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Laura A Siminoff, Gerard P Alolod, Maureen Wilson-Genderson, Eva Y N Yuen, Heather M Traino
Available literature points to healthcare providers' discomfort with donation after cardiac death (DCD) and their perception of the public's reluctance toward the procedure. Using a national sample, we report on the communication content of actual DCD and donation after brain death (DBD) approaches by organ procurement organization (OPO) requesters and compare family decision makers' (FDMs') experiences of both modalities. We recruited 1,601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors...
October 18, 2016: American Journal of Transplantation
Wen-Jin Zhang, Wei-Liang Xia, Hui-Yun Pan, Shu-Sen Zheng
BACKGROUND: With the increasing use of donation after cardiac death (DCD), especially of the graft liver with steatosis or other pathological changes, the frequency of postreperfusion hyperkalemia in liver transplantation has increased significantly. The present study aimed to determine the factors associated with developing postreperfusion hyperkalemia in liver transplantation from DCD. METHODS: One hundred thirty-one consecutive adult patients who underwent orthotopic liver transplantation from DCD were retrospectively studied...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Hiroshi Date
Lung transplantation has been performed worldwide and recognized as an effective treatment for patients with various end-stage lung diseases. Shortage of lung donors is one of the main obstacles in most of the countries, especially in Japan. Every effort has been made to promote organ donation during the past 20 years. In 2010, Japanese transplant low was revised so that the family of the brain dead donors can make a decision for organ donation. Since then, the number of cadaveric lung donor has increased by 5-fold...
August 2016: Journal of Thoracic Disease
Krzysztof Pabisiak, Arkadiusz Krejczy, Grażyna Dutkiewicz, Krzysztof Safranow, Jerzy Sienko, Romuald Bohatyrewicz, Kazimierz Ciechanowski
BACKGROUND Donation after cardiac death offers the possibility of increasing the pool of organs for transplantation by up to 30%. Maastricht category type 3 (M3) dominates in most countries with active DCD programs. During preparations to introduce a permanent program for uncontrolled donation after circulatory death in Szczecin, Poland, the donor pool has been estimated. In Poland, Maastricht category type 2 (M2) is considered a basic source for organ recovery. MATERIAL AND METHODS This was a retrospective cohort study of out-of-hospital cardiac arrests (OHCA) reported to local Emergency Medical Services (EMS) between 1 December 2014 and 30 November 2015...
2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Yin Zongyi, Li Baifeng, Zou Funian, Li Hao, Wang Xin
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at
August 5, 2016: EBioMedicine
An Martens, Marc Boada, Bart M Vanaudenaerde, Stijn E Verleden, Robin Vos, Geert M Verleden, Eric K Verbeken, Dirk Van Raemdonck, Dominique Schols, Sandra Claes, Arne P Neyrinck
Donation after circulatory death (DCD) is being used to increase the number of transplantable organs. The role and timing of steroids in DCD donation and ex-vivo lung perfusion (EVLP) has not been thoroughly investigated. In this study, we investigated the effect of steroids on warm-ischemic injury in a porcine model (n=6/group). Following cardiac arrest, grafts were left untouched in the donor (90 minutes warm ischemia). Graft function was assessed after 6 hours of EVLP. In MP-group, 500 mg methylprednisolone was given prior to cardiac arrest and during EVLP...
August 12, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
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 1994-2012 using adjusted Cox regression models...
July 29, 2016: Transplantation
Leif Pierre, Sandra Lindstedt, Richard Ingemansson
OBJECTIVES: The use of donation after cardiac death (DCD) to overcome organ shortage is slowly moving into the clinic. In this study, we compare the protective effect of warm ischaemia versus cold ischaemia on thrombotic formation in non-heparinized pulmonary grafts. METHODS: Twelve Landrace pigs were randomized into two groups: warm ischaemia and cold ischaemia. Ventricular fibrillation without the administration of heparin was induced to mimick an uncontrolled DCD situation...
