Sample records for brain dead donors

  1. Uterus retrieval process from brain dead donors. (United States)

    Gauthier, Tristan; Piver, Pascal; Pichon, Nicolas; Bibes, Romain; Guillaudeau, Angelique; Piccardo, Alessandro; Pesteil, Francis; Tricard, Jeremy; Gardet, Emmanuel; Laskar, Marc; Lalloué, Fabrice; Marquet, Pierre; Aubard, Yves


    To describe the feasibility of human uterus retrieval after donation after brain death. Single-center, prospective study. University hospital. Female brain dead donors. The families of female brain dead donors were informed about consent to uterus donation. A specific organ retrieval procedure was performed. At the end of the procedure the uterus was removed together with the hypogastric vessels, parametria, and vaginal fornix. The tolerance of the uterus to cold ischemia was evaluated with histology and TUNEL reaction up to 24 hours. Rate of uterus donation refusal. Between August 1, 2012 and July 31, 2013, seven uteri were retrieved from 14 female multiorgan donors. No refusal to uterus donation occurred. Our surgical protocol did not interfere with vital organ retrieval and was readily accepted by the other transplantation teams. The hypogastric vessels could be preserved in all cases but for one vein loss in the first retrieval. Histology studies did not find major morphologic changes after 24 hours of cold ischemia. Apoptosis was rare. Uterus retrieval could be part of a reproducible multiorgan procurement procedure. Uterus donation seems readily accepted. This preliminary study is a necessary step before any transplantation project. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Hypoalbuminaemia in brain-dead donors for liver transplantation

    African Journals Online (AJOL)


    Liver transplantation has become established as the treat- ment of choice for most patients with end-stage liver disease and is performed on a routine basis in most major centres throughout the world. The majority of donors for liver trans- plantation are brain-dead cadaver donors following either a severe head injury or a ...

  3. Brain-Dead Donors on Extracorporeal Membrane Oxygenation. (United States)

    Bronchard, Régis; Durand, Louise; Legeai, Camille; Cohen, Johana; Guerrini, Patrice; Bastien, Olivier


    To describe donors after brain death with ongoing extracorporeal membrane oxygenation and to analyze the outcome of organs transplanted from these donors. Retrospective analysis of the national information system run by the French Biomedicine Agency (CRISTAL database). National registry data of all donors after brain death in France and their organ recipients between 2007 and 2013. Donors after brain death and their organ recipients. None. During the study period, there were 22,270 brain-dead patients diagnosed in France, of whom 161 with extracorporeal membrane oxygenation. Among these patients, 64 donors on extracorporeal membrane oxygenation and 10,805 donors without extracorporeal membrane oxygenation had at least one organ retrieved. Donors on extracorporeal membrane oxygenation were significantly younger and had more severe intensive care medical conditions (hemodynamic, biological, renal, and liver insults) than donors without extracorporeal membrane oxygenation. One hundred nine kidneys, 37 livers, seven hearts, and one lung were successfully transplanted from donors on extracorporeal membrane oxygenation. We found no significant difference in 1-year kidney graft survival (p = 0.24) and function between recipients from donors on extracorporeal membrane oxygenation (92.7% [85.9-96.3%]) and matching recipients from donors without extracorporeal membrane oxygenation (95.4% [93.0-97.0%]). We also found no significant difference in 1-year liver recipient survival (p = 0.91): 86.5% (70.5-94.1) from donors on extracorporeal membrane oxygenation versus 80.7% (79.8-81.6) from donors without extracorporeal membrane oxygenation. Brain-dead patients with ongoing extracorporeal membrane oxygenation have more severe medical conditions than those without extracorporeal membrane oxygenation. However, kidney graft survival and function were no different than usual. Brain-dead patients with ongoing extracorporeal membrane oxygenation are suitable for organ procurement.

  4. Targeting complement activation in brain-dead donors improves renal function after transplantation

    NARCIS (Netherlands)

    Damman, Jeffrey; Hoeger, Simone; Boneschansker, Leo; Theruvath, Ashok; Waldherr, Ruediger; Leuvenink, Henri G.; Ploeg, Rutger J.; Yard, Benito A.; Seelen, Marc A.

