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Organ donor management

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https://www.readbyqxmd.com/read/28318674/organ-donor-management-eight-common-recommendations-and-actions-that-deserve-reflection
#1
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/28288014/the-times-they-are-a-changing-hope-for-hiv-to-hiv-organ-transplantation
#2
Ghady Haidar, Nina Singh
HIV-infected persons who achieve undetectable viral loads on antiretroviral therapy currently have near-normal lifespans. Liver disease is a major cause of non-AIDS-related deaths, and as a result of longer survival, the prevalence of end-stage renal disease in HIV is increasing. HIV-infected persons undergoing organ transplantation generally achieve comparable patient and graft survival rates compared to their HIV-uninfected counterparts, despite a nearly threefold increased risk of acute rejection. However, the ongoing shortage of suitable organs can limit transplantation as an option, and patients with HIV have higher waitlist mortality than others...
March 1, 2017: Transplantation
https://www.readbyqxmd.com/read/28280376/single-donor-islet-transplantation-in-type-1-diabetes-patient-selection-and-special-considerations
#3
REVIEW
Jacob A Tatum, Max O Meneveau, Kenneth L Brayman
Type 1 diabetes mellitus is an autoimmune disorder of the endocrine pancreas that currently affects millions of people in the United States. Although the disease can be managed with exogenous insulin administration, the ultimate cure for the condition lies in restoring a patient's ability to produce their own insulin. Islet cell allotransplantation provides a means of endogenous insulin production. Though far from perfected, islet transplants are now a proven treatment for type 1 diabetics. However, proper patient selection is critical for achieving optimal outcomes...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28279666/pediatric-heart-failure-a-practical-guide-to-diagnosis-and-management
#4
REVIEW
Daniele Masarone, Fabio Valente, Marta Rubino, Rossella Vastarella, Rita Gravino, Alessandra Rea, Maria Giovanna Russo, Giuseppe Pacileo, Giuseppe Limongelli
Pediatric heart failure represents an important cause of morbidity and mortality in childhood. Currently, there are well-established guidelines for the management of heart failure in the adult population, but an equivalent consensus in children is lacking. In the clinical setting, ensuring an accurate diagnosis and defining etiology is essential to optimal treatment. Diuretics and angiotensin-converting enzyme inhibition are the first-line therapies, whereas beta-blockers and devices for electric therapy are less used in children than in adults...
February 1, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28266049/standardization-of-transfusion-practice-in-organ-donors-using-the-digital-intern-an-electronic-decision-support-algorithm
#5
Joseph P Connor, Ashley M Cunningham, Thomas Raife, William N Rose, Joshua E Medow
BACKGROUND: Prospective clinical trials support restrictive thresholds for red blood cell (RBC) transfusion. Nonsurvivable donors are a major source of organs for transplantation. The Digital Intern (DI) is a computer algorithm to standardize donor care that includes a more restrictive transfusion threshold. The impact of standardized and restrictive RBC transfusion in organ donors, as determined by the DI, has not been reported. STUDY DESIGN AND METHODS: We conducted a retrospective cohort study to compare the transfusion practice of the DI (n = 100) to a historic group of physician-managed donors (n = 90)...
March 7, 2017: Transfusion
https://www.readbyqxmd.com/read/28260484/impact-of-a-full-time-donor-management-protocol-on-donors-liver-biopsy-findings-progress-to-date
#6
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
#7
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/28244199/liver-transplantation-with-an-uncommon-full-right-hemiliver-graft-after-hydatid-cysts-resection-case-report-and-review-of-the-literature
#8
Damiano Patrono, Francesco Tandoi, Giorgia Rizza, Giorgia Catalano, Stefano Mirabella, Piero Celoria, Silvia Corcione, Francesco Giuseppe De Rosa, Mauro Salizzoni, Renato Romagnoli
Because of widespread organ shortage, the transplant community has been exploiting more and more so-called "extended criteria" donors. In this scenario, liver grafts harboring benign tumors or large cysts represent an infrequent but potentially valuable source of viable grafts. We depict a challenging case of liver transplantation performed using a graft harboring two large Echinococcus granulosus hydatid cysts in close proximity with the hilar plate and complicated by cystobiliary communication. Although liver transplantation using grafts with hydatid cyst has been rarely reported (three published cases), our case was peculiar as one of the cysts was located close to the hilum and was ruptured into left hepatic duct...
