring context. The tools used and the results obtained are presented in this study.
October 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28940540/successful-kidney-transplantation-in-a-patient-with-congenital-thrombotic-thrombocytopenic-purpura-upshaw-schulman-syndrome
#8
Hasan Fattah, Dhiren Kumar, James N George, H Davis Massey, Anne L King, Kenneth D Friedman, Gaurav Gupta
BACKGROUND: Congenital thrombotic thrombocytopenic purpura (TTP) may not be recognized until organ failure related to the microvascular thrombosis occurs. Kidney failure may be the initial presenting clinical feature. Kidney transplantation has been contraindicated because of the assumption that the continuing microvascular thrombosis will cause inevitable graft failure. CASE REPORT: We report a 48-year-old nulliparous woman who presented with end-stage kidney disease that was attributed to hypertension...
September 20, 2017: Transfusion
https://www.readbyqxmd.com/read/28937070/renal-transplantation-in-hiv-positive-patients-no-more-a-scare
#9
Eswarappa Mahesh, Manns Manohar John, Gurudev Channabasappa Konana, Rakesh Madhyastha Parampalli, Sujeeth Reddy Bande, Sarita Suryadevara
Human immunodeficiency virus (HIV) infection has posed as a major global health epidemic for almost three decades. With the advent of highly active antiretroviral therapy in 1996 and the application of prophylaxis and management of opportunistic infections, acquired immunodeficiency syndrome mortality has decreased markedly. The most aggressive HIV-related renal disease is end-stage renal disease due to HIV-associated nephropathy. Presence of HIV infection used to be viewed as a contraindication to renal transplantation for multiple reasons; concerns for exacerbation of an already immunocompromised state by administration of additional immunosuppressants; the use of a limited supply of donor organs with unknown long-term outcomes...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28926189/environmental-peer-pressure-cd4-t-cell-help-in-tolerance-and-transplantation
#10
REVIEW
Dana Tedesco, Arash Grakoui
The liver participates in a multitude of metabolic functions that are critical for sustaining human life. Despite constant encounters with antigenic-rich intestinal blood, oxidative stress and metabolic intermediates, there is no appreciable immune response. Interestingly, patients undergoing orthotopic liver transplantation benefit from a high rate of graft acceptance in comparison to other solid organ transplant recipients. In fact, co-transplantation of a donor liver in tandem with a rejection-prone graft increases the likelihood of graft acceptance...
September 19, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28923612/deceased-organ-donation-from-pediatric-donors-does-the-literature-really-help-us-implication-for-more-powerful-guidelines
#11
M Mojtabaee, F Sadegh Beigee, F Ghorbani
BACKGROUND: Brain-dead pediatric donors have always been the focus of attention because of the higher quality, utility, and possibility of their organ donation. However, donors under the age of 5 years always necessitate making more challenging management efforts, which are not clearly implied in most parts of the guidelines. METHODS: The data obtained from 79 brain-dead pediatric donors of the Organ Procurement Unit of Masih Daneshvari Hospital, Tehran, Iran, were assessed...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28895380/how-to-optimize-the-lung-donor
#12
Gabriele Sales, Andrea Costamagna, Vito Fanelli, Massimo Boffini, Francesco Pugliese, Luciana Mascia, Luca Brazzi
In the last two decades, lung transplantation emerged as the standard of care for patients with advanced and terminal lung disease. Despite the increment in lung transplantation rates, in 2016 the overall mortality while on waiting list in Italy reached the 10%, whereas only the 39% of the wait-list patients were successfully transplanted. A number of approaches, including protective ventilatory strategy, accurate management of fluid balance, administration of a hormonal resuscitation therapy have been reported to improve lung donor performance before organ retrieval...
September 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28888434/ensuring-food-safety-in-food-donations-case-study-of-the-belgian-donation-acceptation-chain
#13
E De Boeck, L Jacxsens, H Goubert, M Uyttendaele
The food donation process in Belgium is mapped and analyzed to identify bottlenecks in compliance with the legal framework and implementation of food safety management, based on literature search and interviews with stakeholders (donors, acceptors, regulators and facilitators) in Belgium and at EU level. The study revealed that the food donation/acceptation chain is far less structured and organized than the conventional food supply chain. The fragmented landscape of many small food banks and charity organizations (acceptors), often directed by and working with volunteers without training in food safety and lack of knowledge of legal food hygiene requirements is a bottleneck to generate trust among food donors and restricts the provision of perishable products in food donations...
