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Donor after cardiac death

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https://www.readbyqxmd.com/read/28937258/sensitivity-to-perioperative-ischemia-reperfusion-injury-in-male-and-female-donor-myocardium
#1
M Smetana, J Besik, I Netuka, J Maly, J Maluskova, A Lodererova, L Hoskova, J Franeková, E Pokorna, J Pirk, O Szarszoi
Many functions of the cardiovascular apparatus are affected by gender. The aim of our study was find out whether markers of cell death present in the donor myocardium differ in male and female hearts. The study involved 81 patients undergoing heart transplantation from September 2010 to January 2013. Patients were divided into two groups: male allograft (n=49), and female allograft (n=32). Two types of myocardial cell death were analyzed. High-sensitive cardiac troponin T as a necrosis marker and protein bcl-2, caspase 3 and TUNEL as apoptosis markers were measured...
September 22, 2017: Physiological Research
https://www.readbyqxmd.com/read/28885771/impact-of-donor-age-in-donation-after-cardiac-death-liver-transplantation-is-the-cut-off-60-still-of-relevance
#2
Andrea Schlegel, Irene Scalera, M Thamara, P R Perera, Marit Kalisvaart, Hynek Mergental, Darius F Mirza, John Isaac, Paolo Muiesan
Background Advanced donor age has been identified as risk factor, when combined with donor warm ischemia, e.g. in donation after circulatory death (DCD). In several countries DCD livers, older than 60 years are not considered suitable due to concerns related to poor graft function and development of ischaemic cholangiopathy. We evaluate in this study outcome after DCD liver transplantation using grafts from donors older than 60 years. Methodology We analysed outcome after DCD liver transplantation (n=315), comparing donors >60 years (n=93) and donors ≤60 years (n=222) from our centre between 2005 and 2015...
September 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28883707/donor-derived-infections-among-chinese-donation-after-cardiac-death-liver-recipients
#3
Qi-Fa Ye, Wei Zhou, Qi-Quan Wan
AIM: To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients. METHODS: We retrospectively studied the results of blood cultures among our donation after cardiac death (DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors...
August 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28870676/hypothermic-oxygenated-perfusion-hope-for-fatty-liver-grafts-in-rats-and-humans
#4
P Kron, A Schlegel, L Mancina, P-A Clavien, P Dutkowski
BACKGROUND: Pretreatment of marginal organs by perfusion is a promising opportunity to consider more organs for transplantation. Protection of human DCD (donation after cardiac death) livers by a novel machine perfusion technique, hypothermic oxygenated perfusion (HOPE), was recently established. Here we tested in a rodent transplant model, whether HOPE is also useful for fatty liver grafts. METHODS: Rats were fed over 3 weeks with a special Methionine-Choline-Deficient-Diet (MCDD) to induce severe hepatic macrosteatosis (≥60%)...
September 1, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28868123/orthotopic-liver-transplantation-from-cardiac-death-donors-in-the-mouse-a-new-model-and-evaluation-of-cardiac-death-time
#5
Zhenzhen Liu, Ning Pan, Xiangwei Lv, Song Li, Liming Wang, Qinlong Liu
OBJECTIVES: The goal of this research was to develop a mouse orthotopic liver transplantation (LTx) model from donor-after-cardiac-death (DCD) grafts. MATERIALS AND METHODS: Mice were randomly assigned to the experimental group or the sham group. The mice in the experimental group were divided into three groups according to the warm ischemia time (WIT) of liver graft: normal LTx, WIT 30 minute (min) +LTx and WIT 45 min +LTx. The descending aorta was clamped using a miniature aortic clamp to simulate cardiac arrest in the DCD grafts...