    Kidneys recovered from brain-dead donors have inferior outcomes after transplantation compared to kidneys from living donors. Since complement activation plays an important role in renal transplant related injury, targeting complement activation in brain-dead donors might improve renal function

  5. Organ donation from brain-dead and circulatory-dead donors: single-institution experiences. (United States)

    Kenmochi, T; Nishiyama, S; Hayashi, M; Ito, T; Kato, Y; Hoshinaga, K


    Although the number of organ donations is extremely small in Japan, organ donation from brain dead (DBD) donors is increasing since the revised Law for Organ Transplantation was enacted on July 17, 2010. In our institution, organ donations had so far been performed from 247 donors (DCD 242, DBD 5), which is the largest number in Japan. In this study, we analyzed the status of organ donation before and after the enforcement of the revised law. After the enforcement of the revised law, the option of organ donation was shown to the more families of potential donors by the doctors or donor coordinators. However, the final number of donors was almost the same. The frequency of DBD donors of all donors increased (33.3%) as compared to 9.1% before the enforcement of the revised law. Reasons for rejection of donation from donor families were mainly based on the lack of understanding of brain death. To increase organ donation, we should promote social recognition of brain death, having the Organ Donation Card, and discussion of organ donation in each family. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Changes in the organ procurement system in South Korea: effects on brain-dead donor numbers. (United States)

    Lee, S D; Kim, J H


    In Korea, the Organ Transplantation Act came into effect in 2000, establishing the Korean Network for Organ Sharing (KONOS) with centralized authority for organ procurement as well as for approval of donors and recipients to ensure fair organ allocation. However, the number of brain-dead donors decreased sharply, and the organ allocation system proved inefficient. The government revised the Organ Transplantation Act in August 2002, introducing an incentive system. If a transplantation hospital formed a Committee for Brain Death Evaluation and a Hospital Organ Procurement Organization, it could receive a kidney from a brain dead-donor as an incentive to foster organ procurement regardless of the KONOS wait list. The government also launched a pilot brain-dead donor registry program to strengthen Hospital Organ Procurement Organization activity. If local hospitals collaborated with specialized hospitals in organ procurement, local hospitals obtained financial incentives. But because the organ shortage problem has not been resolved, the government has proposed four initiatives: first, broadening the incentive system, which makes it possible to give each specialized hospital a choice of one of eight organs from each donor as an incentive; second, development of an Independent Organ Procurement Organization; third introduction of an opt-out system; and last, improvement of the Committee for Brain Death Evaluation system. It is uncertain which initiatives will be adopted, but changes in organ procurement systems are nonetheless considered a key to solve the organ shortage problem in Korea.

  7. Dimethyloxalylglycine treatment of brain-dead donor rats improves both donor and graft left ventricular function after heart transplantation. (United States)

    Hegedűs, Péter; Li, Shiliang; Korkmaz-Icöz, Sevil; Radovits, Tamás; Mayer, Tobias; Al Said, Samer; Brlecic, Paige; Karck, Matthias; Merkely, Béla; Szabó, Gábor


    Hypoxia inducible factor (HIF)-1 pathway signalling has a protective effect against ischemia/reperfusion injury. The prolyl-hydroxylase inhibitor dimethyloxalylglycine (DMOG) activates the HIF-1 pathway by stabilizing HIF-1α. In a rat model of brain death (BD)-associated donor heart dysfunction we tested the hypothesis that pre-treatment of brain-dead donors with DMOG would result in a better graft heart condition. BD was induced in anesthetized Lewis rats by inflating a subdurally placed balloon catheter. Controls underwent sham operations. Then, rats were injected with an intravenous dose of DMOG (30 mg/kg) or an equal volume of physiologic saline. After 5 hours of BD or sham operation, hearts were perfused with a cold (4°C) preservation solution (Custodiol; Dr. Franz Köhler Chemie GmbH; Germany), explanted, stored at 4°C in Custodiol, and heterotopically transplanted. Graft function was evaluated 1.5 hours after transplantation. Compared with control, BD was associated with decreased left ventricular systolic and diastolic function. DMOG treatment after BD improved contractility (end-systolic pressure volume relationship E'max: 3.7 ± 0.6 vs 3.1 ± 0.5 mm Hg/µ1; p brain-dead group. After heart transplantation, DMOG treatment of brain-dead donors significantly improved the altered systolic function and decreased inflammatory infiltration, cardiomyocyte necrosis, and DNA strand breakage. In addition, compared with the brain-dead group, DMOG treatment moderated the pro-apoptotic changes in the gene and protein expression. In a rat model of potential brain-dead heart donors, pre-treatment with DMOG resulted in improved early recovery of graft function after transplantation. These results support the hypothesis that activation of the HIF-1 pathway has a protective role against BD-associated cardiac dysfunction. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  8. Increased resistin in brain dead organ donors is associated with delayed graft function after kidney transplantation (United States)