October 2017: Food Research International
https://www.readbyqxmd.com/read/28880430/human-leukocyte-antigen-sensitization-in-solid-organ-transplantation-a-primer-on-terminology-testing-and-clinical-significance-for-the-apheresis-practitioner
#14
REVIEW
Sarah Abbes, Ara Metjian, Alice Gray, Tereza Martinu, Laurie Snyder, Dong-Feng Chen, Matthew Ellis, Gowthami M Arepally, Oluwatoyosi Onwuemene
The human leukocyte antigen (HLA) system is an important immunologic barrier that must be considered for successful solid organ transplantation. Formation of donor-specific HLA antibodies in solid organ transplantation is an important cause of allograft injury and may contribute to recipient morbidity and mortality. Therapeutic plasma exchange is often requested to lower HLA antibody levels prior to or after transplantation and for management of HLA antibodies in the context of organ rejection. In this review, we summarize the current terminology, laboratory testing, and clinical significance of HLA sensitization in the solid organ transplant population...
October 2017: Therapeutic Apheresis and Dialysis
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
#15
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/28868984/the-new-kidney-donor-allocation-system-and-implications-for-anesthesiologists
#16
Srikanth Sridhar, Sara Guzman-Reyes, Sam D Gumbert, Semhar J Ghebremichael, Angelina R Edwards, Mark J Hobeika, Wasim A Dar, Evan G Pivalizza
Given potential disparity and limited allocation of deceased donor kidneys for transplantation, a new federal kidney allocation system was implemented in 2014. Donor organ function and estimated recipient survival in this system has implications for perioperative management of kidney transplant recipients. Early analysis suggests that many of the anticipated goals are being attained. For anesthesiologists, implications of increased dialysis duration and burdens of end-stage renal disease include increased cardiopulmonary disease, challenging fluid, hemodynamic management, and central vein access...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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
#17
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/28857060/observations-and-lessons-learnt-from-more-than-a-decade-of-water-safety-planning-in-south-east-asia
#18
David Sutherland
In many countries of the World Health Organization (WHO) South-East Asia Region, drinking water is not used directly from the tap and faecal contamination of water sources is prevalent. As reflected in Sustainable Development Goal 6, access to safer drinking water is one of the most successful ways of preventing disease. The WHO Water Safety Framework promotes the use of water safety plans (WSPs), which are structured tools that help identify and mitigate potential risks throughout a water-supply system, from the water source to the point of use...
September 2017: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28838179/implementing-the-synchronized-global-switch-from-trivalent-to-bivalent-oral-polio-vaccines-lessons-learned-from-the-global-perspective
#19
Alejandro Ramirez Gonzalez, Margaret Farrell, Lisa Menning, Julie Garon, Hans Everts, Lee M Hampton, Samantha B Dolan, Stephanie Shendale, Sarah Wanyoike, Chantal Laroche Veira, Gaël Maufras du Châtellier, Feyrouz Kurji, Jennifer Rubin, Liliane Boualam, Diana Chang Blanc, Manish Patel
In 2015, the Global Commission for the Certification of Polio Eradication certified the eradication of type 2 wild poliovirus, 1 of 3 wild poliovirus serotypes causing paralytic polio since the beginning of recorded history. This milestone was one of the key criteria prompting the Global Polio Eradication Initiative to begin withdrawal of oral polio vaccines (OPV), beginning with the type 2 component (OPV2), through a globally synchronized initiative in April and May 2016 that called for all OPV using countries and territories to simultaneously switch from use of trivalent OPV (tOPV; containing types 1, 2, and 3 poliovirus) to bivalent OPV (bOPV; containing types 1 and 3 poliovirus), thus withdrawing OPV2...
July 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28834072/a-severely-cholestatic-liver-graft-can-be-successfully-used-in-deceased-donor-liver-transplantation
#20
Seisuke Sakamoto, Kengo Sasaki, Hajime Uchida, Soichi Narumoto, Toshihiro Kitajima, Rie Irie, Akinari Fukuda, Takako Yoshioka, Mureo Kasahara
The shortage of deceased organs is still a serious issue in Japan. A proactive approach to using liver grafts from extended criteria donors (ECDs) may be one way of expanding the donor pool; however, if it is recklessly attempted, a recipient receiving such a marginal graft can be at risk of mortality due to the primary non-function or a delayed graft function. We herein report the successful outcome of a recipient receiving a severely cholestatic graft that was considered transplantable because it lacked features characteristic of a long duration of "cholestasis" according to the precise interpretation of a donor biopsy...
August 18, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
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