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"Donation after cardiac death"

James R Rodrigue, Richard Luskin, Helen Nelson, Alexandra Glazier, Galen V Henderson, Francis L Delmonico
INTRODUCTION: Unfavorable attitudes and insufficient knowledge about donation after cardiac death among critical care providers can have important consequences for the appropriate identification of potential donors, consistent implementation of donation after cardiac death policies, and relative strength of support for this type of donation. The lack of reliable and valid assessment measures has hampered research to capture providers' attitudes. Design and Research Aims: Using stakeholder engagement and an iterative process, we developed a questionnaire to measure attitudes of donation after cardiac death in critical care providers (n = 112) and examined its psychometric properties...
January 1, 2018: Progress in Transplantation
Janske Reiling, Elizabeth Forrest, Kim R Bridle, Laurence J Britton, Nishreen Santrampurwala, Darrell H G Crawford, Cornelis H C Dejong, Jonathan Fawcett
Background: In recent years, an increasing number of donor livers are being declined for transplantation in Australia. The aim of this study was to evaluate the impact of donation after cardiac death and other factors associated with organ quality on liver utilization rates in Australia. Methods: Data on organ donors who donated at least 1 organ between 2005 and 2014 were obtained from the Australia and New Zealand organ donation registry. Temporal changes in donor characteristics were assessed and a logistical regression analysis was performed to evaluate their association with liver nonuse...
December 2017: Transplantation Direct
Jessica Lindemann, Leigh Anne Dageforde, Neeta Vachharajani, Emily Stahlschmidt, Diane Brockmeier, Jason R Wellen, Adeel Khan, William C Chapman, Majella Doyle
BACKGROUND: Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. DCD program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported. STUDY DESIGN: Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected...
March 2, 2018: Journal of the American College of Surgeons
Kevin Koomalsingh, Jon A Kobashigawa
The first human-to-human heart transplant was performed 50 years ago in 1967. Heart transplantation has now entered an era of tremendous growth and innovation. The future of heart transplantation is bright with the advent of newer immunosuppressive medications and strategies that may even result in tolerance. Much of this progress in heart transplant medicine is predicated on a better understanding of acute and chronic rejection pathways through basic science studies. The future will also include personalized medicine where genomics and molecular science will dictate customized treatment for optimal outcomes...
January 2018: Annals of Cardiothoracic Surgery
Abbas Rana, Rohini R Sigireddi, Karim J Halazun, Aishwarya Kothare, Meng-Fen Wu, Hao Liu, Michael L Kueht, John M Vierling, Norman L Sussman, Ayse L Mindikoglu, Tamir Miloh, N Thao N Galvan, Ronald T Cotton, Christine A O'Mahony, John A Goss
BACKGROUND: An index that predicts liver allograft discard can effectively grade allografts and can be used to preferentially allocate marginal allografts to aggressive centers. AIM: to devise an index to predict liver allograft discard using only risk factors available at the time of initial DonorNet offer. METHODS: Using univariate and multivariate analyses on a training set of 72,297 deceased donors, we identified independent risk factors for liver allograft discard...
February 26, 2018: Transplantation
Shaifali Sandal, Xun Luo, Allan B Massie, Steven Paraskevas, Marcelo Cantarovich, Dorry L Segev
Background: The use of machine perfusion (MP) in kidney transplantation lowers delayed graft function (DGF) and improves 1-year graft survival in some, but not all, grafts. These associations have not been explored in grafts stratified by the Kidney Donor Profile index (KDPI). Methods: We analyzed 78 207 deceased-donor recipients using the Scientific Registry of Transplant Recipients data from 2006 to 2013. The cohort was stratified using the standard criteria donor/expanded criteria donor (ECD)/donation after cardiac death (DCD)/donation after brain death (DBD) classification and the KDPI scores...
February 20, 2018: Nephrology, Dialysis, Transplantation
Ilker Iskender, Marcelo Cypel, Tereza Martinu, Manyin Chen, Jin Sakamoto, Hyunhee Kim, Keke Yu, Huiqing Lin, Zehong Guan, Kohei Hashimoto, Thomas K Waddell, Mingyao Liu, Shaf Keshavjee
BACKGROUND: Ischemia-reperfusion injury related to lung transplantation is a major contributor to early postoperative morbidity and mortality. We hypothesized that donation after cardiac death donor lungs experience warm ischemic conditions that activate different injurious mechanisms compared with donor lungs that undergo prolonged cold ischemic conditions. METHODS: Rat donor lungs were preserved under different cold ischemic times (CIT: 12 hours or 18 hours), or under warm ischemia time (WIT: 3 hours) after cardiac death, followed by single left lung transplantation...
