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Suitable Donor (suitable + donor)
Selected AbstractsThe effects of supraphysiological doses of corticosteroids in hypotensive liver failureLIVER INTERNATIONAL, Issue 2 2003Rachael Harry Abstract: Background: In septic shock, supraphysiological doses of corticosteroids reduce norepinephrine requirements. We reviewed our experience of this treatment in hypotensive liver failure. Methods: We retrospectively analysed 20 patients with liver failure who were treated with supraphysiological doses of hydrocortisone because of norepinephrine dependence. We compared their norepinephrine requirements, outcome, microbiology and incidence of gastrointestinal bleeding to an historical control group treated with norepinephrine but not corticosteroids. Results: After 48 h of steroid treatment, the median norepinephrine dose was reduced (0.14 µg/kg/min to 0.08 µg/kg/min; P < 0.05) while the blood pressure over the same period of time did not change significantly (67.3 mm Hg to 70 mm Hg). Duration of ITU stay was longer in the steroid treated group (13.5 days vs 3 days; P < 0.05) but survival was similar in both groups. There were 23 episodes of positive bacterial cultures after norepinephrine was started in the steroid treated group, compared with 18 episodes in the control group. More of the positive cultures were due to resistant organisms in the steroid treated group (65% vs 17% in the control group; P < 0.002). There was no significant bleeding due to gastrointestinal inflammation in either group. Conclusions: Supraphysiological doses of corticosteroids reduce norepinephrine requirements in hypotensive liver failure. They do not improve survival but may extend time to find a suitable donor in those awaiting urgent liver transplantation. [source] Selection of donors for living donor liver transplantationLIVER TRANSPLANTATION, Issue 10C 2003James F. Trotter Key points 1. The donor evaluation is performed in three staged phases to disqualify inappropriate candidates as early as possible in the process. 2. Approximately half the potential transplant recipients are unable to identify a suitable donor for evaluation. 3. Approximately half the individuals evaluated for living donation are found suitable. 4. The donor pool in many parts of the country is significantly limited by the high prevalence of obesity. [source] American Society of Transplantation Symposium on B Cells in Transplantation: Harnessing Humoral Immunity from Rodent Models to Clinical PracticeAMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2007A. D. Kirk There is growing awareness that B cells and alloantibodies are important mediators of both acute and chronic allograft injury. Unfortunately, few therapies are clinically available to mitigate the function of B cells or the effects of established alloantibody. As a result, many sensitized people await transplantation without a suitable donor, and several rejection syndromes are emerging that appear to involve B cells either as antibody producers or as antigen-presenting cells. In recognition of this unmet need in transplantation, the American Society of Transplantation organized a Symposium on B cells in Organ Transplantation to foster interest in this topic amongst basic researchers attending the annual meeting of the American Association of Immunologists. This manuscript will give an overview of the presentations from this symposium including the current risks of allosensitization, adaptive accommodation, approaches toward B-cell tolerance for allo- and xenoantigens and clinical application of these concepts in ABO incompatible neonatal cardiac transplantation. [source] Membrane bioreactors for regenerative medicine: an example of the bioartificial liverASIA-PACIFIC JOURNAL OF CHEMICAL ENGINEERING, Issue 1 2010Sabrina Morelli Abstract Liver transplantation is the only established treatment for liver failure. Because of the organ scarsity, liver support strategies are being developed with the aim of either supporting patients with the borderline functional liver cell mass until the organ transplantation or liver regeneration. A bioartificial liver (BAL) consisting of functional liver cells supported by an artificial cell culture material could provide a vital temporary support to patients with liver failure, and could serve as a bridge to transplantation while awaiting a suitable donor. In this paper, we discuss the critical issues for the development of BAL such as bioreactor configuration, mass transfer, cell source and culture technique. The characteristics of membrane BAL systems in clinical, preclinical and in vitro tests are reviewed. Membrane bioreactors used for the generation of in vitro physiological model systems for studying biological mechanisms and testing the efficacy of potential therapies are also discussed. Copyright © 2009 Curtin University of Technology and John Wiley & Sons, Ltd. [source] Probabilities of heart donors arising within specified times for child recipientsJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2007John C Galati Aim: To determine the availability of donor hearts for children of different blood group and weight needing urgent heart transplantation. Methods: Data maintained by the Australia and New Zealand Organ Donor Registry 1989,2004 were analysed to determine the frequency of donation. Probabilities of suitable donor availability within 10, 20, 30, 40, 60, 90 and 180 days were estimated using a Poisson model with the assumptions that traditional ABO blood compatibilities applied, suitable donors were 0.8,4.0 times the recipient's body weight (BW) and suitable adult donors were aged <40 years. Results: Probabilities of suitable donor availability increase with passage of time from 10 to 180 days and decrease with competition from other needful recipients. Maximum suitable donor availability occurs for children of all blood groups at body weight 20 kg. The probabilities of a donor heart arising within 40 days (maximum safe duration of extracorporeal membrane oxygenation support locally available for young children) for this recipient body weight according to blood group is 0.89, 0.85, 0.73, 0.67 (AB, A, B, O). Probabilities for recipients of BW 3 kg and 60 kg respectively are 0.16, 0.14, 0.10, 0.09 (AB, A, B, O) and 0.66, 0.61, 0.47, 0.42 (AB, A, B, O). Conclusion: Expectation of suitable heart donation arising within 40 days for needful recipients in Australia is low for infants (probability <0.3), moderate for small children (probability 0.5,0.9) and modest for large children (probability 0.4,0.7), with variation at all body weights according to blood group and waiting time. [source] Thoracic organ donor characteristics associated with successful lung procurementCLINICAL TRANSPLANTATION, Issue 1 2001Doff B McElhinney Purpose: A shortage of suitable donors is the major impediment to clinical lung transplantation. The rate of lung recovery from potential donors is lower than that for other organs. The purpose of this study was to evaluate what factors could be modified to improve the rate of cadaver lung recovery. Methods: We performed a retrospective review of records from all thoracic organ donors procured by the California Transplant Donor Network between 1 January 1995 and 31 May 1997 (251 donors) to determine which donor management factors were associated with an increased likelihood of successful lung procurement. Results: There were 88 lung donors (L) and 163 donors from which hearts but no lungs were procured (H). Longer time to donor network referral was associated with a reduced chance for successful lung procurement. Donor age, cause of death, and time of admission were not important factors. Most donors in this study had an acceptable A-a gradient at admission to the hospital but lung function deteriorated in group H. Corticosteroid usage and initially clear breath sounds were independent predictors of successful procurement by multivariate analysis. Conclusions: Early contact with the donor referral network, and corticosteroids may help to improve the lung procurement rate from potential donors. [source] | ||||||||||