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donation after circulatory death

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https://www.readbyqxmd.com/read/29217818/proteomic-analysis-of-perfusate-from-machine-cold-perfusion-of-transplant-kidneys-insights-into-protection-from-injury
#1
Michael A J Moser, Katherine Sawicka, Steven Arcand, Preston O'Brien, Patrick Luke, Gavin Beck, Jolanta Sawicka, Alejandro Cohen, Grzegorz Sawicki
BACKGROUND Machine cold perfusion is beneficial to the preservation of kidneys for transplantation. At the end of preservation, the perfusion solution contains many proteins. Using a proteomics approach, we searched for useful biomarkers and potential therapeutic targets in the perfusate. Our program is unique in that all transplant kidneys (even living donor kidneys, LKD) are placed on machine cold perfusion prior to transplantation. MATERIAL AND METHODS Perfusates from donation after neurological and circulatory determination of death (DNDD and DCDD respectively) and LKD were collected (n=41) and analyzed for LDH, neutrophil gelatinase-associated lipocalin (NGAL), and matrix metalloproteinase-2 (MMP-2) as markers of injury...
December 8, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29210064/normothermic-machine-perfusion-for-the-assessment-and-transplantation-of-declined-human-kidneys-from-donation-after-circulatory-death-donors
#2
S A Hosgood, E Thompson, T Moore, C H Wilson, M L Nicholson
BACKGROUND: A significant proportion of donation after circulatory death (DCD) kidneys are declined for transplantation because of concerns over their quality. Ex vivo normothermic machine perfusion (NMP) provides a unique opportunity to assess the quality of a kidney and determine its suitability for transplantation. METHODS: In phase 1 of this study, declined human DCD kidneys underwent NMP assessment for 60 min. Kidneys were graded 1-5 using a quality assessment score (QAS) based on macroscopic perfusion, renal blood flow and urine output during NMP...
December 6, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29206661/the-need-and-opportunity-for-donation-after-circulatory-death-worldwide
#3
Martí Manyalich, Helen Nelson, Francis L Delmonico
PURPOSE OF REVIEW: The global shortage of organ donors will not be resolved solely by relying on deceased donation following a brain death determination (DBD). Expansion of deceased donation after circulatory death (DCD) will be needed to address the shortfall of organs for transplantation. Approximately 120 000 organ transplants are performed each year; however, the WHO estimates that this number of transplants only resolves 10% of the annual worldwide transplant need. RECENT FINDINGS: The report addresses the opportunity of DCD expansion by evaluating the DCD potential that is not being realized, the utility of DCD enabling DBD to emerge in some clinical situations, by the effectiveness of a donor registry in achieving DCD, and by the current clinical research of heart, lung, and liver transplantation from DCD...
December 4, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29202255/patterns-of-organ-donation-in-children-in-australia-and-new-zealand
#4
Tarryn Corkery-Lavender, Johnny Millar, Elena Cavazzoni, Ben Gelbart
OBJECTIVES: Paediatric organ donation (OD) represents a small proportion of total OD in Australia and New Zealand. Our aim was to describe the patterns of paediatric OD, specifically, the demographic characteristics and donation outcomes over two time periods. DESIGN: We performed a retrospective study using national OD and intensive care registry data from intensive care units in Australia and New Zealand from 1 January 2000 to 31 December 2015. Data were analysed between two time periods...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29198667/donation-after-circulatory-arrest-in-pancreas-transplantation-a-report-of-10-cases
#5
J A Fridell, R S Mangus, C M Thomas, C A Kubal, J A Powelson
INTRODUCTION: Transplantation of pancreas allografts procured from donation after circulatory death (DCD) remains uncommon. This study reviews a series of pancreas transplants at a single center to assess the donor and recipient characteristics for DCD pancreas transplant and to compare clinical outcomes. METHODS: DCD procurement was performed with a 5-minute wait time from pronouncement of death to first incision. In 2 patients, tissue plasminogen activator was infused as a thrombolytic during the donor flush...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29187117/practical-considerations-in-donation-after-circulatory-determination-of-death-in-switzerland
#6
Anne L Dalle Ave, David M Shaw, Bernice Elger
Faced with similar issues of organ scarcity to its neighbors, Switzerland has developed donation after circulatory determination of death (DCDD) as a way to expand the organ pool since 1985. Here, we analyze the history, practical considerations, and ethical issues relating to the Swiss donation after circulatory death programs. In Switzerland, determination of death for DCDD requires a stand-off period of 10 minutes. This time between cardiac arrest and the declaration of death is mandated in the guidelines of the Swiss Academy of Medical Sciences...
September 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29187088/european-vignettes-in-donation-after-circulatory-death
#7
Dale Gardiner, Tineke Wind, Ben Cole, Walter van Mook, Francisco Del Río, Beatriz Domínguez-Gil
Donation after circulatory death (DCD) is increasing in Europe, yet there is widespread variability in practice. Insight into actual practice is difficult to acquire simply by analyzing protocols and laws from each individual country. For this reason, the 3 DCD vignettes in this article have been constructed to outline routine and standard DCD practice in the United Kingdom, the Netherlands, and Spain. These imagined vignettes reflect a "typical" case, based on the authors' extensive experience with DCD but are not real patient cases...
