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donation after circulatory death

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https://www.readbyqxmd.com/read/28104156/long-term-outcomes-in-kidney-transplantation-from-expanded-criteria-donors-after-circulatory-death
#1
Y Tomita, T Tojimbara, K Iwadoh, I Nakajima, S Fuchinoue
The number of recipients waiting for a transplant is increasing. In Japan, there is more frequent use of organs from expanded-criteria donors (ECDs) after circulatory death. We retrospectively analyzed long-term outcomes of kidney transplantation (KT) from expanded-criteria donation after circulatory death (DCD). From 1995 to 2013, 97 cases of KT from DCD donors were performed in our department. Death-censored graft survival rates of ECD kidneys (n = 50) versus standard-criteria deceased-donor (SCD) kidneys (n = 47) for 1, 5, and 10 years after transplantation were 84...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28066980/how-spain-reached-40-deceased-organ-donors-per-million-population
#2
REVIEW
R Matesanz, B Domínguez-Gil, E Coll, B Mahíllo, R Marazuela
With 40 donors and more than 100 transplant procedures per million population in 2015, Spain holds a privileged position worldwide in providing transplant services to its patient population. The Spanish success derives from a specific organizational approach to ensure the systematic identification of opportunities for organ donation and their transition to actual donation and to promote public support for the donation of organs after death. The Spanish results are to be highlighted in the context of the dramatic decline in the incidence of brain death and the changes in end-of-life care practices in the country since the beginning of the century...
January 9, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28060242/adult-liver-allocation-in-eurotransplant
#3
Ina Jochmans, Marieke van Rosmalen, Jacques Pirenne, Undine Samuel
Liver allocation in Eurotransplant is complex as allocation rules need to follow not only the guidelines of the European Commission but also the specific regulations of each of the 7 Eurotransplant countries with active liver transplant programs. Thirty-eight liver transplant centers served a population of about 135 million in 2015. Around 1600 deceased donor livers are transplanted annually. The number of deceased organ donors remains stable but donor age is increasing. Nevertheless, liver utilization rates are unchanged at around 80%...
January 6, 2017: Transplantation
https://www.readbyqxmd.com/read/28053342/liver-transplantation-for-hepatocellular-carcinoma-outcomes-and-novel-surgical-approaches
#4
REVIEW
Gonzalo Sapisochin, Jordi Bruix
Liver transplantation for hepatocellular carcinoma (HCC) is the best treatment option for patients with early-stage tumours and accounts for ∼20-40% of all liver transplantations performed at most centres worldwide. The Milan criteria are the most common criteria to select patients with HCC for transplantation but they can be seen as too restrictive. Several proposals have been made for a moderate expansion of the criteria, which result in good outcomes but with an increase in the risk of tumour recurrence...
January 5, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28032366/permanence-can-be-defended
#5
Andrew Mcgee, Dale Gardiner
In donation after the circulatory-respiratory determination of death (DCDD), the dead donor rule requires that the donor be dead before organ procurement can proceed. Under the relevant limb of the Uniform Determination of Death Act 1981 (USA), a person is dead when the cessation of circulatory-respiratory function is 'irreversible'. Critics of current practice in DCDD have argued that the donor is not dead at the time organs are procured, and so the procurement of organs from these donors violates the dead donor rule...
December 28, 2016: Bioethics
https://www.readbyqxmd.com/read/28027614/decision-modelling-in-donation-after-circulatory-death-dcd-liver-transplantation
#6
K A McLean, J Camilleri-Brennan, S R Knight, T Drake, R Ots, C A Shaw, S J Wigmore, E M Harrison
INTRODUCTION: Donation after circulatory death (DCD) liver allografts are increasingly used for transplantation. However, the post-transplantation clinical and quality of life outcomes of DCD recipients are traditionally considered to be inferior compared with donation after brain death (DBD) allograft recipients. Decision making for such marginal organs can be difficult. This study investigated the optimal decision to accept or decline a DCD liver allograft for a patient based on their current health...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27987369/procurement-professionalization-a-mandatory-step-to-improve-the-availability-and-quality-of-whole-pancreas-grafts
#7
Axel Andres, Michela Assalino, Graziano Oldani, Christian Toso, Thierry Berney
The lack of available organs remains one of the main limitations in the field of solid organ transplantation. Most transplant organizations work on improving donation rate through public information programs, and by exploring new organ sources, such as Donors after Cardio-circulatory Death (DCD). This article is protected by copyright. All rights reserved.
December 17, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27984290/the-potential-to-increase-organ-donation-after-death-by-circulatory-criteria
#8
Michael A Kuiper, Steven Hollenberg, David Crippen, Leslie M Whetstine
No abstract text is available yet for this article.