    Introduction Resistin increases during several inflammatory diseases and after intracerebral bleeding or head trauma. Resistin activates the endothelium and may initiate an inflammatory response. No data are available on resistin in brain dead donors (DBD) that regularly manifest a pronounced inflammatory state. Methods We analyzed plasma resistin in 63 DBDs and correlated results with donor variables and the postoperative course following kidney transplantation using organs from these donors. Endocan and monocyte chemotactic protein (MCP)-1 were also studied. Twenty-six live kidney donors (LD) and the corresponding kidney transplantations were used as controls. Results DBDs had higher resistin (median/range 30.75 ng/ml, 5.41–173.6) than LD (7.71 ng/ml, 2.41–15.74, p organ retrieval are associated with DGF after kidney transplantation. The resistin increase seems related to the inflammatory state after brain death but not to the cause of death. PMID:24070260

  9. Trends in brain-dead organ donor characteristics: a 13-year analysis (United States)

    Hassanain, Mazen; Simoneau, Eve; Doi, Suhail A.; Aljiffry, Murad; Aloraini, Abdulla; Madkhali, Ahmad; Metrakos, Peter


    Background Driven by disease trends, such as obesity and metabolic syndrome, that are increasingly prevalent in the general population, we aimed to evaluate the comorbidities and attributes of the brain-dead organ donor population over time in a longitudinal study. Methods We compared overall health and baseline attributes of organ donors between 2000–2005 and 2006–2012 using our prospective transplant database. Descriptive and comparative analyses of the 2 historical cohorts were performed. Results A total of 1040 brain-dead organ donors were included in our analysis: 496 from the 2000–2005 period and 544 from the 2006–2012 period. Our analysis revealed that donors from the recent (2006–2012) period were more likely to have increased body mass index (26.4 ± 6.0 v. 25.0 ± 4.8, p = 0.003), smoking history (57.0% v. 27.2%, p organ donors have somewhat deteriorated over the last decade. Further studies are needed to evaluate the impact of these health attributes on donated organ utilization and outcomes. PMID:26999472

  10. Complement-mediated inflammation and injury in brain dead organ donors. (United States)

    Poppelaars, Felix; Seelen, Marc A


    The importance of the complement system in renal ischemia-reperfusion injury and acute rejection is widely recognized, however its contribution to the pathogenesis of tissue damage in the donor remains underexposed. Brain-dead (BD) organ donors are still the primary source of organs for transplantation. Brain death is characterized by hemodynamic changes, hormonal dysregulation, and immunological activation. Recently, the complement system has been shown to be involved. In BD organ donors, complement is activated systemically and locally and is an important mediator of inflammation and graft injury. Furthermore, complement activation can be used as a clinical marker for the prediction of graft function after transplantation. Experimental models of BD have shown that inhibition of the complement cascade is a successful method to reduce inflammation and injury of donor grafts, thereby improving graft function and survival after transplantation. Consequently, complement-targeted therapeutics in BD organ donors form a new opportunity to improve organ quality for transplantation. Future studies should further elucidate the mechanism responsible for complement activation in BD organ donors. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Wait, treat and see: echocardiographic monitoring of brain-dead potential donors with stunned heart

    Directory of Open Access Journals (Sweden)

    Casartelli Marilena


    Full Text Available Abstract Background Heart transplantation is limited by a severe donor organ shortage. Potential donors with brain death (BD and left ventricular dysfunction due to neurogenic stunning are currently excluded from donation – although such abnormalities can be reversible with aggressive treatment including Hormonal Treatment (HT and deferred organ retrieval. Aim To assess the recovery of left ventricular dysfunction in potential brain-dead donors with hemodynamic instability treated by aggressive treatment and HT. Methods In a single-center, observational study design, we evaluated 15 consecutive brain-dead potential donors (DBD (8 males, age = 48 ± 15 years with hemodynamic instability. All underwent standard hemodynamic monitoring and transthoracic 2-dimensional echo (2-DE with assessment of Ejection Fraction (EF. Measurements were obtained before BD and after BD within 6 h, at 24 h and within 48 h. HT (with insulin, methylprednisolone, vasopressin and T3 was started as soon as possible to treat hemodynamic instability and avoid administration of norepinephrine (NE. Eligible potential heart donors underwent coronary angiography. Results After HT, we observed a normalization of hemodynamic conditions with improvement of mean arterial pressure (pre = 68 ± 8 mmHg vs post = 83 ± 13 mmHg, p 2 vs post 3.7 ± 1.2 L/min/m2, p , coronary artery stenosis was present in 2 of the 10 consented donors. Eight hearts were uneventfully transplanted. No early graft failure occurred and all eight recipients were alive at 6-month follow-up. Conclusion In BD donors, intensive treatment including HT is associated with improvement of regional and global LV function and reverse remodeling detectable by transthoracic 2DE. Donor hearts with recovered LV function may be eligible for uneventful heart transplant. The wait (in brain death, treat (with HT and see (with 2D echo strategy can help rescue organs suitable for

