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"Donation after cardiac death"

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https://www.readbyqxmd.com/read/28207629/short-and-long-term-outcome-after-lung-transplantation-from-circulatory-dead-donors-a-single-center-experience
#1
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/28176336/effect-of-hypothermic-machine-perfusion-on-the-preservation-of-kidneys-donated-after-cardiac-death-a-single-center-randomized-controlled-trial
#2
Wei Wang, Dawei Xie, Xiaopeng Hu, Hang Yin, Hang Liu, Xiaodong Zhang
To assess the application of a hypothermic machine perfusion device (LifePort) in kidney transplantation from donation after cardiac death (DCD) donors, 24 pairs of DCD kidneys were randomly divided into two groups: one of the paired kidneys from the same donor was perfused with the LifePort machine (hypothermic machine perfusion [HMP]), and the contralateral kidney was prepared using common static cold preservation (CCP). The two groups were compared with respect to the incidence of delayed graft function (DGF), level of graft function, and pathological changes in time-zero biopsy specimens...
February 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28174393/-lung-transplantation-allograft-and-xenograft
#3
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. Lung transplantation in the use of donation after cardiac death has now been increasingly performed in Europe and USA with promising results. However, controlled death is not permitted in Japan making it difficult to accept this strategy. Use of marginal donors is one of the strategies. In Japan, the rate of lung usage is now well over 60% owing to careful donor management by medical consultants and aggressive use of marginal donors...
January 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28134286/risk-factors-of-acute-kidney-injury-after-orthotopic-liver-transplantation-in-china
#4
Yin Zongyi, Li Baifeng, Zou Funian, Li Hao, Wang Xin
In this study, we determined the risk factors for acute kidney injury (AKI) following orthotopic liver transplantation (OLT) in China. We collected 5074 donation after cardiac death (DCD) OLT recipients who underwent surgery between January 1, 2010, and December 31, 2015, in 86 academic hospitals or transplant centers in China. Univariate and multivariate analyses were used to investigate the criticality of donor, graft, or recipient variables in the development of post-OLT AKI. In all, 4482 patients were included (median age, 49...
January 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28111066/enabling-donation-after-cardiac-death-in-the-emergency-department-overcoming-clinical-legal-and-ethical-concerns
#5
Michael Dailey, Sean P Geary, Stefan Merrill, Marleen Eijkholt
BACKGROUND: In light of the growing gap between candidates for organ donation and the actual number of organs available, we present a unique case of organ donation after cardiac death. We hope to open a discussion regarding organ procurement from eligible donors in the prehospital and emergency department setting. CASE: This case study, involving an otherwise healthy man who, after suffering an untimely death, was able to successfully donate his organs, highlights the need to develop an infrastructure to make this type of donation a viable and streamlined option for the future...
January 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28104166/kidney-donor-risk-index-as-the-predictor-for-the-short-term-clinical-outcomes-after-kidney-transplant-from-deceased-donor-with-acute-kidney-injury
#6
H Jun, C W Jung, S Lim, M G Kim
BACKGROUND: The Kidney Donor Risk Index (KDRI) scoring system for deceased donors has been widely introduced for postoperative evaluation of graft function. We analyzed the usefulness of the KDRI in deceased donors with acute kidney injury (AKI). METHODS: Forty-nine recipients from deceased donors with AKI between January 2009 and December 2014 were reviewed retrospectively. Data collected from donor medical records included age, height, weight, hypertension or diabetes history, cause of death, serum creatinine (sCr), and donation after cardiac death...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28088954/-experiences-of-rescuing-infective-arterial-hemorrhage-and-pseudoaneurysm-in-dcd-kidney-transplantation
#7
D D Zhao, L Q Hong, Z Y Huang, N Na, X F Hua, B Miao, H Li, Q Q Sun
Objective: To summarize experiences of rescuing arterial hemorrhage and pseudoaneurysm caused by infection in donation after cardiac death (DCD) kidney transplantation. Methods: A total of 198 consecutive DCD kidney transplantations between 1 June 2013 and 30 July 2016 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The means of rescuing infective arterial hemorrhage and pseudoaneurysm after operation and their therapeutic effects were summarized. Results: A total of 5 infective arterial hemorrhage, 2 infective pseudoaneurysm with hemorrhage, and 1 infective pseudoaneurysm developed in 198 DCD kidney transplantation recipients with total morbidity of 4...
