Transplant Coordination as the “Keystone” in Non—Heart-Beating Donations

2002 ◽  
Vol 12 (3) ◽  
pp. 181-184
Author(s):  
Joaquin Alvarez ◽  
Maria Rosario del Barrio
Keyword(s):  
Survival Rate ◽  
Organ Donation ◽  
Donor Pool ◽  
Heart Beating ◽  
Brain Dead

The shortage of donated organs has become a problem in the transplantation world. Transplant teams are continuously looking for new ways to increase and improve the donor pool. Non—Heart-beating donors could be a source for increasing the number of donors, even though in some countries legal, ethical, or logistical problems obstruct the development of that source. The good results obtained by some groups working with Non—Heart-beating donors should stimulate others to implement this type of policy in their hospitals. We describe the origin and development of our policy on Non—Heart-beating donation, which has become the main source for organ donation in our hospital. We have found that the 5-year survival rate for kidneys from these donors is similar to the survival rate for kidneys obtained from brain-dead donors, and this encourages us to continue to use kidneys from Non—Heart-beating donors.

scholarly journals Inflammatory Signalling Associated with Brain Dead Organ Donation: From Brain Injury to Brain Stem Death and Posttransplant Ischaemia Reperfusion Injury

2013 ◽  
Vol 2013 ◽  
pp. 1-19 ◽  
Author(s):  
Ryan P. Watts ◽  
Ogilvie Thom ◽  
John F. Fraser
Keyword(s):  
Brain Injury ◽  
Brain Death ◽  
Organ Donation ◽  
Reperfusion Injury ◽  
Inflammatory Mediators ◽  
Ischaemia Reperfusion Injury ◽  
Donor Pool ◽  
Ongoing Research ◽  
Ischaemia Reperfusion ◽  
Brain Dead

Brain death is associated with dramatic and serious pathophysiologic changes that adversely affect both the quantity and quality of organs available for transplant. To fully optimise the donor pool necessitates a more complete understanding of the underlying pathophysiology of organ dysfunction associated with transplantation. These injurious processes are initially triggered by catastrophic brain injury and are further enhanced during both brain death and graft transplantation. The activated inflammatory systems then contribute to graft dysfunction in the recipient. Inflammatory mediators drive this process in concert with the innate and adaptive immune systems. Activation of deleterious immunological pathways in organ grafts occurs, priming them for further inflammation after engraftment. Finally, posttransplantation ischaemia reperfusion injury leads to further generation of inflammatory mediators and consequent activation of the recipient’s immune system. Ongoing research has identified key mediators that contribute to the inflammatory milieu inherent in brain dead organ donation. This has seen the development of novel therapies that directly target the inflammatory cascade.

scholarly journals How Inaccurate Metrics Hide the True Potential for Organ Donation in the United States

2018 ◽  
Vol 28 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Laura A. Siminoff ◽  
Heather M. Gardiner ◽  
Maureen Wilson-Genderson ◽  
Teresa J. Shafer
Keyword(s):  
United States ◽  
Organ Donation ◽  
Organ Procurement ◽  
Secondary Analysis ◽  
The United States ◽  
Transplant Recipients ◽  
Donor Pool ◽  
Conversion Rates ◽  
The Us ◽  
Brain Dead

Background: There is a discrepancy between the reported increase in donor conversion rates and the number of organs available for transplant. Methods: Secondary analysis of data obtained from the Scientific Registry of Transplant Recipients from January 2003 through December 2015 was performed. The primary outcomes were the (1) number of brain-dead donors from whom solid organs were recovered and (2) number of the organs transplanted. Descriptive statistics and growth plots were used to examine the trajectory of organ donation, recovery, and transplantation outcomes over the 11-year period. Results: From 2003 to 2006, the number of brain-dead donors increased from 6187 to 7375, remaining relatively stable at approximately 7200 thereafter. The average eligible deaths per organ procurement organization dropped from 182.7 (standard deviation [SD]: 131.3) in 2003 to 149.3 (SD: 111.4) in 2015. This suggests a total of 12 493 unrealized potential donors (2006-2015). Conclusions: Since 2006, a steady decline in the number of donor-eligible deaths was reported. In 2003, the reported eligible deaths was 11 326. This number peaked in 2004 at 11 346, tumbling to 9781 eligible donors in 2015, despite a 9% increase in the US population. From 2006 to 2015, the data indicate an artificial depression and underestimation of the true potential of brain-dead donors in the United States of conservatively 12 493 donors or 39 728 missing organs. New metrics providing objective but verifiable counts of the donor pool are needed.

