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Donation after cardiac death

Laura A Siminoff, Gerard P Alolod, Maureen Wilson-Genderson, Eva Y N Yuen, Heather M Traino
Available literature points to healthcare providers' discomfort with donation after cardiac death (DCD) and their perception of the public's reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers' (FDMs') experiences of both modalities. We recruited 1,601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors...
October 18, 2016: American Journal of Transplantation
J Hunter Mehaffey, Eric J Charles, Ashish K Sharma, Dustin T Money, Yunge Zhao, Mark H Stoler, Christine L Lau, Curtis G Tribble, Victor E Laubach, Mark E Roeser, Irving L Kron
OBJECTIVE: Critical organ shortages have resulted in ex vivo lung perfusion gaining clinical acceptance for lung evaluation and rehabilitation to expand the use of donation after circulatory death organs for lung transplantation. We hypothesized that an innovative use of airway pressure release ventilation during ex vivo lung perfusion improves lung function after transplantation. METHODS: Two groups (n = 4 animals/group) of porcine donation after circulatory death donor lungs were procured after hypoxic cardiac arrest and a 2-hour period of warm ischemia, followed by a 4-hour period of ex vivo lung perfusion rehabilitation with standard conventional volume-based ventilation or pressure-based airway pressure release ventilation...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
Kyoko Hijiya, Toyofumi F Chen-Yoshikawa, Takeshi Kondo, Hideki Motoyama, Akihiro Ohsumi, Daisuke Nakajima, Jin Sakamoto, Keiji Ohata, Mamoru Takahashi, Satona Tanaka, Ei Miyamoto, Akihiro Aoyama, Hiroshi Date
BACKGROUND: We hypothesized that an injured lung graft from donation after cardiac death donors could be reconditioned before transplantation using an ex vivo lung perfusion (EVLP) system and ventilation with high-dose short-acting β2-adrenergic receptor agonists. METHODS: Cardiac arrest was induced in a canine model by intravenous potassium chloride injection. Lungs were randomly assigned to two groups after 150 minutes of warm ischemia: inhalation of 1,400 μg of procaterol (BETA group, n = 5) or control group receiving solvent (CON group, n = 5) during EVLP...
October 10, 2016: Annals of Thoracic Surgery
Osamu Muramoto
BACKGROUND: This essay provides an ethical and conceptual argument for the use of informed consent prior to the diagnosis of brain death. It is meant to enable the family to make critical end-of-life decisions, particularly withdrawal of life support system and organ donation, before brain death is diagnosed, as opposed to the current practice of making such decisions after the diagnosis of death. The recent tragic case of a 13-year-old brain-dead patient in California who was maintained on a ventilator for over 2 years illustrates how such a consent would have made a crucial difference...
October 13, 2016: Philosophy, Ethics, and Humanities in Medicine: PEHM
Wen-Jin Zhang, Wei-Liang Xia, Hui-Yun Pan, Shu-Sen Zheng
BACKGROUND: With the increasing use of donation after cardiac death (DCD), especially of the graft liver with steatosis or other pathological changes, the frequency of postreperfusion hyperkalemia in liver transplantation has increased significantly. The present study aimed to determine the factors associated with developing postreperfusion hyperkalemia in liver transplantation from DCD. METHODS: One hundred thirty-one consecutive adult patients who underwent orthotopic liver transplantation from DCD were retrospectively studied...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Emre A Eren, Nicholas Latchana, Eliza Beal, Don Hayes, Bryan Whitson, Sylvester M Black
The supply of liver grafts for treatment of end-stage liver disease continues to fall short of ongoing demands. Currently, most liver transplants originate from donations after brain death. Enhanced utilization of the present resources is prudent to address the needs of the population. Donation after circulatory or cardiac death is a mechanism whereby the availability of organs can be expanded. Donations after circulatory death pose unique challenges given their exposure to warm ischemia. Technical principles of donations after circulatory death procurement and pertinent studies investigating patient outcomes, graft outcomes, and complications are highlighted in this review...
