Transplantation Reports最新文献_第5页

Trends in donation after circulatory determination of death donor utilization: Lessons from Houston 循环确定死亡捐赠者利用率后的捐赠趋势：休斯顿的经验教训

Transplantation Reports Pub Date : 2023-06-01 DOI: 10.1016/j.tpr.2023.100135

Andrew B. Barboza , Naila H Dhanani , Kristine Browning , R. Patrick Wood , David R Hall

{"title":"Trends in donation after circulatory determination of death donor utilization: Lessons from Houston","authors":"Andrew B. Barboza , Naila H Dhanani , Kristine Browning , R. Patrick Wood , David R Hall","doi":"10.1016/j.tpr.2023.100135","DOIUrl":"10.1016/j.tpr.2023.100135","url":null,"abstract":"<div><h3>Background</h3><p>Modern advancements have made organ transplantation an increasingly viable option for patients with organ failure. The resulting increases in patients awaiting transplant has resulted in significant morbidity and mortality due to increasing waiting time for transplant. The use of Donation after Circulatory Determination of Death (DCD) organ donors has been the most successful avenue to address the increased need for organ allografts. This review provides a brief history of DCD organ donation in the United States as represented by the experience of the Houston-based LifeGift Organ Procurement Organization (OPO).</p></div><div><h3>Methods</h3><p>Organ donation data from the Scientific Registry of Transplant Recipients (SRTR) and OPO specific data to include all available DCD donors for LifeGift were obtained for analysis. Trends in DCD donation were analyzed in the context of United Network for Organ Sharing policy.</p></div><div><h3>Results</h3><p>By the end of 2021 20% of organs donated in the United States were from DCD donors, in a steadily increasing trend since the mid-1990′s. Metrics utilized by UNOS to monitor organ donation rates and OPO performance do not clearly capture potential DCD donors. Individual OPOs have varying success in utilization of DCD donors, with OPOs like LifeGift focusing on increased DCD utilization.</p></div><div><h3>Conclusion</h3><p>DCD utilization remains the most successful avenue for increasing the deceased donor organ pool in the United States. Increased utilization of DCD organs by transplant centers and focused efforts by OPOs to promote DCD donation can improve the organ shortage nationally. Improved clarity in UNOS metrics can further facilitate OPO performance evaluation and promote further DCD donation in the United States.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"8 2","pages":"Article 100135"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49549278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Investigative and laboratory assays for allogeneic rejection – A clinical perspective 异基因排斥反应的研究和实验室分析——从临床角度

Transplantation Reports Pub Date : 2023-06-01 DOI: 10.1016/j.tpr.2023.100133

Xin Jiang , Qiang Sebastian Shi , Cheng-Yu Wu , Lu Xu , Hongji Yang , MedhatAskar

引用次数: 1

Use of donation after circulatory death donors in pediatric liver transplantation 循环性死亡供体在儿童肝移植中的应用

Transplantation Reports Pub Date : 2023-06-01 DOI: 10.1016/j.tpr.2023.100128

Veysel Umman, Murat Zeytunlu, Sukru Emre

引用次数: 1

Thoracic organ donation after circulatory determination of death 循环测定死亡后胸部器官捐献

Transplantation Reports Pub Date : 2023-02-01 DOI: 10.1016/j.tpr.2022.100125

Sanaz Hatami , Jennifer Conway , Darren H. Freed , Simon Urschel

{"title":"Thoracic organ donation after circulatory determination of death","authors":"Sanaz Hatami , Jennifer Conway , Darren H. Freed , Simon Urschel","doi":"10.1016/j.tpr.2022.100125","DOIUrl":"10.1016/j.tpr.2022.100125","url":null,"abstract":"<div><p>The availability of thoracic organ transplantation as the treatment of choice for end-stage cardiac or pulmonary diseases is limited by the insufficient number of donor organs from brain dead donors, especially for organs where live-donation is not an option. Patients, who have not progressed to brain death, but have exhausted therapeutic options and life sustaining therapies are withdrawn can become donors with circulatory determination of death (DCD) when they meet criteria for the definition of this state. This approach can fulfill the wish of a patient to become an organ donor and also help to increase the number of donor organs. The DCD process exposes organs to prolonged warm ischemia that increases the possibility of primary graft dysfunction and failure. However, new technologies help in protecting the organs from cold preservation-related ischemia and facilitate resuscitation and monitoring of viability after the occurrence of the DCD-related ischemic insult. Herein, we review the opportunities and challenges in DCD thoracic organ transplantation, emerging techniques in preservation and monitoring of these organs and the potential effect of DCD thoracic organ transplantation on expanding the donor pool.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"8 1","pages":"Article 100125"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41537676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Social and ethical-moral considerations in cardiopulmonary death donation 心肺死亡捐赠的社会和伦理道德考虑

