Transplantation Reports最新文献_第5页

DCD kidney transplantation in Italy: Past, present, and future 意大利的DCD肾移植:过去，现在和未来

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100121

Evaldo Favi , Francesca Vespasiano , Massimo Cardillo , Mariano Ferraresso

{"title":"DCD kidney transplantation in Italy: Past, present, and future","authors":"Evaldo Favi , Francesca Vespasiano , Massimo Cardillo , Mariano Ferraresso","doi":"10.1016/j.tpr.2022.100121","DOIUrl":"10.1016/j.tpr.2022.100121","url":null,"abstract":"<div><p>The disproportion between the number of patients on the kidney transplant waiting list and the actual donors pool represents a primary issue for the international Transplant community. The development of donation after circulatory death (DCD) programs has been associated with a remarkable increase in organs procurement and transplants activities across the globe. However, effective DCD donation and transplantation require the resolution of several legal, ethical, deontological, logistical, and technical issues. In Italy, the major obstacle to this very specific type of dation was represented by the 20-minute no-touch period for the declaration of death by cardio-circulatory criteria established by the Italian legislation. Following the encouraging results obtained with the use of in situ Normothermic Regional Perfusion in the setting of a single-center exploratory trial performed between 2008 and 2013 (Alba project), the Comitato Nazionale per la Bioetica and the Centro Nazionale Trapianti eventually managed to start a national-scale controlled and uncontrolled DCD program. We herein describe the Italian DCD KT program with a special focus on the most crucial and peculiar aspects of the national organ donation and allocation process.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000294/pdfft?md5=c8dec87275a9dc07a87e256aa87c1ebd&pid=1-s2.0-S2451959622000294-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44387815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Donor substance use and lung transplantation: A single center experience 供体物质使用与肺移植:单中心经验

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100124

Charles R. Liu , Christopher A. Heid , Edward Hauptmann , Mir Ali , Jessica Pruszynski , Ananya Pillai , Amit Banga , Michael A. Wait , Lynn C. Huffman , Matthias Peltz , Amy E. Hackmann , Michael E. Jessen , W. Steves Ring , John S. Murala

{"title":"Donor substance use and lung transplantation: A single center experience","authors":"Charles R. Liu , Christopher A. Heid , Edward Hauptmann , Mir Ali , Jessica Pruszynski , Ananya Pillai , Amit Banga , Michael A. Wait , Lynn C. Huffman , Matthias Peltz , Amy E. Hackmann , Michael E. Jessen , W. Steves Ring , John S. Murala","doi":"10.1016/j.tpr.2022.100124","DOIUrl":"10.1016/j.tpr.2022.100124","url":null,"abstract":"<div><h3>Background</h3><p>Lung transplantation (LT) demand outpaces supply. Consequently, extended criteria for donor selection are used, resulting in LT from donors with a history of substance use (SU). The aim of this study is to assess the association between donor SU and short-term LT outcomes.</p></div><div><h3>Methods</h3><p>We obtained recipient and donor data for LTs performed between January 2014 to January 2019 from electronic health records and the United Network for Organ Sharing (UNOS) database. We defined SU as cigarette/e-cigarette smoking, illicit SU (cannabis, cocaine, opioids, amphetamines), or heavy alcohol use (2+ alcoholic drinks per day). Our primary outcome was late high-grade primary graft dysfunction (PGD), which we defined as grade 2-3 PGD between 48-72 hours post-LT. Secondary outcomes included mechanical ventilation (MV) hours, intensive care unit (ICU) length of stay (LOS), hospital LOS, number of bronchoscopies, cumulative acute rejection (CAR) score in the first year after LT, and overall survival (OS).</p></div><div><h3>Results</h3><p>A total of 352 LTs were included in this study. On multivariable regression, we found that any donor cigarette smoking was associated with increased odds of late high grade PGD (p=0.021), while any donor cannabis use was associated with reduced odds of late high grade PGD (p=0.002). There was no association between any donor SU and secondary outcomes.</p></div><div><h3>Conclusions</h3><p>Donor cigarette use was associated with higher risk for PGD. Our findings may suggest a history of donor cannabis use and other illicit SU are not associated with PGD or worse OS.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000324/pdfft?md5=1887a9cbf9e6302ddb6ece397cbc95f9&pid=1-s2.0-S2451959622000324-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42128408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Organ donation after cardiac death in Japan 日本心脏病死亡后的器官捐献

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100114

Takashi Kobayashi , Kazuhide Saito , Yoshiaki Kinoshita

引用次数: 1

Lung transplantation following donation after circulatory death 循环性死亡后捐赠肺移植

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100110

Gustavo A. Parrilla , Willian R. Hunt , Mani A. Daneshmand

引用次数: 1

Development of Non heart-beating donor programs for kidney transplantation in Italy: A perspective view 意大利肾移植非心脏跳动供体项目的发展:一个视角

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100112

Alessandra De Iacob, Filomena Misuriello, Franco Citterio

引用次数: 1

Donation after circulatory death – activity review in the Asian region 亚洲地区循环死亡后的捐赠活动回顾

