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Maastricht donation

Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Maciej Sip, Sebastian Stefaniak, Tomasz Kłosiewicz, Łukasz Gąsiorowski, Marek Karczewski, Tomasz Małkiewicz, Małgorzata Ładzińska, Marcin Zieliński, Aleksander Pawlak, Bartłomiej Perek, Michael Czekajlo, Marek Jemielity
Maintaining the viability of organs from donors after circulatory death (DCD) for transplantation is a complicated procedure, from a time perspective in the absence of appropriate organizational capabilities, that makes such transplantation cases difficult and not yet widespread in Poland. We present the procedural preparation for Poland's first case of organ (kidney) transplantation from a DCD donor in which perfusion was supported by extracorporeal membrane oxygenation (ECMO). Because this organizational model is complex and expensive, we used advanced high-fidelity medical simulation to prepare for the real-life implementation...
June 1, 2017: Perfusion
Bas W M van Balkom, Hendrik Gremmels, Liselotte S S Ooms, Raechel J Toorop, Frank J M F Dor, Olivier G de Jong, Laura A Michielsen, Gert J de Borst, Wilco de Jager, Alferso C Abrahams, Arjan D van Zuilen, Marianne C Verhaar
BACKGROUND AND OBJECTIVES: Kidney transplantation is the preferred treatment for ESRD, and donor kidney shortage urges proper donor-recipient matching. Zero-hour biopsies provide predictive values for short- and long-term transplantation outcomes, but are invasive and may not reflect the entire organ. Alternative, more representative methods to predict transplantation outcome are required. We hypothesized that proteins accumulating in preservation fluid during cold ischemic storage can serve as biomarkers to predict post-transplantation graft function...
May 8, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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 ( and Embase ( 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...
November 2016: Progrès en Urologie
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...
September 15, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
J J Rubio, D Palacios
No abstract text is available yet for this article.
October 2016: Medicina Intensiva
Yann Delannoy, Nathalie Jousset, Benoit Averland, Valéry Hedouin, Clotilde Rougé-Maillart, Didier Gosset
The need for organs has increased in the recent years, and this shortage will only worsen. In addition to the organs procured from brain-dead donors, a procedure for non-heart-beating donors was therefore developed. When deaths involve legal proceedings, the medical examiner makes the decision of whether or not to remove organs. To assist medical examiner in their decision-making, a number of forensic scientific societies aimed to develop recommendations, and legal adjustments were adopted. Nevertheless, these do present certain limits in special cases of procurement: Maastricht class I and II non-heart-beating donors...
September 2016: Progress in Transplantation
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
S Alcantara Carmona, N Martínez Sanz, B Lobo Valbuena, J Palamidessi Domínguez, R Fernández Rivas, M Pérez Redondo, M Valdivia de la Fuente, B Balandín Moreno, J J Rubio Muñoz
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
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 2017: Transplantation
Marie Thuong, Angel Ruiz, Patrick Evrard, Michael Kuiper, Catherine Boffa, Mohammed Z Akhtar, James Neuberger, Rutger Ploeg
In the face of a crisis in organ donation, the transplant community are increasingly utilizing donation after circulatory death (DCD) donors. Over the last 10 years, with the increasing usage of DCD donors, we have seen the introduction in a number of new terms and definitions. We report the results of the 6th International Conference in Organ Donation held in Paris in 2013 and report a consensus agreement of an established expert European Working Group on the definitions and terminology regarding DCD donation, including refinement of the Maastricht definitions...
July 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
J Bollen, W de Jongh, J Hagenaars, G van Dijk, R Ten Hoopen, D Ysebaert, J Ijzermans, E van Heurn, W van Mook
Many physicians and patients do not realize that it is legally and medically possible to donate organs after euthanasia. The combination of euthanasia and organ donation is not a common practice, often limited by the patient's underlying pathology, but nevertheless has been performed >40 times in Belgium and the Netherlands since 2005. In anticipation of patients' requests for organ donation after euthanasia and contributing to awareness of the possibility of this combination among general practitioners and medical specialists, the Maastricht University Medical Center and the Erasmus University Medical Center Rotterdam have developed a multidisciplinary practical manual in which the organizational steps regarding this combined procedure are described and explained...
July 2016: American Journal of Transplantation
Z Wu, X Gao, F Chen, X Tao, J Cai, J Guo, X Chen, J Tan, S Yang
OBJECTIVE: Organ donation with scheduled cardiac arrest after brain death (s-DBCD) is a special category in China. This study was to evaluate the procedure of pediatric s-DBCD, graft quality, and clinical outcomes of single kidney transplantation. METHODS: We retrospectively analyzed the data of 8 Chinese pediatric donors. RESULTS: The death causes of the donors (age 4-12 years) were cerebral hypoxia after cardiopulmonary resuscitation (n = 1), intracranial vascular malformation (n = 1), severe traumatic brain injury (n = 3), and brain malignancy (n = 3)...
December 2015: Transplantation Proceedings
T M Egan
No abstract text is available yet for this article.