  12. Are patients brain-dead after successful resuscitation from cardiac arrest suitable as organ donors? A systematic review. (United States)

    Sandroni, Claudio; Adrie, Christophe; Cavallaro, Fabio; Marano, Cristina; Monchi, Mehran; Sanna, Tommaso; Antonelli, Massimo


    To compare the outcome of organs retrieved from patients brain dead due to cardiac arrest (CA) with that of organs retrieved from patients brain dead due to other causes (non-CA). Systematic review. Clinical studies comparing the outcome of patients and organs retrieved from donors brain dead after being resuscitated from cardiac arrest with that of patients and organs retrieved from donors brain dead not due to cardiac arrest were considered for inclusion. Full-text articles were searched on MEDLINE, EmBASE, Cochrane Register of Controlled Trials and Cochrane Register of Systematic Reviews. One-year patient or organ survival rate. Four studies fulfilling inclusion criteria were found and three had sufficient quality to be included in final analysis. A total of 858 organs were transplanted from 741 donors. Since the transplanted organs (heart, liver, kidney, lung and intestine) were different in the three studies, metanalysis was not performed. There were no significant differences in 1-year survival rates between CA and non-CA groups. No significant differences were reported for 5-year survival rates, early recovery of transplanted organ function, and organ rejection rates. Survival rates of kidneys, livers, hearts and intestines retrieved from CA donors were not significantly different from that of organs transplanted from non-CA donors. Patients brain dead after having been resuscitated from cardiac arrest can be considered as potential donors for organ transplantation. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Effect of Insulin Therapy using Hyper-insulinemic Normoglycemic Clamp on Inflammatory Response in Brain Dead Organ Donors. (United States)

    Aljiffry, M; Hassanain, M; Schricker, T; Shaheen, M; Nouh, T; Lattermann, R; Salman, A; Wykes, L; Metrakos, P


    Brain death is a major stress that is associated with a massive inflammatory response and systemic hyperglycemia. Severe inflammation leads to increased graft immunogenicity and risk of graft dysfunction; while acute hyperglycemia aggravates the inflammatory response and increases the risk of morbidity and mortality. Insulin therapy not only controls hyperglycemia but also suppresses inflammation. The present study is to investigate the anti-inflammatory properties and the normoglycemia maintenance of high dose insulin on brain dead organ donors. 15 brain dead organ donors were divided into 2 groups, insulin treated (n=6) and controls (n=9). Insulin was provided for a minimum of 6 h using the hyperinsulinemic normoglycemic clamp technique. The changes of serum cytokines, including IL-6, IL-10, IL-1β, IL-8, TNFα, TGFα and MCP-1, were measured by suspension bead array immunoassay and glucose by a glucose monitor. Compared to controls, insulin treated donors had a significant lower blood glucose 4.8 (4-6.9) vs. 9 (5.6-11.7) mmol/L, pinsulin treated donors compared with those in controls. High dose insulin therapy decreases the concentrations of inflammatory cytokines in brain dead donors and preserves normoglycemia. High dose of insulin may have anti-inflammatory effects in brain dead organ donors and therefore, improve the quality of donor organs and potentially improve outcomes. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Decision making on organ donation: the dilemmas of relatives of potential brain dead donors. (United States)

    de Groot, Jack; van Hoek, Maria; Hoedemaekers, Cornelia; Hoitsma, Andries; Smeets, Wim; Vernooij-Dassen, Myrra; van Leeuwen, Evert


    This article is part of a study to gain insight into the decision-making process by looking at the views of the relatives of potential brain dead donors. Alongside a literature review, focus interviews were held with healthcare professionals about their role in the request and decision-making process when post-mortal donation is at stake. This article describes the perspectives of the relatives. A content-analysis of 22 semi-structured in-depth interviews with relatives involved in an organ donation decision. Three themes were identified: 'conditions', 'ethical considerations' and 'look back'. Conditions were: 'sense of urgency', 'incompetence to decide' and 'agreement between relatives'. Ethical considerations result in a dilemma for non-donor families: aiding people or protecting the deceased's body, especially when they do not know his/her preference. Donor families respect the deceased's last will, generally confirmed in the National Donor Register. Looking back, the majority of non-donor families resolved their dilemma by justifying their decision with external arguments (lack of time, information etc.). Some non-donor families would like to be supported during decision-making. The discrepancy between general willingness to donate and the actual refusal of a donation request can be explained by multiple factors, with a cumulative effect. Firstly, half of the participants (most non-donor families) stated that they felt that they were not competent to decide in such a crisis and they seem to struggle with utilitarian considerations against their wish to protect the body. Secondly, non-donor families refused telling that they did not know the deceased's wishes or contesting posthumous autonomy of the eligible. Thirdly, the findings emphasise the importance of Donor Registration, because it seems to prevent dilemmas in decision-making, at least for donor families. Discrepancies between willingness to consent to donate and refusal at the bedside can be attributed

