scholarly journals When Operating on Dead People Saves Lives: Benefits of Surgical Organ Donor Intensivists

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Kristin Long ◽  
Cynthia Talley ◽  
Rebecca B. Yarrison ◽  
Andrew Bernard
Keyword(s):  
Ethical Issues ◽  
Solid Organ Transplantation ◽  
Organ Donor ◽  
Time Frame ◽  
Solid Organ ◽  
Organ Donors ◽  
Life Saving ◽  
Decompressive Laparotomy ◽  
End Stage ◽  
Aggressive Interventions

Solid organ transplantation has emerged as a life-saving treatment for many patients suffering from end-stage organ failure. Organs have been successfully recovered after a variety of aggressive interventions. We propose that decompressive laparotomy, when clinically indicated, should be considered in the aggressive resuscitation of potential organ donors. A thorough literature review examining aggressive interventions on potential organ donors was conducted after experience with a unique case at this institution. Articles were reviewed for the types of interventions performed as well as the time frame in relation to organ donation. In our case, several ethical issues were raised when considering decompressive laparotomy in a patient pronounced dead by neurologic criteria. We propose that having a surgical intensivist involved in the management of potential donors will further increase the salvage rate, as more invasive resuscitation options are possible.

scholarly journals Rapid Disease Progression of Liver Metastases following Resection in a Liver-Transplanted Patient with Probable Lynch Syndrome – A Case Report and Review of the Literature

2017 ◽  
Vol 10 (1) ◽  
pp. 244-251 ◽  
Author(s):  
Noelle Suemi Wassano ◽  
Francisco  Sergi ◽  
Gustavo Ferro ◽  
Tércio Genzini ◽  
Renata D’Alpino Peixoto
Keyword(s):  
Case Report ◽  
Lynch Syndrome ◽  
Immunosuppressive Therapy ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Life Saving ◽  
Microbial Infections ◽  
End Stage ◽  
Risk Of Cancer

Solid organ transplantation provides life-saving therapy for patients with end-stage organ disease, and its outcomes have been improving dramatically over the past few decades. However, substantial morbidity results from chronic immunosuppressive therapy administered to prevent graft rejection. It predisposes patients to several life-threatening complications, such as opportunistic microbial infections and the development of different types of cancers. Here, we presented the case of a young man with probable Lynch syndrome, who developed an aggressive colon carcinoma after long-term immunosuppressive therapy due to a prior liver transplantation. Based on this case report, we attempt to find an answer to the question about the risk of cancer development or recurrence in patients with familial syndromes receiving long-term immunosuppressive therapy and to find out how it can be minimized. Answering these questions is particularly important, given the facts that disease course is substantially more aggressive among transplanted patients and that prognosis is poor due to lack of immunocompetence, especially in the setting of Lynch syndrome.

scholarly journals Retrospective screening of solid organ donors in Italy, 2009, reveals unpredicted circulation of West Nile virus

2010 ◽  
Vol 15 (34) ◽  
Author(s):  
M R Capobianchi ◽  
V Sambri ◽  
C Castilletti ◽  
A M Pierro ◽  
G Rossini ◽  
...  
Keyword(s):  
Risk Assessment ◽  
West Nile Virus ◽  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Organ Donors ◽  
West Nile ◽  
Retrospective Survey ◽  
Italian Regions ◽  
Potential Risks

Since the occurrence of West Nile virus (WNV) infection in humans in 2008 in Italy, concerns have been raised about the potential risks associated with solid organ transplantation (SOT). A nationwide retrospective survey showed that 1.2% of SOT donors in 2009 were WNV-seropositive and demonstrated that human WNV infection is distributed throughout several Italian regions. Transmission of WNV or other arboviruses through SOT is a possibility and risk assessment should be carried out before SOT to avoid infection through transplantation.

scholarly journals Real-Time Healthcare Intelligence in Organ Transplantation

2018 ◽  
pp. 128-152
Author(s):  
Bruno Fernandes ◽  
Cecília Coimbra ◽  
António Abelha
Keyword(s):  
Decision Making ◽  
Organ Transplantation ◽  
Organ Donor ◽  
Decision Making Process ◽  
Organ Donors ◽  
Potential Organ Donor ◽  
Critical Areas ◽  
Deceased Donors ◽  
End Stage ◽  
Donor Criteria

Organ transplantation is the best and often the only treatment for patients with end-stage organ failure. However, the universal shortage of deceased donors results in a worrying situation that must be addressed. Brain dead donors constitute the largest share of organ donors, but identifying a patient that may progress to brain death can be a complex task. Therefore, the urgent need of intelligent solutions to support the decision-making process is crucial in critical areas as the organ transplantation is. This work aims at acquiring knowledge on the potential organ donor criteria for further detection and implementing a platform to assist the process of identification of potential organ donors at Centro Hospitalar do Porto – Hospital de Santo António. The developed system is currently implemented and displays a steady and competent behavior providing consequently a way to have more control of the information needed for the decision-making process

Living Organ Donation Role of Ethics for Improved Clinical Practice

2018 ◽  
pp. 242-259
Author(s):  
Pierpaolo Di Cocco
Keyword(s):  
Organ Donation ◽  
Organ Transplantation ◽  
Financial Incentives ◽  
Ethical Issues ◽  
Supply And Demand ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Live Donor ◽  
Live Donation

