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donation after circulatory death

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https://www.readbyqxmd.com/read/28982695/use-and-outcomes-of-kidneys-from-donation-after-circulatory-death-donors-in-the-united-states
#1
John Gill, Caren Rose, Julie Lesage, Yayuk Joffres, Jagbir Gill, Kevin O'Connor
Donation after circulatory death (DCD) donors are an important source of kidneys for transplantation, but DCD donor transplantation is less common in the United States than in other countries. In this study of national data obtained between 2008 and 2015, recovery of DCD kidneys varied substantially among the country's 58 donor service areas, and 25% of DCD kidneys were recovered in only four donor service areas. Overall, 20% of recovered DCD kidneys were discarded, varying from 3% to 33% among donor service areas...
October 5, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28980398/external-validation-of-prediction-models-for-time-to-death-in-potential-donors-after-circulatory-death
#2
A M M Kotsopoulos, F Böing-Messing, N E Jansen, P Vos, W F Abdo
Predicting time to death in controlled donation after circulatory death (cDCD) donors following withdrawal of life-sustaining treatment (WLST) is important but poses a major challenge. The aim of this study is to determine factors predicting time to circulatory death within 60 minutes after WSLT and validate previously developed prediction models. In a single-center retrospective study we used the data of 92 potential cDCD donors. Multivariable regression analysis demonstrated that absent cough-, corneal reflex, lower morphine dosage, and midazolam use were significantly associated with death within 60 minutes (area under the curve (AUC) 0...
October 5, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28980391/the-duration-of-asystolic-ischemia-time-determines-the-risk-of-graft-failure-after-circulatory-dead-donor-kidney-transplantation-a-eurotransplant-cohort-study
#3
L Heylen, I Jochmans, U Samuel, I Tieken, M Naesens, J Pirenne, B Sprangers
Circulatory death donor (DCD) kidney transplantations are steadily increasing. Consensus reports recommend to limit donor warm ischemia time (DWIT) in DCD donation, although an independent effect on graft outcome has not been demonstrated. We investigated death-censored graft survival in 18,065 recipients of deceased-donor kidney transplants in the Eurotransplant region: 1,059 DCD and 17,006 brain-dead donor (DBD) kidney recipients. DWIT was defined as time from circulatory arrest until cold flush. DCD donation was an independent risk factor for graft failure (adjusted HR 1...
October 5, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28975767/cd47-blockade-reduces-ischemia-reperfusion-injury-in-donation-after-cardiac-death-rat-kidney-transplantation
#4
Xuanchuan Wang, Min Xu, Jianluo Jia, Zhengyan Zhang, Joseph P Gaut, Gundumi A Upadhya, Pamela T Manning, Yiing Lin, William C Chapman
Modulation of nitric oxide (NO) activity through blockade of CD47 signaling has been shown to reduce ischemia-reperfusion injury (IRI) in various models of tissue ischemia. Here, we evaluate the potential effect of an antibody-mediated CD47 blockade in a syngeneic and an allogeneic DCD rat kidney transplant model. The donor organ was subjected to 1 hr of warm ischemia time after circulatory cessation, then flushed with a CD47 monoclonal antibody (CD47mAb) in the treatment group, or an isotype-matched immunoglobulin in the control group...
October 4, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28972677/hepatocellular-uptake-of-cyclodextrin-complexed-curcumin-during-liver-preservation-a-feasibility-study
#5
Saber Abdelkader Saidi, Nicolas Meurisse, Ina Jochmans, Veerle Heedfeld, Tine Wylin, Jaakko Parkkinen, Jacques Pirenne, Diethard Monbaliu, Abdelfattah El Feki, Jos van Pelt
Increasing demand for donor organs and decreasing organ quality is prompting research toward new methods to reduce ischemia reperfusion injury (IRI). Several strategies have been proposed to protect the preserved organ from this injury. Before curcumin/dextrin complex (CDC), a potent antioxidant and anti-inflammatory agent, can be used clinically we need to better understand the intracellular uptake under hypothermic conditions on rat model of liver donation after circulatory death (DCD) and brain death (DBD)...
October 3, 2017: Biopharmaceutics & Drug Disposition
https://www.readbyqxmd.com/read/28971641/derivation-and-implementation-of-a-protocol-in-israel-for-organ-donation-after-cardio-circulatory-death
#6
Jonathan Cohen, Ruth Rahamimov, Aaron Hoffman, Eyal Katvan, Kyril Grozovski, Tamar Ashkenazi
BACKGROUND: Strategies aimed at expanding the organ donor pool have been sought, which has resulted in renewed interest in donation after cardio-circulatory death (DCCD), also known as non-heart beating donors (NHBDs). OBJECTIVES: To describe the derivation and implementation of a protocol for DCCD in Israel and report on the results with the first six cases. METHODS: After receiving approval from an extraordinary ethics committee, Ministry of Health, the steering committee of the National Transplant Center defined and reached consensus on the unique challenges presented by a DCCD program...
