scholarly journals Evaluating the Impact of COVID-19 Pandemic on Organ Donation and Transplantation Activities in Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Marzieh Latifi ◽  
Farzaneh Bagherpour ◽  
Arefeh Jafarian ◽  
Amirali Hamidiyeh ◽  
Ehsan Javandoost ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Organ Procurement ◽  
Chief Executive ◽  
Time Intervals ◽  
Potential Donor ◽  
Before And After ◽  
The Impact ◽  
Family Consent ◽  
New Strategies

Background: Coronavirus disease 2019 (COVID-19) pandemic has had a great impact on reducing organ transplantation activities. Objectives: The aim of this study was to determine the donation and transplantation activities before and after COVID-19 outbreak in Iran. Methods: This retrospective study compared the donation and transplantation activities in two specific 9-month periods (December 2018 to March 2019 vs. March-December 2020). The questionnaire included the numbers of brain death confirmations, family consents, organ recoveries, and transplanted solid organs. The questionnaire was sent by email to the chief executive of the organ procurement unit. Results: A total of 15 organ procurement units responded to the survey. The largest reduction was seen in tissue transplantations (62.5%) during two time intervals. Brain death due to head trauma significantly decreased in two time intervals and suicide increased by 14.44% during the COVID-19 pandemic compared to 2018-2019 period. Significant reductions between the median of donation (P = 0.0187), median of potential donor (P = 0.005), median of family consent (P = 0.002), and median of eligible donor (P = 0.009) were observed during the two time periods. Conclusions: A significant reduction was observed in organ donation and transplantation during COVID-19 pandemic. Developing protocols and establishing new strategies for evaluation of organ donation to ensure the safety of organ recipients and medical staff is necessary.

An assessment of advance relatives approach for brain death organ donation

2017 ◽  
Vol 26 (2) ◽  
pp. 553-563
Author(s):  
Carine Michaut ◽  
Antoine Baumann ◽  
Hélène Gregoire ◽  
Corinne Laviale ◽  
Gérard Audibert ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Healthcare Professionals ◽  
Ethical Issues ◽  
Organ Procurement ◽  
Post Mortem ◽  
Potential Donor ◽  
Tissue Procurement ◽  
Study Population ◽  
Network Administrators

Background: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. Research design: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called ‘Prélor’. Participants: The study population comprised 460 physicians and nurses in the Neurosurgical, Surgical and Medical Intensive Care Units, the Stroke Units and the Emergency Departments. Ethical considerations: The project was approved by the board of the Lorraine University Diploma in Medical Ethics and the Prélor Network administrators. Main findings: A slight majority of 53.5% of respondents had previously participated in an advance relatives approach: 83% of the physicians and 42% of the nurses. A majority of healthcare professionals (68%) think that the main justification for advance relatives approach is the comprehensive care of the dying patient and the research of his or her most likely opinion (74%). The misunderstanding of the related issues by relatives is an obstacle for 47% of healthcare professionals and 51% think that the answer given by the relatives regarding the most likely opinion of the person regarding post-mortem organ donation really corresponds to the person opinion in only 50% of the cases or less. Conclusion: Time given by advance approach should be employed to help and enable relatives to authentically bear the values and interests of the potential donor in the post-mortem organ donation discussion. Nurses’ attendance of advance relatives approach seems necessary to enable them to optimally support the families facing death and post-mortem organ donation issues.

