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Organ donor management

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https://www.readbyqxmd.com/read/28447929/five-year-follow-up-on-transplanted-organs-from-donors-after-brain-death-after-acute-stroke
#1
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/28441386/graft-derived-cell-free-dna-a-noninvasive-early-rejection-and-graft-damage-marker-in-liver-transplantation-a-prospective-observational-multicenter-cohort-study
#2
Ekkehard Schütz, Anna Fischer, Julia Beck, Markus Harden, Martina Koch, Tilo Wuensch, Martin Stockmann, Björn Nashan, Otto Kollmar, Johannes Matthaei, Philipp Kanzow, Philip D Walson, Jürgen Brockmöller, Michael Oellerich
BACKGROUND: Graft-derived cell-free DNA (GcfDNA), which is released into the blood stream by necrotic and apoptotic cells, is a promising noninvasive organ integrity biomarker. In liver transplantation (LTx), neither conventional liver function tests (LTFs) nor immunosuppressive drug monitoring are very effective for rejection monitoring. We therefore hypothesized that the quantitative measurement of donor-derived cell-free DNA (cfDNA) would have independent value for the assessment of graft integrity, including damage from acute rejection...
April 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28439697/heart-transplantation-for-adults-with-congenital-heart-disease-current-status-and-future-prospects
#3
REVIEW
Hikaru Matsuda, Hajime Ichikawa, Takayoshi Ueno, Yoshiki Sawa
Increased survival rates after corrective or palliative surgery for complex congenital heart disease (CHD) in infancy and childhood are now being coupled with increased numbers of patients who survive to adulthood with various residual lesions or sequelae. These patients are likely to deteriorate in cardiac function or end-organ function, eventually requiring lifesaving treatment including heart transplantation. Although early and late outcomes of heart transplantation have been improving for adult survivors of CHD, outcomes and pretransplant management could still be improved...
April 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#4
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28433405/epidemiology-of-toxoplasma-gondii-among-blood-donors-in-iran-a-systematic-review-and-meta-analysis
#5
REVIEW
Akram Mansouri, Mohammad Reza Adhami Mojarad, Gholamreza Badfar, Lila Abasian, Shoboo Rahmati, Wesam Kooti, Mohammad Hossein YektaKooshali, Ali Soleymani, Milad Azami
INTRODUCTION: Asymptomatic Toxoplasma gondii transmitted from blood donors to receiving patients has become a concern. Numerous articles have been published on the epidemiology of T. gondii in blood donors in Iran and a systematic review of the results shows quite different findings, hence this study was conducted to determine the seroprevalence of T. gondii in Iranian blood donors using meta-analysis. METHODS: We searched for epidemiological studies that were published until July 2016 in eight English databases including: Scopus, PubMed, Ovid, Science Direct, Cochrane, Web of Science, Springer, Wiley Online Library, and four Iranian databases: Magiran, Iranmedex, SID and Medlib as well as Google Scholar...
March 29, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28405138/long-term-follow-up-and-outcome-of-liver-transplantation-from-hepatitis-b-surface-antigen-positive-donors
#6
EDITORIAL
Roberto Ballarin, Alessandro Cucchetti, Francesco Paolo Russo, Paolo Magistri, Matteo Cescon, Umberto Cillo, Patrizia Burra, Antonio Daniele Pinna, Fabrizio Di Benedetto
Liver transplant for hepatitis B virus (HBV) currently yields excellent outcomes: it allows to rescue patients with an HBV-related advanced liver disease, resulting in a demographical modification of the waiting list for liver transplant. In an age of patient-tailored treatments, in liver transplantation as well the aim is to offer the best suitable graft to the patient who can benefit from it, also expanding the criteria for organ acceptance and allocation. With the intent of developing strategies to increase the donor pool, we set-up a multicenter study involving 3 Liver Transplant Centers in Italy: patients undergoing liver transplantation between March 03, 2004, and May 21, 2010, were retrospectively evaluated...
