Background: The demand for organ transplants, both globally and in South Korea, substantially exceeds the supply, a situation that might have been aggravated by the enactment of the Life-Sustaining Treatment Decision Act (LSTDA) in February 2018. This legislation may influence emergency medical procedures and the availability of organs from brain-dead donors. This study aimed to assess LSTDA's impact, introduced in February 2018, on organ donation status in out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city and identified related factors.
Methods: We conducted a retrospective analysis of a regional cardiac arrest registry. This study included patients aged 16 or older with cardiac arrest and a cerebral performance category (CPC) score of 5 from January 2015 to December 2022. The exclusion criteria were CPC scores of 1-4, patients under 16 years, and patients declared dead or transferred from emergency departments. Logistic regression analysis was used to analyse factors affecting organ donation.
Results: Of the 751 patients included in this study, 47 were organ donors, with a median age of 47 years. Before the LSTDA, there were 30 organ donations, which declined to 17 after its implementation. In the organ donation group, the causes of cardiac arrest included medical (34%), hanging (46.8%), and trauma (19.2%). The adjusted odds ratio for organ donation before the LSTDA implementation was 6.12 (95% CI 3.09-12.12), with non-medical aetiology as associated factors.
Conclusion: The enactment of the LSTDA in 2018 in South Korea may be linked to reduced organ donations among patients with OHCA, underscoring the need to re-evaluate the medical and legal aspects of organ donation, especially considering end-of-life care decisions.
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http://dx.doi.org/10.1186/s12910-024-01090-4 | DOI Listing |
Langenbecks Arch Surg
December 2024
Department of Surgery, TUM Universitätsklinikum Klinikum Rechts der Isar Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
Objective: Splenectomy is regularly performed in total and distal pancreatectomy due to technical reasons, lymph node dissection and radicality of the operation. However, the spleen serves as an important organ for competent immune function, and its removal is associated with an increased incidence of cancer and a worse outcome in some cancer entities (Haematologica 99:392-398, 2014; Dis Colon Rectum 51:213-217, 2008; Dis Esophagus 21:334-339, 2008). The impact of splenectomy in pancreatic cancer is not fully resolved (J Am Coll Surg 188:516-521, 1999; J Surg Oncol 119:784-793, 2019).
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Shiraz Organ Transplant Center,, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Background: Corrosive substance ingestion is rare but can cause severe injury, especially to the upper gastrointestinal tract, and can be a potentially fatal event. Various surgical procedures have been advocated for gastroesophageal reconstruction, but especially those using the right colon, when the ileocecal valve is preserved for gastric reconstruction, are briefly exposed in literature and have not been studied in humans by controlled studies. Using the right colon is believed to be beneficial because of the anti-reflux mechanism of the ileocecal valve.
View Article and Find Full Text PDFBr J Clin Pharmacol
December 2024
Department of Pharmacology, Toxicology and Pharmacovigilance, CHU de Limoges, Limoges, France.
Aims: Mycophenolic acid (MPA), the active component of enteric-coated mycophenolate sodium (EC-MPS), exhibits highly variable pharmacokinetics. Only a few population pharmacokinetic (popPK) models and Bayesian estimators (MAP-BE) exist for estimating MPA AUC and all in renal transplantation. This study aimed to develop a popPK model and MAP-BE for MPA AUC estimation using a limited sampling strategy (LSS) in solid organ transplant (SOT), haematopoietic stem cell (HSC) recipients and patients with autoimmune diseases (AID) on EC-MPS.
View Article and Find Full Text PDFMicrob Pathog
December 2024
School of Animal Science and Technology, Foshan University, Foshan 528225, Guangdong Province, China; Department of Infectious Diseases, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130122, Jilin Province, China; Institute of Zoology, Guangdong Academy of Sciences, Guangzhou 510260, Guangdong Province, China. Electronic address:
Beiji nairovirus (BJNV) is a recently discovered tick-borne RNA virus associated with human febrile illness. This study aimed to develop a loop-mediated isothermal amplification (LAMP) assay for the precise detection of BJNV, with a specific focus on assessing its effectiveness with clinical samples. The optimal molecular target was identified as the BJNV small (S) segment gene, and the ideal reaction conditions were established at 65 °C for 50 min.
View Article and Find Full Text PDFTransfus Apher Sci
December 2024
University of Health Sciences, Ankara Oncology Training and Research Hospital, Department of Hematology & Apheresis Unit, Ankara, Turkey; Ankara Yildirim Beyazit University, School of Medicine, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
Objective: Acute graft versus host disease (GVHD) occurs in 20-80 % of patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Of these patients, 40 % will be resistant to steroids, which is the standard first-line approach. There is no standard second line treatment approach for patients with steroid refractory acute GVHD (SR-aGVHD).
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