  15. The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

    Directory of Open Access Journals (Sweden)

    Mi Z


    Full Text Available Zhibao Mi,1 Dimitri Novitzky,2 Joseph F Collins,1 David KC Cooper3 1Cooperative Studies Program Coordinating Center, VA Maryland Health Care Systems, Perry Point, MD, USA; 2Department of Cardiothoracic Surgery, University of South Florida, Tampa, FL, USA; 3Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA Abstract: The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA, are statistically conservative. Hsu’s multiple comparisons with the best (MCB – adapted from the Dunnett’s multiple comparisons with control (MCC – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM or generalized linear mixed models (GLMM, and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS, among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. Keywords: best treatment selection, brain-dead organ donors, hormonal replacement, multiple binary endpoints, organ procurement, multiple comparisons

  16. The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors. (United States)

    Mi, Zhibao; Novitzky, Dimitri; Collins, Joseph F; Cooper, David Kc


    The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy) is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA), are statistically conservative. Hsu's multiple comparisons with the best (MCB) - adapted from the Dunnett's multiple comparisons with control (MCC) - has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM) or generalized linear mixed models (GLMM), and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS), among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation.

  17. Arguments against promoting organ transplants from brain-dead donors, and views of contemporary Japanese on life and death. (United States)

    Asai, Atsushi; Kadooka, Yasuhiro; Aizawa, Kuniko


    As of 2009, the number of donors in Japan is the lowest among developed countries. On July 13, 2009, Japan's Organ Transplant Law was revised for the first time in 12 years. The revised and old laws differ greatly on four primary points: the definition of death, age requirements for donors, requirements for brain-death determination and organ extraction, and the appropriateness of priority transplants for relatives. In the four months of deliberations in the National Diet before the new law was established, various arguments regarding brain death and organ transplantation were offered. An amazing variety of opinions continue to be offered, even after more than 40 years have elapsed since the first heart organ transplant in Japan. Some are of the opinion that with the passage of the revised law, Japan will finally become capable of performing transplants according to global standards. Contrarily, there are assertions that organ transplants from brain-dead donors are unacceptable because they result in organs being taken from living human beings. Considering the current conditions, we will organize and introduce the arguments for and against organ transplants from brain-dead donors in contemporary Japan. Subsequently, we will discuss the primary arguments against organ transplants from brain-dead donors from the perspective of contemporary Japanese views on life and death. After introducing the recent view that brain death should not be regarded as equivalent to the death of a human being, we would like to probe the deeply-rooted views on life and death upon which it is based. © 2010 Blackwell Publishing Ltd.

  18. Rate of family refusal of organ donation in dead-brain donors: the Iranian tissue bank experience. (United States)

    Mahdavi-Mazdeh, M; Khodadadi, A; Tirgar, N; Riazi, N


    The growing gap between organ supply and demand remains a worldwide serious problem. Losing dead-brain donor organs can be attributed to several reasons including un-recognition of potential donor by ICU staff, death before official declaration of brain death and high refusal rate of deceased donors' families. To study the trend of dead-brain patients' relatives refusal of organ donation from 2007 to 2011. This study was a retrospective review of all patients who had been introduced as brain death to the organ procurement unit (OPU) of Iranian Tissue Bank between April 2007 and April 2012 according to preliminary neurological exam performed in the hospital of origin. The refusal rate of dead-brain patients' families and its reasons was evaluated. A total of 874 ICU admitted patients with severe brain injury (Glasgow coma score donation according to the approved medical protocols (n=205) and not fulfilling the brain death criteria (n=66). The families of the remaining cases (n=462) had been interviewed 343 (74.2%) of whom permitted donation. The mean±SD age of donors was 29.8±13.2 years; the male/female ratio was almost 2. The most common reason of brain death was traffic collision (n=120; 56.3%) and cerebrovascular accidents (n=40; 18.8%). The refusal rate from 2007 to 2011 has decreased respectively, from 30.4% to 20% in Tehran, and from 57.1% to 51.6% in other cities. The overall refusal rate was 25.8%. Our study confirmed that more level of expertise of the coordinator team and continuous public education, would result in higher rate of consent to organ donation.

