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Donor after cardiac death

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https://www.readbyqxmd.com/read/29731083/single-center-experience-using-marginal-liver-grafts-in-korea
#1
P-J Park, Y-D Yu, Y-I Yoon, S-R Kim, D-S Kim
BACKGROUND: Liver transplantation (LT) is an established therapeutic modality for patients with end-stage liver disease. The use of marginal donors has become more common worldwide due to the sharp increase in recipients, with a consequent shortage of suitable organs. We analyzed our single-center experience over the last 8 years in LT to evaluate the outcomes of using so-called "marginal donors." METHODS: We retrospectively analyzed the database of all LTs performed at our institution from 2009 to 2017...
May 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29705279/effects-of-subnormothermic-perfusion-before-transplantation-for-liver-grafts-from-donation-after-cardiac-death-a-simplified-dripping-perfusion-method-in-pigs
#2
Y Kakizaki, S Miyagi, K Shimizu, H Kumata, M Matsumura, Y Miyazaki, K Fukuoka, S S Uematsu, K Tokodai, Y Hara, C Nakanishi, M Unno, T Kamei, M Goto
BACKGROUND: Liver transplantation from donors after cardiac death (DCD) provides a solution to the donor shortage. However, DCD liver grafts are associated with a high incidence of primary graft nonfunction. We investigated the effectiveness of subnormothermic porcine liver perfusion, before transplantation from DCD, on graft viability. METHODS: Landrace pigs (25-30 kg) were randomly allocated to 3 groups (5 per group): heart-beating (HB) graft, transplanted after a 4-hour period of cold storage (CS); DCD graft, retrieved 20 minutes after apnea-induced cardiac arrest (respiratory withdrawal) and transplanted after a 4-hour period of CS; and subnormothermic ex vivo liver perfusion (SELP) graft, retrieved in the same manner as the DCD graft but perfused with a subnormothermic oxygenated Krebs-Henseleit buffer (21-25°C, 10-15 cm H2 O) for 30 minutes in a simplified dripping manner, without a machine perfusion system, after the 4-hour period of CS, and subsequently transplanted...
April 25, 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29676390/receiving-hypertensive-donor-grafts-is-associated-with-inferior-prognosis-in-simultaneous-liver-kidney-transplantation-recipients
#3
Zebin Zhu, Shanzhou Huang, Qiang Zhao, Yunhua Tang, Zhiheng Zhang, Linhe Wang, Weiqiang Ju, Zhiyong Guo, Xiaoshun He
BACKGROUND The impact of hypertensive (HTN) donor grafts on the prognosis of simultaneous liver-kidney transplantation (SLKT) patient is not known, and an applicable risk scoring system for SLKT patient survival is lacking. This study aimed to evaluate the impact of donor HTN on patient survival of SLKT recipients and to identify independent risk factors. MATERIAL AND METHODS Data from 3844 adult SLKT recipients receiving deceased donor grafts from March 2002 to December 2014 in the Scientific Registry of Transplant Recipients (SRTR) database were retrospectively analyzed...
April 20, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29660548/how-to-deal-with-the-empty-space-after-organ-removal-for-transplantation-a-single-medical-center-experience
#4
Ding-Ping Sun, Ling-Hsien Lee, Yu-Feng Tian, Hong-Xiang Zheng, Jinn-Rung Kuo, Che-Chuan Wang
PURPOSE: Dealing with the empty space after organ removal for transplantation has not been investigated. MATERIALS AND METHODS: From January 28, 2005, to November 21, 2017, 111 organ donors were enrolled in this study. They were divided into three groups: no replacement, replaced with paper printed with organ graphics, or replaced with 3D-printed simulated organs after the organs were removed at different periods. The donor's age, gender, etiology of admission, characteristic and clinical pictures, time interval between admission and the date of donation, and time interval between donor coordinator consultations were evaluated...