January 10, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28031256/organ-donation-after-medical-assistance-in-dying-or-cessation-of-life-sustaining-treatment-requested-by-conscious-patients-the-canadian-context
#8
Julie Allard, Marie-Chantal Fortin
In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many implications, including the possibility of combining this practice with organ donation through the controlled donation after cardiac death (cDCD) protocol. cDCD most often occurs in cases where the patient has a severe neurological injury but does not meet all the criteria for brain death...
December 28, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28027600/comparison-of-longterm-outcomes-and-quality-of-life-in-recipients-of-donation-after-cardiac-death-liver-grafts-with-a-propensity-matched-cohort
#9
Kristopher P Croome, David D Lee, Dana K Perry, Justin M Burns, Justin H Nguyen, Andrew P Keaveny, C Burcin Taner
The use of liver grafts from donation after cardiac death (DCD) has been limited due to the increased rate of graft failure, mostly related to ischemic cholangiopathy (IC). It is our hypothesis that longterm outcomes and quality of life (QOL) similar to patients undergoing liver transplantation (LT) with donation after brain death (DBD) can be achieved. Clinical outcomes of all patients undergoing DCD LT (n = 300) between 1998 and 2015 were compared with a propensity score-matched cohort of patients undergoing DBD LT (n = 300)...
March 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28027062/organ-donation-and-imminent-death-pro-position
#10
Paul E Morrissey
PURPOSE OF REVIEW: Donation after cardiac death is associated with many problems including ischemic injury, high rates of delayed allograft function, prolonged time to asystole, and frequent organ discard. Imminent death donation (IDD) has been proposed as a separate category of organ donation: distinct from living donation and donation after cardiac death. RECENT FINDINGS: A protocol for IDD was developed at Rhode Island Hospital and published in the ethics literature...
December 23, 2016: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/27977900/noneligible-donors-as-a-strategy-to-decrease-the-organ-shortage
#11
K P Croome, D D Lee, A P Keaveny, C B Taner
Organ procurement organization (OPO) performance is generally evaluated by the number of organ procurement procedures divided by the number of eligible deaths (donation after brain death [DBD] donors aged <70 years), whereas the number of noneligible deaths (including donation after cardiac death donors and DBD donors aged >70 years) is not tracked. The present study aimed to investigate the variability in the proportion of noneligible liver donors by the 58 donor service areas (DSAs). Patients undergoing liver transplant (LT) between 2011 and 2015 were obtained from the United Network for Organ Sharing Standard Transplant Analysis and Research file...
December 15, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27931565/ex%C3%A2-vivo-perfusion-characteristics-of-donation-after-cardiac-death-kidneys-predict-long-term-graft-survival
#12
M Sevinc, S Stamp, J Ling, N Carter, D Talbot, N Sheerin
BACKGROUND: Ex vivo perfusion is used in our unit for kidneys donated after cardiac death (DCD). Perfusion flow index (PFI), resistance, and perfusate glutathione S-transferase (GST) can be measured to assess graft viability. We assessed whether measurements taken during perfusion could predict long-term outcome after transplantation. METHODS: All DCD kidney transplants performed from 2002 to 2014 were included in this study. The exclusion criteria were: incomplete data, kidneys not machine perfused, kidneys perfused in continuous mode, and dual transplantation...
December 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27930543/left-branch-of-portal-vein-thrombosis-in-a-liver-transplant-recipient-with-donation-after-cardiac-death-donor-a-case-report
#13
Maogen Chen, Weiqiang Ju, Xiaohong Lin, Qiang Zhao, Dongping Wang, Xiaoshun He
INTRODUCTION: Portal vein thrombosis (PVT) is one of the most severe complications after liver transplantation, which usually causes graft loss and recipient mortality. The founding of the embolic branch of portal system and its result are not well described in the literature. CLINICAL FINDINGS AND DIAGNOSES: We report here an unusual case of complete right branch thrombosis of portal vein after orthotopic liver transplantation from a donation after cardiac death donor, without obvious malaise...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27913812/association-between-cytokines-and-their-receptor-antagonist-gene-polymorphisms-and-clinical-risk-factors-and-acute-rejection-following-renal-transplantation
#14
SIqing Ding, Jianfei Xie, Qiquan Wan
BACKGROUND Acute rejection (AR) after renal transplantation affects both patient and graft survival. There is growing evidence of the genetic association between cytokine or its receptor antagonist and AR in solid organ transplantation. The objectives of this study were to investigate the role of recipient TNF β, IL-10, IL-1β, and IL-1 receptor antagonist (ra) gene polymorphism, as well as traditional clinical variables such as panel-reactive antibody (PRA) levels, donor type, and HLA mismatches in AR following renal transplantation...