September 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29173395/challenges-diligence-and-a-breakthrough-in-donation-after-circulatory-death-in-heart-transplantation
#8
EDITORIAL
Mandeep R Mehra
No abstract text is available yet for this article.
December 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29173394/outcome-after-heart-transplantation-from-donation-after-circulatory-determined-death-donors
#9
Simon Messer, Aravinda Page, Richard Axell, Marius Berman, Jules Hernández-Sánchez, Simon Colah, Barbora Parizkova, Kamen Valchanov, John Dunning, Evgeny Pavlushkov, Sendhil K Balasubramanian, Jayan Parameshwar, Yasir Abu Omar, Martin Goddard, Stephen Pettit, Clive Lewis, Anna Kydd, David Jenkins, Christopher J Watson, Catherine Sudarshan, Pedro Catarino, Marie Findlay, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: The requirement for heart transplantation is increasing, vastly outgrowing the supply of hearts available from donation after brain death (DBD) donors. Transplanting hearts after donation after circulatory-determined death (DCD) may be a viable additive alternative to DBD donors. This study compared outcomes from the largest single-center experience of DCD heart transplantation against matched DBD heart transplants. METHODS: DCD hearts were retrieved using normothermic regional perfusion (NRP) or direct procurement and perfusion (DPP)...
December 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29166361/the-impact-of-hepatectomy-time-of-the-liver-graft-on-post-transplant-outcome-a-eurotransplant-cohort-study
#10
Ina Jochmans, Steffen Fieuws, Ineke Tieken, Undine Samuel, Jacques Pirenne
OBJECTIVE: Assessing the effect of donor hepatectomy time on outcome after transplantation. SUMMARY OF BACKGROUND DATA: When blood supply in a deceased organ donor stops, ischemic injury starts. Livers are cooled to reduce cellular metabolism and minimize ischemic injury. This cooling is slow and livers are lukewarm during hepatectomy, potentially affecting outcome. METHODS: We used the Eurotransplant Registry to investigate the relationship between donor hepatectomy time and post-transplant outcome in 12,974 recipients of deceased-donor livers (January 1, 2004, to December 31, 2013)...
November 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29155020/the-uk-dcd-risk-score-a-new-proposal-to-define-futility-in-donation-after-circulatory-death-liver-transplantation
#11
Andrea Schlegel, Marit Kalisvaart, Irene Scalera, Richard W Laing, Hynek Mergental, Darius F Mirza, Thamara Perera, John Isaac, Philipp Dutkowski, Paolo Muiesan
OBJECTIVES: To design a new score on risk assessment in liver transplantation donated after circulatory death (DCD) based on donor and recipient parameters. BACKGROUND: Primary-non-function (PNF) and ischemic cholangiopathy (IC) are the most feared complications following DCD liver transplantation. METHODS: Using the United Kingdom (UK) national DCD database, a risk analysis was performed in adult recipients of DCD liver grafts in UK between 2000 and 2015 (n=1153)...
November 15, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/29149973/hepatitis-c-virus-recurrence-occurs-earlier-in-patients-receiving-donation-after-circulatory-death-liver-transplant-grafts-compared-with-those-receiving-donation-after-brainstem-death-grafts
#12
S A Townsend, M A Monga, P Nightingale, D Mutimer, A M Elsharkawy, A Holt
INTRODUCTION: Hepatitis C virus (HCV)-related cirrhosis remains the commonest indication for liver transplantation worldwide, yet few studies have investigated the impact of donation after circulatory death (DCD) graft use on HCV recurrence and patient outcomes. DCD grafts have augmented the limited donor organ pool and reduced wait-list mortality, although concerns regarding graft longevity and patient outcome persist. METHODS: This was a single-center study of all HCV + adults who underwent DCD liver transplantation between 2004 and 2014...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149095/proton-nuclear-magnetic-resonance-%C3%A2-h-nmr-based-metabolomic-evaluation-of-human-renal-allografts-from-donations-after-circulatory-death
#13
Zijie Wang, Haiwei Yang, Chunchun Zhao, Jifu Wei, Junsong Wang, Zhijian Han, Jun Tao, Zhen Xu, Xiaobin Ju, Ruoyun Tan, Min Gu
BACKGROUND Delayed graft function (DGF) is a common complication that impairs allograft function after kidney transplantation. However, the mechanism of DGF remains unclear. Nuclear magnetic resonance (NMR)-based analysis has been widely used in recent times to assess changes in metabolite levels. MATERIAL AND METHODS Samples of perfusate from allografts donated after circulatory death were collected prior to transplantation, during static cold storage. ¹H-NMR-based metabolomics combined with the statistical methods, orthogonal partial least-squares discriminant analysis (OPLS-DA), and principle-component analysis (PCA), were employed to test different levels of metabolites between the allografts that exhibited DGF and those that exhibited immediate graft function (IGF)...