April 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29650408/normothermic-ex-vivo-preservation-with-the-portable-organ-care-system-lung-device-for-bilateral-lung-transplantation-inspire-a-randomised-open-label-non-inferiority-phase-3-study
#5
Gregor Warnecke, Dirk Van Raemdonck, Michael A Smith, Gilbert Massard, Jasleen Kukreja, Federico Rea, Gabriel Loor, Fabio De Robertis, Jayan Nagendran, Kumud K Dhital, Francisco Javier Moradiellos Díez, Christoph Knosalla, Christian A Bermudez, Steven Tsui, Kenneth McCurry, I-Wen Wang, Tobias Deuse, Guy Lesèche, Pascal Thomas, Igor Tudorache, Christian Kühn, Murat Avsar, Bettina Wiegmann, Wiebke Sommer, Arne Neyrinck, Marco Schiavon, Fiorella Calebrese, Nichola Santelmo, Anne Olland, Pierre-Emanuel Falcoz, Andre R Simon, Andres Varela, Joren C Madsen, Marshall Hertz, Axel Haverich, Abbas Ardehali
BACKGROUND: Severe primary graft dysfunction (PGD) of grade 3 (PGD3) is a common serious complication following lung transplantation. We aimed to assess physiological donor lung preservation using the Organ Care System (OCS) Lung device compared with cold static storage. METHODS: In this non-inferiority, randomised, controlled, open-label, phase 3 trial (INSPIRE) recipients were aged 18 years or older and were registered as standard criteria primary double lung transplant candidates...
April 9, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29643992/description-of-organ-specific-phenotype-and-functional-characteristics-of-tissue-resident-lymphocytes-from-liver-transplantation-donor-and-research-on-immune-tolerance-mechanism-of-liver
#6
Yunpeng Shi, Ping Zhang, Guangyi Wang, Xingkai Liu, Xiaodong Sun, Xin Zhang, Haijun Li, Jun Qi, Lei Ding, Ting Li, Ruoyan Zhang, Yuguo Chen, Jianpeng Zhou, Guoyue Lv, Zhengkun Tu
Aim: Prior to transplantation, Donation after Cardiac Death (DCD) liver transplantation livers are perfused with preservation solution. Therefore, this provides an abundant source of human liver lymphocytes, as well as mesenteric lymph node and spleen for the study of lymphocyte subset diversity in the peripheral blood, lymph node, spleen and liver. Methods: Lymphocyte subsets were isolated and purified from peripheral blood, lymph node, spleen and liver perfusion, the phenotypic and functional analysis of the tissue resident lymphocyte were performed by flow cytometry...
March 20, 2018: Oncotarget
https://www.readbyqxmd.com/read/29620623/suicidal-hanging-donors-for-lung-transplantation-is-this-chapter-still-closed-midterm-experience-from-a-single-center-in-united-kingdom
#7
Olga Ananiadou, Bastian Schmack, Bartlomiej Zych, Anton Sabashnikov, Diana Garcia-Saez, Prashant Mohite, Alexander Weymann, Ashham Mansur, Mohamed Zeriouh, Nandor Marczin, Fabio De Robertis, Andre Rüdiger Simon, Aron-Frederik Popov
In the context of limited donor pool in cardiothoracic transplantation, utilization of organs from high risk donors, such as suicidal hanging donors, while ensuring safety, is under consideration. We sought to evaluate the outcomes of lung transplantations (LTx) that use organs from this group.Between January 2011 and December 2015, 265 LTx were performed at our center. Twenty-two recipients received lungs from donors after suicidal hanging (group 1). The remaining 243 transplantations were used as a control (group 2)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29616522/further-options-and-survival-results-after-failure-following-ecls-implantation
#8
Leopold Rupprecht, Daniele Camboni, Alois Philipp, Dirk Lunz, Thomas Müller, Christof Schmid, Andreas Keyser
BACKGROUND: A retrospective study was designed to analyze the outcome of patients with extracorporeal life support (ECLS) who needed a consecutive cardiac or pulmonary support system. METHODS: From 2006 to 2016, 93 out of 587 patients with their age ranging from 2.4 to 77.3 years required an exchange of an ECLS by another mechanical support system. Sixty- one patients were inhospital cases, 39 patients were referred with ECLS from other institutions by ambulance car (n=15) or helicopter (n=24)...