Lower Rate of Family Refusal for Organ Donation in Non–Heart-Beating Versus Brain-Dead Donors

2009 ◽  
Vol 41 (6) ◽  
pp. 2304-2305 ◽  
Author(s):  
A. Andrés ◽  
E. Morales ◽  
S. Vázquez ◽  
M.P. Cebrian ◽  
E. Nuño ◽  
...  
Keyword(s):  
Organ Donation ◽  
Heart Beating ◽  
Brain Dead

Successful Organ Donation From Brain Dead Donors in a Chinese Organ Transplantation Center

2011 ◽  
Vol 11 (10) ◽  
pp. 2247-2249 ◽  
Author(s):  
W. G. Sui ◽  
Q. Yan ◽  
S. P. Xie ◽  
H. Z. Chen ◽  
D. Li ◽  
...  
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Brain Dead ◽  
Transplantation Center

scholarly journals Perceived Support Among Families Deciding About Organ Donation for Their Loved Ones: Donor Vs Nondonor Next Of Kin

2010 ◽  
Vol 19 (5) ◽  
pp. e52-e61 ◽  
Author(s):  
Liva Jacoby ◽  
James Jaccard
Keyword(s):  
Quality Of Care ◽  
Organ Donation ◽  
Demographic Data ◽  
Quality Care ◽  
Family Members ◽  
Care Staff ◽  
Next Of Kin ◽  
Perceived Quality Of Care ◽  
Brain Dead

BackgroundFamilies’ experiences in the hospital influence their decisions about donating organs of brain-dead relatives. Meeting families’ support needs during this traumatic time is an obligation and a challenge for critical care staff.Objectives(1) To elicit family members’ accounts of various types of support received and perceived quality of care for themselves and their loved ones when they made the donation decision, and (2) to examine the relationship between these factors and the families’ donation decision.MethodsRetrospective telephone interviews of 199 families from different regions of the country were completed. Aside from demographic data, the survey addressed perceptions of informational, emotional, and instrumental support and quality of care.ResultsOne hundred fifty-four study participants consented to donation; 45 declined. White next of kin were significantly more likely than African Americans to consent. Specific elements of reported support were significantly associated with consent to donate. Donor and nondonor families had differing perceptions of quality care for themselves and their loved ones. Receiving understandable information about organ donation was the strongest predictor of consent.ConclusionsSpecific supportive behaviors by staff as recounted by family members of potential donors were significantly associated with consent to donation. These behaviors lend themselves to creative training and educational programs for staff. Such interventions are essential not only for next of kin of brain-dead patients, but also for staff and ultimately for the public as a whole.

Brain Death and Organ Donation

2018 ◽  
Author(s):  
Thomas I. Cochrane
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Cardiac Death ◽  
Donation After Cardiac Death ◽  
Donation After Brain Death ◽  
Brain Death Determination ◽  
Brain Dead ◽  
American Academy Of Neurology ◽  
Death Determination

Brain death is the state of irreversible loss of the clinical functions of the brain. A patient must meet strict criteria to be declared brain dead. They must have suffered a known and demonstrably irreversible brain injury and must not have a condition that could render neurologic testing unreliable. If the patient meets these criteria, a formal brain death examination can be performed. The three findings in brain death are coma or unresponsiveness, absence of brainstem reflexes, and apnea. Brain death is closely tied to organ donation, because brain-dead patients represent approximately 90% of deceased donors and thus a large majority of donated organs. This review details a definition and overview of brain death, determination of brain death, and controversy over brain death, as well as the types of organ donation (living donation versus deceased donation), donation after brain death, and donation after cardiac death. A figure presents a comparison of organ donation after brain death and after cardiac death, and a table lists the American Academy of Neurology Criteria for Determination of Brain Death. This review contains 1 highly rendered figure, 3 table, and 20 references.

scholarly journals Knowledge and Attitudes about Organ Donation among Patient Companion at a Tertiary Hopsital in Ethiopia

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Mahteme Bekele ◽  
Wubshet Jote ◽  
Tigist Workneh ◽  
Berhanu Worku
Keyword(s):  
Organ Donation ◽  
Medical Center ◽  
Negative Attitude ◽  
Organ Donor ◽  
Tertiary Hospital ◽  
Favorable Attitude ◽  
Good Knowledge ◽  
Donor Pool ◽  
Cross Sectional ◽  
Study Participants

BACKGROUND: Worldwide, the supply of organs continues to be much less than the demand. Many studies identify poor knowledge and negative attitude about organ donation for this. The purpose of this study was to assess knowledge and attitude towards organ donation and associated factors among people who accompany patient during hospital visit at tertiary hospital in Ethiopia.METHODS: A hospital-based cross-sectional study was conducted from March 1st to May 31, 2019, at a tertiary hospital and the only transplant center in Ethiopia. The patient companions were interviewed with structured questionnaires. Descriptive statistics were presented and factors associated with good knowledge and favorable attitude were assessed using Binary logistic regression.RESULTS: A total of 414 patient companion participated in the study. The mean age of the respondents was 35+13years, and 252(60.9%) were males. Forty-four (10.6%) of the study participants had good knowledge about organ donation. Male gender was significantly associated with improved knowledge (AOR=2.127 95% CI: 1.036, 4.368). A favorable attitude towards donation was found in 219(52.9%) of the study participants. Participants who had completed secondary education were more likely to have unfavorable attitude towards organ donation (AOR=0.498, 95% CI: 0.290, 0.857).CONCLUSION: Knowledge about organ donation was found to be poor, and attitudes towards organ donation were found to be unfavorable among patient companions at a major medical center in Ethiopia. Strategies focused on education of the general public and broad dissemination of information on the benefits of organ donation will be critical for improving the organ donor pool.

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