Introduction: Family refusal is an important factor that limits the number of organ donors. Cultural and religious factors as well as perception of brain death are the principal reasons for these refusals. We examined whether the type of potential donor, that is brain-dead or non-heart-beating, had an influence on family refusal. In July 2005, we initiated a program of non-heart-beating donors who had died in the street or at home.
Materials And Methods: We compared family refusals among these potential donors with those among potential brain-dead donors from July 2005 to October 2008.
Results: The mean time of stay in the hospital was significantly greater for brain-dead donors than those who were non-heart-beating: 4 +/- 2 versus 0.23 +/- 0.01 days (P < .01). The rate of family refusals was significantly greater among the families of potential brain-dead donors, that is 24% (24/99) than non-heart-beating donors, that is, 4% (2/47; P < .01). Donor age was similar in both groups.
Conclusion: The rate of family refusals among potential non-heart-beating donors was significantly lower than that among families of brain-dead individuals. Greater understanding of death because the heart is not beating, less time of uncertainty about death, and shorter hospital stay could explain this difference.
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http://dx.doi.org/10.1016/j.transproceed.2009.06.039 | DOI Listing |
Ann Thorac Surg Short Rep
September 2024
Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri.
Background: Organ procurement organizations coordinate organ donation through 2 distinct models of care: the conventional model, in which donors are managed at hospitals where brain death occurs, and the specialized donor care facility (SDCF) model, where brain dead donors are transferred to a freestanding facility. The aim of this study is to compare operating room efficiency for procurements between the SDCF and conventional models of care.
Methods: We performed a prospective analysis of operating room efficiency between thoracic donor procurement operations performed at a SDCF and other organ procurement organizations using the conventional model of care.
Alzheimers Dement
December 2024
Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Background: Enlarged perivascular spaces (ePVS) on MRI can signal impaired cerebral fluid clearance and predict dementia risk. Risk factors and biological correlates of ePVS are uncertain partially due to the lack of pathological correlation studies. Repetitive head impacts (RHI) from contact sports might represent one risk factor for ePVS, given their association with vascular pathologies and chronic traumatic encephalopathy (CTE), a neurodegenerative disease characterized by perivascular p-tau aggregates.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA.
Background: Adverse social exposome (indexed by national Area Deprivation Index [ADI] 80-100 or 'high ADI') is linked to structural inequities and increased risk of Alzheimer's disease neuropathology. Twenty percent of the US population resides within high ADI areas, predominantly in inner cities, tribal reservations and rural areas. The percentage of brain donors from high ADI areas within the Alzheimer's Disease Research Center (ADRC) brain bank system is unknown.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Background: The social exposome, all social-environmental exposures accumulated over the life course, could partially explain Alzheimer's disease and other dementias (ADRD) disparities. Measurement and linkage of life course social exposome metrics to biological samples may inform opportunities for intervention. While there is increasing emphasis on the life course social exposome in ADRD research, there is little consensus on its measurement.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Background: Working conditions and contexts may influence the development of Alzheimer's Disease and related dementias (ADRD), exposing individuals to modifiable risk factors across their life. Measurement of ADRD pathology at autopsy provides a gold standard outcome for evaluating the effects of lifetime exposures, but approaches to quantify ante-mortem work exposures are limited. Here we describe a new method to retrospectively capture occupational histories by systematically extracting occupational information using archival public records- i.
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