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Donor after cardiac death

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https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#1
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/27916030/-short-term-outcomes-of-lung-transplant-recipients-using-organs-from-brain-death-donors
#2
W X He, C Jiang, X G Liu, W Huang, C Chen, L Jiang, B Yang, K Wu, Q K Chen, Y Yang, Y M Yu, G N Jiang
Objective: To assess short-term outcomes after lung transplantation with organs procured following brain death. Methods: Between April 2015 and July 2016, all 17 recipients after lung transplantation using organs from brain death donors (DBD) at Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine were enrolled in this study. All patients were male, aging (60±7) years, including 11 chronic obstructive pulmonary disease, 5 idiopathic pulmonary fibrosis, 1 silicosis...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27913812/association-between-cytokines-and-their-receptor-antagonist-gene-polymorphisms-and-clinical-risk-factors-and-acute-rejection-following-renal-transplantation
#3
SIqing Ding, Jianfei Xie, Qiquan Wan
BACKGROUND Acute rejection (AR) after renal transplantation affects both patient and graft survival. There is growing evidence of the genetic association between cytokine or its receptor antagonist and AR in solid organ transplantation. The objectives of this study were to investigate the role of recipient TNF β, IL-10, IL-1β, and IL-1 receptor antagonist (ra) gene polymorphism, as well as traditional clinical variables such as panel-reactive antibody (PRA) levels, donor type, and HLA mismatches in AR following renal transplantation...
December 3, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27906826/factors-associated-with-short-and-long-term-liver-graft-survival-in-the-united-kingdom-development-of-a-uk-donor-liver-index
#4
Dave Collett, Peter J Friend, Christopher Je Watson
BACKGROUND: A measure of donor liver quality, the donor liver index, was developed and validated for the UK population of transplant recipients. Unlike previously proposed measures, this index is only based on variables that are available at the point of retrieval, and so does not include cold ischaemic time. METHODS: Indices of liver quality were based on data from the UK Transplant Registry on all 7929 liver transplants between January 2000 and December 2014. RESULTS: The donor liver index (DLI) was based on factors shown to affect graft survival, which included donor age, sex, height, type (donor after brain death or circulatory death), bilirubin, smoking history, and whether the liver was split...
December 1, 2016: Transplantation
https://www.readbyqxmd.com/read/27861305/trends-and-determinants-of-familial-consent-for-corneal-donation-in-chinese
#5
Allie Lee, Michael Y Ni, Amanda C K Luk, Jessie K P Lau, Karen S Y Lam, Tom K Li, Catherine S M Wong, Victoria W Y Wong
PURPOSE: Corneal transplantation is the treatment of choice for many corneal diseases. At present, there is a global shortage of corneal transplant tissues, and failure to obtain consent from families of potential donors is a major limiting factor in tissue procurement. METHODS: All family members of potential donors after cardiac death approached by the local eye bank staff members from January 2008 to December 2014 in Hong Kong were included. Reasons for consent or refusal and sociodemographic details of the deceased and the family members approached were reviewed...
November 16, 2016: Cornea
https://www.readbyqxmd.com/read/27861295/improving-national-results-in-liver-transplantation-using-grafts-from-donation-after-cardiac-death-donors
#6
Kristopher P Croome, David D Lee, Andrew P Keaveny, C Burcin Taner
BACKGROUND: Published reports describing the national experience with liver grafts from donation after cardiac death (DCD) donors have resulted in reservations with their widespread utilization. The present study aimed to investigate if temporal improvements in outcomes have been observed on a national level and to determine if donor and recipient selection have been modified in a fashion consistent with published data on DCD use in liver transplantation (LT). METHODS: Patients undergoing DCD LT between 2003 and 2014 were obtained from the United Network of Organ Sharing Standard Transplant Analysis and Research file and divided into 3 equal eras based on the date of DCD LT: era 1 (2003-2006), era 2 (2007-2010), and era 3 (2011-2014)...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27799051/somatic-survival-and-organ-donation-among-brain-dead-patients-in-the-state-of-qatar
#7
Saibu George, Merlin Thomas, Wanis H Ibrahim, Ahmed Abdussalam, Prem Chandra, Husain Shabbir Ali, Tasleem Raza
BACKGROUND: The Qatari law, as in many other countries, uses brain death as the main criteria for organ donation and cessation of medical support. By contrast, most of the public in Qatar do not agree with the limitation or withdrawal of medical care until the time of cardiac death. The current study aims to examine the duration of somatic survival after brain death, organ donation rate in brain-dead patients as well as review the underlying etiologies and level of support provided in the state of Qatar...