July 5, 2016: Interactive Cardiovascular and Thoracic Surgery
Paria Mahboub, Adel Bozorgzadeh, Paulo N Martins
There is a growing discrepancy between the supply and demand of livers for transplantation resulting in high mortality rates on the waiting list. One of the options to decrease the mortality on the waiting list is to optimize organs with inferior quality that otherwise would be discarded. Livers from donation after cardiac death (DCD) donors are frequently discarded because they are exposed to additional warm ischemia time, and this might lead to primary-non-function, delayed graft function, or severe biliary complications...
June 24, 2016: World Journal of Transplantation
M Furukori, N Matsuno, L T Meng, T Shonaka, Y Nishikawa, K Imai, H Obara, H Furukawa
BACKGROUND: The use of grafts from donors after cardiac death (DCD) would greatly contribute to the expansion of the donor organ pool. However, the implementation of such a strategy requires the development of novel preservation methods to recover from changes owing to warm ischemia. The aim of this study was to evaluate the effectiveness of subnormothermic machine perfusion (MP) preservation with rewarming for porcine DCD liver grafts for transplantation. METHODS: Porcine livers were perfused with newly developed MP system...
May 2016: Transplantation Proceedings
Franklin Rosenfeldt, Ruchong Ou, Robert Salamonsen, Silvana Marasco, Adam Zimmet, Joshua Byrne, Filip Cosic, Pankaj Saxena, Donald Esmore
BACKGROUND: Donation after circulatory death (DCD) represents a potential new source of hearts to increase the donor pool. We showed previously that DCD hearts in Greyhound dogs could be resuscitated and preserved by continuous cold crystalloid perfusion but not by cold static storage and could demonstrate excellent contractile and metabolic function on an in vitro system. In the current study, we demonstrate that resuscitated DCD hearts are transplantable. METHODS: Donor Greyhound dogs (n = 12) were divided into perfusion (n = 8) and cold static storage (n = 4) groups...
April 1, 2016: Journal of Heart and Lung Transplantation
Xuping Yao, Guobin Weng, Junjun Wei, Wenbo Gao
Basiliximab is a monoclonal antibody that binds to the α-chain of the interleukin (IL)-2 receptor. It is used as induction therapy in kidney transplantation. The objective of the present study was to evaluate induction therapy with single-dose basiliximab (Simulect(®)) in kidney transplantation with donation after cardiac death (DCD) donors. A total of 33 DCD kidney transplants were performed between December 2010 and July 2013 in patients who received single-dose basiliximab (20 mg) as induction therapy...
June 2016: Experimental and Therapeutic Medicine
Anne Porschen, Pramod Kadaba Srinivasan, Junji Iwasaki, Mamdouh Afify, René H Tolba
BACKGROUND/AIM: Worldwide shortage of donor organs has increased the use of donation after cardiac death (DCD). The aim of this study was to analyze the best time point for venous systemic oxygen persufflation (VSOP) supplemented with nitric oxide (NO) gas during the 1st and 24th hour of cold storage (CS) in warm ischemia (WI)-damaged experimental liver grafts. MATERIALS AND METHODS: Liver grafts (n = 5) were retrieved after 30 min of WI induced by cardiac arrest and CS in histidine-tryptophan-ketoglutarate solution at 4°C...
2016: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
D D Zhao, Z Y Huang, L Q Hong, T Liao, Y E Tang, N Na, H Li, B Miao, X F Hua, Q Q Sun
OBJECTIVE: To study the characteristics and prevention and treatment strategies of massive hemorrhage caused by fungal infections after donation-after-cardiac-death (DCD) kidney transplantation. METHODS: A total of 91 cases of DCD kidney transplantation between August 25, 2013 and June 30, 2015 in Third Affiliated Hospital of Sun Yat-sen Univservity were retrospectively analyzed. The characteristics of and prevention and treatments strategies for postoperative massive hemorrhage caused by fungal infections were summarized...