  19. The effect of cortisol in rat steatotic and non-steatotic liver transplantation from brain-dead donors. (United States)

    Jiménez-Castro, Mónica B; Negrete-Sánchez, Elsa; Casillas-Ramírez, Araní; Gulfo, Jose; Álvarez-Mercado, Ana I; Cornide-Petronio, María Eugenia; Gracia-Sancho, Jordi; Rodés, Juan; Peralta, Carmen


    In the present study, we examined the effects of cortisol on steatotic and non-steatotic liver grafts from brain-dead donors and characterized the underlying mechanisms involved. Non-steatotic liver grafts showed reduced cortisol and increased cortisone levels in association with up-regulation of enzymes that inactivate cortisol. Conversely, steatotic liver grafts exhibited increased cortisol and reduced cortisone levels. The enzymes involved in cortisol generation were overexpressed, and those involved in cortisol inactivation or clearance were down-regulated in steatotic liver grafts. Exogenous administration of cortisol negatively affected hepatic damage and survival rate in non-steatotic liver transplantation (LT); however, cortisol treatment up-regulated the phosphoinositide 3-kinase (PI3K)-protein kinase C (PKC) pathway, resulting in protection against the deleterious effects of brain-dead donors on damage and inflammatory response in steatotic LT as well as in increased survival of recipients. The present study highlights the differences in the role of cortisol and hepatic mechanisms that regulate cortisol levels based on the type of liver. Our findings suggest that cortisol treatment is a feasible and highly protective strategy to reduce the adverse effects of brain-dead donor livers in order to ultimately improve liver graft quality in the presence of steatosis, whereas cortisol treatment would not be recommended for non-steatotic liver grafts. © 2017 The Author(s). published by Portland Press Limited on behalf of the Biochemical Society.

  20. The ethics of extracorporeal membrane oxygenation in brain-dead potential organ donors. (United States)

    Dalle Ave, Anne L; Gardiner, Dale; Shaw, David M


    Organ-preserving extracorporeal membrane oxygenation (OP-ECMO) is defined as the use of extracorporeal support for the primary purpose of preserving organs for transplantation, rather than to save the patient's life. This paper discusses the ethics of using OP-ECMO in donation after brain determination of death (DBDD) to avoid the loss of organs for transplantation. We review case reports in the literature and analyze the ethical issues raised. We conclude that there is little additional ethical concern in continuing OP-ECMO in patients already on ECMO if they become brain dead. The implementation of OP-ECMO in hemodynamically unstable brain-dead patients is ethically permissible in certain clinical situations but requires specific consent from relatives if the patient's wish to donate is not clear. If no evidence of a patient's wish to donate is available, OP-ECMO is not recommended. In countries with presumed consent legislation, failure to opt out should be considered as a positive wish to donate. If a patient is not-yet brain-dead or is undergoing testing for brain death, OP-ECMO is not recommended. Further research on OP-ECMO is needed to better understand the attitudes of professionals, families, and lay people to ensure agreement on key ethical issues. © 2016 Steunstichting ESOT.

  1. Activity of urine arylsulfatase A in brain-dead graft donors is a predictor of early and late graft function

    Directory of Open Access Journals (Sweden)

    Ewa Kwiatkowska


    Full Text Available Objective: Human lysosomal arylsulfatase A (ASA is a member of the sulfatase family. Arylsulfatase A is required to degrade sulfatides. Sulfatides occur in the myelin sheets of the central and peripheral nervous system. In this study we evaluated the urine activity of lysosomal enzyme arylsulfatase A in brain-dead donors as a marker and predictor of short – and long-term renal allograft function. Patients/Methods: We analyzed data from kidney recipients who received organs from brain‑dead donors. Data from 40 donors and 68 recipients were analyzed. Results: Urine activity of arylsulfatase A in graft donors correlated positively with creatinine clearance in graft recipients after transplantation: : significantly after 30 days (Rs=0.38, p=0.004 and after 3 years (Rs=0.38, p=0.03, and with borderline significance after 14 days (Rs=0.25, p=0.08 and after one year (Rs=0.23, p=0.07. Conclusions: The results of this study suggest that arylsulfatase A has a protective effect on kidney allograft, and the urine activity of this enzyme in kidney donors correlates positively with graft function.

  2. Abdominal organ donation: surgical aspects and recommended practice guidelines for controlled donation of brain-dead donor. (United States)

    Matevossian, E; Kordzaia, D; Chkhaidze, Z; Khodeli, N; Partsakashvili, J; Khachiperadze, Z; Doll, D; Lobzhanidze, G


    The shortage of organ donors along with the increased number of waiting recipients have created the need for new strategies to expand the organ pool from donations after brain death. Organ procurement from brain-dead deceased donors is a complex task. Multiple, complicated operations are performed simultaneously. Very often, this involves numerous physicians and transplant coordinators. An extensive coordination between the thoracic and abdominal surgical teams is crucial for the successful procurement of all suitable organs. The quality of donor organs and the successful recovery therefore depends on a good communication. Organ procurement for transplantation should generally be performed in a calm and dignified atmosphere. The last wishes of the organ donor itself or the relatives must be respected unconditionally. In general, a dignified and respectful treatment of the organ donor is a condition sine qua non for each person involved in the process of organ procurement. The purpose of this article was to focus on the surgical aspects of organ donation after brain death. The proposed recommendations, in cases where they are applicable, are acceptable, however, one should never forget the importance of the ethical side of the issue with respect to the doctor-donating side relationship.