October 31, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27789022/end-of-life-practices-in-patients-with-devastating-brain-injury-in-spain-implications-for-organ-donation
#8
B Domínguez-Gil, E Coll, T Pont, M Lebrón, E Miñambres, A Coronil, B Quindós, J E Herrero, C Liébanas, B Marcelo, A M Sanmartín, R Matesanz
OBJECTIVE: To describe end-of-life care practices relevant to organ donation in patients with devastating brain injury in Spain. DESIGN: A multicenter prospective study of a retrospective cohort. PERIOD: 1 November 2014 to 30 April 2015. SETTING: Sixty-eight hospitals authorized for organ procurement. PATIENTS: Patients dying from devastating brain injury (possible donors). Age: 1 month-85 years...
October 24, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27788786/potential-pediatric-organ-donors-after-cardiac-death
#9
A Pregernig, O Karam
BACKGROUND: More than 50 people die each year on the Swiss transplant waiting list. To increase their organ donors pool, some centers have developed a post-cardiac death organ donation program. Information about its impact in the pediatric population is still scarce. The aim of this work was to determine the potential impact of a program of organ donation after cardiac in a pediatric population. METHODS: This was a retrospective study of all children deceased from 2005 to 2014 in a tertiary pediatric and neonatal intensive care unit...
October 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27788674/mesenchymal-stem-cells-improve-mouse-non-heart-beating-liver-graft-survival-by-inhibiting-kupffer-cell-apoptosis-via-tlr4-erk1-2-fas-fasl-caspase3-pathway-regulation
#10
Yang Tian, Jingcheng Wang, Wei Wang, Yuan Ding, Zhongquan Sun, Qiyi Zhang, Yan Wang, Haiyang Xie, Sheng Yan, Shusen Zheng
BACKGROUND: Liver transplantation is the optimal treatment option for end-stage liver disease, but organ shortages dramatically restrict its application. Donation after cardiac death (DCD) is an alternative approach that may expand the donor pool, but it faces challenges such as graft dysfunction, early graft loss, and cholangiopathy. Moreover, DCD liver grafts are no longer eligible for transplantation after their warm ischaemic time exceeds 30 min. Mesenchymal stem cells (MSCs) have been proposed as a promising therapy for treatment of certain liver diseases, but the role of MSCs in DCD liver graft function remains elusive...
October 27, 2016: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/27783454/successful-donation-after-cardiac-death-liver-transplants-with-prolonged-warm-ischemia-time-using-normothermic-regional-perfusion
#11
R De Carlis, S Di Sandro, A Lauterio, F Ferla, A Dell'Acqua, M Zanierato, L De Carlis
The role of donation after cardiac death (DCD) in expanding the donor pool is mainly limited by the incidence of primary non-function (PNF) and ischemia-related complications. Even greater concern exists towards uncontrolled DCD, which represents the largest potential pool of DCD donors. We recently started the first Italian series of DCD liver transplantation, using normothermic regional perfusion (NRP) in 6 uncontrolled donors and in 1 controlled case to deal with the legally required no-touch period of 20 minutes...
October 26, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/27779800/the-expanded-criteria-donor-for-kidney-transplant-not-a-nearly-new-car
#12
Johan De Meester
From late nineteen nineties, the higher number of suitable renal transplant candidates has forced the transplant community to re-explore the whole spectrum of deceased donors after brain death (DBD) as well as after cardiac death (DCD); in practice, donors of older age and donors with more chronic diseases or "medical complexities". This new kidney donor population - finally defined as extended criteria donors (ECD) - currently comprises on average 20 to 25%. In his seminal paper in 2003 on the introduction of ECD in the US, Metzger et al...
October 25, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27779281/policy-options-for-increasing-the-supply-of-transplantable-kidneys-in-singapore
#13
Jia Loon Chong
Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation...
October 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27753206/a-comparison-of-request-process-and-outcomes-in-donation-after-cardiac-death-and-donation-after-brain-death-results-from-a-national-study
#14
L A Siminoff, G P Alolod, M Wilson-Genderson, E Y N Yuen, H M Traino
Available literature points to healthcare providers' discomfort with donation after cardiac death (DCD) and their perception of public 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 1601 FDMs using a validated protocol; 347 (21.7%) were of potential DCD donors...