October 2016: Experimental and Clinical Transplantation
R Thuret, F Kleinclauss, N Terrier, M O Timsit
OBJECTIVES: To review epidemiologic data's and medical results of deceased donation in renal transplantation. MATERIAL AND METHODS: Relevant publications were identified through Medline ( and Embase ( database using the following keywords, alone or in association, "brain death; cardiac arrest; deceased donation; organ procurement; transplantation". Articles were selected according to methods, language of publication and relevance...
October 7, 2016: Progrès en Urologie
Yanfei Chen, Bryan W Tillman, Sung Kwon Cho, Tara D Richards, Amit D Tevar, Xinzhu Gu, William R Wagner, Youngjae Chun
Donation after cardiac death has been adopted to address the critical shortage of donor organs for transplant. Recovery of these organs is hindered by low blood flow that leads to permanent organ injury. We propose a novel approach to isolate the perfusion of the abdominal organs from the systemic malperfusion of the dying donor. We reasoned that this design could improve blood flow to organs without open surgery, while respecting the ethical principle that cardiac stress not be increased during organ recovery...
October 7, 2016: Journal of Medical Engineering & Technology
Claudio Sandroni, Sonia D'Arrigo, Clifton W Callaway, Alain Cariou, Irina Dragancea, Fabio Silvio Taccone, Massimo Antonelli
BACKGROUND: The occurrence of brain death in patients with hypoxic-ischaemic brain injury after resuscitation from cardiac arrest creates opportunities for organ donation. However, its prevalence is currently unknown. METHODS: Systematic review. MEDLINE via PubMed, ISI Web of Science and the Cochrane Database of Systematic Reviews were searched for eligible studies (2002-2016). The prevalence of brain death in adult patients resuscitated from cardiac arrest and the rate of organ donation among brain dead patients were summarised using a random effect model with double-arcsine transformation...
October 3, 2016: Intensive Care Medicine
Hiroshi Date
Lung transplantation has been performed worldwide and recognized as an effective treatment for patients with various end-stage lung diseases. Shortage of lung donors is one of the main obstacles in most of the countries, especially in Japan. Every effort has been made to promote organ donation during the past 20 years. In 2010, Japanese transplant low was revised so that the family of the brain dead donors can make a decision for organ donation. Since then, the number of cadaveric lung donor has increased by 5-fold...
August 2016: Journal of Thoracic Disease
Pierluigi Toniutto, Alberto Zanetto, Alberto Ferrarese, Patrizia Burra
Liver transplantation is an effective and widely used therapy for several patients with acute and chronic liver diseases. The discrepancy between the number of patients on the waiting list and available donors remains the key issue and is responsible for the high rate of waiting list mortality. The recent news is that the majority of patients with hepatitis C virus related liver disease will be cured by new antivirals therefore we should expect soon a reduction in the need of liver transplantation for these recipients...
September 16, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Krzysztof Pabisiak, Arkadiusz Krejczy, Grażyna Dutkiewicz, Krzysztof Safranow, Jerzy Sienko, Romuald Bohatyrewicz, Kazimierz Ciechanowski
BACKGROUND Donation after cardiac death offers the possibility of increasing the pool of organs for transplantation by up to 30%. Maastricht category type 3 (M3) dominates in most countries with active DCD programs. During preparations to introduce a permanent program for uncontrolled donation after circulatory death in Szczecin, Poland, the donor pool has been estimated. In Poland, Maastricht category type 2 (M2) is considered a basic source for organ recovery. MATERIAL AND METHODS This was a retrospective cohort study of out-of-hospital cardiac arrests (OHCA) reported to local Emergency Medical Services (EMS) between 1 December 2014 and 30 November 2015...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Ramon Correa Bedenko, Renato Nisihara, Douglas Shun Yokoi, Vinícius de Mello Candido, Ismael Galina, Rafael Massayuki Moriguchi, Nico Ceulemans, Paolo Salvalaggio
OBJECTIVE: To evaluate the knowledge and acceptance of the public and professionals working in intensive care units regarding organ donation after cardiac death. METHODS: The three hospitals with the most brain death notifications in Curitiba were selected, and two groups of respondents were established for application of the same questionnaire: the general public (i.e., visitors of patients in intensive care units) and health professionals working in the same intensive care unit...
