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"Donation after cardiac death"

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https://www.readbyqxmd.com/read/28807212/comparison-of-normothermic-and-hypothermic-perfusion-in-porcine-kidneys-donated-after-cardiac-death
#1
Matthew F Blum, Qiang Liu, Basem Soliman, Paul Dreher, Toshihiro Okamoto, Emilio D Poggio, David A Goldfarb, William M Baldwin, Cristiano Quintini
BACKGROUND: Normothermic machine perfusion (NMP) is an alternative strategy for preserving kidneys donated after cardiac death (DCD). The relative efficacy of prolonged NMP compared to hypothermic machine perfusion (HMP) in DCD kidneys with moderate ischemic injury is undetermined. This study compares NMP and HMP kidney preservation in a porcine DCD model. METHODS: Ten porcine kidneys underwent NMP or HMP preservation following 45 minutes of warm ischemia and 5 hours of cold ischemia...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28797760/effect-of-left-ventricular-dysfunction-on-utilization-of-donor-hearts
#2
David Tryon, Nahidh W Hasaniya, Brice Jabo, Anees J Razzouk, Leonard L Bailey, David G Rabkin
BACKGROUND: In this study we investigated modern, non-utilization rates of potential cardiac donors with left ventricular dysfunction (LVD) to clarify this phenomenon's magnitude and the impact of recent studies suggesting these organs can be safely transplanted. METHODS: Using the United Network for Organ Sharing transplant database, we reviewed all donors evaluated between January 1, 2007 and June 30, 2014. Exclusion criteria included lack of consent and age <13 or >59 years...
July 19, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28771455/confirmed-transmission-of-bacterial-or-fungal-infection-to-kidney-transplant-recipients-from-donated-after-cardiac-death-dcd-donors-in-china-a-single-center-analysis
#3
Qiquan Wan, Huanmiao Liu, Shaojun Ye, Qifa Ye
BACKGROUND We aimed to investigate blood and urine cultures of donated after cardiac death (DCD) donors and report the cases of confirmed (proven/probable) transmission of bacterial or fungal infection from donors to kidney recipients. MATERIAL AND METHODS Seventy-eight DCD donors between 2010 and 2016 were included. Sixty-one DCD donors underwent blood cultures and 22 episodes of bacteremias developed in 18 donors. Forty-three donors underwent urine cultures and 14 donors experienced 17 episodes of urinary infections...
August 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28742013/first-canadian-experience-with-donation-after-cardiac-death-simultaneous-pancreas-and-kidney-transplants
#4
Patrick T Anderson, Shahid Aquil, Kelly McLean, Vivian C McAlister, Alp Sener, Patrick P Luke
BACKGROUND: Compared with neurologic determination of death (NDD) donor organs, donation after cardiac death (DCD) donor organs have traditionally been considered of inferior quality owing to warm ischemia experienced during procurement. We present, to our knowledge, the first analysis of simultaneous pancreas and kidney (SPK) transplants using DCD donor organs in Canada. METHODS: We carried out a retrospective cohort study of SPK transplants from 13 DCD and 68 NDD donors performed between October 2008 and July 2016...
August 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28736011/pediatric-donor-to-adult-recipients-in-donation-after-cardiac-death-liver-transplantation-a-single-center-experience
#5
C Lan, J L Song, L N Yan, J Y Yang, T F Wen, B Li, M Q Xu
BACKGROUND: The impact of using liver allografts from donors who are younger than 14 years at the time of donation after cardiac death (DCD) liver transplantation in terms of early allograft dysfunction (EAD) and graft survival is undefined. To determine if adults undergoing DCD liver transplantation who receive a graft from a donor age younger than or equal to 13 years have similar outcomes to recipients of organs from older than 18-year-old donors. METHODS: Records from adult patients undergoing DCD liver transplantation between March 2012 and December 2015 who received whole grafts from donors after cardiac death were reviewed...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28718858/donationsutredningen-%C3%A3-ppnar-f%C3%A3-r-nya-organdonatorer-kr%C3%A3-ver-reflexion-om-m%C3%A3-nniskov%C3%A3-rdesprincipen-och-samtycke
#6
Stellan Welin
Swedish white paper on donation can give more donors without compromising ethics The White Paper on organ donation (SOU 2015:84) proposes new regulations for organ donation. In particular it spells out that it is permissible to take medical steps to preserve organs while the patient is still alive. It is proposed that this should be allowed after the medical team has declared that the continuation of life sustaining treatment is futile. The white paper opens up for donation after cardiac death. There has been some critique of the white paper for lack of deeper ethical discussions...
