Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)最新文献

{"title":"Model organ description protocols for completion by transplant surgeons using organs procured from medical examiner cases.","authors":"F T Zugibe,&nbsp;J Costello,&nbsp;M Breithaupt,&nbsp;J Segelbacher","doi":"10.7182/prtr.1.9.2.y51812mx53671756","DOIUrl":"https://doi.org/10.7182/prtr.1.9.2.y51812mx53671756","url":null,"abstract":"<p><p>A significant number of donor organs emanate from the medical examiner's or coroner's offices, because victims of head injuries from vehicular accidents, falls, assaults, gunshot injuries, and unattended cerebrovascular accidents fall under the jurisdiction of the medical examiner or coroner. Unfortunately, many organ procurement organizations may not fully understand the legal responsibilities of the medical examiner. Most of the medical examiner or coroner cases could be used without compromising the medical-legal responsibilities of the medical examiner or coroner if a reliable description of the respective organ could be made after surgical removal by either having a pathologist present or by having the surgeon prepare a description of the respective organ. The objective of this paper is to present a series of protocols that have been designed to describe the heart, lungs, liver, kidney, and spleen for use by organ transplant surgeons. These protocols have proven to be highly successful in making more organs available for transplantation.</p>","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 2","pages":"73-80"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21555480","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}

{"title":"When donor families and organ recipients meet.","authors":"L Clayville","doi":"10.7182/prtr.1.9.2.0046q06v05v6652v","DOIUrl":"https://doi.org/10.7182/prtr.1.9.2.0046q06v05v6652v","url":null,"abstract":"<p><p>Medical decisions about organ donation and transplantation are considered by a growing number of individuals. The complex issue of whether and to what extent organ recipients and donor families should interact or communicate has gained increasing public awareness, thereby creating an area of major ethical and legal concern for the transplant community. Communication issues have traditionally been decided by transplant coordinators and guided by personal beliefs, agency guidelines, and organizational policies. Organizations are often inconsistent in their practices, and this in turn causes frustration and confusion for both donor families and transplant recipients. This study explored how the experience of meeting the recipient(s) of a loved one's organ affected the grieving process of donor families and altered their lives. The information from this study might be useful to transplant professionals to develop guidelines and policies that lessen the confusion and frustration felt by those involved with the transplant process.</p>","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 2","pages":"81-6"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21555481","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}

{"title":"Generic Drugs in Transplantation: New Responsibilities for Clinical Transplant Coordinators","authors":"","doi":"10.1177/090591999900900201","DOIUrl":"https://doi.org/10.1177/090591999900900201","url":null,"abstract":"","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 1","pages":"71 - 72"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/090591999900900201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65465348","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}

{"title":"Organizational characteristics of solid-organ donor hospitals and nondonor hospitals.","authors":"A C Klassen,&nbsp;D K Klassen,&nbsp;R Aronoff,&nbsp;A G Hall,&nbsp;J Braslow","doi":"10.7182/prtr.1.9.2.g84672412q751347","DOIUrl":"https://doi.org/10.7182/prtr.1.9.2.g84672412q751347","url":null,"abstract":"<p><strong>Context: </strong>Efforts to increase organ donation include serious attempts in hospital settings, where unrealized donation potential exists. Research on hospital donation must include understanding organizational as well as patient-specific influences on the donation process.</p><p><strong>Objective: </strong>To identify organizational characteristics that distinguish hospitals producing organ donations from those that do not, and to estimate the number of nondonor hospitals with donor potential.</p><p><strong>Design: </strong>Data from the American Hospital Association's 1992 annual survey of hospitals were matched to Organ Procurement and Transplantation Network information from the United Network for Organ Sharing regarding the number of solid-organ donors in 1992. Hospitals with donation capability were identified, based on bed size and factors necessary to produce successful donor maintenance and organ recovery. Based on statistical analyses, organizational characteristics distinguishing donor hospitals from nondonor hospitals were identified. We also compared the number of donors and the number of donor hospitals in 1992 and 1996.</p><p><strong>Setting: </strong>United States.</p><p><strong>Results: </strong>Among all hospitals affiliated with the American Hospital Association (n = 5607), 1214 (22%) were identified as donor hospitals (> or = 1 donation in 1992). Of 2333 hospitals with procurement capability, 1268 (54%) produced no donors in 1992. Based on a multiple logistic regression model, donor hospitals differed from nondonor hospitals by hospital ownership, with municipally owned hospitals more likely and federally owned hospitals less likely to produce donation, compared with for-profit and not-for-profit hospitals. Other organizational characteristics associated with donor hospitals were level of trauma services, whether the hospital had a transplant surgery program or a hospital ethics committee, and whether it was located in the South Atlantic, Southwest Central, or Pacific regions of the United States.</p><p><strong>Conclusions: </strong>Among hospitals not currently producing organ donations, there is a sizable subgroup with donor potential. This area merits further attention.</p>","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 2","pages":"87-94; quiz 95-6"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21555482","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}