January 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27920725/controlled-reperfusion-strategies-improve-cardiac-hemodynamic-recovery-after-warm-global-ischemia-in-an-isolated-working-rat-heart-model-of-donation-after-circulatory-death-dcd
#9
Emilie Farine, Petra Niederberger, Rahel K Wyss, Natalia Méndez-Carmona, Brigitta Gahl, Georg M Fiedler, Thierry P Carrel, Hendrik T Tevaearai Stahel, Sarah L Longnus
Aims: Donation after circulatory death (DCD) could improve cardiac graft availability, which is currently insufficient to meet transplant demand. However, DCD organs undergo an inevitable period of warm ischemia and most cardioprotective approaches can only be applied at reperfusion (procurement) for ethical reasons. We investigated whether modifying physical conditions at reperfusion, using four different strategies, effectively improves hemodynamic recovery after warm ischemia. Methods and Results: Isolated hearts of male Wistar rats were perfused in working-mode for 20 min, subjected to 27 min global ischemia (37°C), and 60 min reperfusion (n = 43)...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#10
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27916031/-experience-of-the-selection-and-maintainence-for-donor-lung-62-cases-attached
#11
G L Peng, X Xu, D X Huang, B Wei, D Xiao, W Wang, Y D Wang, J X He
Objective: To summarize the experience of selection and maintainence for the lungs from donation. Methods: From January 2015 to June 2016, 62 cases had been evaluated by Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University. All the clinic data had been collected to evaluate the donor lungs, including the basic information, physical examination, results of radiology and laboratory, the bronchoscope, etc. All the satisfactory donors had been harvested and transplanted to the receipient and then follow up...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27906828/presence-of-cytotoxic-extracellular-histones-in-machine-perfusate-of-donation-after-circulatory-death-kidneys
#12
Tim C van Smaalen, Daniëlle M H Beurskens, E R Pieter Hoogland, Bjorn Winkens, Maarten H L Christiaans, Chris P Reutelingsperger, L W Ernest van Heurn, Gerry A F Nicolaes
BACKGROUND: Extracellular histones are cytotoxic molecules that are related to cell stress and death. They have been shown to play a crucial role in multiple pathophysiologic processes like sepsis, inflammation, vascular dysfunction and thrombosis. Their role in organ donation and graft function and survival is still unknown. The aim of this study was to assess whether an association exists between the presence of extracellular histones in machine perfusates and deceased donor kidney viability...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27888715/making-a-case-for-controlled-organ-donation-after-cardiac-death-the-story-of-italy-s-first-experience
#13
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...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27888556/evaluate-quality-of-kidneys-from-dcd-ecd-donors-by-parameters-of-machine-perfusion
#14
Guodong Chen, Chang Wang, Yi Zhao, Longhui Qiu, Xiaopeng Yuan, Jiang Qiu, Changxi Wang, Xiaoshun He, Lizhong Chen
AIM: To investigate whether the parameters of machine perfusion could predict the quality of kidneys from donation after circulatory death(DCD) donors and expanded criteria donors (ECD) . METHODS: 58 kidneys from DCD/ECD donors were harvested in our hospital from July 2011 to August 2014. All kidneys were preserved with machine perfusion(Life Port), and parameters of machine perfusion were collected. All kidneys were biopsied before transplantation. The primary endpoints were delayed graft function(DGF), graft loss and patient death...
November 26, 2016: Nephrology
https://www.readbyqxmd.com/read/27861290/pathophysiological-trends-during-withdrawal-of-life-support-implications-for-organ-donation-after-circulatory-death
#15
Arjun Iyer, Hong Chee Chew, Ling Gao, Jeanette Villanueva, Mark Hicks, Aoife Doyle, Gayathri Kumarasinghe, Andrew Jabbour, Paul Cassius Jansz, Michael P Feneley, Richard P Harvey, Robert M Graham, Kumud K Dhital, Peter S Macdonald
BACKGROUND: Donation after circulatory death (DCD) provides an alternative pathway to deceased organ transplantation. Although clinical DCD lung, liver, and kidney transplantation are well established, transplantation of hearts retrieved from DCD donors has reached clinical translation only recently. Progress has been limited by concern regarding the viability of DCD hearts. The aim of this study was to document the pathophysiological changes that occur in the heart and circulation during withdrawal of life (WLS) support...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27850267/628-uncontrolled-donation-after-circulatory-death-a-single-centre-retrospective-study
#16
Olivier Lachance, Vincent Lafleur, Ivan Ortega, Marie-Hélène Masse, Frédérick D'Aragon
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850201/561-development-of-national-guidelines-for-pediatric-donation-after-circulatory-determined-death
#17
Matthew Weiss, Laura Hornby, Sam Shemie, Bram Rochwerg
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850141/501-descriptive-comparison-of-pediatric-brain-dead-donors-versus-donation-after-circulatory-death-donors
#18
Ahmeneh Ghavam, Kimberly Lee, Nathan Thompson
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27835640/mass-spectrometry-based-metabolomics-comparison-of-liver-grafts-from-donors-after-circulatory-death-dcd-and-donors-after-brain-death-dbd-used-in-human-orthotopic-liver-transplantation
#19
Olga Hrydziuszko, M Thamara P R Perera, Richard Laing, Jennifer Kirwan, Michael A Silva, Douglas A Richards, Nick Murphy, Darius F Mirza, Mark R Viant
Use of marginal liver grafts, especially those from donors after circulatory death (DCD), has been considered as a solution to organ shortage. Inferior outcomes have been attributed to donor warm ischaemic damage in these DCD organs. Here we sought to profile the metabolic mechanisms underpinning donor warm ischaemia. Non-targeted Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometry metabolomics was applied to biopsies of liver grafts from donors after brain death (DBD; n = 27) and DCD (n = 10), both during static cold storage (T1) as well as post-reperfusion (T2)...
2016: PloS One
https://www.readbyqxmd.com/read/27805506/only-time-will-tell-the-future-of-donation-after-circulatory-death
#20
Joseph R Scalea, Hans W Sollinger
The rapid rise of transplantation over the past 60 years has been marked by a number of critical milestones. Donation after circulatory death (DCD) has played an important role in the development of this young field. Although early observations by Dr. Tom Starzl touched on the importance of warm ischemic time, new and exciting data may be changing our views of ischemia. Indeed, as we learn more about the importance of time-to-death for DCD donors after circulatory death, the hemodynamic changes experienced by DCD donors, and the other physiologic perturbations surrounding all forms of death, we are beginning to drill down to the factors that drive recipient outcomes after deceased donor transplant...
November 2016: Experimental and Clinical Transplantation
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