July 14, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28698837/developing-a-donation-after-cardiac-death-risk-index-for-adult-and-pediatric-liver-transplantation
#7
Shirin Elizabeth Khorsandi, Emmanouil Giorgakis, Hector Vilca-Melendez, John O'Grady, Michael Heneghan, Varuna Aluvihare, Abid Suddle, Kosh Agarwal, Krishna Menon, Andreas Prachalias, Parthi Srinivasan, Mohamed Rela, Wayel Jassem, Nigel Heaton
AIM: To identify objective predictive factors for donor after cardiac death (DCD) graft loss and using those factors, develop a donor recipient stratification risk predictive model that could be used to calculate a DCD risk index (DCD-RI) to help in prospective decision making on organ use. METHODS: The model included objective data from a single institute DCD database (2005-2013, n = 261). Univariate survival analysis was followed by adjusted Cox-regressional hazard model...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28688150/national-assessment-of-early-hospitalization-after-liver-transplantation-risk-factors-and-association-with-patient-survival
#8
Pratima Sharma, Nathan P Goodrich, Douglas E Schaubel, Abigail R Smith, Robert M Merion
Hospitalization is known to occur frequently in the first 6 months following liver transplantation (LT). Using a novel data linkage between the Scientific Registry of Transplant Recipients and Centers for Medicare and Medicaid Services, our study has two objectives: (i) determine risk factors for "early" hospitalization (i.e., within 6 months of LT) (ii) quantify the importance of hospitalization history in the first 6 months with respect to subsequent patient survival (i.e., survival, conditional on surviving 6 months post-LT)...
July 7, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28684160/looking-inward-the-impact-of-operative-time-on-graft-survival-after-liver-transplantation
#9
David D Lee, Jun Li, Guihua Wang, Kristopher P Croome, Justin M Burns, Dana K Perry, Justin H Nguyen, Wallace J Hopp, C Burcin Taner
BACKGROUND: Operative time often has been cited as an important factor for postoperative outcomes. Despite this belief, most efforts to improve liver transplant outcomes have largely focused on only patient and donor factors, and little attention has been paid on operative time. The primary objective of this project was to determine the impact of operative time on graft survival after liver transplant. METHODS: A retrospective review of 2,877 consecutive liver transplants performed at a single institution was studied...
July 3, 2017: Surgery
https://www.readbyqxmd.com/read/28657945/expanding-the-margins-high-volume-utilization-of-marginal-liver-grafts-among-2000-liver-transplants-at-a-single-institution
#10
Karim J Halazun, Ralph C Quillin, Russel Rosenblatt, Advaith Bongu, Adam D Griesemer, Tomoaki Kato, Craig Smith, Fabrizio Michelassi, James V Guarrera, Benjamin Samstein, Robert S Brown, Jean C Emond
OBJECTIVE: Marginal livers (ML) have been used to expand the donor pool. National utilization of MLs is variable, and in some centers, they are never used. We examined the outcomes of MLs in the largest single center series of MLs used to date and compared outcomes to standard (SL) and living donor (LD) livers. METHODS: Analysis of a prospectively maintained database of all liver transplants performed at our institution from 1998 to 2016. ML grafts were defined as livers from donors >70, livers discarded regionally and shared nationally, livers with cold ischemic time >12 hours, livers from hepatitis C virus positive donors, livers from donation after cardiac death donors, livers with >30% steatosis, and livers split between 2 recipients...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28650112/liver-graft-preservation-using-perfluorocarbon-improves-the-outcomes-of-simulated-donation-after-cardiac-death-liver-transplantation-in-rats
#11
Shinya Okumura, Tadahiro Uemura, Xiangdong Zhao, Yuki Masano, Tatsuaki Tsuruyama, Yasuhiro Fujimoto, Taku Iida, Shintaro Yagi, Dmitri Bezinover, Bruce Spiess, Toshimi Kaido, Shinji Uemoto
INTRODUCTION: The outcomes of liver transplantation from donation after cardiac death (DCD) donors remain poor due to the severe warm ischemic injury. Perfluorocarbon (PFC) is a novel compound with high oxygen carrying capacity. In the present study, a rat model simulating DCD liver transplantation was used, and the impact of improved graft oxygenation provided by PFC addition on liver ischemia-reperfusion injury (IRI) and survival after DCD liver transplantation was investigated. MATERIAL AND METHODS: Orthotopic liver transplants were performed in male Lewis rats, using DCD liver grafts preserved with cold University of Wisconsin (UW) solution in the control group and preserved with cold oxygenated UW solution with addition of 20% PFC in the PFC group...