Comparison of 1 vs 2 Brain Death Examinations on Time to Death Pronouncement and Organ Donation

Neurology ◽  
2021 ◽  
Vol 96 (10) ◽  
pp. e1453-e1461
Author(s):  
Panayiotis N. Varelas ◽  
Mohammed Rehman ◽  
Chandan Mehta ◽  
Lisa Louchart ◽  
Lonni Schultz ◽  
...  
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Brain Function ◽  
Brain Injuries ◽  
Organ Procurement ◽  
Tertiary Hospital ◽  
Consent Rate ◽  
Organ Procurement Organization ◽  
Time To Death ◽  
Elapsed Time

ObjectiveTo fill the evidence gap on the value of a single brain death (SBD) or dual brain death (DBD) examination by providing data on irreversibility of brain function, organ donation consent, and transplantation.MethodsTwelve-year tertiary hospital and organ procurement organization data on brain death (BD) were combined and outcomes, including consent rate for organ donation and organs recovered and transplanted after SBD and DBD, were compared after multiple adjustments for covariates.ResultsA total of 266 patients were declared BD, 122 after SBD and 144 after DBD. Time from event to BD declaration was longer by an average of 20.9 hours after DBD (p = 0.003). Seventy-five (73%) families of patients with SBD and 86 (72%) with DBD consented for organ donation (p = 0.79). The number of BD examinations was not a predictor for consent. No patient regained brain function during the periods following BD. Patients with SBD were more likely to have at least 1 lung transplanted (p = 0.031). The number of organs transplanted was associated with the number of examinations (β coefficient [95% confidence interval] −0.5 [−0.97 to −0.02]; p = 0.044), along with age (for 5-year increase, −0.36 [−0.43 to −0.29]; p < 0.001) and PaO2 level (for 10 mm Hg increase, 0.026 [0.008–0.044]; p = 0.005) and decreased as the elapsed time to BD declaration increased (p = 0.019).ConclusionsA single neurologic examination to determine BD is sufficient in patients with nonanoxic catastrophic brain injuries. A second examination is without additional yield in this group and its delay reduces the number of organs transplanted.

scholarly journals Organ Donation in the Context of Brain Death in Muslim Countries: Bioethical Positions

2020 ◽  
Vol 5 (07) ◽  
pp. 222-224
Author(s):  
Alqahtani Ibtesam Mohammed
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Organ Transplantation ◽  
Organ Procurement ◽  
Modern Medicine ◽  
Organ Transplants ◽  
Clear Cut ◽  
Muslim Countries ◽  
The Right ◽  
End Stage

One of the miracles of modern medicine for patients with end stage organ failure is organ transplantation. The Organ Procurement and Transplantation Network (OPTN) defines organ donation as giving an organ, tissue, cells, or part of an organ from a living or deceased person (i.e., the donor) to a living person in need (i.e., the recipient). In the last two decades, the number of organ transplants has gradually increased; however, the demand for organ transplantation exceeds the number of available donors. Organs from brain dead donors have been suggested as an alternative option for increasing donation rates when living donors are not available. This article explores the debate surrounding brain death organ donation in Muslim countries. Because organ transplantation is based on Ijtihad, Muslim jurists have no clear-cut text in the Holy Quran or Sunna to use as a foundation for judgment. This has made organ transplants an issue among Muslim scholars and researchers, splitting them into two opinion groups, with one side seeing organ transplantation as legal and the other believing it to be illegal. However, all individuals have the right to choose whether they want to help others by sacrificing parts of themselves and donating their organs. Autonomy, justice, and beneficence must be employed in organ transplantation decision-making.

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

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.

Organ Donation, Brain Death and the Family: Valid Informed Consent

2015 ◽  
Vol 43 (2) ◽  
pp. 369-382 ◽  
Author(s):  
Ana S. Iltis
Keyword(s):  
Informed Consent ◽  
Brain Death ◽  
Organ Donation ◽  
Organ Procurement ◽  
Organ Donor ◽  
Public Understanding ◽  
Organ Procurement Organization ◽  
The Family ◽  
Driver's License ◽  
Brain Dead

In July 2013, parents in Ohio objected to their 21-year-old son becoming an organ donor. Elijah Smith was involved in an accident and pronounced dead using neurological criteria. The organ procurement organization (OPO) went to court and argued that because the young man was brain dead and because his driver's license indicated that he wished to be a donor, the court should allow them to use his organs. The mother argued that her son did not understand what he was signing when he signed his license and that his signature did not reflect an informed decision. The court disagreed with her, saying that he had indicated a wish to donate his organs and that no one but Elijah could revoke that wish. His organs were removed.Elijah's mother suspected that he did not understand what he was signing. She might have been right, given what we know about the process for obtaining permission for organ donation and the limited public understanding of brain death.