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100122

Zsolt Kaposztas

{"title":"Donation after circulatory death – activity review in the Asian region","authors":"Zsolt Kaposztas","doi":"10.1016/j.tpr.2022.100122","DOIUrl":"10.1016/j.tpr.2022.100122","url":null,"abstract":"<div><p>Transplantation remains the optimum treatment for many patients. The availability of donor organs has failed to keep pace with demand, resulting in an ever-increasing waiting list of potential recipients. Using organs from donation after circulatory death (DCD) donors is one of the strategies available to increases the number of donor organs. On one hand in many countries DCD donation has gained popularity and the outcomes are comparable to organ transplantations following brain death donation, but on the other hand still a lot of problems exist for both controlled and uncontrolled DCD regarding ethical and legal issues of DCD program in several regions. There are guidelines though available for the whole process of DCD donation and transplantation from national transplant societies and anaesthesiology societies.</p><p>The aim of this paper was to review the DCD activity and the possibilities to improve the number of organ transplantation in the Asian region based on literature search.</p><p>A novel donation concept, namely organ donation after brain death followed by circulatory death (DBCD) has been initiated in many Asian countries to help increase the available organs for transplantation since around 2011. The reason why there are so many DBCD donors is because brain death law has not been approved on a national level in most of the Asian countries, and culturally many relatives of deceased donors can only accept donor death when heart beating is irreversibly arrested.</p><p>Based on this review there is a need to implement DCD transplant programs and to establish reliable protocols for this type of donation across all the Asian countries to increase the number of transplantations.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000300/pdfft?md5=d2d0789e2794d28a7a315ea33c8f4036&pid=1-s2.0-S2451959622000300-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42123346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Contemporary considerations in solid organ transplantation utilizing DCD donors 利用DCD供体进行实体器官移植的当代思考

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100118

Farjad Siddiqui , Yazan Al-Adwan , Jayanthan Subramanian , Mitchell L. Henry

{"title":"Contemporary considerations in solid organ transplantation utilizing DCD donors","authors":"Farjad Siddiqui , Yazan Al-Adwan , Jayanthan Subramanian , Mitchell L. Henry","doi":"10.1016/j.tpr.2022.100118","DOIUrl":"10.1016/j.tpr.2022.100118","url":null,"abstract":"<div><h3>Introduction</h3><p>Donation after cardiac death (DCD) has been leading the way to help bridge the growing gap between availability of donors and recipients on waitlist. With advances in technology and our understanding of DCD donation the safety profile is growing. It is becoming an increasing viable option even in marginal settings.</p></div><div><h3>Discussion</h3><p>The ethos surroundings DCD is still a matter of contention but there is support and collaboration from larger societies and establishments with development of standardizing protocols. Preparation is key. Experience of the procurement and transplanting surgeons are pivotal. There are multiple moving parts and for the success of a DCD program, dedication is needed from the donor hospitals, organ procurement organizations and the transplant centers. Previous practices based on anecdotal experiences are now either supported by or refuted by increasing evidence and data, based on the development of consensus-based guidelines with the end goal of having uniform outcomes. Normothermic regional and machine perfusion have expanded options in the DCD world, challenging the limits and expanding our paradigm. Recognition of the weaknesses and organ specific complications allow the clinician to make choices for optimal outcomes. These advancements have allowed outcomes to be optimized.</p></div><div><h3>Conclusions</h3><p>Expanding the organ donor pool is one solution to increase the availability of organs for transplantation. Increasing the attention to and the use of DCD organs combined with machine and normothermic perfusion is a future strategy to obtain ongoing clinical success in organ transplantation and lower the waiting list mortality.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000269/pdfft?md5=845a8b7e27b054e183ca23995ed2c8a5&pid=1-s2.0-S2451959622000269-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45316635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Donation after circulatory death in Turkey and the Middle East: Current status 土耳其和中东地区循环死亡后的捐赠:现状

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100109

Mehmet Haberal

{"title":"Donation after circulatory death in Turkey and the Middle East: Current status","authors":"Mehmet Haberal","doi":"10.1016/j.tpr.2022.100109","DOIUrl":"10.1016/j.tpr.2022.100109","url":null,"abstract":"<div><p>Tissue and organ transplantation is the best treatment option for end-stage organ failure. However, organ shortage still remains to be the greatest challenge facing the field of organ transplantation. Millions of people die and are buried with healthy organs, which could save the lives of many patients who continue to wait on transplant lists. Countries must aim to work towards a system of matching organs as much as possible with the deceased donation to meet the growing demand for organs. This action will not only result in the reduction of organ trafficking activities but shall also make an enormous difference to those patients awaiting transplants where living organ donors are not an option.</p><p>Donation after circulator death (DCD) has gained much attention over the last decade as one of the accepted practices in order to expand the donor pool. DCD donation takes place after declaration of death using cardio-respiratory criteria in contrast to donation after brain death (DBD) where neurological criteria are used. Although DCD remains a focus of interest and contributes to donor numbers in many countries, it also poses many challenges medically, ethically and legally. Unfortunately, controlled DCD is not really in practice in Turkey and the Middle East.</p><p>Therefore, the purpose of this review is to provide an overview of current status of DCD in Turkey and the Middle East and to identify associated concerns medically and ethically.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000178/pdfft?md5=236d8870802dfc032c635ed7407de883&pid=1-s2.0-S2451959622000178-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47615704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Pancreas transplantation following donation after circulatory death 循环性死亡后捐献胰腺移植

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100120

Jeffery Campsen, Michael A. Zimmerman

引用次数: 1

Where are we today with machine perfusion of liver in donation after circulatory death liver transplantation? 机器灌注肝在循环死亡后肝移植捐献中的应用进展如何?

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100111

Badi Rawashdeh, Joohyun Kim, Johnny C. Hong

引用次数: 1