April 3, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29609890/increasing-circulating-sphingosine-1-phosphate-attenuates-lung-injury-during-ex-vivo-lung-perfusion
#9
J Hunter Mehaffey, Eric J Charles, Adishesh K Narahari, Sarah Schubert, Victor E Laubach, Nicholas R Teman, Kevin R Lynch, Irving L Kron, Ashish K Sharma
BACKGROUND: Sphingosine-1-phosphate regulates endothelial barrier integrity and promotes cell survival and proliferation. We hypothesized that upregulation of sphingosine-1-phosphate during ex vivo lung perfusion would attenuate acute lung injury and improve graft function. METHODS: C57BL/6 mice (n = 4-8/group) were euthanized, followed by 1 hour of warm ischemia and 1 hour of cold preservation in a model of donation after cardiac death. Subsequently, mice underwent 1 hour of ex vivo lung perfusion with 1 of 4 different perfusion solutions: Steen solution (Steen, control arm), Steen with added sphingosine-1-phosphate (Steen + sphingosine-1-phosphate), Steen plus a selective sphingosine kinase 2 inhibitor (Steen + sphingosine kinase inhibitor), or Steen plus both additives (Steen + sphingosine-1-phosphate + sphingosine kinase inhibitor)...
March 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29607780/brain-death-in-intensive-care-units-problems-differences-in-methods-of-diagnosis-and-donor-care
#10
Aykut Sarıtaş, Burcu Acar Çinleti, Çiler Zincircioğlu, Uğur Uzun, Işıl Köse, Nimet Şenoğlu
OBJECTIVES: Our aim was to investigate the most common problems in diagnosing brain death, the care of the organ donor, and organ donation after death. MATERIALS AND METHODS: A survey was sent randomly to clinicians working in national intensive care units in Turkey. The survey, which consisted of 17 questions for clinicians, had 163 responders. RESULTS: The most common cause of brain death was traumatic brain injury. Although 22% of clinicians found the apnea test necessary for brain death diagnosis, 78% stated that it could be used as an optional confirmatory test...
April 2, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29602202/renal-resistance-trend-during-hypothermic-machine-perfusion-is-more-predictive-of-postoperative-outcome-than-biopsy-score-preliminary-experience-in-35-consecutive-kidney-transplantations
#11
Massimiliano Bissolati, Paolo Giovanni Gazzetta, Rossana Caldara, Giovanni Guarneri, Olga Adamenko, Fabio Giannone, Michele Mazza, Giulia Maggi, Deborah Tomanin, Riccardo Rosati, Antonio Secchi, Carlo Socci
Hypothermic machine perfusion (HPM) grants a better postoperative outcome in transplantation of organs procured from extended criteria donors (ECDs) and donors after cardiac death (DCD). So far, the only available parameter for outcome prediction concerning those organs is pretransplant biopsy score. The aim of this study is to evaluate whether renal resistance (RR) trend during HPM may be used as a predictive marker for post-transplantation outcome. From December 2015 to present, HMP has been systematically applied to all organs from ECDs and DCD...
March 30, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29595892/pediatric-perioperative-nurses-and-the-ethics-of-organ-donation-after-cardiac-death
#12
Elizabeth A Austin, Pamela Lovett, Wendy C Moore, Ingrid Zuzarte
Pediatric perioperative nurses are experiencing increased opportunities to participate in donations after cardiac death. An increased public awareness regarding transplantation has inspired more people to donate than in previous years. The demand for transplantable organs has led to opportunities that have increased donor candidates including living donors and cardiac death donors. Cardiac death in children is often sudden and unexpected, and is an emotional time not only for the family members but also for the hospital staff members, including perioperative nurses...
April 2018: AORN Journal
https://www.readbyqxmd.com/read/29587521/orthotopic-heart-transplantation-in-children
#13
Nagarajan Muthialu
Heart transplantation is a relatively infrequent but technically demanding procedure in pediatric cardiac surgery. Orthotopic heart transplantation is often offered to older children or adolescents following multiple previous operations, but with advances in intensive care, diagnostics, and management, more infants with complex congenital heart diseases are being listed for transplantation. Primary cardiomyopathies remain the most common indication. Outcomes following cardiothoracic transplantation have improved steadily in recent times...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29564207/normothermic-machine-preservation-of-the-liver-state-of-the-art
#14
REVIEW
Carlo D L Ceresa, David Nasralla, Wayel Jassem
Purpose of Review: This review aims to introduce the concept of normothermic machine perfusion (NMP) and its role in liver transplantation. By discussing results from recent clinical studies and highlighting the potential opportunities provided by this technology, we aim to provide a greater insight into NMP and the role it can play to enhance liver transplantation. Recent Findings: NMP has recently been shown to be both safe and feasible in liver transplantation and has also demonstrated its superiority to traditional cold storage in terms of early biochemical liver function...
