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Donor after cardiac death

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https://www.readbyqxmd.com/read/28627046/donor-specific-antibodies-are-associated-with-micro-and-macrovascular-coronary-disease-restrictive-myocardial-damage-and-poor-outcome-in-heart-transplanted-patients
#1
Tor Skibsted Clemmensen, Pernille Koefoed-Nielsen, Lis-Ann Jensen, Steen Hvitfeldt Poulsen, Niels Ramsing Holm, Brian Bridal Løgstrup, Evald Høj Christiansen, Jouke Dijkstra, Kamilla Pernille Bjerre Valen, Hans Eiskjaer
AIMS: We examined the relationship between donor-specific HLA antibody (DSA) presence and graft function, hemodynamics, cardiac allograft vasculopathy (CAV), and major adverse cardiac events (MACE) in stable long-term heart-transplanted (HTx) patients. METHODS: Sera from 79 patients (median 7.5 years after HTx) were analyzed for DSA presence. Graft function was evaluated by echocardiography and right heart catheterization. CAV-burden was determined by coronary angiography, optical coherence tomography (OCT), and coronary flow velocity reserve (CFVR)...
June 19, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#2
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28617162/the-use-of-stroke-volume-variation-to-guide-donor-management-is-associated-with-increased-organs-transplanted-per-donor
#3
Benjamin Bergstrom, J Salvador de la Cruz, Mitch Sally, Scott Louis, Melissa Friedman, Floyd Petersen, Darren Malinoski
BACKGROUND: There is a national shortage of organs available for transplantation, and utilization rates for thoracic organs are less than 40%. In addition, the optimal method of assessing cardiovascular status during donor management is uncertain. FloTrac is a noninvasive hemodynamic technique that measures cardiac output and fluid responsiveness. Our objective was to measure the impact of using this technique to guide management on fluid balance, vasopressor usage, thyroid hormone usage, and pulmonary function...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28601322/the-center-volume-outcome-effect-in-pancreas-transplantation-a-national-analysis
#4
Young Kim, Vikrom K Dhar, Koffi Wima, Andrew D Jung, Brent T Xia, Richard S Hoehn, Tayyab S Diwan, Shimul A Shah
BACKGROUND: Although increased hospital volume has been correlated with improved outcomes in certain surgical procedures, the effect of center volume on pancreas transplantation (PT) is less understood. Our study aims to establish whether a volume-outcome effect exists for PT. METHODS: Through an established linkage between the University HealthSystem Consortium and the Scientific Registry of Transplant Recipients (SRTR) databases, we performed a retrospective cohort analysis of adult PT recipients between 2009 and 2012...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600129/angiogenic-peptide-nanofibers-repair-cardiac-tissue-defect-after-myocardial-infarction
#5
Abdul Jalil Rufaihah, I Ceren Yasa, Vaibavi Srirangam Ramanujam, Suganya Cheyyatraivendran Arularasu, Theo Kofidis, Mustafa O Guler, Ayse B Tekinay
Myocardial infarction remains one of the top leading causes of death in the world and the damage sustained in the heart eventually develops into heart failure. Limited conventional treatment options due to the inability of the myocardium to regenerate after injury and shortage of organ donors require the development of alternative therapies to repair the damaged myocardium. Current efforts in repairing damage after myocardial infarction concentrates on using biologically derived molecules such as growth factors or stem cells, which carry risks of serious side effects including the formation of teratomas...
