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https://www.readbyqxmd.com/read/28643577/an-assessment-of-advance-relatives-approach-for-brain-death-organ-donation
#1
Carine Michaut, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, Xavier Ducrocq
BACKGROUND: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. RESEARCH DESIGN: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28640022/brain-dead-donors-on-extracorporeal-membrane-oxygenation
#2
Régis Bronchard, Louise Durand, Camille Legeai, Johana Cohen, Patrice Guerrini, Olivier Bastien
OBJECTIVES: To describe donors after brain death with ongoing extracorporeal membrane oxygenation and to analyze the outcome of organs transplanted from these donors. DESIGN: Retrospective analysis of the national information system run by the French Biomedicine Agency (CRISTAL database). SETTING: National registry data of all donors after brain death in France and their organ recipients between 2007 and 2013. PATIENTS: Donors after brain death and their organ recipients...
June 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28624178/liver-transplantation-in-patients-with-liver-metastases-from-neuroendocrine-tumors-a%C3%A2-systematic-review
#3
Dimitrios Moris, Diamantis I Tsilimigras, Ioannis Ntanasis-Stathopoulos, Eliza W Beal, Evangelos Felekouras, Spiridon Vernadakis, John J Fung, Timothy M Pawlik
BACKGROUND: Liver transplantation to treat neuroendocrine tumors, especially in the setting of diffuse liver involvement not amenable to operative resection remains controversial. We sought to perform a systematic review of the current literature to summarize data on patients undergoing liver transplantation with neuroendocrine tumors liver metastases as the indication. METHODS: A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines...
June 14, 2017: Surgery
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#4
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28617166/challenges-in-providing-timely-physiotherapy-and-opportunities-to-influence-outcomes-for-potential-lung-donors
#5
Cassandra Raios, Jenny L Keating, Nicola Stitt, Helen I Opdam, Elizabeth H Skinner
CONTEXT: There is a critical shortage of donor lungs however, considerable ethical considerations are associated with the conduct of research to optimize care of the potential organ donor. OBJECTIVE: To investigate pathways of consent, respiratory care by physiotherapists and donation rates to contextualize future research on physiotherapy effects on donor lung suitability for procurement. DESIGN: Retrospective audit. SETTING: Australian tertiary hospital...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28617156/the-effect-of-transplant-education-on-nurses-attitudes-toward-organ-donation-and-advocacy-for-transplantation
#6
Haley Hoy, Susan Alexander, Karen H Frith, Yeow Chye Ng
Nurses are the largest group of health-care professionals, yet they are not uniformly educated regarding transplantation and organ donation. The future of transplantation hinges on education of this group. Before meaningful studies can be conducted, an instrument to measure attitudes and commitment to organ transplantation is needed. The purpose of this study was to examine content and construct validity as well as establish internal reliability of an investigator-developed online instrument to measure nurses' attitudes and commitment to organ transplantation by registered nurses...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28612162/li-rads-and-transplantation-for-hepatocellular-carcinoma
#7
REVIEW
An Tang, Kathryn J Fowler, Victoria Chernyak, William C Chapman, Claude B Sirlin
Patients with hepatocellular carcinoma (HCC) may be eligible for liver transplantation. Liver transplant candidates with HCC compete for the same deceased donor organs as those without HCC. These scarce organs must be allocated fairly and justly to those who will benefit most. Unlike most other cancers, HCC is often diagnosed noninvasively by imaging without biopsy confirmation. Therefore, radiologists play an important role in diagnosing definite HCC (i.e., LR-5 category) that counts toward staging and determination of liver transplant eligibility...
June 13, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28603094/liver-transplantation-in-patients-with-incidental-hepatocellular-carcinoma-cholangiocarcinoma-and-intrahepatic-cholangiocarcinoma-a-single-center-experience
#8
Mohammed Elshamy, Naftali Presser, Abdulrahman Y Hammad, Daniel J Firl, Christopher Coppa, John Fung, Federico N Aucejo
BACKGROUND: Reports of liver transplantation (LT) in patients with mixed hepatocellular carcinoma/cholangiocarcinoma (HCC/CC) and intrahepatic cholangiocarcinoma (ICC) are modest and have been mostly retrospective after pathological categorization in the setting of presumed HCC. Some studies suggest that patients undergoing LT with small and unifocal ICC or mixed HCC/CC can achieve about 40%-60% 5-year post-transplant survival. The study aimed to report our experience in patients undergoing LT with explant pathology revealing HCC/CC and ICC...
