REWARDING A LIVING KIDNEY DONOR: A COMPARISON BETWEEN SOUTH AFRICA, SINGAPORE AND IRAN

There are thousands of desperate people globally who need a kidney for transplantation. The number of people who require a kidney transplant continues to escalate faster than the number of kidneys available for a transplant. If South Africa wants to improve its current kidney-donation rate it should seek guidance from abroad. This article will compare South African transplant legislation with currentlegislation in Singapore and Iran. These two countries are of significance to the transplant debate as Singapore has recently legalized the reimbursement of costs of the organ donor while Iran goes a step further and pays the kidney donor. In conclusion it is argued that South Africa could learn from these two countries in order to try and address the shortage of transplantable organs locally.

Effective methods for reactivating inactive blood donors: a stratified randomized controlled study

Background: Recruiting of sufficient numbers of donors of blood products is vital worldwide. In this study we assessed the efficacy and cost-effectiveness of telephone calls and SMS reminders for re-recruitment of inactive blood donors. Methods: This single-centre, non-blinded, parallel randomized controlled trial in Guangzhou, China included 11,880 inactive blood donors whose last donation was between January 1 and June 30, 2014. The donors were randomly assigned to one of two intervention groups (telephone call or short message service [SMS] communications) or to a control group without intervention. SMS messages with altruistic appeal were adopted in the SMS group; in addition to altruistic appeal, reasons for deferral of blood donation were also asked in the telephone group. All participants were followed up for 1 year. The primary outcome was re-donation rate, and rates in different groups were compared by intention-to-treat (ITT) analysis and estimation of the average treatment effect on the treated (ATT). Secondary outcomes were the self-reported deterrents. Other outcomes included the re-donation interval, and the incremental cost-effectiveness ratio (ICER) of telephone calls and SMS reminders on re-recruitment. Results: ITT analysis revealed no significant differences in the re-donation rate among the three groups. ATT estimations indicated that among compliers, telephone calls significantly increased re-donation compared to both SMS reminders and no intervention. Donor return behaviour was positively associated with receiving reminders successfully, being male, older age, and previous donation history. The SMS reminder prompted donors to return sooner than no reminder within 6 months, and according to ICER calculations, SMS reminders were more cost-effective than telephone calls. Donors reported time constraints as the most main causes of self-deferral in the telephone group, and altruistic appeal had a positive effect on these donors. Conclusions: Interventions to reactivate inactive blood donors can be effective, with telephone calls prompting more donors to return but at a greater cost than SMS messages. SMS reminder with altruistic appeal can urge donors to re-donate sooner within 6 months than no reminder.

Outcomes in patients with gunshot wounds to the brain

IntroductionGunshot wounds to the brain (GSWB) confer high lethality and uncertain recovery. It is unclear which patients benefit from aggressive resuscitation, and furthermore whether patients with GSWB undergoing cardiopulmonary resuscitation (CPR) have potential for survival or organ donation. Therefore, we sought to determine the rates of survival and organ donation, as well as identify factors associated with both outcomes in patients with GSWB undergoing CPR.MethodsWe performed a retrospective, multicenter study at 25 US trauma centers including dates between June 1, 2011 and December 31, 2017. Patients were included if they suffered isolated GSWB and required CPR at a referring hospital, in the field, or in the trauma resuscitation room. Patients were excluded for significant torso or extremity injuries, or if pregnant. Binomial regression models were used to determine predictors of survival/organ donation.Results825 patients met study criteria; the majority were male (87.6%) with a mean age of 36.5 years. Most (67%) underwent CPR in the field and 2.1% (n=17) survived to discharge. Of the non-survivors, 17.5% (n=141) were considered eligible donors, with a donation rate of 58.9% (n=83) in this group. Regression models found several predictors of survival. Hormone replacement was predictive of both survival and organ donation.ConclusionWe found that GSWB requiring CPR during trauma resuscitation was associated with a 2.1% survival rate and overall organ donation rate of 10.3%. Several factors appear to be favorably associated with survival, although predictions are uncertain due to the low number of survivors in this patient population. Hormone replacement was predictive of both survival and organ donation. These results are a starting point for determining appropriate treatment algorithms for this devastating clinical condition.Level of evidenceLevel II.

Development of a Mobile Application for Blood Donation Management

The creation of an application that deals with blood donation in order to facilitate knowledge about the act to its users, whether they are donors or not. Although the blood donation rate in Brazil is stable, there is always a search for ways to increase this incentive for donors to stay at or improve this level. Through a qualitative research, it was determined a knowledge of possible donors, their characteristics and limitations to donate and the benefits presented to both, the patient and the donor. The prototype presents the registration screen, information about benefits and general information about updating the registration, scheduling possible donations and how the process works. It has been found that most people have a certain fear about donating blood, as they are unaware of how the process works, and are supposed to cause some kind of harm to their body.

Current scenario of organ donation and transplantation in Kerala, India

Organ donation rate in India is very low when compared to many developed countries which contribute to the deaths due to organ failures every year. Kerala, one of the southern states in India with best health statistics in the country, has a deceased organ donation programme and has an organ donation rate higher than national average. However, there is a significant decline in number of donations in recent years.