Solid organ transplantation represents one of the most important achievements in history of medicine. Over the last decades, the increasing number of transplants has not been of the same extent of the number of patients in the waiting lists. Live donation has been implemented in order to reduce the gap between supply and demand. From an ethical standpoint, the donation process from a live donor seems to violate the traditional first rule of medicine—primum non nocere because inevitably exposes healthy persons to a risk in order to benefit another person. In the chapter will be presented the crucial role of ethics and specific ethical issues in the different forms of live donation, such as financial incentives for living donation, reimbursement in unrelated live donation, minor sibling-to-sibling organ donation. The ethical aspects of live donor organ transplantation are continuously evolving; in order to make this strategy more beneficial and lifesaving, everyone involved in the process should make every possible effort with in mind the best interests of the patients.

scholarly journals Solid Organ Transplantation in Amyloidosis

2020 ◽  
Vol 143 (4) ◽  
pp. 352-364 ◽  
Author(s):  
Foteini Theodorakakou ◽  
Despina Fotiou ◽  
Meletios A. Dimopoulos ◽  
Efstathios Kastritis
Keyword(s):  
Organ Transplantation ◽  
Solid Organ Transplantation ◽  
Organ Damage ◽  
Precursor Protein ◽  
Multidisciplinary Teams ◽  
Al Amyloidosis ◽  
Solid Organ ◽  
Transthyretin Amyloidosis ◽  
Improved Outcomes ◽  
Life Saving

Amyloidosis comprises a diverse group of diseases characterized by misfolding of precursor proteins which eventually form amyloid aggregates and preceding intermediaries, which are deposited in target tissues causing progressive organ damage. In all forms of amyloidosis, vital organs may fail; depending on the specific amyloidosis type, this may occur rapidly or progress slowly. Beyond therapies to reduce the precursor protein (chemotherapy for light chain [AL] amyloidosis, anti-inflammatory therapy in serum A amyloid­osis [AA], and antisense RNA therapy in transthyretin amyloidosis [ATTR]), organ transplantation may also be a means to reduce amyloidogenic protein, e.g., in types of amyloid­osis in which the variant precursor is produced by the liver. Heart transplantation is a life-saving approach to the treatment of patients with advanced cardiac amyloidosis; however, amyloidosis may still be considered a contraindication to the procedure despite data supporting improved outcomes, similar to patients with other indications. Kidney transplantation is associated with particularly favorable outcomes in patients with amyloidosis, especially if the precursor protein has been eliminated. Overall, outcomes of solid organ transplantation are improving, but more data are needed to refine the selection criteria and the timing for organ transplantation, which should be performed in highly experienced centers involving multidisciplinary teams with close patient follow-up to detect amyloid recurrence.

scholarly journals Randomised sham-controlled double-blind trial evaluating remote ischaemic preconditioning in solid organ transplantation: a study protocol for the RIPTRANS trial

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038340
Author(s):  
Aki Uutela ◽  
Ilkka Helanterä ◽  
Karl Lemström ◽  
Arie Passov ◽  
Simo Syrjälä ◽  
...  
Keyword(s):  
Organ Transplantation ◽  
Study Protocol ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Organ Donors ◽  
Ischaemic Preconditioning ◽  
Study Results ◽  
Remote Ischaemic Preconditioning ◽  
Brain Dead ◽  
Transplanted Organs

IntroductionRemote ischaemic preconditioning (RIPC) using a non-invasive pneumatic tourniquet is a potential method for reducing ischaemia-reperfusion injury. RIPC has been extensively studied in animal models and cardiac surgery, but scarcely in solid organ transplantation. RIPC could be an inexpensive and simple method to improve function of transplanted organs. Accordingly, we aim to study whether RIPC performed in brain-dead organ donors improves function and longevity of transplanted organs.Methods and analysesRIPTRANS is a multicentre, sham-controlled, parallel group, randomised superiority trial comparing RIPC intervention versus sham-intervention in brain-dead organ donors scheduled to donate at least one kidney. Recipients of the organs (kidney, liver, pancreas, heart, lungs) from a randomised donor will be included provided that they give written informed consent. The RIPC intervention is performed by inflating a thigh tourniquet to 300 mm Hg 4 times for 5 min. The intervention is done two times: first right after the declaration of brain death and second immediately before transferring the donor to the operating theatre. The sham group receives the tourniquet, but it is not inflated. The primary endpoint is delayed graft function (DGF) in kidney allografts. Secondary endpoints include short-term functional outcomes of transplanted organs, rejections and graft survival in various time points up to 20 years. We aim to show that RIPC reduces the incidence of DGF from 25% to 15%. According to this, the sample size is set to 500 kidney transplant recipients.Ethics and disseminationThis study has been approved by Helsinki University Hospital Ethics Committee and Helsinki University Hospital’s Institutional Review Board. The study protocol was be presented at the European Society of Organ Transplantation congress in Copenhagen 14−15 September 2019. The study results will be submitted to an international peer-reviewed scientific journal for publication.Trial registration numberNCT03855722.

Ethical issues associated with solid organ transplantation and substance use: a scoping review

2019 ◽  
Vol 37 (3-4) ◽  
pp. 111-135 ◽  
Author(s):  
Lauren Notini ◽  
Denitsa Vasileva ◽  
Ani Orchanian-Cheff ◽  
Daniel Z. Buchman
Keyword(s):  
Substance Use ◽  
Organ Transplantation ◽  
Scoping Review ◽  
Ethical Issues ◽  
Solid Organ Transplantation ◽  
Solid Organ
Sign in / Sign up

Export Citation Format

Share Document