June 2017: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/28602588/long-term-results-of-organ-procurement-from-burn-victims
#9
Daniel Schmauss, Amir K Bigdeli, Susanne Hellmich, Ana P Barreiros, Thomas Kremer, Günter Germann, Ulrich Kneser, Kai O Megerle
BACKGROUND: With the increasing success of organ transplantation, many traditional contraindications to organ procurement are being reconsidered. Burn disease has constituted a traditional contraindication to solid organ procurement because of concerns that such organs may have been compromised by ischemia secondary to burn shock and contaminated by bacteremia. With the current shortage of solid organs, the transplant community continues to look for ways to increase the number of organ donors, including the use of marginal donors...
June 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28592187/outcomes-of-organ-donation-in-brain-dead-patient-s-families-ethical-perspective
#10
Shamsi Ahmadian, Abolfazl Rahimi, Ebrahim Khaleghi
BACKGROUND: The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28586179/improved-post-transplant-mortality-after-share-35-for-liver-transplantation
#11
Allison J Kwong, Aparna Goel, Ajitha Mannalithara, W Ray Kim
BACKGROUND AND AIMS: The Share 35 policy was implemented in June 2013 to improve equity in access to liver transplantation (LT) between patients with fulminant liver failure and those with cirrhosis and severe hepatic decompensation. The aim of this study was to assess post-LT outcomes after Share 35. METHODS: Relevant donor, procurement, and recipient data were extracted from the OPTN/UNOS database. All adult deceased donor LT from January 1, 2010 to March 31, 2016 were included in the analysis...
June 6, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28579113/waitlist-outcomes-in-pediatric-lung-transplantation-poor-results-for-children-listed-in-adult-transplant-programs
#12
Brandi B Scully, Matthew Goss, Hao Liu, Michael L Keuht, Iki Adachi, E Dean McKenzie, Charles D Fraser, Ernestina Melicoff, George B Mallory, Jeffery S Heinle, Abbas Rana
BACKGROUND: Low case volume has been associated with lower survival after pediatric lung transplantation. Our aim was to analyze waitlist outcomes among pediatric lung transplant centers in the USA. METHODS: We studied a cohort of 1,139 pediatric candidates listed in the Organ Procurement and Transplantation Network for lung transplantation between 2002 and 2014. Of these candidates, 720 (63.2%) received a transplant. Candidates were divided into groups according to the clinical activity of the center of listing: high-volume pediatric (≥4 transplants per year); low-volume pediatric (<4 transplants per year); and adult (transplant volume predominantly in adults)...
April 24, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28578209/a-method-for-understanding-generic-procurement-of-hiv-medicines-by-developing-countries-with-patent-protection
#13
Reed F Beall, Amir Attaran
Patent protection on medicines may frustrate access by blocking generic competition. Nevertheless, circumstances may still allow for generic procurement to occur anyway, especially for humanitarian cause. But to what extent does this occur? And which legal flexibilities may facilitate such procurement? We attempted to design a replicable methodology that involved linking antiretroviral (ARV) patent data (1260 patents for 12 medicines) from a World Intellectual Property Organization patent study on the 2013 World Health Organization's (WHO) Model List of Essential Medicines to all available matching procurement records in the WHO's Global Price Reporting Mechanism...
May 4, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28560337/simple-technologies-and-diverse-food-strategies-of-the-late-pleistocene-and-early-holocene-at-huaca-prieta-coastal-peru
#14
Tom D Dillehay, Steve Goodbred, Mario Pino, Víctor F Vásquez Sánchez, Teresa Rosales Tham, James Adovasio, Michael B Collins, Patricia J Netherly, Christine A Hastorf, Katherine L Chiou, Dolores Piperno, Isabel Rey, Nancy Velchoff
Simple pebble tools, ephemeral cultural features, and the remains of maritime and terrestrial foods are present in undisturbed Late Pleistocene and Early Holocene deposits underneath a large human-made mound at Huaca Prieta and nearby sites on the Pacific coast of northern Peru. Radiocarbon ages indicate an intermittent human presence dated between ~15,000 and 8000 calendar years ago before the mound was built. The absence of fishhooks, harpoons, and bifacial stone tools suggests that technologies of gathering, trapping, clubbing, and exchange were used primarily to procure food resources along the shoreline and in estuarine wetlands and distant mountains...