September 2016: Revista Brasileira de Terapia Intensiva
Alexander R Manara, Beatriz Dominguez-Gil, Jose Miguel Pérez-Villares, Jasmeet Soar
No abstract text is available yet for this article.
September 7, 2016: Resuscitation
S A Yong, S D'Souza, S Philpot, D V Pilcher
With the advent of donation after circulatory death programs in Australia and New Zealand, greater knowledge is needed about physiologic variation in haemodynamic activity following withdrawal of cardiorespiratory support. The ANZICS Statement on Death and Organ Donation allows provision for variation in the observation times between two and five minutes after cessation of the circulation prior to declaration of death. We report our experience of two cases, the first where electrical activity and pulse returned after a 102 second pause and the second where electrical activity returned after a three minute pause; both longer than previously reported cases...
September 2016: Anaesthesia and Intensive Care
X Liu, B Wang, X Zhang, J Xiang, J Shi, M Tian, A Zhang, H Chang, K Qu, C Liu, L Yu, Y Lv
BACKGROUND: Liver transplantation (LTx) using donation after brain and cardiac death (DBCD) has increased steadily in China. The aims of this study were to evaluate the outcomes of DBCD LTx and to assess its feasibility to expand the donor pool. METHODS: We retrospectively analyzed the clinical characteristics of DBCD donors and recipients, survival of allografts and recipients, and prognostic factors in DBCD LTx recipients from March 2010 to December 2014 in our institution...
July 2016: Transplantation Proceedings
D A Axelrod, M A Schnitzler, H Xiao, A S Naik, D L Segev, V R Dharnidharka, D C Brennan, K L Lentine
Kidney transplantation has become more resource intensive as recipient complexity has increased and average donor quality has diminished over time. A national retrospective cohort study was performed to assess the impact of kidney donor and recipient characteristics on transplant center cost (exclusive of organ acquisition) and Medicare reimbursement. Data from the national transplant registry, University HealthSystem Consortium hospital costs, and Medicare payments for deceased donor (N = 53 862) and living donor (N = 36 715) transplants from 2002 to 2013 were linked and analyzed using multivariate linear regression modeling...
August 27, 2016: American Journal of Transplantation
Yin Zongyi, Li Baifeng, Zou Funian, Li Hao, Wang Xin
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at
August 5, 2016: EBioMedicine
Luo Aijing, Xie Wenzhao, Wei Wei, Wan Qiquan, Deng Xuantong
BACKGROUND China officially launched a pilot program of organ donation after cardiac death to overcome the shortage of available organs since 2011. Voluntary organ donation by deceased citizens became the only source of transplant organs beginning January 1, 2015. To investigate public opinions on organ donation by deceased donors, and discuss the effect of these opinions on the willingness and attitude of the public regarding voluntary organ donation. MATERIAL AND METHODS We designed a questionnaire. The survey was conducted from December 2014 to January 2015 in Changsha City, and 417 valid questionnaires were recovered...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Christopher White, Emma Ambrose, Alison Müller, Sanaz Hatami, Yun Li, Hoa Le, James Thliveris, Rakesh Arora, Trevor Lee, Ian Dixon, Ganghong Tian, Jayan Nagendran, Larry Hryshko, Darren Freed
BACKGROUND: Hearts donated after circulatory death may represent an additional donor source. The influx of sodium and calcium ions across the sarcolemma play a central role in the pathogenesis of ischemia-reperfusion injury; however, this process may be inhibited if the initial reperfusion solution is rendered hypocalcemic and acidic. We sought to determine the calcium concentration and pH of the initial reperfusion solution that yielded optimal functional recovery of hearts donated after circulatory death during ex vivo heart perfusion...
August 12, 2016: Annals of Thoracic Surgery
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