{"title":"Bone Densitometry Should Be Included in the Evaluation of Candidates for Lung Transplantation","authors":"V. A. Dodd, R. Staron, A. Papadopoulos, L. Evans, L. Schulman, B. Jørgensen, R. Gerow-Smith, E. Shane","doi":"10.1177/090591999900900210","DOIUrl":"https://doi.org/10.1177/090591999900900210","url":null,"abstract":"Bone loss and fractures are common complications of heart and liver transplantation, and are likely related to high-dose immunosuppressive therapy. We have previously demonstrated that many patients with end-stage lung disease already have osteoporosis and may be at even greater risk for fracture after lung transplantation. The purpose of this study is to determine the incidence of fracture in lung transplant recipients on osteoporosis prevention regimens, the relationship of fracture to pretransplant bone mineral density, and the impact of fracture on quality of life after lung transplantation. Twenty-one lung transplant candidates were prospectively evaluated with spine radiographs and bone mineral densitometry. Bone density was expressed as T scores, the number of standard deviations from the mean bone density of a young normal population of the same gender. Of 21 patients, 8 (38%) fractured during the first year. The mean pretransplant lumbar spine T score was significantly lower in the fracture patients (P=.03). Four of the 7 surviving fracture patients and 1 of the 10 patients who survived without fracture believed that chronic pain diminished their quality of life (X2=4.408; P=.04). These findings suggest that bone mineral density should be routinely included in the evaluation of lung transplant candidates. Patients with extremely low bone density or osteoporotic fracture should be counseled about the increased risk of fracture after transplantation.","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 1","pages":"119 - 123"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/090591999900900210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65465583","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}

{"title":"A comparison of OPO pulsatile machine preservation practices and results.","authors":"J Szust,&nbsp;L Olson,&nbsp;L Cravero","doi":"10.7182/prtr.1.9.2.150x67kn7750w444","DOIUrl":"https://doi.org/10.7182/prtr.1.9.2.150x67kn7750w444","url":null,"abstract":"<p><strong>Context: </strong>Kidney preservation has been performed by either ice (static) or machine pulsatile perfusion. Ice storage is simple, with only 1 methodology. Machine perfusion, on the other hand, is accomplished using multiple methodologies. This article delineates the different methodologies of pumping centers throughout the country.</p><p><strong>Objective: </strong>Pulsatile machine perfusion is again being viewed as the preservation method of choice for kidneys from non-heart-beating cadaver donors and cadaver kidneys from marginal donors. To develop indices to predict the viability of cadaver kidneys for transplant, a review of the organ procurement organizations, specific perfusion techniques, and a comparison of the delayed graft function and graft survival rates were considered.</p><p><strong>Methods: </strong>A survey, asking for specifics on perfusion parameters, pulsatile machine perfusion experience, and criteria for perfusion implementation and graft survival results, was mailed to all organ procurement organizations in the United States.</p><p><strong>Results: </strong>Of the 44 centers that responded to the survey, 12 used pulsatile machine perfusion (11 used the Waters perfusion machine), 6 pumped marginal cadaver kidneys, and the remaining 6 pumped all cadaver kidneys. Minimum perfusion criteria, pulse rates, perfusate composition, pressures, renal resistance, and renal pressure and flow were considered. Vasodilators and other machine additives were used to improve flow. The variance in each center's number of cadaver kidneys pumped each year, as well as the differences in pump times, was noted.</p><p><strong>Conclusion: </strong>Twelve centers use pulsatile machine perfusion. A variety of techniques are used to perform pulsatile machine perfusion, but 11 of 12 have less delayed graft function than those programs employing ice storage preservation.</p>","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 2","pages":"97-100"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21555483","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}