May 2017: Science Advances
https://www.readbyqxmd.com/read/28551055/fresh-osteochondral-allografts-procurement-and-tissue-donation-in-europe
#15
S Schmidt, A Schulte, S Schwarz, N Hofmann, S Tietz, M Boergel, S U Sixt
Fresh osteochondral allografts are a well-established treatment for large, full-thickness cartilage defects. The clinical outcome for carefully selected patients is very favorable, especially for the young and active and graft survival up to 25 years has been described in the literature. Furthermore, a high patient satisfaction rate has been reported, but the biggest obstacle to overcome is the availability of tissue for transplantation. Large fresh bone allografts for cartilage damage repair only can be harvested from organ donors following organ removal or cadaveric donors, preferably in the setting of an operation room to minimize possible contamination of the tissue...
May 11, 2017: Injury
https://www.readbyqxmd.com/read/28546439/survival-benefit-of-transplantation-with-a-deceased-diabetic-donor-kidney-compared-with-remaining-on-the-waitlist
#16
Jordana B Cohen, Kevin C Eddinger, Jayme E Locke, Kimberly A Forde, Peter P Reese, Deirdre L Sawinski
BACKGROUND AND OBJECTIVES: Use of diabetic donor kidneys has been a necessary response to the donor organ shortage. Recipients of diabetic donor kidneys have higher mortality risk compared with recipients of nondiabetic donor kidneys. However, the survival benefit of transplantation with diabetic donor kidneys over remaining on the waitlist has not been previously evaluated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed an observational cohort study of 437,619 kidney transplant candidates from the Organ Procurement and Transplantation Network database, including 8101 recipients of diabetic donor kidneys and 126,560 recipients of nondiabetic donor kidneys...
June 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28538045/donor-derived-infections-in-solid-organ-transplant-patients-toward-a-holistic-approach
#17
Esther Benamu, Cameron R Wolfe, Jose G Montoya
PURPOSE OF REVIEW: Solid organ demand far exceeds organ supply. Strategies to increase the donor pool include the liberalization of selection criteria without increasing the risk of unexpected donor-derived infection (DDI), a rare complication of transplantation carrying high morbidity and mortality. We review the challenging aspects in the prevention of DDI, focusing on the complexities of data sharing and efficient communication and the role infectious diseases specialists play in the process...
May 19, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28521795/ex-vivo-recruitment-and-x-ray-assessment-of-donor-lungs-in-a-challenging-retrieval-from-a-donor-supported-by-lvad-using-the-portable-normothermic-perfusion-system-a-case-report
#18
Marco Schiavon, Francesca Calabrese, Guido Di Gregorio, Monica Loy, Giuseppe Marulli, Alessandro Rebusso, Fiorella Calabrese, Federico Rea
BACKGROUND: Lung transplantation (LTx) is limited by the shortage of suitable donors. To overcome this problem, many programs have begun to use donors with extended criteria (marginal donors). However, brain-dead patients with implanted mechanical circulatory support system have rarely been considered as potential lung donors. This case demonstrates the feasibility of lung transplantations from organ donors supported by a mechanical circulatory support system despite the possible difficulties of lung retrieval...
May 18, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28521593/use-of-high-frequency-percussive-ventilation-to-expand-organ-donor-pool
#19
Francis Benn, Ashwad Afzal, Berhane Worku, Felix Khusid, Bashar H Fahoum, Iosif Gulkarov
A 34-year-old woman was brought in to the emergency department after a motor vehicle accident. She had signs of traumatic head injury with Glasgow Coma Scale score of 3, and her neurological examination was consistent with brain death. She was persistently hypoxic on conventional mechanical ventilation and high-frequency percussive ventilation was initiated. The patient's oxygenation improved and was sustained long enough to provide time for organ procurement. This is the first case portraying high-frequency percussive ventilation as a bridge for donors failing on conventional mechanical ventilation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28520316/the-living-donor-collective-a-scientific-registry-for-living-donors
#20
B L Kasiske, S K Asrani, M A Dew, M L Henderson, C Henrich, A Humar, A K Israni, K L Lentine, A J Matas, K A Newell, D LaPointe Rudow, A B Massie, J J Snyder, S J Taler, J F Trotter, A D Waterman
In the setting of an overall decline in living organ donation and new questions about long-term safety, a better understanding of outcomes after living donation has become imperative. Adequate information on outcomes important to donors may take many years to ascertain and may be evident only by comparing large numbers of donors with suitable controls. Previous studies have been unable to fully answer critical questions, primarily due to lack of appropriate controls, inadequate sample size, and/or follow-up duration that is too short to allow detection of important risks attributable to donation...
May 18, 2017: American Journal of Transplantation
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