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donation after circulatory death

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https://www.readbyqxmd.com/read/29433886/expanding-the-donor-lung-pool-how-many-donations-after-circulatory-death-organs-are-we-missing
#1
William Zachary Chancellor, Eric J Charles, James Hunter Mehaffey, Robert B Hawkins, Carrie A Foster, Ashish K Sharma, Victor E Laubach, Irving L Kron, Curtis G Tribble
BACKGROUND: The number of patients with end-stage pulmonary disease awaiting lung transplantation is at an all-time high, while the supply of available organs remains stagnant. Utilizing donation after circulatory death (DCD) donors may help to address the supply-demand mismatch. The objective of this study is to determine the potential donor pool expansion with increased procurement of DCD organs from patients who die at hospitals. MATERIAL AND METHODS: The charts of all patients who died at a single, rural, quaternary-care institution between August 2014 and June 2015 were reviewed for lung transplant candidacy...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29394233/canadian-guidelines-for-controlled-pediatric-donation-after-circulatory-determination-of-death-summary-report-erratum
#2
(no author information available yet)
No abstract text is available yet for this article.
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29382512/steroids-limit-myocardial-edema-during-ex-vivo-perfusion-of-hearts-donated-after-circulatory-death
#3
Jaskiran K Sandha, Christopher W White, Alison Müller, Emma Avery, James Thliveris, Ian M C Dixon, Rakesh C Arora, Ganghong Tian, Larry V Hryshko, Jayan Nagendran, Darren H Freed
BACKGROUND: Normothermic ex vivo heart perfusion (EVHP) has been shown to improve the preservation of hearts donated after circulatory arrest and facilitate clinical successful transplantation. Steroids are added to the perfusate solution in current clinical EVHP protocols; however, the impact of this approach on donor heart preservation has not been previously investigated. We sought to determine the impact of steroids on the inflammatory response and development of myocardial edema during EVHP...
January 27, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29373667/experimental-ex-vivo-lung-perfusion-with-sevoflurane-effects-on-damaged-donor-lung-grafts
#4
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
https://www.readbyqxmd.com/read/29369470/hypothermic-oxygenated-machine-perfusion-reduces-bile-duct-reperfusion-injury-after-transplantation-of-donation-after-circulatory-death-livers
#5
Rianne van Rijn, Otto B van Leeuwen, Alix P M Matton, Laura C Burlage, Janneke Wiersema-Buist, Marius C van den Heuvel, Ruben H J de Kleine, Marieke T de Boer, Annette S H Gouw, Robert J Porte
INTRODUCTION: Dual hypothermic oxygenated machine perfusion (DHOPE) of the liver has been advocated as a method to reduce ischemia-reperfusion injury. This study aimed to determine whether DHOPE reduces IR injury of the bile ducts in DCD liver transplantation. MATERIALS AND METHODS: In a recently performed phase 1-trial, ten DCD livers were preserved with DHOPE after static cold storage (SCS) (www.trialregister.nl NTR4493). Bile duct biopsies were obtained at the end of SCS (before DHOPE; baseline) and after graft reperfusion in the recipient...
January 25, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29351370/avoid-rejecting-livers-from-donation-after-circulatory-death-donors-based-on-donor-age-alone
#6
EDITORIAL
David P Foley
No abstract text is available yet for this article.
January 19, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29331633/organ-donation-in-the-icu-a-document-analysis-of-institutional-policies-protocols-and-order-sets
#7
Simon J W Oczkowski, John E Centofanti, Pamela Durepos, Erika Arseneau, Julija Kelecevic, Deborah J Cook, Maureen O Meade
OBJECTIVE: To better understand how local policies influence organ donation rates. RESEARCH METHODOLOGY/DESIGN: We conducted a document analysis of our ICU organ donation policies, protocols and order sets. We used a systematic search of our institution's policy library to identify documents related to organ donation. We used Mindnode software to create a publication timeline, basic statistics to describe document characteristics, and qualitative content analysis to extract document themes...
January 10, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29329188/the-impact-of-combined-warm-ischemia-time-on-development-of-acute-kidney-injury-in-donation-after-circulatory-death-liver-transplantation-stay-within-the-golden-hour
#8
Marit Kalisvaart, Andrea Schlegel, Ilaria Umbro, Jubi E de Haan, Irene Scalera, Wojciech G Polak, Jan Nm IJzermans, Darius F Mirza, M Thamara Pr Perera, John I Isaac, James Ferguson, Anna Paola Mitterhofer, Jeroen de Jonge, Paolo Muiesan
BACKGROUND: Acute kidney injury (AKI) is a common complication after liver transplantation and more frequently observed when high-risk grafts, such as DCD grafts are used. Our aim was to investigate the impact of the ischemia periods on development of AKI in DCD liver transplantation. METHODS: We performed a 2-center retrospective study with 368 DCD graft-recipients. Donor warm ischemia time (DWIT) was divided into agonal phase (withdrawal of life-support - cardiac arrest) and asystolic phase (cardiac arrest - start cold perfusion)...