Organ Donation

2019 ◽  
pp. 545-551
Author(s):  
Lissi Hansen ◽  
Lauren F. Dunn
Keyword(s):  
Palliative Care ◽  
Brain Death ◽  
Organ Donation ◽  
Organ Procurement ◽  
Federal Regulations ◽  
Donation After Circulatory Death ◽  
Bedside Nurse ◽  
Donation Process ◽  
Organ Procurement Organizations ◽  
Circulatory Death

This chapter examines the organ donation process from the time the bedside nurse recognizes that a patient should be referred for organ donation until organ procurement has been completed. It also discusses when to speak with families about organ donation, how to address family concerns, the clinical triggers for organ donation, differences between brain death donation and donation after circulatory death (DCD), and palliative care for patients who are candidates for DCD. State and federal regulations related to prospective donors and safeguarding standards that are in place for organ procurement organizations (OPO) and hospitals are also included.

733: Organ Dysfunction Trends in Children Who Succumb to Brain Death and the Impact on Organ Donation

2020 ◽  
Vol 49 (1) ◽  
pp. 362-362
Author(s):  
Taylor Nickerson ◽  
Marlina Lovett ◽  
Nicole O’Brien
Keyword(s):  
Brain Death ◽  
Organ Donation ◽  
Organ Dysfunction ◽  
The Impact

The Impact of Intoxication on the Number of Organs Available for Transplantation after Brain Death

2009 ◽  
Vol 75 (5) ◽  
pp. 416-420
Author(s):  
Pantelis Hadjizacharia ◽  
Ali Salim ◽  
Joseph Dubose ◽  
Angela Mascarenhas ◽  
Daniel R. Margulies
Keyword(s):  
Brain Death ◽  
Retrospective Review ◽  
Trauma Center ◽  
Statistical Difference ◽  
Organ Procurement ◽  
Organ Donor ◽  
Trauma Patients ◽  
Head Injured ◽  
Level I ◽  
The Impact

A significant number of head-injured trauma patients are likely to present with a positive toxicology. The purpose of this study is to investigate whether intoxication with substances such as cocaine, amphetamine, alcohol, and opiates on admission has any influence on the number of organs that are recovered after brain death in these patients. We conducted a retrospective review of all organ donor patients admitted to a Level I trauma center over a 4-year period (2002 to 2005). Patients with positive toxicology screens on admission were compared to counterparts with negative screens with regard to the number of organs harvested. There were 90 organ donor patients during the 4-year period. There were 63 (70%) patients to negative toxicology screens. The remaining 27 (30%) were found to be intoxicated with a variety of substances, including alcohol (18%), cocaine (4%), amphetamines (9%), benzodiazepines (4%), opiates (4%), and poly-substances (10%). A comparison of total organs and individual organs donated by both intoxicated and nonintoxicated patients showed no overall statistical difference in the number or type of organs donated between the two groups. Thus, the prospect of organ procurement should not be overlooked in intoxicated patients.

scholarly journals Gerência do cuidado de enfermagem ao paciente em morte encefálica

2019 ◽  
Vol 13 (4) ◽  
pp. 1124
Author(s):  
Aline Lima Pestana Magalhães ◽  
Roberta Juliane Tono de Oliveira ◽  
Saulo Fabio Ramos ◽  
Milene Mendes Lobato ◽  
Neide Da Silva Knihs ◽  
...  
Keyword(s):  
Brain Death ◽  
Patient Care ◽  
Organ Donation ◽  
Nursing Care ◽  
Organ Procurement ◽  
Physical Structure ◽  
Structured Interviews ◽  
Recursos Humanos ◽  
Brain Dead ◽  
The Brain