February 20, 2018: Transplantation
A Vileito, M J Siebelink, A A E Verhagen
AIM: Paediatric donation is a unique and extremely sensitive process that requires specific knowledge and competencies. Most countries use protocols for organ and tissue donation to ensure optimal care for the donor and family, but these mainly focus on adults. However, the donation process for children differs from adults in many ways. An overview of the literature was performed to identify protocols for the paediatric population. METHODS: PubMed, Web of Science, Embase and the Internet were searched up to March 2016 for papers or other sources in English related to specific organ and tissue donation protocols for children and neonates...
February 22, 2018: Acta Paediatrica
Q Tai, W Xue, X Ding, P Tian, H Xiang, X Feng, H Yan, J Hou
BACKGROUND: Donation after cardiac death is the only source of the deceased donor in China at present. Hypothermic machine perfusion has been used increasingly over the years. We determined the hypothermic machine perfusion parameters associated with early transplant outcomes based on the expanded criteria donor (ECD) designation. METHODS: There were 446 consecutive kidneys donated after cardiac death and preserved by hypothermic machine perfusion (LifePort) in our center that were included in this study...
January 2018: Transplantation Proceedings
J X Tang, N Na, J J Li, L Fan, R H Weng, N Jiang
BACKGROUND: Controlled donation after cardiac death (CDCD) is increasingly common for liver transplantation due to donor shortage. However, the outcomes, in terms of grafts and recipients, remain unclear. The current study is a systematic review and meta-analysis that compared CDCD with donation after brain death (DBD). METHODS: We conducted an electronic search of MEDLINE, EMBASE, and the Cochrane Database (from January 2007 to May 2017). Studies reporting Maastricht category III or IV CDCD liver transplantation were screened for inclusion...
January 2018: Transplantation Proceedings
T Yunhua, Z Qiang, J Lipeng, H Shanzhou, Z Zebin, J Fei, Z Zhiheng, W Linhe, J Weiqiang, W Dongping, G Zhiyong, H Xiaoshun
BACKGROUND: The incidence of end-stage renal disease (ESRD) after liver transplant (LT) has increased. The actual benefit of kidney transplantation (KT) is not completely understood in LT recipients with ESRD. METHODS: We analyzed Scientific Registry of Transplant Recipients data for all KT candidates with prior LT from 1998 to 2014; the benefits of KT relative to remaining on dialysis were compared by means of multivariate Cox proportional hazards regression analysis...
January 2018: Transplantation Proceedings
Kristopher P Croome, Amit K Mathur, David D Lee, Adyr A Moss, Charles B Rosen, Julie K Heimbach, C Burcin Taner
INTRODUCTION: As the population in the United States continues to age, an increase in the number of potential DCD donors with advanced chronological age can be expected. The aim of this study was to analyze a multi-institutional experience in liver transplantation using DCD donor age ≥50 years. METHODS: All DCD LT performed at Mayo Clinic Florida, Mayo Clinic Rochester and Mayo Clinic Arizona from 2002-2016 were included. Recipients of DCD LT were divided into 2 groups: those with donor age ≥50 years(N=155) and those with donor age <50 years(N=316)...
January 31, 2018: Transplantation
Xingyu Wang, Roumen Parapanov, Cyril Francioli, Jean Yannis Perentes, Igor Letovanec, Michel Gonzalez, Christian Kern, Hans-Beat Ris, Lise Piquilloud, Carlo Marcucci, Thorsten Krueger, Lucas Liaudet, Fabrizio Gronchi
OBJECTIVES: Volatile anaesthetics can provide significant protection against reperfusion injury in various experimental settings. The aim of this study was to assess the potential of sevoflurane treatment, the most commonly used volatile anaesthetic in modern anaesthesia, in rat lungs donated after circulatory death and reconditioned in an ex vivo lung perfusion (EVLP) system. METHODS: Fifteen rats were sacrificed and divided into 3 groups. In the control and sevoflurane groups, the heart-lung blocks were exposed to 1 h of warm ischaemia and 2 h of cold ischaemia and were mounted on an EVLP circuit for 3 h, in the absence or in the presence of 2% sevoflurane...
January 24, 2018: Interactive Cardiovascular and Thoracic Surgery
Anastasio Salazar-Bañuelos, Mauricio Monroy-Cuadros, Hoover Henriquez-Cooper
BACKGROUND: Minimizing ischemia is paramount in the procurement of kidneys for transplantation. A fast cooling and expeditious removal is ideal to minimize damage from warm ischemia, however, since the removal of kidneys is delayed in cadaver donation until all other organs are harvested, the risk of kidney damage increases due to contact with the warmer soft body tissues. Surgical techniques that expedite organ retrieval were developed to avoid organ damage. METHODS: We test a modification of Thomas Starzl's improved technique for multi-organ harvesting by interposing an ice bag between the posterior aspect of the kidney and the psoas muscle in a randomized trial with 21 multi-organ cadaver donors...
