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https://www.readbyqxmd.com/read/28319566/pancreas-transplantation-from-pediatric-donors-a-unos-registry-analysis
#1
Mario Spaggiari, Martha Bissing, Maya Campara, Chun-Chieh Yeh, Ivo Tzvetanov, Hoonbae Jeon, Enrico Benedetti
BACKGROUND: Pancreas grafts from pediatric donors are still considered "not ideal". Perceived concerns are related to low islet mass and potential for graft thrombosis. METHODS: The study evaluated all pancreas transplants from January 2000 to May 2015 using the Organ Procurement and Transplant Network (OPTN) database. Comparative analysis of recipient and graft survival was performed between pediatric (≤18 years) and adult donors. In the pediatric group, the outcomes were stratified based on donor age (≤ 6 years; 7-12 years; 13-18 years) and weight (<30 kg; 30-95 Kg; >95 kg)...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28306670/innovations-in-cardiac-transplantation
#2
Reema Hasan, Ashraf Abou El Ela, Daniel Goldstein
PURPOSE OF REVIEW: As the number of people living with heart failure continues to grow, future treatments will focus on efficient donor organ donation and ensuring safe and durable outcomes. This review will focus on organ procurement, graft surveillance and emerging therapies. RECENT FINDINGS: Preliminary studies into donation after cardiac death have indicated that this may be an effective means to increase the donor pool. Novel preservation techniques that include ex-vivo perfusion to improve donor metabolic stabilization prior to implantation may also expand the donor pool...
March 16, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28306594/extending-normothermic-regional-perfusion-to-the-thorax-in-donors-after-circulatory-death
#3
Steven S L Tsui, Gabriel C Oniscu
PURPOSE OF REVIEW: Despite a significant increase in the utilization of donors after circulatory death (DCD), the number of organs recovered and their function are largely inferior to those from donors after brain death. This review summarizes recent advances in in-situ normothermic regional perfusion of DCD organs prior to procurement. RECENT FINDINGS: The combination of warm and cold ischemia in DCD donation are detrimental to organ function. As a consequence, the acceptance criteria are far more restrictive and many organs are discarded...
March 16, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28274037/antimicrobial-effects-of-garcinia-mangostana-on-cariogenic-microorganisms
#4
Sunitha Janardhanan, Jaideep Mahendra, A S Smiline Girija, Little Mahendra, Vijayashree Priyadharsini
INTRODUCTION: Garcinia mangostana commonly called as Mangosteen fruit has been used as an antibacterial agent since age old times. The mangosteen pericarp has proven to have antibacterial effect, but the effect of the same on cariogenic organisms has not been explored. The present study was an attempt to gain a better understanding of the antibacterial effect of mangosteen pericarp on the cariogenic bacteria, to unravel the therapeutic potential for the same. AIM: The aim of the study was to assess the antibacterial efficacy of the crude chloroform extract of mangosteen pericarp against cariogenic bacteria...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28266143/the-influence-of-donor-factors-on-corneal-organ-culture-contamination
#5
Anja K Gruenert, Katja Rosenbaum, Gerd Geerling, Thomas A Fuchsluger
PURPOSE: To evaluate the contamination rate and the corresponding spectrum of microbes and to identify donor risk factors for corneal organ culture contaminations. METHODS: A total of 3306 organ-cultured donor corneas were included in the study. We performed a retrospective database analysis to evaluate donor factors such as gender, age, death-to-explantation interval (DEI), procurement site and cause of death and to determine their influence on donor cornea contaminations...