April 2016: American Journal of Transplantation
M A Gentil, C Gonzalez-Corvillo, P Castro, P Ruiz-Esteban, C Gracia-Guindo, T Garcia-Alvarez, M L Agüera, L Ballesteros, A Osuna, M Alonso
BACKGROUND: Kidneys from donors after brain death (DBD) cannot meet the demand for renal transplants in Andalusia. METHODS: We analyzed the impact of using non-heart-beating donors (NHBD) in Andalusia from the start of this program to the present. RESULTS: From 2010 to 2014, brain-death kidney donations remained at a standstill (1,635 in total) although NHBD increased from 2.4% to 16% annually, to 5% of the total (n = 164: 83 type II Maastricht [NHBD-T2] and 81 type III Maastricht [NHBD-T3])...
November 2015: Transplantation Proceedings
Marcelo Cypel, Bronwyn Levvey, Dirk Van Raemdonck, Michiel Erasmus, John Dark, Robert Love, David Mason, Allan R Glanville, Daniel Chambers, Leah B Edwards, Josef Stehlik, Marshall Hertz, Brian A Whitson, Roger D Yusen, Varun Puri, Peter Hopkins, Greg Snell, Shaf Keshavjee
BACKGROUND: The objective of this study was to review the international experience in lung transplantation using lung donation after circulatory death (DCD). METHODS: In this retrospective study, data from the International Society for Heart and Lung Transplantation (ISHLT) DCD Registry were analyzed. The study cohort included DCD lung transplants performed between January 2003 and June 2013, and reported to the ISHLT DCD Registry as of April 2014. The participating institutions included 10 centers in North America, Europe and Australia...
October 2015: Journal of Heart and Lung Transplantation
Marc E Gentili
First kidney transplant attempts begin with the 20th century: improving vascular sutures, understanding the phenomena of rejection or tolerance, then progress in HLA groups enable early success in the second half of the century. Definition of brain death, use of corticosteroids, radiotherapy and prime immunosuppressors promote the development of transplants. Discover of cyclosporine in the 1980s, and legislative developments augur a new era. Many advances are arising: use of stem cells from the donor, enhancement of Maastricht 3 donor or living donation...
November 2015: Néphrologie & Thérapeutique
C Lanchon, J-A Long, G Boudry, N Terrier, O Skowron, L Badet, J-L Descotes, J-J Rambeaud, P Malvezzi, B Boillot, C Thuillier, V Arnoux, G Fiard, D Poncet, D Dorez
In 2015, Annecy Hospital was the first French hospital to perform non-heartbeating organ donation from a Maastricht category III donor (patient awaiting cardiac arrest after withdrawal of treatment). Non-heartbeating organ donation (NHBD), performed in France since 2006, had initially excluded this category, due to ethical questions concerning end of life and treatment withdrawal, as well as technical specificities linked to this procedure. Grenoble University Hospital and Edouard-Herriot Hospital in Lyon then performed the first kidney transplants, with satisfactory outcomes in both recipients...
September 2015: Progrès en Urologie
Kumud K Dhital, Arjun Iyer, Mark Connellan, Hong C Chew, Ling Gao, Aoife Doyle, Mark Hicks, Gayathri Kumarasinghe, Claude Soto, Andrew Dinale, Bruce Cartwright, Priya Nair, Emily Granger, Paul Jansz, Andrew Jabbour, Eugene Kotlyar, Anne Keogh, Christopher Hayward, Robert Graham, Phillip Spratt, Peter Macdonald
BACKGROUND: Orthotopic heart transplantation is the gold-standard long-term treatment for medically refractive end-stage heart failure. However, suitable cardiac donors are scarce. Although donation after circulatory death has been used for kidney, liver, and lung transplantation, it is not used for heart transplantation. We report a case series of heart transplantations from donors after circulatory death. METHODS: The recipients were patients at St Vincent's Hospital, Sydney, Australia...
June 27, 2015: Lancet
M Vendrell, A J Hessheimer, A Ruiz, E de Sousa, D Paredes, C Rodríguez, S Saavedra, J Fuster, A Alcaraz, F Oppenheimer, P Taurá, J C García-Valdecasas, C Fondevila
It has been suggested that vascular stasis during cardio-circulatory arrest leads to the formation of microvascular thrombi and the viability of organs arising from donation after circulatory determination of death (DCDD) donors may be improved through the application of fibrinolytic therapy. Our aim was to comprehensively study the coagulation profiles of Maastricht category II DCDD donors in order to determine the presence of coagulation abnormalities that could benefit from fibrinolytic therapy. Whole blood from potential DCDD donors suffering out-of-hospital cardiac arrest was sampled after declaration of death in the emergency department, and rotational thromboelastomeric analysis was performed...
March 2015: American Journal of Transplantation
M D Salmeron-Rodriguez, M D Navarro-Cabello, M L Agüera-Morales, M Lopez-Andreu, A Rodriguez-Benot, J C Robles-Arista, J M Dueñas-Jurado, J P Campos-Hernandez, M J Requena-Tapia, P Aljama-Garcia
BACKGROUND: Kidney transplantation from donors after cardiac death (Type III Maastricht category) is a therapeutic option for patients with terminal renal failure. MATERIALS AND METHODS: We present a cohort of 8 patients who received a kidney transplant from donors after cardiac death (DCD). We analyzed the analytical results for the first 6 months after transplantation. RESULTS: We included 8 cases of kidney transplants with organs from DCD (Type III Maastricht category)...
January 2015: Transplantation Proceedings
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