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https://www.readbyqxmd.com/read/28230644/expanding-the-donor-pool-through-intensive-care-to-facilitate-organ-donation-results-of-a-spanish-multicenter-study
#1
Beatriz Domínguez-Gil, Elisabeth Coll, José Elizalde, Jaime E Herrero, Teresa Pont, Brígida Quindós, Bella Marcelo, María A Bodí, Adolfo Martínez, Agustín Nebra, Francisco Guerrero, José M Manciño, Juan Galán, Miguel Lebrón, Eduardo Miñambres, Rafael Matesanz
BACKGROUND: Intensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. METHODS: ACCORD-Spain consisted of an audit of the donation pathway from patients dead as a result of a devastating brain injury (possible donors) in 68 hospitals during 11/1/2014-4/30/2015. We focused on possible donors whose family was interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome...
February 23, 2017: Transplantation
https://www.readbyqxmd.com/read/28229804/immediately-functioning-grafts-from-brain-dead-donors-treated-with-extracorporeal-membrane-oxygenation
#2
Faissal A M Shaheen, Mohamed Shalabi, Ahmed Zain, Mahmood Hasanain, Abdulla Al Sayyari
A brain-dead donor experienced repeated cardiac arrests followed by severe hypotension requiring multiple vasoactive agents. These events were associated with severe lactic acidosis and dysregulated kidney function in the donor. A 10-hour treatment with extracorporeal membranous oxygenation was instituted, which was able to hemodynamically stabilize the donor. This treatment protocol resulted in the procurement of 2 viable kidney grafts transplanted into 2 recipients, who had immediate kidney graft function and excellent serum creatinine levels upon hospital discharge...
February 23, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28226226/microglia-function-in-the-central-nervous-system-during-health-and-neurodegeneration
#3
Marco Colonna, Oleg Butovsky
Microglia are resident cells of the brain that regulate brain development, maintenance of neuronal networks, and injury repair. Microglia serve as brain macrophages but are distinct from other tissue macrophages owing to their unique homeostatic phenotype and tight regulation by the central nervous system (CNS) microenvironment. They are responsible for the elimination of microbes, dead cells, redundant synapses, protein aggregates, and other particulate and soluble antigens that may endanger the CNS. Furthermore, as the primary source of proinflammatory cytokines, microglia are pivotal mediators of neuroinflammation and can induce or modulate a broad spectrum of cellular responses...
February 9, 2017: Annual Review of Immunology
https://www.readbyqxmd.com/read/28222055/ex-situ-perfusion-of-human-limb-allografts-for-24-hours
#4
Nicole L Werner, Fares Alghanem, Stephanie L Rakestraw, Dylan C Sarver, Bruce Nicely, Richard E Pietroski, Paul Lange, Steven M Rudich, Christopher L Mendias, Alvaro Rojas-Pena, John C Magee, Robert H Bartlett, Kagan Ozer
BACKGROUND: Vascularized composite allografts, particularly hand and forearm, have limited ischemic tolerance after procurement. In bilateral hand transplantations, this demands a 2 team approach and expedited transfer of the allograft, limiting the recovery to a small geographic area. Ex situ perfusion may be an alternative allograft preservation method to extend allograft survival time. This is a short report of 5 human limbs maintained for 24 hours with ex situ perfusion. METHODS: Upper limbs were procured from brain-dead organ donors...
March 2017: Transplantation
https://www.readbyqxmd.com/read/28222054/ucp2-expression-is-increased-in-pancreas-from-brain-dead-donors-and-involved-in-cytokine-induced-%C3%AE-cells-apoptosis
#5
Leticia A Brondani, Tatiana H Rech, Gabriela Boelter, Andrea C Bauer, Cristiane B Leitão, Décio L Eizirik, Daisy Crispim
BACKGROUND: Systemic inflammation associated with brain death (BD) decreases islet yield and quality, negatively affecting outcomes of human islet transplantation. A recent study from our group showed an increased expression of uncoupling protein-2 (UCP2) in pancreas from rats with BD as compared with controls. UCP2 is located in the mitochondrial inner membrane and regulates production of reactive oxygen species and glucose-stimulated insulin secretion. It has been suggested that UCP2 also plays a role in β cell apoptosis, but these findings remain controversial...
