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Archives of Organ Transplantation
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This is an Open Access Journal

Open Access journal
ISSN (Online) 2640-7973
Published by Peertechz

[75 journals]

Effects on organ donation of transition from apnoeic-oxygenation to
radioisotope brain scanning to diagnose brain death in children
- Abstract: We studied rates of cadaveric organ donation on transition from apnoeic-oxygenation to radioisotope brain perfusion scanning to diagnose brain death. We studied records of children who were organ donors and/or had Technetium Tc99m Exametazine brain scans over 1989-2018. Donation after Brain Death (DBD) commenced in 1989, Donation after Circulatory Death (DCD) in 2011. Brain scanning was adopted in 2002 and apnoeic-oxygenation abandoned in 2007. In total, 95 of 1930 children (4.9%) donated organs (81 DBD, 14 DCD). During 1989-2001, with brain death diagnosed by clinical tests including apnoeic-oxygenation, 40 of 1059 children (3.8%) donated organs at average 3.1/annum. During 2002-2007 when either apnoeic-oxygenation or scanning was used, 18 of 351 children (5.1%) donated organs at average 3.0/year. During 2008-2018 with scanning in lieu of apnoeic-oxygenation, 23 of 520 children (4.4%) donated organs at average 2.1/annum. The difference in DBD rate between eras was not significant (P=0.52). Of 77 children scanned, 65(84%) were diagnosed brain dead after 1 or 2 scans, and 29 (45%) of these donated organs. Of 12 children with limited brain perfusion (not brain dead), DCD proceeded in 8 (67%). DCD or DBD (death diagnosed by scanning) was performed during 2011-2018 in 35 of 370 children (9.5%) which is significantly more (P<0.0001) than DBD (death diagnosed by apnoeic-oxygenation) in 1989-2001. Transition from apnoeic-oxygenation to scanning to diagnose brain death did not change DBD and may facilitate DCD. Brain death can be diagnosed by radionuclide scanning in lieu of apnoeic-oxygenation.
  PubDate: 26 Feb, 2021
Analysis of early relaparotomy in recipients of adult living donor liver
transplantation
- Abstract: Background: While early relaparotomy following living donor liver transplantation (LDLT) is an important event and its outcomes are still unclear, the aim of this retrospective study is to investigate the causes and outcomes of early relaparotomy in recipients of adult living donor liver transplantations.Materials and methods: Between April 2015 and April 2020 at Medipol University Medical Faculty Hospital Organ Transplantation Department, Istanbul, Turkey, 15 patients (9.3%) who underwent early relaparotomy were studied retrospectively. Results: Eight patients (53.3%) had a history of upper abdominal surgery in the early laparotomy group. The most common cause of early relaparotomy had postoperative bleeding in 9 patients (60%). The overall survival rate was 66.7%. Mortality was higher in the group over 60 years old and with a history of upper abdominal surgery.Conclusions: The history of upper abdominal surgery appears to be a risk factor for early relaparotomy. Also, previous upper abdominal surgery group and elderly patients group present with more mortality. We should be very careful in these groups.
  PubDate: 24 Aug, 2021
Size matching in lung transplantation: A narrative review
- Abstract: Background: Size matching between donor lungs and recipient chest space is an important technical problem that affects the outcome and survival following lung transplantation. The size of the lung can vary according to underlying disease, previous resections, and ethnicity, as well as height, age, and sex. Measurements of predicted total lung capacity according to height, age, and sex are frequently used, although other measurement methods are available.
  PubDate: 31 Jan, 2020
Decoding Cultural Obstructions in Way of organ Transplants
- Abstract: Apart from basic language, different aspects of an individual’s culture can play its role in literacy and influence the ability of health workers to comprehend and follow instructions. The most critical goals for patients after organ transplantation are to optimize health and wellness. Low health literacy has significant health and well-being implications and increased risk to patients for negative health outcomes. The definition of death and especially brain death is a major issue in organ transplantation. The internal tendency of a particular society to donate organs is another major factor. The organ theft, organ transfers, the fragile balancing of live contributions between the recipient’s benefit and potential loss to the donor and others are among the crucial ethical concerns that require active intervention. In the following study, we address the several cultural challenges facing donation of organ around the world , and is literacy the reason of less organ transplants, particularly in India.