March 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28385575/intersecting-worlds-of-transfusion-and-transplantation-medicine-an-international-symposium-organized-by-the-canadian-blood-services-centre-for-innovation
#7
REVIEW
Kendra M Hodgkinson, Jeffrey Kiernan, Andrew W Shih, Ziad Solh, William P Sheffield, Nicolas Pineault
The principal theme of the symposium was centered on how the world of regenerative medicine intersects with that of transfusion medicine, with a particular focus on hematopoietic stem cells (HSCs) and stem cell therapies. The symposium highlighted several exciting developments and identified areas where additional research is needed. A revised map of human hematopoietic hierarchy was presented based on the functional and phenotypic analysis of thousands of single stem and progenitor cells from adult bone marrow and fetal liver...
March 22, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28381252/tracing-africa-s-progress-towards-implementing-the-non-communicable-diseases-global-action-plan-2013-2020-a-synthesis-of-who-country-profile-reports
#8
Gertrude Nsorma Nyaaba, Karien Stronks, Ama de-Graft Aikins, Andre Pascal Kengne, Charles Agyemang
BACKGROUND: Half of the estimated annual 28 million non-communicable diseases (NCDs) deaths in low- and middle-income countries (LMICs) are attributed to weak health systems. Current health policy responses to NCDs are fragmented and vertical particularly in the African region. The World Health Organization (WHO) led NCDs Global action plan 2013-2020 has been recommended for reducing the NCD burden but it is unclear whether Africa is on track in its implementation. This paper synthesizes Africa's progress towards WHO policy recommendations for reducing the NCD burden...
April 5, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28380482/allergic-and-nonallergic-asthma-have-distinct-phenotypic-and-genotypic-features
#9
Priscila Takejima, Rosana Câmara Agondi, Helcio Rodrigues, Marcelo Vivolo Aun, Jorge Kalil, Pedro Giavina-Bianchi
BACKGROUND: Identification of asthma phenotypes enables a better understanding and management of this heterogeneous disease. Studies have reported associations between human leukocyte antigens (HLA) and asthma in different populations, but the results have been inconclusive and they have rarely considered the distinct disease phenotypes. Our objective was to characterize allergic and nonallergic asthma phenotypes and evaluate possible associations with the HLA system. METHODS: A total of 109 patients with asthma were prospectively followed during 2 years...
April 6, 2017: International Archives of Allergy and Immunology
https://www.readbyqxmd.com/read/28369932/successful-management-of-passenger-lymphocyte-syndrome-in-an-abo-compatible-nonidentical-isolated-bowel-transplant-a-case-report-and-review-of-the-literature
#10
Daniel Foell, Sabina Glasmeyer, Norbert Senninger, Heiner Wolters, Daniel Palmes, Ralf Bahde
BACKGROUND: Passenger lymphocyte syndrome (PLS), a subtype of graft-versus-host disease, is a rare disorder encountered mainly in ABO-mismatched hematopoietic stem cell transplantation and infrequently in all types of ABO-mismatched solid organ transplantation. We here report the fifth case of PLS in small bowel transplantation (SBTx) and the first one describing the successful management of PLS in a cadaveric, isolated SBTx. CASE REPORT: A 60-year-old Caucasian female with blood group A D+ suffering from short bowel syndrome received a small bowel transplant from a 32-year-old Caucasian female with blood group O D+ (HLA mismatch 2/6)...
March 28, 2017: Transfusion
https://www.readbyqxmd.com/read/28363269/establishing-a-large-animal-model-for-in-vivo-reprogramming-of-bile-duct-cells-into-insulin-secreting-cells-to-treat-diabetes
#11
Caitlin Marie Hill, Anannya Banga, Juan E Abrahante, Ce Yuan, Lucas A Mutch, Jody Janecek, Timothy O'Brien, Melanie L Graham, James Dutton
Type I diabetes manifests in autoimmune destruction of beta cells requiring metabolic management with an exogenous replacement source of insulin, either by repeated injection of recombinant insulin or by transplantation of allogenic islets from cadaveric donors. Both of these approaches have severe limitations. Repeated insulin injection requires intensive blood glucose monitoring, is expensive, and is associated with decreased quality of life measures. Islet transplant, while highly effective, is severely limited by shortage of donor organs...