  3. Surgical illustration ofen-bloc(dual) kidney transplant from a 16-month old brain-dead donor to an adult recipient. (United States)

    Jain, Vikas; Jain, Saurabh; Singhal, Paras; Nayak, Suman Lata; Mathur, Rajendra P


    Transplantable organs from pediatric donors have been contributing significantly to donor pool worldwide. Pediatric donors are excellent resources that should be procured whenever available, and with the recent increase in deceased donations in India, more pediatric donors will be available for organ harvesting. We share a rare instance of multi-organ harvesting from a 16-month old brain dead donor and implanting both kidneys en-bloc in an adult male, while liver went to a 4-year old child. The report provides the surgical illustration of salient steps of transplanting both kidneys from pediatric donor into an adult, in an en-bloc manner.

  4. Thyroid hormone therapy in the management of 63,593 brain-dead organ donors: a retrospective analysis. (United States)

    Novitzky, Dimitri; Mi, Zhibao; Sun, Qing; Collins, Joseph F; Cooper, David K C


    Hormonal therapy to the brain-dead potential organ donor can include thyroid hormone (triiodothyronine [T3] or levothyroxine [T4]), corticosteroids, antidiuretic hormone, and insulin. Data on 66,629 donors (2000-2009) were retrospectively reviewed. Documentation on T3/T4 was available in 63,593 (study 1), but 23,469 had incomplete documentation of other hormones. In 40,124, details of all four hormones were recorded (study 2). In this cohort, group A (received T3/T4) consisted of 23,022, and group B (no T3/T4) consisted of 17,102 donors. A multivariate analysis was performed to determine whether age, sex, ethnicity, cause of death, body mass index, Organ Procurement Organization region, or other hormonal therapy influenced procurement. Posttransplantation organ graft survival at 1 and 12 months was compared. In study 1, 30,962 (48.69%) received T3/T4, providing a mean of 3.35 organs per donor, and 32,631 (51.31%) did not receive T3/T4, providing a mean of 2.97 organs per donor, an increase of 12.8% of organs from T3/T4-treated donors (Porgans per donor and group B provided a mean of 2.87 organs per donor, an increase of 15.3% in group A (Pdonor was associated with improved posttransplantation graft survival or no difference in survival, except for pancreas recipient (but not graft) survival at 12 months in study 2. T3/T4 therapy results in more transplantable organs, with no detriment to posttransplantation graft survival.

  5. Attitude of Healthcare Professionals: A Major Limiting Factor in Organ Donation from Brain-Dead Donors

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    Maciej Kosieradzki


    Full Text Available Public attitude toward deceased donor organ recovery in Poland is quite positive, with only 15% opposing to donation of their own organs, yet actual donation rate is only 16/pmp. Moreover, donation rate varies greatly (from 5 to 28 pmp in different regions of the country. To identify the barriers of organ donation, we surveyed 587 physicians involved in brain death diagnosis from regions with low (LDR and high donation rates (HDR. Physicians from LDR were twice more reluctant to start diagnostic procedure when clinical signs of brain death were present (14% versus 5.5% physicians from HDR who would not diagnose death, resp.. Twenty-five percent of LDR physicians (as opposed to 12% of physicians from HDR would either continue with intensive therapy or confirm brain death and limit to the so-called minimal therapy. Only 32% of LDR physicians would proceed with brain death diagnosis regardless of organ donation, compared to 67% in HDR. When donation was not an option, mechanical ventilation would be continued more often in LDR regions (43% versus 26.7%; P<0.01. In conclusion, low donation activity seems to be mostly due to medical staff attitude.

  6. [Diagnostic workup of brain-dead organ donors and organ retrieval]. (United States)

    Wunderlich, H


    Renal transplantation is well established as the best and often the only treatment for many patients with end-stage kidney failure. Because of an increasing shortfall between the diminishing number of deceased donor organs available and the increasing waiting list of patients in need of transplantation the shortage of suitable donors remains one of the most pressing challenges. The success of organ transplantation can be attributed to many factors but ultimately depends upon retrieval and preservation techniques to maintain the quality of an organ. Although the literature on organ retrieval is extensive, the level of evidence provided is mainly low. But as techniques and treatments improve, it may be possible to use organs from donors who were previously thought to be unsuitable. This article provides the reader an overview on the topic of organ donation.

