Objective: The capnometry values during resuscitation are an evolutive predictor of kidneys obtained from uncontrolled non-heart beating donors.
Design: The study comprised a retrospective onset cohort of 37 non-heart beating donors and a validation cohort of 55 trasplanted kidneys in the period 2013-2017.
Scope: The population served by the emergency service and referred to Hospital Universitario Doce de Octubre (Madrid, Spain) as potential uncontrolled non-heart beating donors.
Patients: A total of 55 renal transplant patients subjected to hemodialysis and with grafts from uncontrolled non-heart beating donors.
Interventions: Capnometry and capnography measurements in potential uncontrolled non-heart beating donors.
Variables: Capnometry values recorded initially and at transfer in hospital for comparison with the viability of the extracted kidneys; renal failure and delayed renal function.
Results: A total of 55 out of 74 extracted kidneys were trasplanted (74.3%). The rest were ruled out due to poor perfusion or signs of ischemia. An association was observed (P=.016) between the capnometry values during resuscitation in the grafted kidneys (μ=22.8 mmHg) and in the kidneys discarded for transplantation (μ=17.35 mmHg).
Conclusions: Capnometry during resuscitation serves as a marker to be taken into account in relation to the viability of the trasplanted organs in uncontrolled non-heart beating donors.
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http://dx.doi.org/10.1016/j.medin.2018.10.008 | DOI Listing |
Scand J Trauma Resusc Emerg Med
December 2024
Emergency Department, Cliniques Universitaires Saint-Luc, Emergency Medicine, Department of Public Health and Primary Care, Faculty of Medicine, Catholic University Leuven, Brussels, Belgium.
Human organ transplantation has begun in the 1960s with donation after circulatory death. At that time this was named non heart beating donation, later donation after cardiac death and nowadays it is named donation after circulatory death. Currently, we are facing a significant shortage of transplant organs in Europe and worldwide.
View Article and Find Full Text PDFEClinicalMedicine
December 2023
Royal Papworth Hospital Biomedical Campus, Cambridge, CB2 0AY, UK.
Heart failure imposes a significant burden on all health care systems and has a 5-year mortality of 50%. Heart transplantation and ventricular assist device (VAD) implantation are the definitive therapies for end stage heart disease, although transplantation appears to offer superior long-term survival and quality of life over VAD implantation. Transplantation is limited by a shortage in donor hearts, resulting in considerable waiting list mortality.
View Article and Find Full Text PDFCell Tissue Bank
June 2024
Working Group on Cells, Tissues and Organs of the Superior Health Council, Brussels, Belgium.
With the present paper, the Working Group on Cells, Tissues and Organs and other experts of the Superior Health Council of Belgium aimed to provide stakeholders in material of human origin with advice on critical aspects of serological and nucleic acid test (NAT) testing, to improve virological safety of cell- and tissue and organ donation. The current paper focusses on a number of preanalytical variables which can be critical for any medical biology examination: (1) sampling related variables (type of samples, collection of the samples, volume of the sample, choice of specific tubes, identification of tubes), (2) variables related to transport, storage and processing of blood samples (transport, centrifugation and haemolysis, storage before and after centrifugation, use of serum versus plasma), (3) variables related to dilution (haemodilution, pooling of samples), and (4) test dependent variables (available tests and validation). Depending on the type of donor (deceased donor (heart-beating or non-heart beating) versus living donor (allogeneic, related, autologous), and the type of donated human material (cells, tissue or organs) additional factors can play a role: pre- and post-mortem sampling, conditions of sampling (e.
View Article and Find Full Text PDFEClinicalMedicine
April 2023
Royal Papworth Hospital Biomedical Campus, Cambridge, CB2 0AY, UK.
Background: Heart transplantation is an effective treatment offering the best recovery in both quality and quantity of life in those affected by refractory, severe heart failure. However, transplantation is limited by donor organ availability. The reintroduction of heart donation after the circulatory determination of death () in 2014 offered an uplift in transplant activity by 30%.
View Article and Find Full Text PDFLeg Med (Tokyo)
March 2023
Regional Centre for Transplant Coordination of Veneto Region, Via Giustiniani 2, 35128 Padova, Italy.
Background: When death occurs through a mechanism requiring a forensic investigation, consent for organ harvesting must be sought from the Judicial Authority (JA).
Aim: To perform a retrospective study of potential organ donors in the Veneto region over a six-year period (2012-2017), analysing any differences between cases in which the JA approved or denied organ harvesting.
Material And Methods: Both non-heart beating (NHB) and heart beating (HB) donors were included.
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