February 28, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28240643/heart-allograft-preservation-an-arduous-journey-from-the-donor-to-the-recipient
#9
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
https://www.readbyqxmd.com/read/28230718/critical-care-management-of-the-potential-organ-donor
#10
Thomas E Grissom, Justin E Richards, Daniel L Herr
No abstract text is available yet for this article.
2017: International Anesthesiology Clinics
https://www.readbyqxmd.com/read/28217596/distribution-of-abo-and-rh-types-in-voluntary-blood-donors-in-jharkhand-area-as-a-study-conducted-by-rims-ranchi
#11
Anu Singh, Ramesh Kumar Srivastava, Kabita S Deogharia, Kranti Kumar Singh
BACKGROUND: This study was done to know the distribution and frequencies of blood groups among blood donors attending voluntary blood donation camps organized by the Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand so that demand and supply ratio of the four blood groups can be maintained so that no patient dies due to lack of a particular blood group. CONTEXT: Up till now about 400 red cells antigen have been identified. The majority follow Mendelian inheritance...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28216707/combined-liver-and-kidney-transplantation-our-experience-and-review-of-literature
#12
Kusuma Ramachandra Halemani, N Bhadrinath
Increased awareness of organ donation has increased the availability of deceased donors, and it has boosted the opportunities for treating patients with multiple organ dysfunction. Simultaneously replacing two organs gives advantages of single surgery, lower immunosuppression dose and better survival than when one organ alone is transplanted. We present reports of management of three cases of combined liver and kidney transplantation (CLKT) from deceased donors. Based on management of these cases we discuss the importance of CLKT and anaesthetic concerns during such complex procedures...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216502/-treatment-of-ureteral-fistula-and-stricture-following-renal-transplantation-with-boari-flap
#13
Peng Jin, Jinliang Xie, Jingeng Dun, Xiang Ding, Cheng Zhou, Xiangrong Zhu, Lielin Wu, Bo Yang, Gang Zhang
To estimate the incidence rate of ureteral fistula and stricture after kidney transplantation, and to evaluate the effect of bladder flap (Boari flap) on ureteral complication of the transplanted kidney. 
 Methods: The clinical data and risk factors from 270 recipients of renal transplantation, who came from the Centre of Organ Transplantation, Xiangya Hospital, Central South University from January 2010 to January 2015, were retrospectively analyzed. The surgical management included Boari flap for ureteral reconstruction, neoureterocystostomy and endoscopic therapy with double-J (DJ) stent placement...
January 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28212150/desensitization-strategies-in-the-patient-awaiting-heart-transplantation
#14
David H Chang, Jon A Kobashigawa
PURPOSE OF REVIEW: The aim of this review is to discuss the impact of antibody sensitization on heart transplant recipients. RECENT FINDINGS: We will discuss the current state of antibody identification, antibody strength and potential antibody pathogenicity. The prevalence of antibody sensitization has increased with increased utilization of mechanical circulatory support (MCS). Data on MCS-related antibody sensitization are reviewed. Important considerations to minimize the prozone effect in antibody testing will be discussed...
February 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28208117/percutaneous-transcatheter-therapies-for-the-management-of-left-ventricular-assist-device-complications
#15
Rohan J Kalathiya, Jonathan Grinstein, Nir Uriel, Atman P Shah
Heart failure is a growing epidemic in the United States and throughout the world. The utilization of continuous-flow left ventricular assist devices (LVADs) has greatly increased over the last decade. In addition, a limited supply of organ donors has led to a rise in the use, and duration, of LVADs for destination therapy. The increased use of LVAD therapy has led to the observation of mechanical complications such as device thrombosis, de novo aortic insufficiency, and outflow graft stenosis, all of which are associated with prolonged LVAD support...