Transplantation Reports Pub Date : 2023-02-01 DOI: 10.1016/j.tpr.2023.100126

Antonio Ríos , Andres Balaguer

{"title":"Social and ethical-moral considerations in cardiopulmonary death donation","authors":"Antonio Ríos , Andres Balaguer","doi":"10.1016/j.tpr.2023.100126","DOIUrl":"10.1016/j.tpr.2023.100126","url":null,"abstract":"<div><p>The sociocultural perception of Cardiopulmonary Death Donation by the population is an important issue, especially at this time when this type of donation is growing. However, the data that are currently available are insufficient to draw definitive conclusions on public reactions. Controlled organ donation after cardiocirculatory determination of death has generated an ethical and social debate since its implementation. The objective is to analyze the most relevant ethical-moral and social issues that involve this type of donation.</p><p>We were selected the 30 articles about this area with the PRISMA methodology. 72.2% of the articles that analyze the ethical conflicts on the withdrawal of life support treatment state that the staff that carries it out must be separate from the donation staff. 38.9% believe that it should be done in the ICM and 44.4% that it should be done by the ICM staff themselves. Regarding who should suggest controlled organ donation after cardiocirculatory determination of death, they all agree that it should be totally unrelated to ICM staff. 71.4% of the articles that analyze the use of premortem procedures justify their use based on scientific evidence and declare that they do not harm the potential donor. 42.1% accept the use of permanent circulatory cessation in determining death and 78.9% believe that a consensus should be reached on the waiting time in asystole. Despite some detractors, the use of ECMO is fully justified. Christian and Jewish culture are in favor of non-heart beating donation, but religious and economic objections continue to be raised in the Middle East. 80% of the articles that mention euthanasia classify it as a subject completely unrelated to controlled organ donation after cardiocirculatory determination of death</p><p>In conclusion, Organ donation after cardiocirculatory determination of death has experienced a boom in recent years and continues to lead to ethical-moral and social debate.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"8 1","pages":"Article 100126"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44203283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Donation after cardiac death - From then to now 心脏死亡后的捐赠——从那时到现在

Transplantation Reports Pub Date : 2023-02-01 DOI: 10.1016/j.tpr.2022.100119

Robert M. Langer

{"title":"Donation after cardiac death - From then to now","authors":"Robert M. Langer","doi":"10.1016/j.tpr.2022.100119","DOIUrl":"10.1016/j.tpr.2022.100119","url":null,"abstract":"<div><p>At the early days of organ transplantation before the diagnosis of brain death came in use only organs of non-heart-beating persons - who were the first donors after cardiac death (DCD) - could be taken for organ transplantation beside the living donors.</p><p>Organs from the first brain-dead donor were transplanted in 1963 in Belgium, five years later the famous Harvard Committee criteria were published. Following that in the Western world DCD was not used for organ transplantation, just in exceptional cases for several decades.</p><p>However, organ scarceness lead the way back to the idea of DCD. The original Maastricht classification discerns uncontrolled and controlled DCD in 4 categories from dead upon arrival through unsuccessful resuscitation attempt and awaiting cardiac death to cardiac arrest of a brain-dead person.</p><p>The time between the cessation of the of the circulation and the perfusion of the organ with the specific storage fluid is crucial for the possible use of the organs as transplants.</p><p>The recent studies explore the possibilities of the reconditioning of the organs to allow more and more of them to use for transplantation. The applicability is mostly needed in DCD cases. It is still open whether cold or warm perfusion, static or machine perfusion in continuous or pulsatile form would be the best for which organ.</p><p>Despite the evidence of the usefulness of this donor category, DCD is still not used universally. For example in Europe only one-third of the countries use DCD, the main reason is the underdevelopment of the infrastructural criteria in some of the countries, and the unsolved ethical and organizational challenges in others.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"8 1","pages":"Article 100119"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44918942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Kidney Donation after circulatory death: The Veneto Region experience in Italy 循环性死亡后的肾脏捐赠:意大利威尼托地区的经验

Transplantation Reports Pub Date : 2023-01-01 DOI: 10.1016/j.tpr.2023.100129

C. Di Bella , G. Feltrin , C. Silvestre , F. Tuci , M. Di Bello , E. Rosso , P. Rigotti , L. Furian

引用次数: 1

Improved renal allograft function with dialysis access ligation to reduce venous hypertension 透析通路结扎改善同种异体肾移植功能以降低静脉高压

Transplantation Reports Pub Date : 2023-01-01 DOI: 10.1016/j.tpr.2023.100140

Scarlett B. Hao , Miguel Arasa , Vaishnavi Siripurapu , David B. Leeser , Margaret M. Romine

引用次数: 0

Graft-versus-host disease: Therapeutic prospects of improving the long-term post-transplant outcomes 移植物抗宿主病:改善移植后长期预后的治疗前景