January 4, 2018: American Journal of Surgery
Andrea Ferrigno, Laura G Di Pasqua, Clarissa Berardo, Veronica Siciliano, Vittoria Rizzo, Barbara Mannucci, Plinio Richelmi, Anna Cleta Croce, Mariapia Vairetti
We compared static preservation (cold storage, CS, 4 °C) with dynamic preservation (machine perfusion, MP, 20 °C) followed by reperfusion using marginal livers: a model of donation after cardiac death (DCD) livers and two models of fatty livers, the methionine-choline deficient (MCD) diet model, and obese Zucker (fa/fa) rats. CS injury in DCD livers was reversed by an oxygenated washout (OW): hepatic damage, bile flow, and the ATP/ADP ratio in the OW + CS group was comparable with the ratio obtained with MP...
December 31, 2017: International Journal of Molecular Sciences
Hong Jiang, Luxi Cao, Qixia Shen, Lihui Qu, Yan Jiang, Tingting Qu, Jian Zhang, Yingying Lu, Bingjue Li, Chaohong Zhu, Guangjun Liu, Rending Wang, Miao Chen, Yucheng Wang, Yanfei Wang, Shi Feng, Junwen Wang, Yunsong Yu, Jianyong Wu, Jianghua Chen
BACKGROUND/AIMS: Infection with Acinetobacter baumannii was emerging as one of the leading causes of mortality after donation after cardiac death transpalantion. METHODS: We reported a case of a recipient who underwent DCD renal transplantation and later got infected by A.baumannii. Etests were done to verify the susceptibility test results in clinic. Whole-genome analysis was applied to investigate the resistant mechanism at gene level. RESULTS: The pathogen was isolated from his draining liquid the day after the surgery, and susceptibility test reavealed that it was sensitive to tigecycline...
December 14, 2017: Kidney & Blood Pressure Research
M Isabel González-Méndez, Luís López-Rodríguez
The decrease in potential donation after brain death has resulted in a need to evaluate alternative sources. Donation after cardiac death is a good option. The objectives of this article were to describe the Maastricht type iii controlled organ donation characteristics and to determine end-of-life care and the role of nurses in the donation process. In this type of donation, cardiocirculatory arrest is predictable after the limitation of life sustaining treatments. These are patients for whom there are no effective therapy options and, in the context of an organised and planned practice involving all the professionals involved in the care of the patient, the decision is made, in consultation with the family, to withdraw life support measures...
December 11, 2017: Enfermería Clínica
Patricia A Webster, Lori E Markham
CONTEXT: Patients never declared brain dead may represent an additional source of donor organs. OBJECTIVE: To determine the number of likely brain dead potential donors who are never declared brain dead and to compare them with brain dead and donation after cardiac death potential organ donors. DESIGN, SETTING, AND PARTICIPANTS: This study was a retrospective chart review of all catastrophically brain-injured patients referred to a single-organ procurement organization (OPO) over a 4-year period...
January 1, 2017: Progress in Transplantation
Jose Maria Navalpotro-Pascual, Alfredo Echarri-Sucunza, Alonso Mateos-Rodríguez, Francisco Peinado-Vallejo, Patricia Fernández Del Valle, Daniel Alonso-Moreno, Carmen Del Pozo-Pérez, María V Mier-Ruiz, Jose Ignacio Ruiz-Azpiazu, José Bravo-Castello, Natalia Martinez-Cuellar, Antonia Sáez-Jiménez, Carmen López-Unanua, Roberto Antón-Ramas, María Del Carmen Escriche-López, Jose Manuel Giraldo-Sebastià, Mª José García-Ochoa, Enrique Martín-Sánchez, Diego Borraz-Clares, Marta Martínez Del Valle, Cristina Carriedo-Scher, Fernando Rosell-Ortiz
OBJECTIVE: To determine the number of potential deceased organ donors from out-of- hospital cardiac arrest cases (OHCA) attended by public physician-led emergency medical services in Spain, based on data recorded in the nationwide Spanish OHCA Registry (OHSCAR). MATERIAL AND METHODS: We analysed OHSCAR data on deceased OHCA patients in Spain during 13 months (1/10/2013 to 31/10/2014). Variables included age, sex, estimated OHCA time, cardiopulmonary resuscitation (CPR) start time and outcome...
January 2018: Resuscitation
Eric J Siskind, Fauzia Vandermeer, Tamar R Siskind, David A Bruno, Samuel Sultan, Josue Alvarez-Casas, Arielle Stafford, Barton Lane, John C Lamattina, Rolf N Barth, Steven I Hanish
Postoperative transplant liver ultrasounds were analyzed in standard criteria donor (SCD), extended criteria donor (ECD), and donation after cardiac death (DCD) liver allografts to determine if elevated resistive indices (RIs) are consistently present and if they are pathological. Postoperative transplant liver ultrasounds were reviewed from 115 consecutive patients. Hepatic arterial RIs were stratified based on the type of donor: DCD, macrosteatosis (>30%), or standard criteria. In all patients with elevated RI, subsequent ultrasounds were reviewed to demonstrate RI normalization...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
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