June 26, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28601322/the-center-volume-outcome-effect-in-pancreas-transplantation-a-national-analysis
#12
Young Kim, Vikrom K Dhar, Koffi Wima, Andrew D Jung, Brent T Xia, Richard S Hoehn, Tayyab S Diwan, Shimul A Shah
BACKGROUND: Although increased hospital volume has been correlated with improved outcomes in certain surgical procedures, the effect of center volume on pancreas transplantation (PT) is less understood. Our study aims to establish whether a volume-outcome effect exists for PT. METHODS: Through an established linkage between the University HealthSystem Consortium and the Scientific Registry of Transplant Recipients (SRTR) databases, we performed a retrospective cohort analysis of adult PT recipients between 2009 and 2012...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28597777/improved-metabolism-and-redox-state-with-a-novel-preservation-solution-implications-for-donor-lungs-after-cardiac-death-dcd
#13
David A Schipper, Anthony V Louis, Destiny S Dicken, Kitsie Johnson, Ryszard T Smolenski, Stephen M Black, Ray Runyan, John Konhilas, Joe G N Garcia, Zain Khalpey
Lungs donated after cardiac death (DCD) are an underutilized resource for a dwindling donor lung transplant pool. Our study investigates the potential of a novel preservation solution, Somah, to better preserve statically stored DCD lungs, for an extended time period, when compared to low-potassium dextran solution (LPD). We hypothesize that Somah is a metabolically superior organ preservation solution for hypothermic statically stored porcine DCD lungs, possibly improving lung transplant outcomes. Porcine DCD lungs (n = 3 per group) were flushed with and submerged in cold preservation solution...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28574105/development-of-a-prolonged-warm-ex-vivo-perfusion-model-for-kidneys-donated-after-cardiac-death
#14
Daniel Urcuyo, Matthew F Blum, Qiang Liu, Ahmed Nassar, Laura D Buccini, Teresa Diago Uso, Emilio D Poggio, William M Baldwin Iii, David A Goldfarb, Cristiano Quintini
PURPOSE: Ex vivo perfusion of marginal kidney grafts offers the chance to expand the donor pool, but there is no current clinical standard for the prolonged warm perfusion of renal grafts. This exploratory pilot study seeks to identify a stable ex vivo kidney perfusion model that can support low intravascular resistance and preserve histologic architecture in a porcine donation after cardiac death (DCD) model. METHODS: 15 kidneys were preserved in 1 of 3 settings: normothermic whole blood (NT-WB), normothermic Steen Solution™ (XVIVO Perfusion) with whole blood (NT-Steen/WB), or subnormothermic Steen Solution™ at 21°C (SNT-Steen)...
June 9, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28556380/waitlist-outcomes-for-patients-relisted-following-failed-donation-after-cardiac-death-liver-transplant-implications-for-awarding-meld-exception-scores
#15
Kristopher P Croome, David D Lee, Justin H Nguyen, Andrew P Keaveny, C Burcin Taner
Understanding of outcomes for patients re-listed for ischemic cholangiopathy (IC) following a donation after cardiac death (DCD) liver transplant (LT) will help standardization of MELD exception scheme for re-transplantation. Early relisting (E-RL) for DCD graft failure due to PNF or HAT was defined as re-listing ≤ 14 days after DCD-LT, late relisting (L-RL) due to biliary complications was defined as re-listing 14 days- 3 years after DCD-LT. Of 3908 DCD-LT performed nationally between 2002-2016, 540 (13...