February 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28205018/the-donor-advocacy-team-a-risk-management-program-for-living-organ-tissue-and-cell-transplant-donors
#16
Susumu Eguchi, Akihiko Soyama, Kazuhiro Nagai, Yasushi Miyazaki, Shintaro Kurihara, Masaaki Hidaka, Shinichiro Ono, Tomohiko Adachi, Koji Natsuda, Takanobu Hara, Fumihiko Fujita, Kengo Kanetaka, Mistuhisa Takatsuki
BACKGROUND AND PURPOSE: Although the incidence of living donor death is low in Japan, statistics show one living liver donor death in more than 7000 living liver transplants. Thus, medical transplant personnel must recognize that the death of a living organ or tissue transplant donor can occur and develop an appropriate risk management program. METHODS AND RESULTS: We describe how Nagasaki University Hospital established and implemented a Donor Advocacy Team (DAT) program: a risk management program for initiation in the event of serious, persistent, or fatal impairment of an organ, tissue, or cell transplantation from a living donor...
February 15, 2017: Surgery Today
https://www.readbyqxmd.com/read/28198133/left-ventricular-assist-device-therapy-in-advanced-heart-failure-patient-selection-and-outcomes
#17
REVIEW
Finn Gustafsson, Joseph G Rogers
Despite improvements in pharmacological therapy and pacing, prognosis in advanced heart failure (HF) remains poor, with a 1-year mortality of 25-50%. While heart transplantation provides excellent survival and quality of life for eligible patients, only a few can be offered this treatment due to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are being used increasingly both as bridge-to-transplantation and as destination therapy...
February 15, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28187813/organ-donation-protocols
#18
C B Maciel, D Y Hwang, D M Greer
Organ transplantation improves survival and quality of life in patients with end-organ failure. Waiting lists continue to grow across the world despite remarkable advances in the transplantation process, from the creation of public engagement campaigns to the development of critical pathways for the timely identification, referral, approach, and treatment of the potential organ donor. The pathophysiology of dying triggers systemic changes that are intimately related to organ viability. The intensive care management of the potential organ donor optimizes organ function and improves the donation yield, representing a significant step in reducing the mismatch between organ supply and demand...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28155817/impact-of-the-genexpert-mtb-rif-technology-on-tuberculosis-control
#19
Wendy Susan Stevens, Lesley Scott, Lara Noble, Natasha Gous, Keertan Dheda
Molecular technology revolutionized the diagnosis of tuberculosis (TB) with a paradigm shift to faster, more sensitive, clinically relevant patient care. The most recent molecular leader is the GeneXpert MTB/RIF assay (Xpert) (Cepheid, Sunnyvale, CA), which was endorsed by the World Health Organization with unprecedented speed in December 2010 as the initial diagnostic for detection of HIV-associated TB and for where high rates of drug resistance are suspected. South Africa elected to take an aggressive smear replacement approach to facilitate earlier diagnosis and treatment through the decision to implement the Xpert assay nationally in March 2011, against the backdrop of approximately 6...
January 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28151807/the-impact-of-antibodies-and-virtual-crossmatching-on-intestinal-transplant-outcomes
#20
Elaine Y Cheng, Bernard J DuBray, Douglas G Farmer
PURPOSE OF REVIEW: Sensitization to human leukocyte antigens (HLAs) limits access to potential donors and contributes to inferior graft survival after transplantation. In this article, we will review the effects of HLA-specific antibodies on intestinal transplant outcomes, and discuss considerations in the monitoring and treatment of anti-HLA antibodies. RECENT FINDINGS: Only a handful of studies has investigated the effects of donor-specific anti-HLA antibodies (DSAs) on intestinal allograft outcomes...
February 1, 2017: Current Opinion in Organ Transplantation
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