RESUMO Objetivo: compreender a gerência do cuidado de enfermagem aos pacientes em morte encefálica na perspectiva de enfermeiros atuantes no processo de doação e transplantes de órgãos. Método: trata-se de estudo qualitativo, fundamentado na Teoria Fundamentada nos Dados, com 25 enfermeiras. Obtiveram-se os dados por meio de entrevistas semiestruturadas individuais e se empregou a codificação aberta, axial e seletiva para análise dos dados. Resultados: emergiram-se duas categorias a partir da análise dos dados: << Observando as dificuldades relacionadas a gerência do cuidado de enfermagem ao paciente em morte encefálica >> e << Compreendendo as ações realizadas pela equipe de enfermagem na gerência do cuidado ao paciente em morte encefálica >>. Destacaram-se como dificuldades a limitação da estrutura física, recursos humanos e materiais. Enfatizaram-se pelos enfermeiros a monitorização e o suporte hemodinâmico, controle glicêmico e de diurese como ações necessárias para a gerência do cuidado ao paciente em morte encefálica. Conclusão: compreende-se que a gerência do cuidado ao paciente em morte encefálica requer entendimento para além das esferas técnicas sendo necessária a desmistificação do significado da doação de órgãos para manutenção de uma nova vida em outro alguém. Descritores: Obtenção de Tecidos e Órgãos; Transplante de Órgãos; Cuidados de Enfermagem; Cuidados Críticos; Morte Encefálica; Papel do Profissional de Enfermagem.ABSTRACT Objective: to understand the management of Nursing care to patients in brain death from the perspective of nurses working in the process of organ donation and transplants. Method: this is a qualitative study, based on the Data Based Theory, with 25 nurses. The data were obtained through individual semi-structured interviews and the open, axial and selective coding was used for data analysis. Results: two categories emerged from the analysis of the data: "Observing the difficulties related to the management of nursing care to the brain dead patient" and "Understanding the actions performed by the nursing team in the management of the brain dead patient's care. The limitations of physical structure and human and material resources were highlighted as difficulties. Monitoring and hemodynamic support, glycemic control and diuresis as necessary actions for the management of patient care in brain death were emphasized by the nurses. Conclusion: it is understood that the management of patient care in brain death requires understanding beyond the technical spheres, and it is necessary to demystify the meaning of organ donation for the maintenance of a new life in another person. Descriptors: Tissue and Organ Procurement; Organ Transplantation; Nursing Care; Critical Care; Brain Death; Nurse’s Role.RESUMEN Objetivo: comprender la gestión del cuidado de enfermería a los pacientes en muerte encefálica en la perspectiva de enfermeros actuantes en el proceso de donación y trasplantes de órganos. Método: se trata de un estudio cualitativo, fundamentado en la Teoría Fundamentada en los Datos, con 25 enfermeras. Se obtuvieron los datos por medio de entrevistas semiestructuradas individuales y se empleó la codificación abierta, axial y selectiva para análisis de los datos. Resultados: surgieron dos categorías a partir del análisis de los datos: << Observando las dificultades relacionadas a la gestión del cuidado de enfermería al paciente en muerte encefálica >> y << Comprendiendo las acciones realizadas por el equipo de enfermería en la gestión del cuidado al paciente en muerte encefálica >>. Se destacaron como dificultades la limitación de la estructura física, recursos humanos y materiales. Se enfatizaron por los enfermeros el monitoreo y el soporte hemodinámico, control glucémico y de diuresis como acciones necesarias para la gestión del cuidado al paciente en muerte encefálica. Conclusión: se comprende que la gestión del cuidado al paciente en muerte encefálica requiere entendimiento más allá de las esferas técnicas siendo necesaria la desmitificación del significado de la donación de órganos para el mantenimiento de una nueva vida en otro. Descriptores: Obtención de Tejidos y Órganos; Trasplante de Órganos; Atención de Enfermería; Cuidados Críticos; Muerte Encefálica; Rol de la Enfermera.

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