Abstract:
BACKGROUND/AIMS:There remains a critical shortage of cadaveric organs. At a large inner city level one trauma centre, several strategies were devised and combined to (a). optimize the physiologic status of potential donors, (b). promote awareness of the donation process among health care professionals and (c). perform quality control on the organ donation system - all in an effort to improve organ donation rates. Resuscitative and maintenance protocols were devised and implemented through a multidisciplinary team approach for patients diagnosed with brain death. We report the effect this approach has had on organ donation in a single centre. METHOD:A death record review (DRR) by the local organ procurement agency (OPO) was used to identify the number of patients diagnosed with brain death at Los Angeles County Hospital each year from 1995 through 2001. Data were collected to determine the number of these potential donors that eventually underwent organ donation. Data were collected for two time intervals: Phase I (1995-98) and Phase II (1999-2001). During Phase I, there was no focused institutional programme for the approach to potential donors. During Phase II, an institutional programme including the following characteristics was implemented: 1). donor resuscitation protocol, 2). assignment of a dedicated OPO coordinator liaison to interact with families, hospital personnel and the coroner's office, 3). assignment of the primary role of stabilization and care of potential donors and the integration of all medical services to the trauma service, and 4). biweekly conferences to review policies, protocols, and outcomes of donor management strategies. RESULTS:From 1995 to 2001 there was a large increase in patient referrals for donor evaluation from 86 (Phase I) to 124 (Phase II). There was a smaller increase in the number of suitable donors: Phase I (mean: 51/year) and Phase II (mean: 63/year). There was, however, an increase in the mean number of actual organ donors from 14.2/year to 25.7/year from Phase I to Phase II and an increase in organs donated from 29 to 49. Organ donor declines decreased from 53% (Phase I) to 39% (Phase II). CONCLUSIONS:Strategies to increase the number of cadaveric organs available for organ transplantation are crucial. A strategy combining prompt identification of potential organ donors, institution of resuscitative protocols, a multidisciplinary team approach, educational activities and utilization of personnel expert in organ procurement led to a marked increase in the number of organ donors and the number of organs donated at a single institution. Wider application of this approach should prove successful in increasing organ donation in a similar fashion in other institutions.
journal_name
Clin Transplantjournal_title
Clinical transplantationauthors
Roth BJ,Sher L,Murray JA,Belzberg H,Mateo R,Heeran A,Romero J,Mone T,Chan L,Selby Rdoi
10.1034/j.1399-0012.17.s9.10.xsubject
Has Abstractpub_date
2003-01-01 00:00:00pages
52-7eissn
0902-0063issn
1399-0012pii
91journal_volume
17 Suppl 9pub_type
杂志文章abstract::Home-based exercise programs may offer a less costly alternative to providing exercise pre-transplant to a large number of patients. We describe the changes in 6-minute walk distance (6MWD) in lung transplant candidates who participated in a home-based exercise program and their relationship to post-transplant outcome...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14045
更新日期:2020-10-01 00:00:00
abstract:INTRODUCTION:Aortoiliac pathology in kidney allograft recipients is not rare but treatment timing is controversial. As most publications on this topic are case reports its difficult to evaluate long-term outcomes of those clinical challenges. Herein we report long-term results of these procedures. METHODS:From 1970 to...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-0012.2009.00981.x
更新日期:2009-03-01 00:00:00
abstract::Coronary angiography (CA) is the gold standard evaluation of coronary artery disease in potential multi-organ donors. This use of iodinated contrast media could lead to contrast-induced acute kidney injury and consequently to delayed graft function (DGF). All patients in France who received a kidney from a 45-70-year-...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13355
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:To clarify the predictive impact of expanded criteria for liver transplantation (LT) for patients with hepatocellular carcinoma (HCC) in 54 patients with HCC beyond the Milan criteria (MC) from a series of 109 consecutive living-related donor liver transplantation (LDLT) recipients with HCC. METHODS:Among 54...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01463.x
更新日期:2011-09-01 00:00:00
abstract:INTRODUCTION:We examined the effect of haemodialysis (HD) or peritoneal dialysis (PD) on acute rejection, delayed graft function (DGF), graft and patient survival after cadaveric renal transplantation. MATERIALS AND METHODS:We carried out a retrospective analysis of 325 patients (cyclosporin [CyA]-based therapy) who h...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2002.00069.x
更新日期:2002-02-01 00:00:00
abstract::We have experienced 5 hepatic vein stenoses in 3 children (8 to 23 months old) after living-related liver transplantation (total 48 liver transplants for 48 children between June 1990 and November 1992). The initial symptoms of hepatic vein stenosis were ascites and/or edema. The blood flow of hepatic vessels was mon...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Early measures of graft function are increasingly used to assess efficacy in clinical trials of kidney transplant immunosuppression. This study aimed to assess the variability and quality of reporting of these endpoints in contemporary trials. Data regarding renal function endpoints were extracted from 213 reports fro...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12861