March 31, 2017: Human Gene Therapy. Clinical Development
https://www.readbyqxmd.com/read/28341302/health-systems-in-the-republic-of-congo-challenges-and-opportunities-for-implementing-tuberculosis-and-hiv-collaborative-service-research-and-training-activities
#12
Laure Stella Ghoma Linguissi, Luc Christian Gwom, Celine Nguefeu Nkenfou, Matthew Bates, Eskild Petersen, Alimuddin Zumla, Francine Ntoumi
The Republic of Congo is on the World Health Organization (WHO) list of 'high burden' countries for tuberculosis (TB) and HIV. TB is the leading cause of death among HIV-infected patients in the Republic of Congo. In this viewpoint, the available data on TB and HIV in the Republic of Congo are reviewed, and the gaps and bottlenecks that the National TB Control Program (NTCP) faces are discussed. Furthermore, priority requirements for developing and implementing TB and HIV collaborative service activities are identified...
March 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28333859/multicenter-prospective-study-for-laboratory-diagnosis-of-hhv8-infection-in-solid-organ-donors-and-transplant-recipients-and-evaluation-of-the-clinical-impact-after-transplantation
#13
Angela Chiereghin, Patrizia Barozzi, Evangelia Petrisli, Giulia Piccirilli, Liliana Gabrielli, Giovanni Riva, Leonardo Potenza, Gianni Cappelli, Nicola De Ruvo, Irene Libri, Umberto Maggiore, Maria Cristina Morelli, Luciano Potena, Paola Todeschini, Dino Gibertoni, Manuel Labanti, Gabriela Sangiorgi, Gaetano La Manna, Antonio Daniele Pinna, Mario Luppi, Tiziana Lazzarotto
BACKGROUND: We performed serological and molecular pretransplant screening in solid organ transplant (SOT) donors and recipients in north-central Italy and a surveillance program for human herpes virus 8 (HHV8) infection after transplant, aiming to establish an optimal management of HHV8 infection in SOT recipients. METHODS: For pretransplant HHV8 screening in both donors and recipients, 6 serological (4 indirect immunofluorescent assays (IFA) and 2 enzyme-linked immunosorbent assays (ELISA) - both HHV8 lytic and latent antigen-based) and 2 molecular assays were used...
March 22, 2017: Transplantation
https://www.readbyqxmd.com/read/28329348/outcome-and-treatment-of-nocardiosis-after-solid-organ-transplantation-new-insights-from-a-european-study
#14
David Lebeaux, Romain Freund, Christian van Delden, Hélène Guillot, Sierk D Marbus, Marie Matignon, Eric Van Wijngaerden, Benoit Douvry, Julien De Greef, Fanny Vuotto, Leïla Tricot, Mario Fernández-Ruiz, Jacques Dantal, Cédric Hirzel, Jean-Philippe Jais, Veronica Rodriguez-Nava, Frédérique Jacobs, Olivier Lortholary, Julien Coussement
Background: Solid organ transplant (SOT) recipients are at risk of nocardiosis, a rare opportunistic bacterial infection, but prognosis and outcome of these patients are poorly defined. Our objectives were to identify factors associated with one-year mortality after nocardiosis and describe the outcome of patients receiving short-course antibiotics (≤120 days). Methods: We analyzed data from a multicenter European case-control study that included 117 SOT recipients with nocardiosis diagnosed between 2000 and 2014...
February 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28318674/organ-donor-management-eight-common-recommendations-and-actions-that-deserve-reflection
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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