May 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28538652/association-between-delayed-graft-function-and-graft-loss-in-donation-after-cardiac-death-kidney-transplants-a-paired-kidney-registry-analysis
#16
Wai H Lim, Stephen P McDonald, Graeme R Russ, Jeremy R Chapman, Maggie Km Ma, Henry Pleass, Bryon Jaques, Germaine Wong
BACKGROUND: Delayed graft function (DGF) is an established complication after donation after cardiac death (DCD) kidney transplants, but the impact of DGF on graft outcomes is uncertain. To minimize donor variability and bias, a paired donor kidney analysis was undertaken where 1 kidney developed DGF and the other did not develop DGF using data from the Australia and New Zealand Dialysis and Transplant Registry. METHODS: Using paired DCD kidney data from the Australia and New Zealand Dialysis and Transplant Registry, we examined the association between DGF, graft and patient outcomes between 1994 and 2012 using adjusted Cox regression models...
June 2017: Transplantation
https://www.readbyqxmd.com/read/28512290/evolution-of-drug-resistant-acinetobacter-baumannii-after-dcd-renal-transplantation
#17
Hong Jiang, Luxi Cao, Lihui Qu, Tingting Qu, Guangjun Liu, Rending Wang, Bingjue Li, Yuchen Wang, Chaoqun Ying, Miao Chen, Yingying Lu, Shi Feng, Yonghong Xiao, Junwen Wang, Jianyong Wu, Jianghua Chen
Infection after renal transplantation remains a major cause of morbidity and death, especially infection from the extensively drug-resistant bacteria, A. baumannii. A total of fourteen A. baumannii isolates were isolated from the donors' preserved fluid from DCD (donation after cardiac death) renal transplantation and four isolates in the recipients' draining liquid at the Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, from March 2013 to November 2014. An outbreak of A...
May 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28470557/development-of-a-canadian-deceased-donation-education-program-for-health-professionals-a-needs-assessment-survey
#18
Jennifer Hancock, Sam D Shemie, Ken Lotherington, Amber Appleby, Richard Hall
PURPOSE: The purpose of this survey was to determine how Canadian healthcare professionals perceive their deficiencies and educational requirements related to organ and tissue donation. METHODS: We surveyed 641 intensive care unit (ICU) physicians, 1,349 ICU nurses, 1,561 emergency room (ER) physicians, and 1,873 ER nurses. The survey was distributed by the national organization for each profession (the Canadian Association of Emergency Physicians, the Canadian Association of Critical Care Nurses, and the National Emergency Nurses Association)...
May 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28376778/outcomes-for-primary-kidney-transplantation-from-donation-after-citizens-death-in-china-a-single-center-experience-of-367-cases
#19
Wujun Xue, Puxun Tian, Heli Xiang, Xiaoming Ding, Xiaoming Pan, Hang Yan, Jun Hou, Xinshun Feng, Linjuan Liu, Chenguang Ding, Xiaohui Tian, Yang Li, Jin Zheng
BACKGROUND: The cases of donation after brain death followed by circulatory death (DBCD) and donation after cardiac death (DCD) have been increased year by year in China. Further research is needed to understand in the outcomes and risk factors of delayed graft function (DGF) in order to minimize the risk of DGF and ameliorate its potential impact on long-term outcomes. This study was to explore the differences in outcomes between DBCD and DCD transplant and the main risk factors for DGF in DBCD...
April 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28364814/extended-criteria-donors-in-liver-transplantation
#20
REVIEW
Irine Vodkin, Alexander Kuo
Mortality rates on the liver transplant waiting list are increasing. The shortage of organs has resulted in higher utilization of extended criteria donors (ECDs), with centers pushing the limits of what is acceptable for transplantation. Donor quality is more appropriately represented as a continuum of risk, and careful selection and matching of ECD grafts with recipients may lead to excellent outcomes. Although there is no precise definition for what constitutes an ECD liver, this review focuses on frequently cited characteristics, including donor age, steatosis, donation after cardiac death, and donors with increased risk of disease transmission...
May 2017: Clinics in Liver Disease
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