March 2017: Transplantation
https://www.readbyqxmd.com/read/28217292/oxygen-or-cooling-to-make-a-decision-after-acute-ischemia-stroke
#6
REVIEW
Wen-Cao Liu, Xin-Chun Jin
The presence of a salvageable penumbra, a region of ischemic brain tissue with sufficient energy for short-term survival, has been widely agreed as the premise for thrombolytic therapy with tissue plasminogen activator (tPA), which remains the only United States Food and Drug Administration (FDA) approved treatment for acute ischemia stroke. However, the use of tPA has been profoundly constrained due to its narrow therapeutic time window and the increased risk of potentially deadly hemorrhagic transformation (HT)...
October 2016: Medical Gas Research
https://www.readbyqxmd.com/read/28215133/use-of-imaging-studies-for-determination-of-brain-death-in-south-australian-intensive-care-units
#7
Brett G Sampson, Luke D Datson, Shailesh Bihari
OBJECTIVES: To describe the use of imaging studies (four-vessel angiography or radionuclide scan) for brain death determination in South Australian intensive care units, and to determine the rates of adherence with The ANZICS statement on death and organ donation of the Australian and New Zealand Intensive Care Society (ANZICS). DESIGN, PATIENTS AND SETTING: Retrospective case-note review of 190 South Australian adult patients (≥ 18 years) who were brain dead and were organ donors (actual and intended), from 1 January 2008 to 31 December 2014...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28207629/short-and-long-term-outcome-after-lung-transplantation-from-circulatory-dead-donors-a-single-center-experience
#8
David Ruttens, An Martens, Sofie Ordies, Stijn E Verleden, Arne P Neyrinck, Robin Vos, Marc Boada Collado, Bart M Vanaudenaerde, Geert M Verleden, Dirk Van Raemdonck
BACKGROUND: Donation after cardiac death (DCD) to overcome the donor organ shortage is well accepted in the clinical setting, although long-term outcome after DCD lung transplantation (LTx) remains largely unknown. METHODS: In this retrospective study, DCD LTx recipients (n=59) were compared with a cohort of donation after brain-death (DBD) LTx recipients (n=331) transplanted between February 2007 and September 2013; follow-up was until January 1st 2016. Short-term (duration of mechanical ventilation, ICU stay, hospital stay and highest PGD score within 72 hours) and long-term (CLAD-free and overall survival) follow-up were compared over a median follow-up of 50...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28203222/unexpected-death-of-a-child-with-complex-febrile-seizures-pathophysiology-similar-to-sudden-unexpected-death-in-epilepsy
#9
Brian J Dlouhy, Michael A Ciliberto, Christina L Cifra, Patricia A Kirby, Devin L Shrock, Marcus Nashelsky, George B Richerson
Febrile seizures are usually considered relatively benign. Although some cases of sudden unexplained death in childhood have a history of febrile seizures, no documented case of febrile seizure-induced death has been reported. Here, we describe a child with complex febrile seizures who died suddenly and unexpectedly after a suspected seizure while in bed at night during the beginning phases of sleep. She was resuscitated and pronounced brain dead 2 days later at our regional medical center. Autopsy revealed multiorgan effects of hypoperfusion and did not reveal an underlying (precipitating) disease, injury, or toxicological cause of death...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28202125/-effect-of-telomerase-activation-on-biological-behaviors-of-neural-stem-cells-in-rats-with-hypoxic-ischemic-insults
#10
Jun-Jie Meng, Shi-Ping Li, Feng-Yan Zhao, Yu Tong, De-Zhi Mu, Yi Qu
OBJECTIVE: To investigate the effect of telomerase activation on biological behaviors of neural stem cells after hypoxic-ischemic insults. METHODS: The neural stem cells passaged in vitro were divided into four groups: control, oxygen-glucose deprivation (OGD), OGD+cycloastragenol (CAG) high concentration (final concentration of 25 μM), and OGD+CAG low concentration (final concentration of 10 μM). The latter three groups were subjected to OGD. Telomerase reverse transcriptase (TERT) expression level was evaluated by Western blot...