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100107

Abdulaziz Umar Kurya , Usama Aliyu , Abdulrahman Ibrahim Tudu , A.G Usman , Mohd Yusuf , Suneel Gupta , Aleem Ali , Mohd Gulfishan , Santosh Kumar Singh , Imran Hussain , Mu'azu Gusau Abubakar

{"title":"Graft-versus-host disease: Therapeutic prospects of improving the long-term post-transplant outcomes","authors":"Abdulaziz Umar Kurya , Usama Aliyu , Abdulrahman Ibrahim Tudu , A.G Usman , Mohd Yusuf , Suneel Gupta , Aleem Ali , Mohd Gulfishan , Santosh Kumar Singh , Imran Hussain , Mu'azu Gusau Abubakar","doi":"10.1016/j.tpr.2022.100107","DOIUrl":"10.1016/j.tpr.2022.100107","url":null,"abstract":"<div><h3>Background</h3><p>Graft-versus-host disease (GVHD) continues to emerge as the topmost causative factor of the morbidity and mortality rate post hematopoietic stem cell transplantation. The graft cells attack the recipient host tissues resulting in acute or chronic GVHD that affect organs, including the lung, liver, skin, and gastrointestinal tract. Certain factors are considered to play a crucial role in the progression of the disease, such as antibodies produced by B cells, reduction in regulatory T cells, and immune tolerance disruption to self-antigen.</p></div><div><h3>Main body</h3><p>This review highlighted the pathophysiology of GVHD, clinical manifestation, stages of GVHD in different organs, and the significant role played by Janus Kinase/Signal Transducers and Activators of Transcription (JAK/STAT) in cytokine signalling, development, and function of several immune cells. Furthermore, we discussed the clinical efficacy of drugs, which comprises JAK inhibitors, monoclonal antibodies, and proteasome inhibitors that are widely used to treat GVHD.</p></div><div><h3>Conclusion</h3><p>Considering the progress recorded in identifying the therapeutic regimens for GVHD, novel and effective therapeutic approaches are much needed to alleviate the complication that arises post hematopoietic stem cell transplantation and reduce the morbidity and mortality rate of the disease.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 4","pages":"Article 100107"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000154/pdfft?md5=2b4043526d8ba76e7be62b67f1229c56&pid=1-s2.0-S2451959622000154-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45463087","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

Lung donation after circulatory death: A single-centre experience with uncontrolled donors with some considerations 循环系统死亡后的肺捐献：不受控制的捐献者的单中心经验

Transplantation Reports Pub Date : 2022-12-01 DOI: 10.1016/j.tpr.2022.100117

Eleonora Faccioli, Vincenzo Verzeletti, Federico Rea, Marco Schiavon

{"title":"Lung donation after circulatory death: A single-centre experience with uncontrolled donors with some considerations","authors":"Eleonora Faccioli, Vincenzo Verzeletti, Federico Rea, Marco Schiavon","doi":"10.1016/j.tpr.2022.100117","DOIUrl":"10.1016/j.tpr.2022.100117","url":null,"abstract":"<div><h3>Introduction</h3><p>Organ shortage represents one of the main issues associated with lung transplantation (LTx). Over the years, in an attempt to increase the donor pool, the use of donors after cardiac death (DCDs) has gradually increased, with good results that bode well for their wider use in the future.</p></div><div><h3>Methods</h3><p>In this work, our experience with DCDs is presented. In addition, a brief literature review on controlled (c) and uncontrolled (u) DCDs was performed on the studies published in the last four years.</p></div><div><h3>Results</h3><p>From 2018 to 2022 our center performed three LTx with DCDs. All the donors were uDCDs (Maastricht class II). The median warm ischemic time of the graft was 160 min. In all the three LTx, lungs were reconditioned using portable Ex-Vivo-Lung-Perfusion (EVLP) system (Organ Care System, OCS, TransMedics) for a median time of 535 min. All the three LTx were performed with an intraoperative veno-arterial extra-corporeal membrane oxygenation (V-A ECMO), which was prolonged postoperatively in one patient.</p><p>Grade 3 primary graft disfunction (PGD) at 72 h was observed in one patient. No signs of acute rejection were observed in any patient at the surveillance transbronchial biopsies. One patient died 317 after LTx for consequences of a lung adenocarcinoma diagnosed in the native lung, while the other two are still alive with a preserved graft function.</p></div><div><h3>Summary</h3><p>The most recent studies confirm similar results between DCDs and DBDs in terms of survival and graft function. Good results can also be achieved in uDCDs if standardized protocols are followed and graft function is monitored by EVLP.</p><p>Hence, the use of DCDs represents a valid solution to expand the donor pool.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"7 4","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2451959622000257/pdfft?md5=bdbdf0f4b6f389e0d7b7664d4c5fed00&pid=1-s2.0-S2451959622000257-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41992419","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