May 31, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Hessel Peters-Sengers, Jaap J Homan van der Heide, Martin B A Heemskerk, Ineke J M Ten Berge, Fred C W Ultee, Mirza M Idu, Michiel G H Betjes, Arjan D van Zuilen, Maarten H L Christiaans, Luuk H Hilbrands, Aiko P J de Vries, Azam S Nurmohamed, Stefan P Berger, Frederike J Bemelman
BACKGROUND: Organ shortage persists despite a high rate of donation after circulatory death (DCD) in the Netherlands. The median waiting time for a deceased donor kidney in 2013 was 3.5 years. Most DCD kidneys are from controlled DCD (cDCD; Maastricht category III). Experience with uncontrolled donors after cardiac death (uDCD), that is, donors with an unexpected and irreversible cardiac arrest (Maastricht categories I and II), is increasing; and its effect on transplant outcomes needs evaluation...
June 2, 2016: Transplantation
S Florman, T Becker, B Bresnahan, A Chevaile-Ramos, D Carvalho, G Grannas, F Muehlbacher, P J O'Connell, U Meier-Kriesche, C P Larsen
The phase III BENEFIT-EXT study compared more-intensive (MI) or less-intensive (LI) belatacept-based immunosuppression with cyclosporine (CsA)-based immunosuppression in recipients of extended-criteria donor kidneys. In this post-hoc analysis, patient outcomes were assessed according to donor kidney subtype. In total, 68.9%, 10.1%, and 21.0% of patients received an expanded-criteria donor kidney (United Network for Organ Sharing [UNOS] definition), donation after cardiac death (DCD) kidney, or a kidney with an anticipated cold ischemic time ≥24 h, respectively...
May 27, 2016: American Journal of Transplantation
Kristin Black, Katherine Miller, Gavin Beck, Michael Moser
INTRODUCTION: The purpose of this study is to determine what information about donation after circulatory death (DCD) is available on the Internet and to document the common statements for and against DCD. METHODS: The search terms non-heart-beating donor, donation after cardiac death, DCD, deceased donor, organ donation, and organ harvesting were entered into the four most-accessed English-language Internet search engines. The top 10 webpages from each search (240 webpages) yielded 116 unique sites...
August 2016: Clinical Transplantation
W Zhang, H Zhong, L Zhuang, J Yu, X Xu, W Wang, M Zhang, L Zhou, S Zheng
BACKGROUND AND AIM: Hepatocellular carcinoma (HCC) recurrence after orthotopic liver transplantation (OLT) continues to confound transplant surgeons and physicians. There are no effective methods to predict the patients at risk for recurrence so far although many studies have sought meaningful biomarkers. The ImmuKnow (IMK) assay is an immune cell function assay that detects cell-mediated immunity in an immunosuppressed population, mainly measuring peripheral blood CD4(+) adenosine triphosphate (ATP) release...
June 2016: International Journal of Clinical Practice
Z Tu, P Xiang, X Xu, L Zhou, L Zhuang, J Wu, W Wang, S Zheng
AIM: The purpose of our study was to evaluate the incidence, timing, location and risk factors for bacterial and fungal infections after donation after cardiac death (DCD) liver transplant and clearly delineate any relationship between infection and survival in DCD liver transplant recipients. METHODS: We retrospectively reviewed 257 consecutive patients undergoing DCD liver transplant between October 2010 and May 2015 at our centre. RESULTS: A total of 133 patients (51...
June 2016: International Journal of Clinical Practice
Caroline C Jadlowiec, Timucin Taner
Great progress has been made in the field of liver transplantation over the past two decades. This progress, however, also brings up the next set of challenges: First, organ shortage remains a major limitation, and accounts for a large proportion of wait list mortality. While living donation has successfully increased the total number of liver transplants done in Asian countries, the total number of such transplants has been stagnant in the western hemisphere. As such, there has been a significant effort over the past decade to increase the existing deceased donor pool...
May 14, 2016: World Journal of Gastroenterology: WJG
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