How clinicians discuss patients' donor registrations of consent and presumed consent in donor conversations in an opt-out system: a qualitative embedded multiple-case study.

Background: The Netherlands introduced an opt-out donor system in 2020. While the default in (presumed) consent cases is donation, family involvement adds a crucial layer of influence when applying this default in clinical practice. We explored how clinicians discuss patients' donor registrations of (presumed) consent in donor conversations in the first years of the opt-out system.

Prospective Multicenter Observational Cohort Study on Time to Death in Potential Controlled Donation After Circulatory Death Donors-Development and External Validation of Prediction Models: The DCD III Study.

Background: Acceptance of organs from controlled donation after circulatory death (cDCD) donors depends on the time to circulatory death. Here we aimed to develop and externally validate prediction models for circulatory death within 1 or 2 h after withdrawal of life-sustaining treatment.

Methods: In a multicenter, observational, prospective cohort study, we enrolled 409 potential cDCD donors.

Intracerebral Hemorrhage and Thrombocytopenia After AstraZeneca COVID-19 Vaccine: Clinical and Diagnostic Challenges of Vaccine-Induced Thrombotic Thrombocytopenia.

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a prothrombotic disorder, which has been described as a rare adverse effect of the adenoviral-vectored coronavirus disease 2019 (COVID-19) vaccines. The diagnosis is confirmed by the detection of anti-platelet factor 4 (PF4) antibodies by enzyme-linked immunosorbent assay (ELISA) or functional assay in individuals with the appropriate clinical history. Here, we report a case of a patient who presented with a severe intracerebral hemorrhage and thrombocytopenia 14 days after receiving the first dose of the Oxford-AstraZeneca COVID-19 vaccine, with negative PF4/heparin antibodies tested with ELISA, but positive heparin-induced platelet activation assay (HIPAA).

External Validation of the DCD-N Score and a Linear Prediction Model to Identify Potential Candidates for Organ Donation After Circulatory Death: A Nationwide Multicenter Cohort Study.

Background: Donation after circulatory death (DCD) is a procedure in which after planned withdrawal of life-sustaining treatment (WLST), the dying process is monitored. A DCD procedure can only be continued if the potential organ donor dies shortly after WLST. This study performed an external validation of 2 existing prediction models to identify potentially DCD candidates, using one of the largest cohorts.

Determining the impact of timing and of clinical factors during end-of-life decision-making in potential controlled donation after circulatory death donors.

Controlled donation after circulatory death (cDCD) occurs after a decision to withdraw life-sustaining treatment and subsequent family approach and approval for donation. We currently lack data on factors that impact the decision-making process on withdraw life-sustaining treatment and whether time from admission to family approach, influences family consent rates. Such insights could be important in improving the clinical practice of potential cDCD donors.

Prediction Model for Timing of Death in Potential Donors After Circulatory Death (DCD III): Protocol for a Multicenter Prospective Observational Cohort Study.

Background: Controlled donation after circulatory death (cDCD) is a major source of organs for transplantation. A potential cDCD donor poses considerable challenges in terms of identification of those dying within the predefined time frame of warm ischemia after withdrawal of life-sustaining treatment (WLST) to circulatory arrest. Several attempts have been made to develop models predicting the time between treatment withdrawal and circulatory arrest.

The Implementation of a Multidisciplinary Approach for Potential Organ Donors in the Emergency Department.

Background: The aim of this study was to evaluate the implementation process of a multidisciplinary approach for potential organ donors in the emergency department (ED) in order to incorporate organ donation into their end-of-life care plans.

Methods: A new multidisciplinary approach was implemented in 6 hospitals in The Netherlands between January 2016 and January 2018. The approach was introduced during staff meetings in the ED, intensive care unit (ICU), and neurology department.

Phlegmasia Alba Dolens Caused by a Distended Bladder.

We describe the case of a 64-year-old patient with a deep venous thrombosis unusually caused by the obstruction of a severely distended atonic bladder as a result of an iatrogenic injury. Distention of the urinary bladder has previously been described to elevate pressure in the iliac veins, but has seldom been linked to the development of deep venous thrombosis. Through this case, we want to attract attention to this major complication of bladder distention, and we emphasize the importance of proper physical examination.

Infected abdominal aneurysm due to Salmonella sepsis: report of a unique case treated using the superficial femoral vein.

We describe a 61-year-old patient with an infected aneurysm of the abdominal aorta due to Salmonella sepsis. Treatment was successful and included aneurysm resection, extensive debridement, and reconstruction of the abdominal aorta using the superficial femoral vein, combined with long-term antibiotic therapy.

Necrotizing fasciitis caused by Salmonella enteritidis.

A 57-year-old immunocompromized female developed a necrotizing fasciitis with sepsis a few days after abdominal complaints and diarrhoea. Surgery was performed because of progressive worsening of the patient's situation and during surgery the decision was made to perform an amputation. After surgery the patient was brought to the intensive care department for a few days.