November 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29136348/outcomes-of-donation-after-circulatory-death-kidneys-undergoing-hypothermic-machine-perfusion-following-static-cold-storage-a-uk-population-based-cohort-study
#14
Kamlesh Patel, Jay Nath, James Hodson, Nick Inston, Andrew Ready
Evidence is currently lacking regarding the outcomes of kidneys undergoing Hypothermic Machine Perfusion (HMP) in the UK. Using the National Health Service Blood and Transplant database, the authors compared outcomes for recipients of single organ Donation after Circulatory Death (DCD) kidneys preserved with HMP to those using only static cold storage (SCS). Between 2007 and 2015, HMP was used in 19.1% (864/4,529) of kidneys. Rates of delayed graft function (DGF) were significantly lower in organs preserved with HMP than for SCS (34...
November 14, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29129151/false-positive-diagnosis-of-brain-death-following-the-pediatric-guidelines-case-report-and-discussion
#15
D Alan Shewmon
A 2-year-old boy with severe head trauma was diagnosed brain dead according to the 2011 Pediatric Guidelines. Computed tomographic (CT) scan showed massive cerebral edema with herniation. Intracranial pressures were extremely high, with cerebral perfusion pressures around 0 for several hours. An apnea test was initially contraindicated; later, one had to be terminated due to oxygen desaturation when the Pco2 had risen to 57.9 mm Hg. An electroencephalogram (EEG) was probably isoelectric but formally interpreted as equivocal...
December 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29120882/donation-after-circulatory-death-and-its-expansion-in-spain
#16
Eduardo Miñambres, Juan J Rubio, Elisabeth Coll, Beatriz Domínguez-Gil
PURPOSE OF REVIEW: Donation after circulatory death (DCD) is still performed in a limited number of countries. This article summarizes the development of DCD in Spain and presents recent Spanish contributions to gain knowledge on the potential benefits and the practical use of normothermic regional perfusion (nRP). RECENT FINDINGS: DCD now contributes to 24% of deceased donors in Spain. The development of DCD has been based on an assessment of practices in the treatment of cardiac arrest and end-of-life care to accommodate the option of DCD; the creation of an adequate regulatory framework; and institutional support, professional training and public education...
November 7, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29103844/prediction-of-potential-for-organ-donation-after-circulatory-death-in-neurocritical-patients
#17
Guixing Xu, Zhiyong Guo, Wenhua Liang, Erye Xin, Bin Liu, Ye Xu, Zhongqin Luan, Paul Michael Schroder, Martí Manyalich, Dicken Shiu-Chung Ko, Xiaoshun He
BACKGROUND: The success or failure of donation after circulatory death depends largely on the functional warm ischemia time, which is closely related to the duration between withdrawal of life-sustaining treatment and circulatory arrest. However, a reliable predictive model for the duration is absent. We aimed to compare the performance of the Chinese Donation after Circulatory Death Nomogram (C-DCD-Nomogram) and 3 other tools in a cohort of potential donors. METHODS: In this prospective, multicenter, observational study, data were obtained from 219 consecutive neurocritical patients in China...
September 30, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29099447/pediatric-donation-after-circulatory-determination-of-death-canadian-guidelines-define-parameters-of-consensus-and-uncertainty
#18
Robert D Truog
No abstract text is available yet for this article.
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29049046/determination-of-death-in-donation-after-circulatory-death-an-ethical-propriety
#19
Andrew McGee, Dale Gardiner, Paul Murphy
PURPOSE OF REVIEW: The recently developed donation after circulatory death (DCD) heart transplant technique, pioneered by Papworth Hospital in the UK, involves the use of extracorporeal perfusion technologies to restart the donor heart in situ and thereby restore the donor's own circulation, after first isolating the donor's cerebral circulation. By restoring the circulation in the deceased donor, even if the cerebral circulation is excluded, the Papworth technique challenges the acceptability of death determination in DCD...
October 18, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/29045706/kidney-injury-molecule-1-staining-in-renal-allograft-biopsies-10-days-after-transplantation-is-inversely-correlated-with-functioning-proximal-tubular-epithelial-cells
#20
Jonna R Bank, Pieter van der Pol, Dianne Vreeken, Catherine Monge-Chaubo, Ingeborg M Bajema, Nicole Schlagwein, Daniëlle J van Gijlswijk, Sandra W van der Kooij, Marlies E J Reinders, Johan W de Fijter, Cees van Kooten
Background: Kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) are promising biomarkers for monitoring delayed graft function (DGF) after kidney transplantation. Here we investigated localization and distribution of KIM-1 and NGAL staining in renal allograft biopsies and studied their association with histological features, functional DGF (fDGF) and the tubular function slope (TFS), a functioning proximal tubular epithelial cell (PTEC) marker. Methods: Day 10 protocol biopsies of 64 donation after circulatory death recipients were stained for KIM-1 and NGAL and the positive area was quantified using ImageJ software...
October 16, 2017: Nephrology, Dialysis, Transplantation
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