February 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28197039/surgical-illustration-of-en-bloc-dual-kidney-transplant-from-a-16-month-old-brain-dead-donor-to-an-adult-recipient
#11
Vikas Jain, Saurabh Jain, Paras Singhal, Suman Lata Nayak, Rajendra P Mathur
Transplantable organs from pediatric donors have been contributing significantly to donor pool worldwide. Pediatric donors are excellent resources that should be procured whenever available, and with the recent increase in deceased donations in India, more pediatric donors will be available for organ harvesting. We share a rare instance of multi-organ harvesting from a 16-month old brain dead donor and implanting both kidneys en-bloc in an adult male, while liver went to a 4-year old child. The report provides the surgical illustration of salient steps of transplanting both kidneys from pediatric donor into an adult, in an en-bloc manner...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/28194201/an-investigation-into-the-factors-effective-in-the-consent-of-families-with-brain-dead-patients-candidates-for-organ-donation-in-isfahan-iran-in-2012-13
#12
Maryam Khalifehsoltani Khajooei, Fereshteh Zamani, Asieh Maghami Mehr
BACKGROUND: Studies have shown that, with regard to social, cultural, and institutional contexts, several factors affect family decision-making on organ donation. This study aimed to investigate the effective factors in organ donation by family members with brain-dead patients. MATERIALS AND METHODS: This was a descriptive-comparative study in which a researcher-made questionnaire was used to collect data. The reliability of the questionnaire was obtained as 0.81 using Cronbach's alpha...
November 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/28181906/activity-of-urine-arylsulfatase-a-in-brain%C3%A2-dead-graft-donors-is-a-predictor-of-early-and-late-graft-function
#13
Ewa Kwiatkowska, Leszek Domanski, Joanna Bober, Krzysztof Safranow, Andrzej Pawlik, Kazimierz Ciechanowski
OBJECTIVE: Human lysosomal arylsulfatase A (ASA) is a member of the sulfatase family. Arylsulfatase A is required to degrade sulfatides. Sulfatides occur in the myelin sheets of the central and peripheral nervous system. In this study we evaluated the urine activity of lysosomal enzyme arylsulfatase A in brain‑dead donors as a marker and predictor of short - and long‑term renal allograft function. PATIENTS/METHODS: We analyzed data from kidney recipients who received organs from brain‑dead donors...
January 4, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/28161098/peracute-bacterial-meningitis-due-to-infection-with-klebsiella-pneumoniae-in-captive-bred-ruffed-lemurs-varecia-variegate
#14
E Sasaki, T Tokiwa, K Tsugo, Y Higashi, H Hori, Y Une
We describe the development of neurological signs in four juvenile black-and-white ruffed lemurs (Varecia variegate), housed at a petting zoo in Japan. The clinical course was severe, with three lemurs dying within 1 day of the appearance of clinical signs. The other lemur was treated and survived. Pathological analyses demonstrated meningitis and the presence of gram-negative bacilli in the cerebrum, cerebellum, palatine tonsil and liver. Klebsiella pneumoniae was isolated from the brain of all of the dead lemurs...
February 1, 2017: Journal of Comparative Pathology
https://www.readbyqxmd.com/read/28151049/effect-of-co-culture-of-mesenchymal-stem-stromal-cells-with-pancreatic-islets-on-viability-and-function-outcomes-a-systematic-review-and-meta-analysis
#15
Bianca Marmontel de Souza, Ana Paula Bouças, Fernanda Dos Santos de Oliveira, Karina Pires Reis, Patrícia Ziegelmann, Andrea Carla Bauer, Daisy Crispim
The maintenance of viable and functional pancreatic islets is crucial for successful islet transplantation from brain-dead donors. To overcome islet quality loss during culture, some studies have co-cultured islets with mesenchymal stem/stromal cells (MSC). However, it is still uncertain if MSC-secreted factors are enough to improve islet quality or if a physical contact between MSCs and islets is needed. Therefore, we performed a systematic review and meta-analysis to clarify the effect of different culture contact systems of islets with MSCs on viability and insulin secretion outcomes...