2018: Current Transplantation Reports
https://www.readbyqxmd.com/read/29558878/measuring-critical-care-providers-attitudes-about-controlled-donation-after-circulatory-death
#15
James R Rodrigue, Richard Luskin, Helen Nelson, Alexandra Glazier, Galen V Henderson, Francis L Delmonico
INTRODUCTION: Unfavorable attitudes and insufficient knowledge about donation after cardiac death among critical care providers can have important consequences for the appropriate identification of potential donors, consistent implementation of donation after cardiac death policies, and relative strength of support for this type of donation. The lack of reliable and valid assessment measures has hampered research to capture providers' attitudes. Design and Research Aims: Using stakeholder engagement and an iterative process, we developed a questionnaire to measure attitudes of donation after cardiac death in critical care providers (n = 112) and examined its psychometric properties...
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29536027/the-implications-of-the-shift-toward-donation-after-circulatory-death-in-australia
#16
Janske Reiling, Elizabeth Forrest, Kim R Bridle, Laurence J Britton, Nishreen Santrampurwala, Darrell H G Crawford, Cornelis H C Dejong, Jonathan Fawcett
Background: In recent years, an increasing number of donor livers are being declined for transplantation in Australia. The aim of this study was to evaluate the impact of donation after cardiac death and other factors associated with organ quality on liver utilization rates in Australia. Methods: Data on organ donors who donated at least 1 organ between 2005 and 2014 were obtained from the Australia and New Zealand organ donation registry. Temporal changes in donor characteristics were assessed and a logistical regression analysis was performed to evaluate their association with liver nonuse...
December 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29513379/changing-demographics-of-heart-donors-the-impact-of-donor-drug-intoxication-on-posttransplant-survival
#17
Mickey S Ising, Michele Gallo, William M Whited, Mark S Slaughter, Jaimin R Trivedi
Recent reports have shown an increase in the number of organ donors from drug intoxication. The impact of donor drug use on survival after cardiac transplant remains unclear. The aim of our study was to illustrate changes in donor death mechanisms and assess the impact on posttransplant survival. We queried United Network of Organ Sharing thoracic transplant and deceased donor databases to identify patients undergoing heart transplantation between 2005 and 2015. We evaluated annual trends in donor death mechanisms...
March 7, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29505825/cost-evaluation-of-a-donation-after-cardiac-death-program-how-cost-per-organ-compares-to-other-donor-types
#18
Jessica Lindemann, Leigh Anne Dageforde, Neeta Vachharajani, Emily Stahlschmidt, Diane Brockmeier, Jason R Wellen, Adeel Khan, William C Chapman, Mb Majella Doyle
BACKGROUND: Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. Donation after cardiac death program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported. STUDY DESIGN: Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected...
May 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29492391/the-future-of-cardiac-transplantation
#19
Kevin Koomalsingh, Jon A Kobashigawa
The first human-to-human heart transplant was performed 50 years ago in 1967. Heart transplantation has now entered an era of tremendous growth and innovation. The future of heart transplantation is bright with the advent of newer immunosuppressive medications and strategies that may even result in tolerance. Much of this progress in heart transplant medicine is predicated on a better understanding of acute and chronic rejection pathways through basic science studies. The future will also include personalized medicine where genomics and molecular science will dictate customized treatment for optimal outcomes...
January 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29487855/transplantation-of-hearts-donated-after-circulatory-death
#20
REVIEW
Christopher W White, Simon J Messer, Stephen R Large, Jennifer Conway, Daniel H Kim, Demetrios J Kutsogiannis, Jayan Nagendran, Darren H Freed
Cardiac transplantation has become limited by a critical shortage of suitable organs from brain-dead donors. Reports describing the successful clinical transplantation of hearts donated after circulatory death (DCD) have recently emerged. Hearts from DCD donors suffer significant ischemic injury prior to organ procurement; therefore, the traditional approach to the transplantation of hearts from brain-dead donors is not applicable to the DCD context. Advances in our understanding of ischemic post-conditioning have facilitated the development of DCD heart resuscitation strategies that can be used to minimize ischemia-reperfusion injury at the time of organ procurement...
2018: Frontiers in Cardiovascular Medicine
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