  PubDate: 26 Nov, 2020
It is time to abandon apneic-oxygenation testing for brain death
- Abstract: The apneic-oxygenation test is an integral part of clinical testing to determine brain death. The medical and legal criticisms of the test are presented together which make a strong argument that it should be abandoned. The requirement for hypercarbia to stimulate spontaneous respiration also causes intra-cranial hypertension and may exacerbate an existing brain injury and as such is a self-fulfilling test. Moreover in children, the onset of spontaneous respiration may commence at levels of blood carbon dioxide in excess of the minimum level used to define brain death. It is thus also unreliable. A number of legal cases in the United States have been adjudicated in favor of plaintiffs seeking to prevent performance of the test on the basis that it causes harm. Physicians have sought to perform the apneic-oxygenation test without consent of legal guardians but have failed. In lieu of the apneic-oxygenation test a brain scan using a lipophilic radionuclide is suggested. Demonstration of absent brain blood flow may be a more stringent test to determine brain death than apneic-oxygenation but is more reliable, less invasive, not harmful and not likely to reduce the rate of organ donation.
  PubDate: 11 Sep, 2020
Purpose of the measurement of intraoperative hepatic hemodynamics in liver
transplant surgery
- Abstract: Liver graft function depends on different biological factors that are related to the donor, the recipient and the potential damage arising from the organ preservation technique. However, adequate hepatic artery flow and portal vein flow rates ensure a sufficient flow of oxygen and nutrients in order to ensure a suitable cellular graft function after the extreme metabolic decrease condition induced by hypothermia and the preservation solution. Liver inflow is a highly complex system due to its double irrigation system. These two systems are connected by the well-known “hepatic arterial buffer response” concept. This mechanism explains changes in hepatic arterial flow (HAF) as a compensation for changes in the portal vein flow (PVF), so that the hepatic artery adjusts total flow in relation to alterations in the portal blood flow. At the moment, the minimum HAF and PVF required for an adequate regeneration and functional recovery of the liver graft have not been yet established.
  PubDate: 22 Mar, 2019
To boldly go where no one has gone before in organ transplantation:
Changes in mating behaviour and buffalo burger eating preferences of giant
forest ants after successful brain transplant from American cockroaches
- Abstract: The implications of ambimorphic archetypes in organ transplantation have been far-reaching and pervasive. After years of natural research into consistent hashing, we argue the simulation of public-private key pairs, which embodies the confi rmed principles of theory. Such a hypothesis might seem perverse but is derived from known results. Our focus in this paper is not on whether the well-known knowledge-based fact that humans breathe through their mouth or nose and the brain controls that critical function, so breathing would stop. The hardy vermin breathe through spiracles, or little holes in each body segment. Plus, the roach brain does not control this breathing and blood does not carry oxygen throughout the body. Overall, a new approach in succesful brain transplant have been developed.
  PubDate: 11 Jul, 2019
BK virus in kidney transplantation: A single center experiences
- Abstract: Background: BK virus is the most common infectious causes of nephropathy and graft loss afterkidney transplantation. In our study, we investigated the factors that may affect positive BK virus in theblood in patients with kidney transplantation.
  PubDate: 04 Sep, 2019
A case of high drain output after renal transplantation: Review of current
evidence
- Abstract: Surgical complications are not uncommon after renal transplantation. They should always be in the differential diagnosis of renal graft dysfunction. While ruling out or confirming a surgical cause of graft dysfunction, a sequential approach should be undertaken starting from clinical examination and moving on to more invasive investigations as the clinical picture becomes clearer. Biochemical assay of drain fluid is important. Causes of a collection around/near the graft include abscess, hematoma, urinoma and lymphocele. Treatment of each of them is different.
  PubDate: 20 Dec, 2018