March 7, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/28264580/-ethical-aspects-of-uterus-transplantation
#6
Roman Chmel, Marta Nováčková, Zlatko Pastor, Jan Matěcha, Miloš Čekal, Jiří Froněk
Uterus transplantation is an experimental treatment method with an ambition to become accepted treatment modality for women with absolute uterine factor infertility. The only legal alternative for these women to get parenthood is adoption which is accepted by most world societies and countries. Surrogate pregnancy is connected with many medical, ethical, legal, religious and social controversies in the great part of the world.Donors (in living donation), recipients, partners and also unborn children must be incorporated into the analysis of ethical risks and benefits of uterus transplantation...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28260484/impact-of-a-full-time-donor-management-protocol-on-donors-liver-biopsy-findings-progress-to-date
#7
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/28260450/questionnaire-on-brain-death-and-organ-procurement
#8
Saleh Hammad, Manal Alnammourah, Farah Almahmoud, Mais Fawzi, Abdel-Hadi Breizat
OBJECTIVES: The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea of paying for organs. Many ethical concerns are raised regarding regulations and procedures for organ transplant in developing countries. These include where and how to obtain organs and the concept of justice in organ distribution. MATERIALS AND METHODS: We administered 2682 questionnaires to 628 men and 2054 women over 24 months (range, 18 to 70 years old)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260435/role-of-more-active-identification-of-brain-dead-cases-in-increasing-organ-donation
#9
Farahnaz Sadegh Beigee, Mojtaba Mohsenzadeh, Shagin Shahryari, Meysam Mojtabaee
OBJECTIVES: Organ donor shortage is a worldwide problem, resulting in 10% to 30% mortality rates for patients on wait lists for organ transplant. For brain-dead patients in Iran, it is mandatory for intensive care unit patients with Glasgow Coma Scale below 5/15 to be reported to an organ procurement unit. However, this process has not been functioning effectively. Here, we present the effects of changing the strategies on detecting brain-dead cases on the organ donor pool. MATERIALS AND METHODS: From March 2015 to March 2016, we changed our strategy in active detection of brain-dead cases...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260434/difficult-consent-scale-an-assessment-scale-for-anticipated-difficulty-in-obtaining-consent-for-organ-donation
#10
Masoud Mazaheri, Farahnaz Sadegh Beigee
OBJECTIVES: Seeking consent for organ procurement from a brain-dead patient 's family is challenging, especially in developing countries. In the Middle East, legislation necessitates an opt-in system that engages all first-degree relatives. To improve our success rate in the Masih Daneshvari Organ Procurement Unit in Tehran, Iran, we invented a scale for the consent process to predict the degree of difficulty of each family interview before venturing into it. MATERIALS AND METHODS: We reviewed the records of brain-dead patients treated in our unit over the previous 10 years...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260423/organ-shortage-can-we-decrease-the-demand
#11
Antoine Stephan
The shortage of organs for transplant is a universal problem. The World Health Organization is urging every nation to seek self-sufficiency regarding their organ procurement program. Reaching self-sufficiency inevitably requires the provision of a well-developed deceased-donor organ procurement program. Most countries represented by the Middle East Society for Organ Transplantation still rely on living-donor organ donations. Some of these countries have been relatively successful in promoting deceased-donor donation as well...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28251816/inferior-outcomes-on-the-waiting-list-in-low-volume-pediatric-heart-transplant-centers
#12
Abbas Rana, Charles D Fraser, Brandi B Scully, Jeffrey S Heinle, E Dean McKenzie, William J Dreyer, Michael Kueht, Hao Liu, Eileen D Brewer, Todd K Rosengart, Christine A O'Mahony, John A Goss
Low case volume has been associated with poor outcomes in a wide spectrum of procedures. Our objective is to study the association of low case volume and worse outcomes in pediatric heart transplant centers, taking the novel approach of including waitlist outcomes in the analysis. We studied a cohort of 6,482 candidates listed in the Organ Procurement and Transplantation Network for pediatric heart transplantation between 2002 and 2014; 4,665 of the candidates (72%) were transplanted. Candidates were divided into groups according to the average annual transplant volume performed in the listing center during the study period: > 10, 6-10, 3-5, and <3...
March 1, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28249957/a-case-based-analysis-of-whether-living-related-donors-listed-for-transplant-share-esrd-causes-with-their-recipients
#13
Arthur J Matas, Rebecca E Hays, Hassan N Ibrahim
BACKGROUND AND OBJECTIVES: Two recent studies reported increased risk of ESRD after kidney donation. In both, the majority of ESRD was seen in those donating to a relative. Confounding this observation is that, in the absence of donation, relatives of those with ESRD are at increased risk for ESRD. Understanding the pathogenesis and risk factors for postdonation ESRD is critical for both donor selection and counseling. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We hypothesized that if familial relationship was an important consideration in pathogenesis, the donor and linked recipient would share ESRD etiology...