更新日期:2016-12-01 00:00:00
abstract:AIM:Uncontrolled donation after cardiac death (uDCD) remains an underutilized source of kidney allografts in the United States. The objective of this study was to estimate the impact of the implementation of a uDCD program on transplantation rates and long-term survival for patients with end-stage renal disease (ESRD) ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13868
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Skin cancer is common after solid organ transplantation, but few have investigated it after lung transplant (LTx). OBJECTIVE:We assessed incidence and predictors of non-melanoma skin cancer (NMSC) post-LTx. METHODS:We studied patients who underwent LTx at our center from 2012 to 2015. RESULTS:Of 287 patie...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13718
更新日期:2019-12-01 00:00:00
abstract::Use of C(2) monitoring for cyclosporine A (CsA) microemulsion results in improved clinical outcomes vs. trough (C(0)) monitoring. Logistical issues include accurate timing of the C(2) sample; requirement for sample dilution with most standard assay techniques; and inconvenience for patients. Recently, it has been show...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00472.x
更新日期:2006-03-01 00:00:00
abstract:PURPOSE:Frail patients who undergo renal transplantation (RT) have more complications; however, little is known if these patients can sustain the wait to RT. We used the Timed Up and Go Test (TUGT) and Montreal Cognitive Assessment (MoCA) to determine outcomes of RT candidates. METHODS:In this retrospective study, 526...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.14161
更新日期:2020-11-20 00:00:00
abstract::Although steroid avoidance and withdrawal in renal transplant recipients (RTR) are actively being evaluated by physicians, the attitudes of recipients toward steroid use have not been systematically studied in the modern era. We conducted a confidential written survey of single-organ adult RTR pertaining to prednisone...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-0012.2003.00034.x
更新日期:2003-04-01 00:00:00
abstract::Flow cytometry crossmatch (FCXM) is a more sensitive technique than classical complement-dependent cytotoxicity (CDC) for the detection of donor-directed antibody before renal transplantation. Nevertheless, the role of FCXM in predicting long-term survival of kidney grafts is still unclear. The purpose of our study wa...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2004.00226.x
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Chronic renal failure (CRF) is a common complication of calcineurin inhibitor (CNI)-based immunosuppression following cardiac transplantation (HTx). The aim of this prospective study was to evaluate the impact of an immunosuppressive conversion from CNIs to mycophenolate mofetil (MMF) and steroids in cardiac...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2008.00828.x
更新日期:2008-09-01 00:00:00
abstract::Nineteen consecutive patients with post-transplant lymphoproliferative disorders (PTLD) in an Asian population were reviewed. The histopathologic diagnoses were monomorphic (CD20-positive diffuse large B-cell lymphoma, n = 14); plasmacytic (n = 1); Burkitt-like (n = 1); natural killer cell lymphoma (n = 1); lymphomato...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2011.01593.x
更新日期:2012-09-01 00:00:00
abstract:INTRODUCTION:Abdominal wall vascularized composite allotransplantation (AW-VCA) is a rarely utilized technique for large composite abdominal wall defects. The goal of this article is to systematically review the literature and current concepts of AW-VCA, outline the challenges ahead, and provide an outlook for the futu...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.12243
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the efficacy of lamivudine (LAM) monoprophylaxis for patients with non-replicating hepatitis B virus (HBV) infection at orthotopic liver transplantation (OLT). METHODS:Among 128 liver recipients with HBV infection between 1994 and 2004 transplanted at our institution, 6...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2006.00557.x
更新日期:2007-03-01 00:00:00
abstract::Mycophenolate mofetil (MMF) combined with conventional cyclosporine and steroids doses efficiently prevents acute rejection in kidney transplants. However, this regimen has been associated with an increased incidence of cytomegalovirus (CMV) disease and leukopenia, specially in patients receiving MMF at 3 g/d, suggest...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1998-06-01 00:00:00
abstract::Bone mineral density (BMD) in the lumbar spine and femoral neck, the incidence of osteoporosis, and survival up to 10 years after heart transplantation (HT) were investigated in 169 patients who underwent HT at Skåne University Hospital in Lund, Sweden, 1988-2016. Within the first year post-transplantation, mean (SD) ...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.13477
更新日期:2019-03-01 00:00:00
abstract:INTRODUCTION:Either deceased or living-related renal transplantation constitutes the best therapeutic option for patients with end-stage renal disease. In this retrospective study, an attempt to identify parameters that affect allograft survival in living donor renal transplantation was made. METHODS:Between January 2...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12219
更新日期:2013-11-01 00:00:00
abstract::Cytotoxic T-lymphocyte antigen-4 (CTLA-4) is a cell surface protein, which down-regulates the immune response at CTLA-4/CD28/B7 pathway. We aimed to investigate the influence of the -318 C/T, +49 A/G, -1661 A/G and CT60A/G, and CTLA-4 gene polymorphisms on acute rejection of kidney allograft in Turkish patients. The s...
