Magyarországi intenzív osztályok szervdonációval                     kapcsolatos személyi és tárgyi feltételei

Abstract: Introduction: At the end of 2016, the number of patients on the domestic transplant waiting list was twice as much as the number of the organ transplantations accomplished that year. The institutional prerequisites for functional organ donation programs are the sufficient number of personnel and the adequate material conditions to be provided in relation to the needs. Aim: The goal of the current study was to evaluate the professional environment in Hungary. Method: The Organ Coordination Office at the Hungarian National Blood Transfusion Service compiled a questionnaire survey on the personnel and material conditions of the intensive care units (ICUs) in Hungary in regards to organ donations. The survey applied an online questionnaire including 43 questions. In addition to the number of beds and employees, we investigated the tools needed for the legal and the medical diagnosis of brain death as well as the accessibility of examinations on the donor information form. The data collection spanned from 12 December 2016 to 30 June 2017. Results: 59 intensive care units completed the questionnaire; the investigation involved 640 hospital beds, 816 physicians and 1252 nurses. In the daytime shift, 0.25 doctors and 0.41 nurses work on a patient bed at an average, while in the night shift, the figures are 0.11 and 0.33, respectively. 51.7% of the doctors are registered to access the National Non-Donor Registry, and brain death diagnosis committee is available in 83% of the hospitals. Among the medical imaging methods (cranial, abdominal-thoracic), CT scan in 71–73%, abdominal ultrasound in 75%, transthoracic echocardiograpy (TTE) in 37%, transoesophageal echocardiography (TEE) in 4%, bronchoscopy in 49%, coronarography in 19% are non-stop available, with instant interpretation in 75% of the cases. Transcranial Doppler (TCD) in 30%, four-vessel angiography in 45% and SPECT in 14% of the cases are available. More than 90% of the laboratory examinations on the donor information form are available 24 hours a day. Conclusion: The number of doctors and nurses did not change compared to our 2008 survey (0.18 doctors, 0.37 nurses/ICU beds in 2008), but the care of potential donors needs more resources and time. The standby availability of personnel and material conditions is a prerequisite for organ donation programs in order to save lives. Orv Hetil. 2018; 159(33): 1360–1367.

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Knowledge and Attitudes Toward Organ Donation and Brain Death Among Medical Staff of Intensive Care Units

Transplantation Journal ◽

10.1097/01.tp.0000525162.70330.20 ◽

2017 ◽

Vol 101 ◽

pp. S118

Author(s):

Bilgehan Kahveci ◽

Kenan Topal ◽

Cigdem Gereklioglu ◽

Avsar Zerman ◽

Sibel Tetiker

Keyword(s):

Intensive Care ◽

Brain Death ◽

Organ Donation ◽

Intensive Care Units ◽

Medical Staff ◽

Knowledge And Attitudes

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Brain death and organ donation in Argentine pediatric intensive care units. A multicenter study

Archivos Argentinos de Pediatria ◽

10.5546/aap.2018.eng.e54 ◽

2018 ◽

Vol 116 (1) ◽

Keyword(s):

Intensive Care ◽

Brain Death ◽

Organ Donation ◽

Intensive Care Units ◽

Multicenter Study ◽

Pediatric Intensive Care ◽

Pediatric Intensive Care Units

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The donor potential of twenty six donor bases in the Russian Federation: external audit (a pilot project)

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2020-48-024 ◽

2020 ◽

Vol 48 (3) ◽

pp. 153-161

Author(s):

V. L. Vinogradov ◽

K. K. Gubarev ◽

A. I. Zakhlevnyy ◽

D. S. Svetlakova

Keyword(s):