June 2017: Iranian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28859788/outcomes-after-transplantation-of%C3%A2-donor%C3%A2-hearts-with-improving-left%C3%A2-ventricular-systolic%C3%A2-dysfunction
#6
MULTICENTER STUDY
Shivank Madan, Omar Saeed, Peter Vlismas, Ioanna Katsa, Snehal R Patel, Julia J Shin, William A Jakobleff, Daniel J Goldstein, Daniel B Sims, Ulrich P Jorde
BACKGROUND: Left ventricular systolic dysfunction (LVSD) accounts for almost 25% of nonacceptance of potential donor hearts. Previous smaller, single-center studies showed that LVSD following brain death may be transient, and such hearts can be successfully resuscitated with resolution of LVSD, then transplanted. OBJECTIVES: This study evaluated outcomes of donor hearts with LVSD on initial transthoracic echocardiogram (TTE) that resolved during donor management...
September 5, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28839932/the-impact-of-alteplase-on-pulmonary-graft-function-in-donation-after-circulatory-death-an-experimental-study
#7
Annika Liersch-Nordqvist, Mohammed Fakhro, Leif Pierre, Joanna Hlebowicz, Malin Malmsjo, Richard Ingemansson, Sandra Lindstedt
OBJECTIVE: Lung transplantation is hampered by the lack of organs resulting in deaths on the waiting list. The usage of donation after circulatory death (DCD) lungs would dramatically increase donor availability. The most optimal organ preservation method, and the need for antithrombotic and fibrinolytic treatment to prevent thrombosis in the donor lungs is currently on debate. The present study investigated, in a simulated clinical DCD situation, whether the addition of alteplase in the flush-perfusion solution at the time of pulmonary graft harvesting could prevent thrombosis in the donor lung and thereby improve pulmonary graft function...
October 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28827516/development-and-assessment-of-normothermic-machine-perfusion-preservation-for-extracorporeal-splitting-of-pig-liver
#8
Zhi-Bin Zhang, Wei Gao, Lei Liu, Yuan Shi, Ning Ma, Zhong-Yang Shen
BACKGROUND Studies have shown that normothermic machine perfusion (NMP) exerts a significant protective role for donations after cardiac death (DCD) livers and verified the effects of NMP in preservation, repair, and preoperative assessment of human donor livers. The objective of this study was to verify the effectiveness and stability of NMP system by splitting pig livers in perfusion preservation. MATERIAL AND METHODS Four healthy Ba-Ma miniature pigs were used. The livers were harvested, and then connected to the NMP system to split the livers...
August 22, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28797760/effect-of-left-ventricular-dysfunction-on-utilization-of-donor-hearts
#9
David Tryon, Nahidh W Hasaniya, Brice Jabo, Anees J Razzouk, Leonard L Bailey, David G Rabkin
BACKGROUND: In this study we investigated modern, non-utilization rates of potential cardiac donors with left ventricular dysfunction (LVD) to clarify this phenomenon's magnitude and the impact of recent studies suggesting these organs can be safely transplanted. METHODS: Using the United Network for Organ Sharing transplant database, we reviewed all donors evaluated between January 1, 2007 and June 30, 2014. Exclusion criteria included lack of consent and age <13 or >59 years...
July 19, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28771455/confirmed-transmission-of-bacterial-or-fungal-infection-to-kidney-transplant-recipients-from-donated-after-cardiac-death-dcd-donors-in-china-a-single-center-analysis
#10
Qiquan Wan, Huanmiao Liu, Shaojun Ye, Qifa Ye
BACKGROUND We aimed to investigate blood and urine cultures of donated after cardiac death (DCD) donors and report the cases of confirmed (proven/probable) transmission of bacterial or fungal infection from donors to kidney recipients. MATERIAL AND METHODS Seventy-eight DCD donors between 2010 and 2016 were included. Sixty-one DCD donors underwent blood cultures and 22 episodes of bacteremias developed in 18 donors. Forty-three donors underwent urine cultures and 14 donors experienced 17 episodes of urinary infections...