{"title":"When Donor Families and Organ Recipients Meet","authors":"L. Clayville","doi":"10.1177/090591999900900203","DOIUrl":"https://doi.org/10.1177/090591999900900203","url":null,"abstract":"Journal of Transplant Coordination, Vol. 9, Number 2, June 1999 and donor families. This growth in interest is generated by the public promotion of organ donation, such as the campaign sponsored by the National Advertisement Council. Nationally televised meetings between donor families and recipients also play a part in promoting interest in organ donation. As the public becomes more educated about organ donation and the issue of recipient and donor family relationships, the transplant community will likely experience even more requests for such meetings. Policies regarding these meetings should be developed based on an understanding of the grieving process and how communication between these 2 groups impedes or facilitates grieving for the donor families.","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 1","pages":"81 - 86"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/090591999900900203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65465459","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}

{"title":"Compliance and noncompliance in kidney transplant patients: cues for transplant coordinators.","authors":"B Siegal,&nbsp;S Greenstein","doi":"10.7182/prtr.1.9.2.a67514546814h767","DOIUrl":"https://doi.org/10.7182/prtr.1.9.2.a67514546814h767","url":null,"abstract":"<p><p>Maximizing kidney transplant patients' long-term compliance with immunosuppressants is a major challenge to transplant coordinators. Although previous research has found substantial proportions of recipients to be noncompliant, predictors of noncompliance and characteristics of noncompliers remain unclear. In this study of more than 1400 kidney transplant patients, we found noncompliance to be associated with patient and transplant characteristics and with patient beliefs concerning the efficacy of immunosuppressants. Three distinct profiles of noncompliers were identified: accidental noncompliers, invulnerables, and decisive noncompliers. This information can be used by transplant coordinators to recognize cues that predict noncompliance and to work with at-risk patients to forestall or remedy noncompliant behavior.</p>","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 2","pages":"104-8"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21555485","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}

{"title":"Interventions in a heart transplant recipient with a histrionic personality disorder.","authors":"C Smith,&nbsp;A Chakraburtty,&nbsp;D Nelson,&nbsp;I Paradis,&nbsp;S Kesinger,&nbsp;K Bak,&nbsp;A Litsey,&nbsp;W Paris","doi":"10.7182/prtr.1.9.2.j228m013wm16725n","DOIUrl":"https://doi.org/10.7182/prtr.1.9.2.j228m013wm16725n","url":null,"abstract":"<p><p>Organ transplantation is a psychosocially demanding process. Patients must undergo a comprehensive evaluation to await a donor organ that may never become available. After transplantation, recipients must deal with the acceptance of a new organ and comply with a medical regimen that includes numerous medications, follow-up exams, and procedures. Emotional well-being is monitored throughout the transplant process. However, despite the best of efforts and thorough pretransplant bio-psycho-social evaluations, it is possible for patients to have significant psychopathology that remains undetected. Following the stress of transplantation, such patients may present with exacerbation of symptomatology, which has the potential to negatively affect compliance and long-term outcome.</p>","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 2","pages":"109-13"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21555486","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}

{"title":"Organizational Characteristics of Solid-Organ Donor Hospitals and Nondonor Hospitals","authors":"A. Klassen, D. Klassen, R. Aronoff, A. G. Hall, J. Braslow","doi":"10.1177/090591999900900204","DOIUrl":"https://doi.org/10.1177/090591999900900204","url":null,"abstract":"Journal of Transplant Coordination, Vol. 9, Number 2, June 1999 for all types of cadaveric organs included more than 53 000 registrations.1 The possibility of cadaveric organ donation exists among only a small percentage of deaths. Therefore, there is considerable effort to continue to identify and approach all potential donors and their families, and to maximize the likelihood of consent and successful procurement as well as the optimal use of the organs donated. Although only a small number of those who die are deemed medically suitable to become cadaveric donors, substantial evidence shows that the pool of potential donors is larger than the number of donations made. Research consistently shows that only 30% to 50% of eligible deaths result in donation.2,3 Organizational characteristics of solid-organ donor hospitals and nondonor hospitals","PeriodicalId":79507,"journal":{"name":"Journal of transplant coordination : official publication of the North American Transplant Coordinators Organization (NATCO)","volume":"9 1","pages":"87 - 96"},"PeriodicalIF":0.0,"publicationDate":"1999-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/090591999900900204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65465558","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}