March 1, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28240643/heart-allograft-preservation-an-arduous-journey-from-the-donor-to-the-recipient
#14
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/28222055/ex-situ-perfusion-of-human-limb-allografts-for-24-hours
#15
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/28219584/outcomes-of-kidney-transplantation-in-patients-exposed-to-hepatitis-b-virus-analysis-by-phase-of-infection
#16
B Chopra, K K Sureshkumar
BACKGROUND: In kidney transplant recipients (KTRs) with hepatitis B virus (HBV) infection, immunosuppression may increase viral replication with increased risk for liver disease progression and HBV-related kidney diseases, factors that could adversely influence graft and patient outcomes. We aimed to analyze the impact of different phases of HBV infection on the outcomes in KTRs. METHODS: Using the Organ Procurement and Transplant Network/United Network for Organ Sharing database, we selected adult KTRs from 2001 to 2011 who received peri-operative antibody induction followed by calcineurin inhibitor/mycophenolate mofetil maintenance with/without steroid...
March 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28218989/liver-transplantation-from-donors-with-positive-blood-cultures-increased-risk-of-graft-failure-or-opportunity-to-expand-the-donor-pool
#17
Paolo Antonio Grossi
Organ transplantation is considered the therapy of choice for end-stage organ failure. However, the growing gap between the number of patients waiting for transplantation and available organs continue to be the number one issue facing the transplant community. As a consequence the major focus in liver transplantation has been developing strategies to increase available donors, including the use of live donor liver segments, splitting deceased donor grafts for two patients and the use of organs procured from donors after circulatory death (DCD)...
February 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28216236/elimination-of-falsely-reactive-results-in-a-commercially-available-west-nile-virus-igm-capture-enzyme-linked-immunosorbent-assay-by-heterophilic-antibody-blocking-reagents
#18
Harry E Prince, Mary Lapé-Nixon, Tara S Givens, Tiffany Bradshaw, Marek J Nowicki
All sera initially reactive in the Focus Diagnostics West Nile virus IgM capture enzyme-linked immunosorbent assay (WNV IgM ELISA) must be retested with background subtraction to identify falsely-reactive (FR) samples due to antibodies that bind to immunoglobulins of other animal species (heterophilic antibodies). In some settings, such as pre-transplant testing of organ donors, the reporting delay associated with retesting can have an adverse impact on donor procurement and organ placement. We sought to determine if inclusion of heterophilic antibody blockers in assay conjugate could eliminate the nonspecific reactivity of FR samples...
February 16, 2017: Journal of Immunological Methods
https://www.readbyqxmd.com/read/28207639/predictors-of-waitlist-mortality-in-portopulmonary-hypertension
#19
Hilary M DuBrock, David S Goldberg, Norman L Sussman, Sonja D Bartolome, Zakiyah Kadry, Reena J Salgia, David C Mulligan, Walter K Kremers, Steven M Kawut, Michael J Krowka, Richard N Channick
BACKGROUND: The current Organ Procurement Transplantation Network (OPTN) policy grants Model for End Stage Liver Disease (MELD) exception points to patients with portopulmonary hypertension (POPH), but potentially important factors, such as severity of liver disease and pulmonary hypertension, are not included in the exception score, and may affect survival. The purpose of this study was to identify significant predictors of waitlist mortality in patients with POPH. METHODS: We performed a retrospective cohort study of patients in the OPTN database with hemodynamics consistent with POPH [defined as mean pulmonary arterial pressure (mPAP) >25mmHg and pulmonary vascular resistance (PVR) ≥240 dynes-s-cm] who were approved for a POPH MELD exception between 2006 and 2014...
February 15, 2017: Transplantation
https://www.readbyqxmd.com/read/28207635/kidney-transplantation-rates-across-glomerulonephritis-subtypes-in-the-united-states
#20
Michelle M O'Shaughnessy, Sai Liu, Maria E Montez-Rath, Richard A Lafayette, Wolfgang C Winkelmayer
BACKGROUND: Whether kidney transplantation rates differ by glomerulonephritis (GN) subtype remains largely unknown. METHODS: Using the US Renal Data System, we identified all adult patients with ESRD attributed to 1 of 6 GN subtypes who initiated dialysis in the US (1996-2013). Patients with diabetic nephropathy (DN) and autosomal-dominant polycystic kidney disease (ADPKD) served as "external" non-GN comparators. Using Cox proportional hazards regression, with death considered a competing risk, we estimated hazard ratios [HRs (95% confidence intervals)] for first kidney transplantation, controlling for year, demographics, comorbidities, socioeconomic factors, and Organ Procurement Organization (OPO)...
February 15, 2017: Transplantation
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