August 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28742013/first-canadian-experience-with-donation-after-cardiac-death-simultaneous-pancreas-and-kidney-transplants
#11
Patrick T Anderson, Shahid Aquil, Kelly McLean, Vivian C McAlister, Alp Sener, Patrick P Luke
BACKGROUND: Compared with neurologic determination of death (NDD) donor organs, donation after cardiac death (DCD) donor organs have traditionally been considered of inferior quality owing to warm ischemia experienced during procurement. We present, to our knowledge, the first analysis of simultaneous pancreas and kidney (SPK) transplants using DCD donor organs in Canada. METHODS: We carried out a retrospective cohort study of SPK transplants from 13 DCD and 68 NDD donors performed between October 2008 and July 2016...
August 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28736011/pediatric-donor-to-adult-recipients-in-donation-after-cardiac-death-liver-transplantation-a-single-center-experience
#12
C Lan, J L Song, L N Yan, J Y Yang, T F Wen, B Li, M Q Xu
BACKGROUND: The impact of using liver allografts from donors who are younger than 14 years at the time of donation after cardiac death (DCD) liver transplantation in terms of early allograft dysfunction (EAD) and graft survival is undefined. To determine if adults undergoing DCD liver transplantation who receive a graft from a donor age younger than or equal to 13 years have similar outcomes to recipients of organs from older than 18-year-old donors. METHODS: Records from adult patients undergoing DCD liver transplantation between March 2012 and December 2015 who received whole grafts from donors after cardiac death were reviewed...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28718858/donationsutredningen-%C3%A3-ppnar-f%C3%A3-r-nya-organdonatorer-kr%C3%A3-ver-reflexion-om-m%C3%A3-nniskov%C3%A3-rdesprincipen-och-samtycke
#13
Stellan Welin
Swedish white paper on donation can give more donors without compromising ethics The White Paper on organ donation (SOU 2015:84) proposes new regulations for organ donation. In particular it spells out that it is permissible to take medical steps to preserve organs while the patient is still alive. It is proposed that this should be allowed after the medical team has declared that the continuation of life sustaining treatment is futile. The white paper opens up for donation after cardiac death. There has been some critique of the white paper for lack of deeper ethical discussions...
July 14, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28698837/developing-a-donation-after-cardiac-death-risk-index-for-adult-and-pediatric-liver-transplantation
#14
Shirin Elizabeth Khorsandi, Emmanouil Giorgakis, Hector Vilca-Melendez, John O'Grady, Michael Heneghan, Varuna Aluvihare, Abid Suddle, Kosh Agarwal, Krishna Menon, Andreas Prachalias, Parthi Srinivasan, Mohamed Rela, Wayel Jassem, Nigel Heaton
AIM: To identify objective predictive factors for donor after cardiac death (DCD) graft loss and using those factors, develop a donor recipient stratification risk predictive model that could be used to calculate a DCD risk index (DCD-RI) to help in prospective decision making on organ use. METHODS: The model included objective data from a single institute DCD database (2005-2013, n = 261). Univariate survival analysis was followed by adjusted Cox-regressional hazard model...
June 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/28688150/national-assessment-of-early-hospitalization-after-liver-transplantation-risk-factors-and-association-with-patient-survival
#15
Pratima Sharma, Nathan P Goodrich, Douglas E Schaubel, Abigail R Smith, Robert M Merion
Hospitalization is known to occur frequently in the first 6 months following liver transplantation (LT). Using a novel data linkage between the Scientific Registry of Transplant Recipients and Centers for Medicare and Medicaid Services, our study has 2 objectives: (1) to determine risk factors for "early" hospitalization (ie, within 6 months of LT); and (2) to quantify the importance of hospitalization history in the first 6 months with respect to subsequent patient survival (ie, survival, conditional on surviving 6 months post-LT)...