Intensive Care ◽

Brain Injury ◽

Brain Death ◽

Organ Donation ◽

Intensive Care Units ◽

Pilot Project ◽

Secondary Brain Injury ◽

External Audit ◽

Potential Donor ◽

Donation Process

Rationale: The imbalance between the need for donor organs and their current availability is a growing problem for all countries. An assessment of potential donor numbers is considered to be an important step towards better understanding of the problem as a whole at the national scale. This would help to build up a concept of a successful strategy to resolve this inequity.Aim: To analyze the use of external audit of the efficacy of identification of potential organ donors with confirmed brain death.Materials and methods: As a part of a pilot project aimed to increase the efficacy of donor bases of the Russian Federal Medical Biological Agency (FMBA), we retrospectively analyzed 5932 medical files of patients who died from 2014 to 2018 in the departments of resuscitation and intensive care units of 26 medical establishments serving as a donor bases in Moscow, Orenburg, Saratov, Abakan, Stavropol and FMBA of Russia. The probability of brain death was assessed with a special QAPDD (Quality Assurance Program in the Deceased Donation Process) technique focused on organ donation after brain death which is used for external audit in Spanish hospitals.Results: Clinical manifestation of brain death were identified in 20.3% (95% confidence interval (CI) 18.4–22.4) of the patients aged 18 to 65 years with severe primary and secondary brain injury who died in the departments of resuscitation and had been maintained on mechanical ventilation at least 12 hours until their death was confirmed. The rate of potential donor identification with clinical manifestations of brain death in the donating in-patient departments was 12% (95% CI 10.5–13.7) of those who died with severe primary and secondary brain injury. The external audit performed in 26 donating in-patient departments, has shown that 41% (95% CI 35.8–46.4) of potential donors with brain death were not identified.Conclusion: With the use of the QAPDD technique in our study, we found that 41% of potential donors were not identified in the Russian in-patient clinics participating in organ donation. Based on the information obtained during the audit of medical files in intensive care units, we can make realistic conclusions on the current system of organ donation, identify potential pitfalls in the identification procedures of potential donors, increase the efficacy of donation process, and to improve the system as a whole. The process could become effective only through the activities of specially trained donor hospital transplant coordinators.

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Factors influencing consent to organ donation after brain death certification: a survey of 29 Intensive Care Units

Minerva Anestesiologica ◽

10.23736/s0375-9393.18.12658-7 ◽

2018 ◽

Vol 84 (9) ◽

Cited By ~ 1

Author(s):

Guya Piemonte ◽

Maria L. Migliaccio ◽

Stefano Bambi ◽

Marco Bombardi ◽

Lorenzo D'antonio ◽

...

Keyword(s):

Intensive Care ◽

Brain Death ◽

Organ Donation ◽

Intensive Care Units ◽

Death Certification ◽

Factors Influencing ◽

Donation After Brain Death

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Faculty Opinions recommendation of Eligibility for organ donation following end-of-life decisions: a study performed in 43 French intensive care units.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718520688.793502703 ◽

2015 ◽

Author(s):

Rik Gerritsen

Keyword(s):

Intensive Care ◽

Organ Donation ◽

End Of Life ◽

Intensive Care Units ◽

End Of Life Decisions ◽

Life Decisions

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PREVALENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII (CRAB) IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS (ICUS) OF JPMC, KARACHI

Pakistan Journal of Medicine and Dentistry ◽

10.36283/pjmd8-4/006 ◽

2019 ◽

Author(s):

Rabia Arshad

Keyword(s):

Intensive Care ◽

Antimicrobial Resistance ◽

Acinetobacter Baumannii ◽

Intensive Care Units ◽

Carbapenem Resistance ◽

Chronic Obstructive ◽

Surgical Intensive Care ◽

Carbapenem Resistant ◽

Number Of Patients ◽

Increased Risk

Background: Antimicrobial resistance is one of the research priorities of health organizations due to increased risk of morbidity and mortality. Outbreaks of nosocomial infections caused by carbapenem-resistant Acinetobacter Baumannii (CRAB) strains are at rise worldwide. Antimicrobial resistance to carbapenems reduces clinical therapeutic choices and frequently led to treatment failure. The aim of our study was to determine the prevalence of carbapenem resistance in A. baumannii isolated from patients in intensive care units (ICUs). Methods: This cross-sectional study was carried out in the Department of Microbiology, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from December 2016 to November 2017. Total 63 non-repetitive A. baumannii were collected from the patients’ specimens, admitted to medical and surgical ICUs and wards of JPMC, Karachi. The bacterial isolates were processed according to standard microbiological procedures to observe for carbapenem resistance. SPSS 21 was used for data analysis. Results: Out of the 63 patients, 40 (63.5%) were male. The age of the patient ranged from 15-85 year, with average of 43 year. 34.9% patients had been hospitalized for 3 days. Chronic obstructive pulmonary disease was present in highest number with average of 58.7% for morbidity. Number of patients on mechanical ventilation was highest (65.1%). All isolates were susceptible to colistin. The resistance to ampicillin-sulbactam, ceftazidime, ciprofloxacin, amikacin, piperacillin- tazobactam and meropenem was 82.5%, 81%, 100%, 87.3%, 82.5% and 82% respectively. Out of 82% CRAB, 77% were obtained from ICUs. Conclusion: This study has revealed the high rate of carbapenem resistance in A. baumannii isolates in ICUs thus leaving behind limited therapeutic options.

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