February 2, 2017: Islets
https://www.readbyqxmd.com/read/28147414/the-brain-after-cardiac-arrest
#16
Jonathan Elmer, Clifton W Callaway
Cardiac arrest is common and deadly. Most patients who are treated in the hospital after achieving return of spontaneous circulation still go on to die from the sequelae of anoxic brain injury. In this review, the authors provide an overview of the mechanisms and consequences of postarrest brain injury. Special attention is paid to potentially modifiable mechanisms of secondary brain injury including seizures, hyperpyrexia, cerebral hypoxia and hypoperfusion, oxidative injury, and the development of cerebral edema...
February 2017: Seminars in Neurology
https://www.readbyqxmd.com/read/28145850/characterization-of-end-of-life-electroencephalographic-surges-in-critically-ill-patients
#17
Lakhmir S Chawla, Megan Terek, Christopher Junker, Seth Akst, Bona Yoon, Ermira Brasha-Mitchell, Michael G Seneff
BACKGROUND: Neuromonitoring devices to assess level of sedation are now used commonly in many hospital settings. We previously reported that electro-encephalic-graphic (EEG) spikes frequently occurred after the time of death in patients being neuro-monitored at the time of cessation of circulation. In addition to our initial report, end of life electrical surges (ELES) have been subsequently documented in animal and human studies by other investigators. The frequency, character, intensity, and significance of ELES are unknown...
February 1, 2017: Death Studies
https://www.readbyqxmd.com/read/28134940/the-neuroprotective-effect-of-erythropoietin-in-rat-hippocampus-in-an-endotoxic-shock-model
#18
Luis Javier Ramírez-Jirano, Tania Zenteno-Savín, Ramón Gaxiola-Robles, Elsy Janeth Ramos-González, Blanca Miriam Torres-Mendoza, Oscar Kurt Bitzer-Quintero
BACKGROUND: Sepsis is characterized by an early systemic inflammation in response to infection. In the brain, inflammation is associated with expression of pro-inflammatory cytokines (e.g. tumor necrosis factor-α, interleukin-1β and interleukin-6, among others) that may induce an overproduction of reactive oxygen and nitrogen species. The constitutive expression of cytokines in the brain is low, but may be induced by various stimuli, including lipopolysaccharide, which causes neuronal damage...
November 2016: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/28121911/normothermic-perfusion-in-the-assessment-and-preservation-of-declined-livers-prior-to-transplantation-hyperoxia-and-vasoplegia-important-lessons-from-the-first-12-cases
#19
Christopher J E Watson, Vasilis Kosmoliaptsis, Lucy V Randle, Alexander E Gimson, Rebecca Brais, John R Klinck, Mazin Hamed, Anastasia Tsyben, Andrew J Butler
BACKGROUND: A programme of normothermic ex situ liver perfusion (NESLiP) was developed to facilitate better assessment and use of marginal livers, while minimising cold ischaemia. METHODS: Declined marginal livers and those offered for research were evaluated. NESLiP was performed using an erythrocyte-based perfusate. Viability was assessed with reference to biochemical changes in the perfusate. RESULTS: 12 livers (9 from circulatory death (DCD) and 3 from brain-dead donors), median Donor Risk Index 2...
January 25, 2017: Transplantation
https://www.readbyqxmd.com/read/28117941/donor-preconditioning-after-the-onset-of-brain-death-with-dopamine-derivate-n-octanoyl-dopamine-improves-early-posttransplant-graft-function-in-the-rat
#20
Shiliang Li, Sevil Korkmaz-Icöz, Tamás Radovits, Mihály Ruppert, Rahel Spindler, Sivakkanan Loganathan, Péter Hegedűs, Paige Brlecic, Bastian Theisinger, Sonja Theisinger, Simone Höger, Maik Brune, Felix Lasitscha, Matthias Karck, Benito Yard, Gábor Szabó
Heart transplantation is the therapy of choice for end-stage heart failure. However, hemodynamic instability, which has been demonstrated in brain-dead donors (BDD), could also affect the posttransplant graft function. We tested the hypothesis that treatment of the BDD with the dopamine derivate n-octanoyl-dopamine (NOD) improves donor cardiac and graft function after transplantation. Donor rats were given a continuous intravenous infusion of either NOD (0.882mg/kg/h, BDD+NOD, n=6) or a physiological saline vehicle (BDD, n=9) for 5h after the induction of brain death by inflation of a subdural balloon catheter...
January 24, 2017: American Journal of Transplantation
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