scholarly journals Practice Patterns for the Acceptance of Medically Complex Living Kidney Donors with Hematuria, Sickle Cell Trait, Smoking, Illegal Drug Use, or Urological Issues: A Multinational Survey

Author(s):  
Ziad Arabi ◽  
Abdullah Hamad ◽  
Muhammad Bukhari ◽  
Abdulrahman Altheaby ◽  
Saleh Kaysi

Abstract Background To review the practice patterns for the acceptance of medically complex living kidney donors (MCLKD) among the transplant providers of the international transplant community. Methods We distributed a survey globally, through major international transplantation societies, among nephrologists and transplant surgeons (TS). The survey contained questions regarding potential donors with microscopic hematuria, sickle cell trait, renal cysts, kidney stones, smoking, or illegal drug use. Results There were 239 respondents from 29 countries, including nephrologists (42%) and TS (58%). Although most respondents would investigate microscopic hematuria, one-third of them indicated they would decline these potential donors without investigation. Interestingly, most respondents accepted heavy smokers, intermittent illegal drug users (with advice to quit), and those with incidentally identified kidney stones, remote history of renal colic or simple renal cysts. We found multiple areas of consensus in practice with some interesting differences between nephrologists and TS. Conclusions This survey highlights the practice patterns of the acceptance of MCLKDs among the international community. In the absence of clear guidelines, this survey provides additional information to counsel kidney donors with microscopic hematuria, sickle cell trait, renal cysts, kidney stones, heavy smoking, or illegal drug use.

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ziad Arabi ◽  
Abdullah Hamad ◽  
Kaysi Saleh ◽  
Mohammad Bukhari

Abstract Background and Aims Potential kidney donors who actively smoke heavily or had intermittent illegal drug use (IIDU) are mostly excluded from donating a kidney. Tobacco use in kidney donor has been linked to worse outcomes for donors and while less evidence exists for IIDU as they mostly excluded from donation. We conducted a short survey about the suitability of these marginal living kidney donors. The purpose of this survey is to form a consensus on live kidney donor with using smoking or illegal drugs. Method This is a cross-sectional survey of nephrologists and transplant surgeons about suitability and acceptance of marginal live kidney donors. We asked physicians about accepting kidney donors who are actively smoking or using illegal drugs. The survey was mainly distributed through AST and ERA-EDTA. The role of these organization is limited to facilitate the distribution of the survey as an external study. We excluded in-training nephrologists or transplant surgeons. Results One hundred twenty-two physicians from 22 countries (80% nephrologists and 20% transplant surgeons (TS)) participated in the survey. Most physicians were experienced in pre-transplant evaluation (72% over 6 years’ experience and 68.5% of responders perform donors’ evaluation on weekly or monthly bases). Interestingly, most physicians would allow donation in active smoker with advice to quit later (56.2%) (62% of nephrologists versus only 29% of TS (p=0.002). TS would decline active smoker patients than nephrologists (42% versus 25%, p=0.09). Less physicians considered donors with IDU (after psychiatric counselling) than active smoking (30% versus 56.2%, p=0.00003). There was no difference in acceptance rate for donors with IIDU between TS and nephrologists (33.3% versus 29% respectively, p=NS) or in declining these donors (37.5% versus 45.3%, p=0.4). TS would accept more active smokers to donate if no alternative donor available than nephrologists (29.2% vs. 12.3%, p=0.04) but not IDU (29.2% vs. 25.8%, p=ns). Conclusion Active heavy smoking and intermittent illegal drug use are not viewed as solo contraindications for kidney donation by most physicians. Nephrologists and TS did not differ in attitude regarding donors with IIDU. Nephrologist seems more confident to accept donors who are actively smoking with advice to quit afterward while TS would accept them more if no alternative donor available or would decline them completely.


1985 ◽  
Vol 3 (3) ◽  
pp. 239-240
Author(s):  
Richard Rogers ◽  
James L. Cavanaugh

2002 ◽  
Vol 32 (2) ◽  
pp. 139-147 ◽  
Author(s):  
George S. Yacoubian ◽  
Ronald J. Peters ◽  
Blake J. Urbach ◽  
Regina J. Johnson

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) symbolized a comprehensive change to the nation's welfare system. Despite several provisions within PRWORA that focus on the use of illegal drugs, few studies have attempted to identify the prevalence of illegal drug use among welfare recipients. Moreover, no scholarly works have compared rates of drug use in welfare-receiving populations to those of non-welfare-receiving populations with an objective measure of drug use. In the current study, urine specimens were collected from 1,572 arrestees interviewed through Houston's Arrestee Drug Abuse Monitoring (ADAM) Program in 1999. Drug positive rates are compared between welfare-receiving arrestees ( n = 116), non-welfare receiving arrestees living below the poverty level ( n = 539), and non-welfare receiving arrestees living above the poverty level ( n = 917). Welfare-receiving arrestees were more likely to be female, older, less educated, and to test positive for opiates and benzodiazepines than the other subgroups. Implications for welfare reform policy are discussed in light of the current findings.


ILR Review ◽  
1992 ◽  
Vol 45 (3) ◽  
pp. 419-434 ◽  
Author(s):  
Andrew M. Gill ◽  
Robert J. Michaels

This study, using microdata from the 1980 and 1984 waves of the National Longitudinal Survey of Youth, examines the effects of drug use on wages and employment. Contrary to most previous researchers' findings that illegal drug use negatively affects earnings, this analysis suggests that, once an allowance is made for self-selection effects (that is, unobservable factors simultaneously affecting wages and the decision to use drugs), drug users actually received higher wages than non-drug users. A similar analysis of employment effects shows that the sample of all drug users (which included users of “hard” and “soft” drugs) had lower employment levels than non-drug users, but the smaller sample consisting only of users of hard drugs, surprisingly, did not.


Author(s):  
David Skarbek

3 shows how in Nordic counties, prison officials provide significantly more resources, more competent administration, and higher-quality governance than is found in Latin American prisons. As a result, prisoners have few reasons to spend time, energy, and resources on providing these same goods and services. The chapter goes on to show that there are few prisoner-created organizations with relatively little influence on the everyday life of prisoners, and social norms are the predominant governance mechanism in place as small prison populations make gossip and ostracism powerful tools for punishing bad behavior. Even in the sphere of illegal drug use, prisoners do not use markets to coordinate the use of resources, relying instead on a system of sharing.


This chapter examines the Morse v. Frederick (2007) case – the most recent United States Supreme Court decision about students' right to free speech under the Free Speech Clause of the First Amendment. It discusses the test created in the case for determining the extent of school-censorship authority over student speech. This test, known as the Morse test, allows schools to censor student speech if the speech advocates illegal drug use. The ultimate goal of the chapter is to analyze the Morse v. Frederick case in order to determine if it gives schools any authority to censor students' off-campus speech.


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