January 11, 2018: Transplantation
https://www.readbyqxmd.com/read/29310591/uncontrolled-donation-after-circulatory-death-comparison-of-two-kidney-preservation-protocols-on-graft-outcomes
#9
Claire Delsuc, Alexandre Faure, Julien Berthiller, Didier Dorez, Xavier Matillon, Vannary Meas-Yedid, Bernard Floccard, Guillaume Marcotte, Vanessa Labeye, Maud Rabeyrin, Ricardo Codas, Cécile Chauvet, Philip Robinson, Emmanuel Morelon, Lionel Badet, William Hanf, Thomas Rimmelé
BACKGROUND: Kidney transplantation following uncontrolled donation after circulatory death (uDCD) presents a high risk of delayed graft function due to prolonged warm ischemia time. In order to minimise the effects of ischemia/reperfusion injury during warm ischemia, normothermic recirculation recently replaced in situ perfusion prior to implantation in several institutions. The aim of this study was to compare these preservation methods on kidney graft outcomes. METHODS: The primary endpoint was the one-year measured graft filtration rate (mGFR)...
January 8, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29302600/a-few-realistic-questions-raised-by-organ-retrieval-in-the-intensive-care-unit
#10
REVIEW
Olivier Lesieur, Liliane Genteuil, Maxime Leloup
Organ transplantation saves the lives of many persons who would otherwise die from end-stage organ disease. The increasing demand for donated organs has led to a renewed interest in donation after circulatory determination of death (CDD). In many countries (including France), terminally ill patients who die of circulatory arrest after a planned withdrawal of life support may be considered as organ donors under certain conditions. While having equal responsibility towards the potential donor and the persons awaiting a transplant, caregivers may experience an ethical dilemma between the responsibility to deliver the best care to the dying, and the need to retrieve the organs...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29297983/impact-of-training-on-intensive-care-providers-attitudes-and-knowledge-regarding-limitation-of-life-support-treatment-and-organ-donation-after-circulatory-death
#11
Maria Del Mar Lomero, María F Jiménez-Herrera, Mireia Llaurado-Serra, María A Bodí, Nuria Masnou, Eva Oliver, Alberto Sandiumenge
The limitation of life-sustaining treatment is common practice in critical care units, and organ donation after circulatory death has come to be included as an option within this care plan. Lack of knowledge and misunderstandings can raise barriers between health-care providers (e.g., confusion about professional roles, lack of collaboration, doubts about the legality of the process, and not respecting patients' wishes in the decision-making process). The aim of the present study was to determine the knowledge and attitudes of intensive care physicians and nurses before and after a multidisciplinary online training program...
January 3, 2018: Nursing & Health Sciences
https://www.readbyqxmd.com/read/29274240/do-clinical-trials-reflect-reality-a-systematic-review-of-inclusion-exclusion-criteria-in-trials-of-renal-transplant-immunosuppression
#12
Anam A Ayaz-Shah, Samia Hussain, Simon R Knight
Renal transplant recipients and donors are becoming increasingly more marginal, with more expanded criteria (ECD) and donation after circulatory death (DCD) donors and older recipients. Despite this, high risk donors and recipients are often excluded from clinical trials, leading to uncertainty about the generalizability of findings. We extracted data regarding inclusion/exclusion criteria from 174 trials of immunosuppression in renal transplant recipients published over a 5-year period, and compared criteria with those specified in published trial registries...
December 23, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29239091/extra-corporeal-normothermic-machine-perfusion-of-the-porcine-kidney-working-towards-future-utilization-in-australasia
#13
Ahmer M Hameed, Ray Miraziz, David B Lu, Neil Warwick, Ali El-Ayoubi, Heather Burns, Yi Vee Chew, Ross Matthews, Greg O'Grady, Lawrence Yuen, Natasha Rogers, Henry C Pleass, Wayne J Hawthorne
BACKGROUND: The ongoing supply-demand gap with respect to donor kidneys for transplantation necessitates the increased use of higher kidney donor profile index and/or donation after circulatory death (DCD) kidneys. Machine perfusion (MP) preservation has become increasingly popular as a means to preserve such organs. Human data regarding normothermic kidney MP (NMP) is in its infancy, and such a system has not been established in the Australasian clinical setting. METHODS: Modified cardio-pulmonary bypass technology was utilized to develop a viable NMP kidney perfusion system using a porcine DCD model...
December 14, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29227984/microrna-146b-5p-identified-in-porcine-liver-donation-model-is-associated-with-early-allograft-dysfunction-in-human-liver-transplantation
#14
Cheukfai Li, Qiang Zhao, Wei Zhang, Maogen Chen, Weiqiang Ju, Linwei Wu, Ming Han, Yi Ma, Xiaofeng Zhu, Dongping Wang, Zhiyong Guo, Xiaoshun He
BACKGROUND Poor transplant outcome was observed in donation after brain death followed by circulatory death (DBCD), since the donor organs suffered both cytokine storm of brain death and warm ischemia injury. MicroRNAs (miRNAs) have emerged as promising disease biomarkers, so we sought to establish a miRNA signature of porcine DBCD and verify the findings in human liver transplantation. MATERIAL AND METHODS MiRNA expression was determined with miRNA sequencing in 3 types of the porcine model of organ donation, including donation after brain death (DBD) group, donation after circulatory death (DCD) group, and DBCD group...
December 11, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29226765/never-declared-brain-dead-potential-organ-donors-an-additional-source-of-donor-organs
#15
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
https://www.readbyqxmd.com/read/29217818/proteomic-analysis-of-perfusate-from-machine-cold-perfusion-of-transplant-kidneys-insights-into-protection-from-injury
#16
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
#17
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
#18
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
#19
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
#20
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
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