June 6, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28597777/improved-metabolism-and-redox-state-with-a-novel-preservation-solution-implications-for-donor-lungs-after-cardiac-death-dcd
#6
David A Schipper, Anthony V Louis, Destiny S Dicken, Kitsie Johnson, Ryszard T Smolenski, Stephen M Black, Ray Runyan, John Konhilas, Joe G N Garcia, Zain Khalpey
Lungs donated after cardiac death (DCD) are an underutilized resource for a dwindling donor lung transplant pool. Our study investigates the potential of a novel preservation solution, Somah, to better preserve statically stored DCD lungs, for an extended time period, when compared to low-potassium dextran solution (LPD). We hypothesize that Somah is a metabolically superior organ preservation solution for hypothermic statically stored porcine DCD lungs, possibly improving lung transplant outcomes. Porcine DCD lungs (n = 3 per group) were flushed with and submerged in cold preservation solution...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28575239/whole-genome-cardiac-dna-methylation-fingerprint-and-gene-expression-analysis-provide-new-insights-in-the-pathogenesis-of-chronic-chagas-disease-cardiomyopathy
#7
Laurie Laugier, Amanda Farage Frade, Frederico Moraes Ferreira, Monique Andrade Baron, Priscila Camillo Teixeira, Sandrine Cabantous, Ludmila Rodrigues Pinto Ferreira, Laurence Louis, Vagner Oliveira Carvalho Rigaud, Fabio Antônio Gaiotto, Fernando Bacal, Pablo Pomerantzeff, Edimar Bocchi, Jorge Kalil, Ronaldo Honorato Barros Santos, Edecio Cunha-Neto, Christophe Chevillard
Background: Chagas disease, caused by the protozoan Trypanosoma cruzi, is endemic in Latin America and affects 10 million people worldwide. Approximately 12,000 deaths attributable to Chagas disease occur annually due to Chagas disease cardiomyopathy (CCC), an inflammatory cardiomyopathy presenting with heart failure and arrythmia; 30% of infected subjects develop CCC years after infection. Genetic mechanisms play a role in differential progression to CCC, but little is known about the role of epigenetic modifications in pathological gene expression patterns in CCC patients' myocardium...
May 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28574105/development-of-a-prolonged-warm-ex-vivo-perfusion-model-for-kidneys-donated-after-cardiac-death
#8
Daniel Urcuyo, Matthew F Blum, Qiang Liu, Ahmed Nassar, Laura D Buccini, Teresa Diago Uso, Emilio D Poggio, William M Baldwin Iii, David A Goldfarb, Cristiano Quintini
PURPOSE: Ex vivo perfusion of marginal kidney grafts offers the chance to expand the donor pool, but there is no current clinical standard for the prolonged warm perfusion of renal grafts. This exploratory pilot study seeks to identify a stable ex vivo kidney perfusion model that can support low intravascular resistance and preserve histologic architecture in a porcine donation after cardiac death (DCD) model. METHODS: 15 kidneys were preserved in 1 of 3 settings: normothermic whole blood (NT-WB), normothermic Steen Solution™ (XVIVO Perfusion) with whole blood (NT-Steen/WB), or subnormothermic Steen Solution™ at 21°C (SNT-Steen)...
May 24, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28553041/a-single-center-experience-of-kidney-transplantation-from-donation-after-circulatory-death-challenges-and-scope-in-india
#9
S Singh, S Kumar, S Dasgupta, D B Kenwar, M Rathi, A Sharma, H S Kohli, V Jha, K L Gupta, M Minz
Donation after circulatory death (DCD) has never been attempted in India because of legal constraints and lack of guidelines for the withdrawal of life support in end-of-life situations. The present report describes the initial experience of transplantation of organs from DCD donors in a tertiary care center in India. Between 2011 and 2015, five donors had kidneys retrieved after cardiac arrest. These patients were declared dead after waiting for 5 min with no electrocardiographic signal on monitor following cardiopulmonary resuscitation (CPR), which was restarted in three patients till organ retrieval...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28538652/association-between-delayed-graft-function-and-graft-loss-in-donation-after-cardiac-death-kidney-transplants-a-paired-kidney-registry-analysis
#10
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 and 2012 using adjusted Cox regression models...