September 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28684160/looking-inward-the-impact-of-operative-time-on-graft-survival-after-liver-transplantation
#16
David D Lee, Jun Li, Guihua Wang, Kristopher P Croome, Justin M Burns, Dana K Perry, Justin H Nguyen, Wallace J Hopp, C Burcin Taner
BACKGROUND: Operative time often has been cited as an important factor for postoperative outcomes. Despite this belief, most efforts to improve liver transplant outcomes have largely focused on only patient and donor factors, and little attention has been paid on operative time. The primary objective of this project was to determine the impact of operative time on graft survival after liver transplant. METHODS: A retrospective review of 2,877 consecutive liver transplants performed at a single institution was studied...
July 3, 2017: Surgery
https://www.readbyqxmd.com/read/28681086/effect-of-low-level-laser-treated-mesenchymal-stem-cells-on-myocardial-infarction
#17
Zaynab H El Gammal, Amr M Zaher, Nagwa El-Badri
Cardiovascular disease is the leading cause of death worldwide. Although cardiac transplantation is considered the most effective therapy for end-stage cardiac diseases, it is limited by the availability of matching donors and the complications of the immune suppressive regimen used to prevent graft rejection. Application of stem cell therapy in experimental animal models was shown to reverse cardiac remodeling, attenuate cardiac fibrosis, improve heart functions, and stimulate angiogenesis. The efficacy of stem cell therapy can be amplified by low-level laser radiation...
July 6, 2017: Lasers in Medical Science
https://www.readbyqxmd.com/read/28665890/the-impact-of-liver-graft-injury-on-cancer-recurrence-posttransplantation
#18
Chang-Xian Li, Kwan Man, Chung-Mau Lo
Liver transplantation is the most effective treatment for selected patients with hepatocellular carcinoma (HCC). However, cancer recurrence, posttransplantation, remains to be the critical issue which affects the long-term outcome of HCC recipients. In addition to tumor biology itself, increasing evidence demonstrates that acute phase liver graft injury is a result of hepatic ischemia reperfusion (I/R) injury (which is an inevitable consequence during liver transplantation) and may promote cancer recurrence at late phase posttransplantation...
June 29, 2017: Transplantation
https://www.readbyqxmd.com/read/28660072/study-of-cardiovascular-outcomes-in-renal-transplantation-a-prospective-multicenter-study-to-determine-the-incidence-of-cardiovascular-events-in-renal-transplant-recipients-in-ontario-canada
#19
Christine M Ribic, David Holland, John Howell, Anthony Jevnikar, S Joseph Kim, Greg Knoll, Brenda Lee, Jeffrey Zaltzman, Azim S Gangji
BACKGROUND: Renal transplant recipients (RTRs) are at significantly higher risk for morbidity and mortality compared with the general population, largely attributed to cardiovascular disease (CVD). Previous estimates of CVD events have come from health care databases and retrospective studies. OBJECTIVE: The objective of this study was to prospectively determine the prevalence of risk factors and incidence of CVD events in a Canadian cohort of RTRs. DESIGN: Study of Cardiovascular Outcomes in Renal Transplantation (SCORe) was a prospective, longitudinal, multicenter observational study...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28657945/expanding-the-margins-high-volume-utilization-of-marginal-liver-grafts-among-2000-liver-transplants-at-a-single-institution
#20
Karim J Halazun, Ralph C Quillin, Russel Rosenblatt, Advaith Bongu, Adam D Griesemer, Tomoaki Kato, Craig Smith, Fabrizio Michelassi, James V Guarrera, Benjamin Samstein, Robert S Brown, Jean C Emond
OBJECTIVE: Marginal livers (ML) have been used to expand the donor pool. National utilization of MLs is variable, and in some centers, they are never used. We examined the outcomes of MLs in the largest single center series of MLs used to date and compared outcomes to standard (SL) and living donor (LD) livers. METHODS: Analysis of a prospectively maintained database of all liver transplants performed at our institution from 1998 to 2016. ML grafts were defined as livers from donors >70, livers discarded regionally and shared nationally, livers with cold ischemic time >12 hours, livers from hepatitis C virus positive donors, livers from donation after cardiac death donors, livers with >30% steatosis, and livers split between 2 recipients...
September 2017: Annals of Surgery
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