September 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28968526/donation-after-circulatory-death-an-expanded-opportunity-for-donation-appreciated-by-families
#7
Torgunn Bø Syversen, Dag Wendelbo Sørensen, Stein Foss, Marit Helen Andersen
No abstract text is available yet for this article.
September 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28954604/untapped-potential-in-australian-hospitals-for-organ-donation-after-circulatory-death
#8
Sandeep S Rakhra, Helen I Opdam, Laura Gladkis, Byron Arcia, Michael A Fink, John Kanellis, Peter S Macdonald, Gregory I Snell, David V Pilcher
OBJECTIVE: To determine the potential for organ donation after circulatory death (DCD) in Australia by applying ideal and expanded organ suitability criteria, and to compare this potential with actual DCD rates. DESIGN: Retrospective cohort study. Setting, methods: We analysed DonateLife audit data for patients aged 28 days to 80 years who died between July 2012 and December 2014 in an intensive care unit or emergency department, or who died within 24 hours of discharge from either, in the 75 Australian hospitals contributing data to DonateLife...
September 2, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28949897/consent-for-organ-donation-after-circulatory-death-at-u-s-transplant-centers
#9
George E Hardart, Matthew K Labriola, Kenneth Prager, Marilyn C Morris
BACKGROUND: Despite calls for a controlled organ donation after circulatory death (cDCD) consent process that is more rigorous, consistent, and transparent, little is known about the cDCD consent processes utilized by U.S. hospitals. The objective of this research was to describe the cDCD consent policies of U.S. transplant hospitals, including consent for antemortem interventions (AMI), in order to inform the development of a more rigorous and sound consent process. METHODS: Cross-sectional study data of cDCD policies of U...
July 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/28947546/effect-of-organ-donation-after-circulatory-determination-of-death-on-number-of-organ-transplants-from-donors-with-neurologic-determination-of-death
#10
Vivek Rao, Sonny Dhanani, Janet MacLean, Clare Payne, Elizabeth Paltser, Atul Humar, Jeffrey Zaltzman
BACKGROUND: To increase the available pool of organ donors, Ontario introduced donation after circulatory determination of death (DCD) in 2006. Other jurisdictions have reported a decrease in donations involving neurologic determination of death (NDD) after implementation of DCD, with a drop in organ yield and quality. In this study, we examined the effect of DCD on overall transplant activity in Ontario. METHODS: We examined deceased donor and organ transplant activity during 3 distinct 4-year eras: pre-DCD (2002/03 to 2005/06), early DCD (2006/07 to 2009/10) and recent DCD (2010/11 to 2013/14)...
September 25, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28945476/assessment-of-lungs-for-transplant-recovered-from-uncontrolled-donation-after-circulatory-determination-of-death-donors
#11
Thomas Egan, John Blackwell, Katherine Birchard, Benjamin Haithcock, Jason Long, Stephen Gazda, Nissa Casey, Caitlin Thys
RATIONALE: To address the lung donor shortage, we obtained institutional review board and US Food and Drug Administration approval to transplant lungs recovered from uncontrolled donation after circulatory determination of death donors (uDCDDs). OBJECTIVES: To compare outcomes of recipients of lungs recovered from uDCDDs vs. brain-dead donors. METHODS: After consent and screening, lungs recovered from uDCDDs were assessed by 4 hours ex vivo lung perfusion (EVLP) and computed tomography (CT) scan...
September 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28925929/canadian-guidelines-for-controlled-pediatric-donation-after-circulatory-determination-of-death-summary-report
#12
Matthew J Weiss, Laura Hornby, Bram Rochwerg, Michael van Manen, Sonny Dhanani, V Ben Sivarajan, Amber Appleby, Mary Bennett, Daniel Buchman, Catherine Farrell, Aviva Goldberg, Rebecca Greenberg, Ram Singh, Thomas A Nakagawa, William Witteman, Jill Barter, Allon Beck, Kevin Coughlin, Alf Conradi, Cynthia Cupido, Rosanne Dawson, Anne Dipchand, Darren Freed, Karen Hornby, Valerie Langlois, Cheryl Mack, Meagan Mahoney, Deepak Manhas, Christopher Tomlinson, Samara Zavalkoff, Sam D Shemie
OBJECTIVES: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. METHODS: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28923643/feasibility-of-lung-transplantation-from-donation-after-circulatory-death-donors-following-portable-ex%C3%A2-vivo-lung-perfusion-a-pilot-study
#13
J G Y Luc, K Jackson, J G Weinkauf, D H Freed, J Nagendran
BACKGROUND: Donation after circulatory death (DCD) has the potential to significantly alleviate the shortage of transplantable lungs. We report our initial experience with the use of portable ex vivo lung perfusion (EVLP) with the Organ Care System Lung device for evaluation of DCD lungs. METHODS: We performed a retrospective review of the DCD lung transplantation (LTx) experience at a single institution through the use of a prospective database. RESULTS: From 2011 to 2015, 208 LTx were performed at the University of Alberta, of which 11 were DCD LTx with 7 (64%) that underwent portable EVLP...