June 2017: Transplantation
https://www.readbyqxmd.com/read/28512290/evolution-of-drug-resistant-acinetobacter-baumannii-after-dcd-renal-transplantation
#11
Hong Jiang, Luxi Cao, Lihui Qu, Tingting Qu, Guangjun Liu, Rending Wang, Bingjue Li, Yuchen Wang, Chaoqun Ying, Miao Chen, Yingying Lu, Shi Feng, Yonghong Xiao, Junwen Wang, Jianyong Wu, Jianghua Chen
Infection after renal transplantation remains a major cause of morbidity and death, especially infection from the extensively drug-resistant bacteria, A. baumannii. A total of fourteen A. baumannii isolates were isolated from the donors' preserved fluid from DCD (donation after cardiac death) renal transplantation and four isolates in the recipients' draining liquid at the Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, from March 2013 to November 2014. An outbreak of A...
May 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28505025/a-rodent-model-of-cardiac-donation-after-circulatory-death-and-novel-biomarkers-of-cardiac-viability-during-ex-vivo-heart-perfusion
#12
Mark J Kearns, Sally Miller, Anson Cheung, Jamil Bashir, Stephanie Wong, Michael A Seidman, John H Boyd
BACKGROUND: Organ donation after circulatory death (DCD) is increasingly being used as a means of addressing the organ supply/demand mismatch in solid organ transplantation. There is reluctance to use DCD hearts, due to an inability to precisely identify hearts that have suffered irreversible injury. We investigated novel biomarkers and clinically relevant endpoints across a spectrum of warm ischemic times (WITs), prior to and during ex vivo heart perfusion (EVHP), to identify features associated with a non-viable cardiac phenotype...
May 13, 2017: Transplantation
https://www.readbyqxmd.com/read/28487457/do-outcomes-after-kidney-transplantation-differ-for-black-patients-in-england-versus-new-york-state-a-comparative-population-cohort-analysis
#13
Sanna Tahir, Holly Gillott, Francesca Jackson-Spence, Jay Nath, Jemma Mytton, Felicity Evison, Adnan Sharif
OBJECTIVES: Inferior outcomes for black kidney transplant recipients in the USA may not be generalisable elsewhere. In this population cohort analysis, we compared outcomes for black kidney transplant patients in England versus New York State. DESIGN: Retrospective, comparative, population cohort study utilising administrative data registries. SETTINGS AND PARTICIPANTS: English data were derived from Hospital Episode Statistics, while New York State data were derived from Statewide Planning and Research Cooperative System...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28483262/lungs-donated-after-circulatory-death-and-prolonged-warm-ischemia-are-transplanted-successfully-after-enhanced-ex%C3%A2-vivo-lung-perfusion-using-adenosine-a2b-receptor-antagonism
#14
Eric J Charles, J Hunter Mehaffey, Ashish K Sharma, Yunge Zhao, Mark H Stoler, James M Isbell, Christine L Lau, Curtis G Tribble, Victor E Laubach, Irving L Kron
OBJECTIVE: The current supply of acceptable donor lungs is not sufficient for the number of patients awaiting transplantation. We hypothesized that ex vivo lung perfusion (EVLP) with targeted drug therapy would allow successful rehabilitation and transplantation of donation after circulatory death lungs exposed to 2 hours of warm ischemia. METHODS: Donor porcine lungs were procured after 2 hours of warm ischemia postcardiac arrest and subjected to 4 hours of cold preservation or EVLP...
April 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28470875/prolonged-corrected-qt-interval-in-the-donor-heart-is-there-a-risk
#15
Derek Leong, Tamar Aintablian, Michelle Kittleson, Michael Olymbios, Jignesh Patel, David H Chang, Jon Kobashigawa
BACKGROUND: Assessing the QT interval in donors is important to exclude long QT syndrome as the cause of death. A donor heart with a corrected QT (QTc)>500 msec is often concerning. We sought to evaluate first-year outcomes for donors with a QTc interval > 500 msec. METHODS: Between 2010 and 2014, we assessed 257 donor hearts for QTc interval > 500msec. Post-transplant outcomes included 1-year survival, 1-year freedom from any-treated rejection, 1- year freedom from CAV defined as stenosis ≥ 30% by angiography, and 1-year freedom from Non-Fatal Major Adverse Cardiac Events...