December 3, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27888715/making-a-case-for-controlled-organ-donation-after-cardiac-death-the-story-of-italy-s-first-experience
#15
Marco Vergano, Emma Magavern, Francesca Baroncelli, Valeria Frisenda, Alessia Fonsato, Diego Artusio, Carlo Alberto Castioni, Maria Elena De Piero, Massimo Abelli, Elena Ticozzelli, Sergio Livigni
Donation after circulatory death (DCD) is a valuable option for the procurement of organs for transplantation. In Italy, organ procurement after controlled DCD is legally and ethically conceivable within the current legislative framework. However, although formal impediments do not exist, the health care team is faced with many obstacles that may hinder the implementation of such programs. We report the case of Italy's first controlled DCD, specifically discussing the role of the patient's family in the shared decision-making process...
April 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27861295/improving-national-results-in-liver-transplantation-using-grafts-from-donation-after-cardiac-death-donors
#16
Kristopher P Croome, David D Lee, Andrew P Keaveny, C Burcin Taner
BACKGROUND: Published reports describing the national experience with liver grafts from donation after cardiac death (DCD) donors have resulted in reservations with their widespread utilization. The present study aimed to investigate if temporal improvements in outcomes have been observed on a national level and to determine if donor and recipient selection have been modified in a fashion consistent with published data on DCD use in liver transplantation (LT). METHODS: Patients undergoing DCD LT between 2003 and 2014 were obtained from the United Network of Organ Sharing Standard Transplant Analysis and Research file and divided into 3 equal eras based on the date of DCD LT: era 1 (2003-2006), era 2 (2007-2010), and era 3 (2011-2014)...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27837413/machine-perfusion-versus-cold-storage-of-livers-a-meta-analysis
#17
Sushun Liu, Qing Pang, Jingyao Zhang, Mimi Zhai, Sinan Liu, Chang Liu
Different organ preservation methods are key factors influencing the results of liver transplantation. In this study, the outcomes of experimental models receiving donation after cardiac death (DCD) livers preserved through machine perfusion (MP) or static cold storage (CS) were compared by conducting a meta-analysis. Standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to compare pooled data from two animal species. Twenty-four studies involving MP preservation were included in the meta-analysis...
November 11, 2016: Frontiers of Medicine
https://www.readbyqxmd.com/read/27788786/potential-pediatric-organ-donors-after-cardiac-death
#18
A Pregernig, O Karam
BACKGROUND: More than 50 people die each year on the Swiss transplant waiting list. To increase their organ donors pool, some centers have developed a post-cardiac death organ donation program. Information about its impact in the pediatric population is still scarce. The aim of this work was to determine the potential impact of a program of organ donation after cardiac in a pediatric population. METHODS: This was a retrospective study of all children deceased from 2005 to 2014 in a tertiary pediatric and neonatal intensive care unit...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788674/mesenchymal-stem-cells-improve-mouse-non-heart-beating-liver-graft-survival-by-inhibiting-kupffer-cell-apoptosis-via-tlr4-erk1-2-fas-fasl-caspase3-pathway-regulation
#19
Yang Tian, Jingcheng Wang, Wei Wang, Yuan Ding, Zhongquan Sun, Qiyi Zhang, Yan Wang, Haiyang Xie, Sheng Yan, Shusen Zheng
BACKGROUND: Liver transplantation is the optimal treatment option for end-stage liver disease, but organ shortages dramatically restrict its application. Donation after cardiac death (DCD) is an alternative approach that may expand the donor pool, but it faces challenges such as graft dysfunction, early graft loss, and cholangiopathy. Moreover, DCD liver grafts are no longer eligible for transplantation after their warm ischaemic time exceeds 30 min. Mesenchymal stem cells (MSCs) have been proposed as a promising therapy for treatment of certain liver diseases, but the role of MSCs in DCD liver graft function remains elusive...
October 27, 2016: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/27783454/successful-donation-after-cardiac-death-liver-transplants-with-prolonged-warm-ischemia-time-using-normothermic-regional-perfusion
#20
Riccardo De Carlis, Stefano Di Sandro, Andrea Lauterio, Fabio Ferla, Antonio Dell'Acqua, Marinella Zanierato, Luciano De Carlis
The role of donation after cardiac death (DCD) in expanding the donor pool is mainly limited by the incidence of primary nonfunction (PNF) and ischemia-related complications. Even greater concern exists toward uncontrolled DCD, which represents the largest potential pool of DCD donors. We recently started the first Italian series of DCD liver transplantation, using normothermic regional perfusion (NRP) in 6 uncontrolled donors and in 1 controlled case to deal with the legally required no-touch period of 20 minutes...
February 2017: Liver Transplantation
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