journal_title:Clinical transplantation
pub_type: 杂志文章,随机对照试验
doi:10.1111/ctr.12563
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Our purpose was to determine the complication rate from intravascular ultrasound (IVUS) in a large, multicenter cohort of pediatric heart transplant (PHT) patients. METHODS:We retrospectively reviewed all PHT who underwent IVUS at 5 institutions (2006-2014). Rates of major and minor complications were calcu...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.13981
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Cardiac allograft vasculopathy (CAV) limits survival after heart transplantation (HTx). Between immunologic and non-immunologic factors, reactive oxygen species generation has been proposed as pathogenetic mechanism. This study was aimed at evaluating redox status in HTx recipients and verifying whether it c...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2005.00352.x
更新日期:2005-06-01 00:00:00
abstract::We report an adult liver transplant recipient with parvovirus B19 infection, presenting as chronic transfusion-dependent anemia ensuing 1 month post-transplantation. Both serum and bone marrow cells were positive for parvovirus B19 DNA detected by polymerase chain reaction. The bone marrow biopsy revealed erythroid hy...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::Histoplasma capsulatum is a dimorphic fungus that most often causes asymptomatic infection in the immunocompetent population. In immunocompromised patients, including solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, however, it is likely to cause severe life-threatening infection. Post-...
journal_title:Clinical transplantation
pub_type: 杂志文章,评审
doi:10.1111/ctr.13087
更新日期:2017-10-01 00:00:00
abstract::Adverse symptoms of immunosuppressants (ASI) impact quality of life (QOL) in solid organ transplant recipients; however, standardized approaches for active ASI surveillance and intervention are lacking. While management is highly clinician dependent, clinician views remain largely unexplored. We surveyed Canadian Soci...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12940
更新日期:2017-05-01 00:00:00
abstract::Micafungin has been approved for the prophylaxis of Candida infections in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Here, we report a single-center experience of three different dose levels regarding efficacy, toxicity, and colonization with Candida ssp. in clinical practice. ...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/ctr.12310
更新日期:2014-03-01 00:00:00
abstract::Temporary graft dysfunction with gas exchange abnormalities is a common finding during the postoperative course of a lung transplant and is often determined by the post-reimplantation syndrome. Supportive measures including oxygen by mask, inotropes, diuretics, and pulmonary vasodilators are usually effective in non-s...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-0012.2009.01050.x
更新日期:2009-09-01 00:00:00
abstract::With the increased number of long-term survivors after liver transplantation, new-onset diabetes after transplantation (NODAT) is becoming more significant in patient follow-up. However, the incidence of new-onset diabetes after living-donor liver transplantation (LDLT) has not been well elucidated. The aim of this st...
journal_title:Clinical transplantation
pub_type: 临床试验,杂志文章
doi:10.1111/ctr.12103
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:After pancreas transplantation (PTx) some patients report occasional symptoms of hypoglycaemia and at times, serious hypoglycaemia. Continuous blood glucose monitoring (CBGM) allows determination of the daily glucose profile and detection of unrecognized hypoglycaemia. The aims of our study were to determine...
journal_title:Clinical transplantation
pub_type: 杂志文章
doi:10.1046/j.1399-0012.2003.00101.x
更新日期:2003-12-01 00:00:00