October 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28922301/hypothermic-liver-perfusion
#14
Andrea Schlegel, Xavier Muller, Philipp Dutkowski
PURPOSE OF REVIEW: The review describes recent developments in hypothermic machine liver perfusion with a special focus on underlying protective mechanisms, and the role of this perfusion technique in high-risk donor-recipient combinations. RECENT FINDINGS: To maximize the number of transplantable donor livers, several centres are exploring new machine preservation techniques. In this context, hypothermic machine perfusion has been recently introduced into the clinical setting of human liver transplantation, and the effect of endischemic cold liver perfusion on posttransplant complications is currently under investigation in two multicentre, randomized controlled trials...
September 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28905773/re-continuous-normothermic-ex%C3%A2-vivo-kidney-perfusion-is-superior-to-brief-normothermic-perfusion-following-static-cold-storage-in-donation-after-circulatory-death-pig-kidney-transplantation
#15
https://www.readbyqxmd.com/read/28886219/comparison-of-outcomes-of-kidney-transplantation-from-donation-after-brain-death-donation-after-circulatory-death-and-donation-after-brain-death-followed-by-circulatory-death-donors
#16
Guodong Chen, Chang Wang, Dicken Shiu-Chung Ko, Jiang Qiu, Xiaopeng Yuan, Ming Han, Changxi Wang, Xiaoshun He, Lizhong Chen
There are three categories of deceased donors of kidney transplantation in China, donation after brain death(DBD), donation after circulatory death(DCD), donation after brain death followed by circulatory death(DBCD) donors. The aim of this study is to compare the outcomes of kidney transplantation from these three categories of deceased donors METHODS: We retrospectively reviewed 469 recipients who received deceased kidney transplantation in our hospital from February 2007 to June 2015. The recipients were divided into three groups according to the source of their donor kidneys: DBD, DCD or DBCD...
September 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28885771/impact-of-donor-age-in-donation-after-cardiac-death-liver-transplantation-is-the-cut-off-60-still-of-relevance
#17
Andrea Schlegel, Irene Scalera, M Thamara, P R Perera, Marit Kalisvaart, Hynek Mergental, Darius F Mirza, John Isaac, Paolo Muiesan
Background Advanced donor age has been identified as risk factor, when combined with donor warm ischemia, e.g. in donation after circulatory death (DCD). In several countries DCD livers, older than 60 years are not considered suitable due to concerns related to poor graft function and development of ischaemic cholangiopathy. We evaluate in this study outcome after DCD liver transplantation using grafts from donors older than 60 years. Methodology We analysed outcome after DCD liver transplantation (n=315), comparing donors >60 years (n=93) and donors ≤60 years (n=222) from our centre between 2005 and 2015...
September 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28885491/pancreas-transplantation-with-grafts-from-donors-deceased-after-circulatory-death-dcd-5-years-single-center-experience
#18
Wouter Kopp, Hwai-Ding Lam, A F M Schaapherder, Volkert Huurman, Paul van der Boog, Eelco de Koning, Johan W de Fijter, Andrzej Baranski, Andries Braat
INTRODUCTION: Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented. METHODS: A retrospective, single center analysis (2011 - 2015) was performed to compare the results of donation after brain death (DBD) to DCD pancreas transplantation. RESULTS: During the study period, 104 pancreas transplantations (83 from DBD and 21 from DCD) were performed...
September 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28839932/the-impact-of-alteplase-on-pulmonary-graft-function-in-donation-after-circulatory-death-an-experimental-study
#19
Annika Liersch-Nordqvist, Mohammed Fakhro, Leif Pierre, Joanna Hlebowicz, Malin Malmsjo, Richard Ingemansson, Sandra Lindstedt
OBJECTIVE: Lung transplantation is hampered by the lack of organs resulting in deaths on the waiting list. The usage of donation after circulatory death (DCD) lungs would dramatically increase donor availability. The most optimal organ preservation method, and the need for antithrombotic and fibrinolytic treatment to prevent thrombosis in the donor lungs is currently on debate. The present study investigated, in a simulated clinical DCD situation, whether the addition of alteplase in the flush-perfusion solution at the time of pulmonary graft harvesting could prevent thrombosis in the donor lung and thereby improve pulmonary graft function...
October 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28838463/beware-cold-agglutinins-in-organ-donors-ex%C3%A2-vivo-lung-perfusion-from-an-uncontrolled-donation-after-circulatory-determination-of-death-donor-with-a-cold-agglutinin-a-case-report
#20
A Venkataraman, J W Blackwell, W K Funkhouser, K R Birchard, S E Beamer, W T Simmons, S H Randell, T M Egan
BACKGROUND: We began to recover lungs from uncontrolled donation after circulatory determination of death to assess for transplant suitability by means of ex vivo lung perfusion (EVLP) and computerized tomographic (CT) scan. Our first case had a cold agglutinin with an interesting outcome. CASE REPORT: A 60-year-old man collapsed at home and was pronounced dead by Emergency Medical Services personnel. Next-of-kin consented to lung retrieval, and the decedent was ventilated and transported...
September 2017: Transplantation Proceedings
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