May 3, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28463671/urgent-organ-retrieval-from-non-heart-beating-donor-with-declared-brain-death-harvest-at-arrest
#16
Ihsan Yıldız, Yavuz Savaş Koca, Mehmet Zafer Sabuncuoglu
OBJECTIVE: Due to insufficient donor number to meet the needs of organ transplantation, new researches are ongoing. In this context, the cases with cardiac arrest and brain dead are assessed as probable donors in recent years. The aim of this study is to discuss the healthfully techniques of organs retrieval with minimum damage and maximum rapidity in conditions of our center and to present our own experiences. MATERIAL AND METHOD: A total 4 of 13 patients brain dead declared and developed cardiac arrest while awaiting for laboratory test results in our center between 2015 and 2016, were urgently taken into operation under external heart massage and urgent organ retrieval were performed...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28430300/left-ventricular-assist-pump-pocket-infection-conservative-treatment-strategy-for-destination-therapy-candidates
#17
Elie Haddad, François-Xavier Lescure, Walid Ghodhbane, Laurent Lepage, Camille D'humieres, William Vindrios, Yazdan Yazdanpanah, Patrick Nataf, Matthias Kirsch
BACKGROUND: Heart failure is a major cause of mortality and morbidity, particularly among patients with advanced disease and no access to cardiac transplantation. LVAD implantation is not only a bridge-to-transplantation option for patients awaiting a heart donor, but is often used as bridge-to-destination therapy in patients unsuited for transplantation for various reasons. LVAD infection is considered the second-most common cause of death in patients who survive the initial 6 months on LVAD support...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28403128/an-oxygenated-and-transportable-machine-perfusion-system-fully-rescues-liver-grafts-exposed-to-lethal-ischemic-damage-in-a-pig-model-of-dcd-liver-transplantation
#18
Philippe Compagnon, Eric Levesque, Hassen Hentati, Mara Disabato, Julien Calderaro, Cyrille Feray, Anne Corlu, José Laurent Cohen, Ismail Ben Mosbah, Daniel Azoulay
BACKGROUND: Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a large animal model. METHODS: Cardiac arrest was induced in female large white pigs by IV injection of potassium chloride...
April 11, 2017: Transplantation
https://www.readbyqxmd.com/read/28392447/s-nitrosation-of-calpains-is-associated-with-cardioprotection-in-myocardial-i-r-injury
#19
Matthias Totzeck, Sebastian Korste, Ilkka Miinalainen, Ulrike B Hendgen-Cotta, Tienush Rassaf
BACKGROUND: Myocardial infarction remains the single leading cause of death worldwide. Upon reperfusion of occluded arteries, deleterious cellular mediators particularly located at the mitochondria level can be activated, thus limiting the outcome in patients. This may lead to the so-called ischemia/reperfusion (I/R) injury. Calpains are cysteine proteases and mediators of caspase-independent cell death. Recently, they have emerged as central transmitters of cellular injury in several cardiac pathologies e...
April 6, 2017: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/28379853/donation-after-circulatory-death-heart-transplantation
#20
Kumud K Dhital, Hong C Chew, Peter S Macdonald
PURPOSE OF REVIEW: Despite continued expansion in the use of extended-criteria donor hearts following donation after brain death, there remains an unacceptable discrepancy between the supply of suitable donor hearts and the demand from increasing recipient numbers on transplant wait lists. Until recently, the additional approach of utilizing organs following donation after circulatory death (DCD) had not been possible for clinical heart transplantation in the modern era. This review describes relevant advances in translational research and provides an update on the favourable adoption of this donation pathway for clinical heart transplantation...
June 2017: Current Opinion in Organ Transplantation
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