October 18, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27751463/re-donor-hemodynamics-as-a-predictor-of-outcomes-after-kidney-transplantation-from-donors-after-cardiac-death
#15
David A Goldfarb
No abstract text is available yet for this article.
November 2016: Journal of Urology
https://www.readbyqxmd.com/read/27742324/scanning-electron-microscopy-findings-of-machine-perfused-liver-graft-after-warm-ischemia-between-hypothermic-and-rewarming-machine-perfusion-in-pigs
#16
L Meng, N Matsuno, K Watanabe, M Furukori, H Obara, H Bochimoto, T Watanabe, H Fukukawa
BACKGROUND: The shortage of organ donors is a universal problem. Use of grafts from donors after cardiac death would greatly contribute to the expansion of the donor organ pool. The two major methods of preservation are cold storage and machine perfusion (MP) preservation, and each has its own advantages. Several studies have reported the relative merits of MP for the preservation for grafts from donors after cardiac death. In this study, we used scanning electron microscopy (SEM) to assess the damage to the liver between hypothermic and rewarming preservation conditions...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27742245/airway-pressure-release-ventilation-during-ex%C3%A2-vivo-lung-perfusion-attenuates-injury
#17
J Hunter Mehaffey, Eric J Charles, Ashish K Sharma, Dustin T Money, Yunge Zhao, Mark H Stoler, Christine L Lau, Curtis G Tribble, Victor E Laubach, Mark E Roeser, Irving L Kron
OBJECTIVE: Critical organ shortages have resulted in ex vivo lung perfusion gaining clinical acceptance for lung evaluation and rehabilitation to expand the use of donation after circulatory death organs for lung transplantation. We hypothesized that an innovative use of airway pressure release ventilation during ex vivo lung perfusion improves lung function after transplantation. METHODS: Two groups (n = 4 animals/group) of porcine donation after circulatory death donor lungs were procured after hypoxic cardiac arrest and a 2-hour period of warm ischemia, followed by a 4-hour period of ex vivo lung perfusion rehabilitation with standard conventional volume-based ventilation or pressure-based airway pressure release ventilation...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27737734/bronchodilator-inhalation-during-ex%C3%A2-vivo-lung-perfusion-improves-posttransplant-graft-function-after-warm-ischemia
#18
Kyoko Hijiya, Toyofumi F Chen-Yoshikawa, Takeshi Kondo, Hideki Motoyama, Akihiro Ohsumi, Daisuke Nakajima, Jin Sakamoto, Keiji Ohata, Mamoru Takahashi, Satona Tanaka, Ei Miyamoto, Akihiro Aoyama, Hiroshi Date
BACKGROUND: We hypothesized that an injured lung graft from donation after cardiac death donors could be reconditioned before transplantation using an ex vivo lung perfusion (EVLP) system and ventilation with high-dose short-acting β2-adrenergic receptor agonists. METHODS: Cardiac arrest was induced in a canine model by intravenous potassium chloride injection. Lungs were randomly assigned to two groups after 150 minutes of warm ischemia: inhalation of 1,400 μg of procaterol (BETA group, n = 5) or control group receiving solvent (CON group, n = 5) during EVLP...
October 10, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27733105/donations-after-circulatory-death-in-liver-transplant
#19
Emre A Eren, Nicholas Latchana, Eliza Beal, Don Hayes, Bryan Whitson, Sylvester M Black
The supply of liver grafts for treatment of end-stage liver disease continues to fall short of ongoing demands. Currently, most liver transplants originate from donations after brain death. Enhanced utilization of the present resources is prudent to address the needs of the population. Donation after circulatory or cardiac death is a mechanism whereby the availability of organs can be expanded. Donations after circulatory death pose unique challenges given their exposure to warm ischemia. Technical principles of donations after circulatory death procurement and pertinent studies investigating patient outcomes, graft outcomes, and complications are highlighted in this review...
October 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27727092/-deceased-donation-in-renal-transplantation
#20
R Thuret, F Kleinclauss, N Terrier, M O Timsit
OBJECTIVES: To review epidemiologic data's and medical results of deceased donation in renal transplantation. MATERIAL AND METHODS: Relevant publications were identified through Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) database using the following keywords, alone or in association, "brain death; cardiac arrest; deceased donation; organ procurement; transplantation". Articles were selected according to methods, language of publication and relevance...
October 7, 2016: Progrès en Urologie
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