  7. Guidelines for the assessment and acceptance of potential brain-dead organ donors (United States)

    Westphal, Glauco Adrieno; Garcia, Valter Duro; de Souza, Rafael Lisboa; Franke, Cristiano Augusto; Vieira, Kalinca Daberkow; Birckholz, Viviane Renata Zaclikevis; Machado, Miriam Cristine; de Almeida, Eliana Régia Barbosa; Machado, Fernando Osni; Sardinha, Luiz Antônio da Costa; Wanzuita, Raquel; Silvado, Carlos Eduardo Soares; Costa, Gerson; Braatz, Vera; Caldeira Filho, Milton; Furtado, Rodrigo; Tannous, Luana Alves; de Albuquerque, André Gustavo Neves; Abdala, Edson; Gonçalves, Anderson Ricardo Roman; Pacheco-Moreira, Lúcio Filgueiras; Dias, Fernando Suparregui; Fernandes, Rogério; Giovanni, Frederico Di; de Carvalho, Frederico Bruzzi; Fiorelli, Alfredo; Teixeira, Cassiano; Feijó, Cristiano; Camargo, Spencer Marcantonio; de Oliveira, Neymar Elias; David, André Ibrahim; Prinz, Rafael Augusto Dantas; Herranz, Laura Brasil; de Andrade, Joel


    Organ transplantation is the only alternative for many patients with terminal diseases. The increasing disproportion between the high demand for organ transplants and the low rate of transplants actually performed is worrisome. Some of the causes of this disproportion are errors in the identification of potential organ donors and in the determination of contraindications by the attending staff. Therefore, the aim of the present document is to provide guidelines for intensive care multi-professional staffs for the recognition, assessment and acceptance of potential organ donors. PMID:27737418

  8. A randomized trial of the effects of nebulized albuterol on pulmonary edema in brain-dead organ donors. (United States)

    Ware, L B; Landeck, M; Koyama, T; Zhao, Z; Singer, J; Kern, R; Neidlinger, N; Nguyen, J; Johnson, E; Janz, D R; Bernard, G R; Lee, J W; Matthay, M A


    Donor lung utilization rates are persistently low primarily due to donor lung dysfunction. We hypothesized that a treatment that enhances the resolution of pulmonary edema by stimulating the rate of alveolar fluid clearance would improve donor oxygenation and increase donor lung utilization. We conducted a randomized, blinded, placebo-controlled trial of aerosolized albuterol (5mg q4h) versus saline placebo during active donor management in 506 organ donors.The primary outcome was change in oxygenation arterial partial pressure of oxygen/fraction of inspired oxygen [PaO2/FiO2] from enrollment to organ procurement.The albuterol (n¼260) and placebo (n¼246)groups were well matched for age, gender, ethnicity,smoking, and cause of brain death. The change in PaO2/FiO2 from enrollment to organ procurement did not differ between treatment groups (p¼0.54) nor did donor lung utilization (albuterol 29% vs. placebo 32%,p¼0.44). Donors in the albuterol versus placebo groups were more likely to have the study drug dose reduced (13% vs. 1%, pdonor management period did not improve donor oxygenation or increase donor lung utilization but did cause tachycardia.High dose aerosolized albuterol should not be used in donors to enhance the resolution of pulmonary edema.

  9. A Randomized Trial of the Effects of Nebulized Albuterol on Pulmonary Edema in Brain Dead Organ Donors (United States)

    Ware, Lorraine B.; Landeck, Megan; Koyama, Tatsuki; Zhao, Zhiguo; Singer, Jonathan; Kern, Ryan; Neidlinger, Nikole; Nguyen, John; Johnson, Elizabeth; Janz, David R.; Bernard, Gordon R.; Lee, Jae W.; Matthay, Michael A.


    Donor lung utilization rates are persistently low primarily due to donor lung dysfunction. We hypothesized that a treatment that enhances the resolution of pulmonary edema by stimulating the rate of alveolar fluid clearance would improve donor oxygenation and increase donor lung utilization. We conducted a randomized, blinded, placebo-controlled trial of aerosolized albuterol (5 mg q4h) versus saline placebo during active donor management in 506 organ donors. The primary outcome was change in oxygenation (PaO2/FiO2) from enrollment to organ procurement. The albuterol (n=260) and placebo (n=246) groups were well matched for age, gender, ethnicity, smoking, and cause of brain death. The change in PaO2/FiO2 from enrollment to organ procurement did not differ between treatment groups (p=0.54) nor did donor lung utilization (albuterol 29% vs. placebo 32%, p=0.44). Donors in the albuterol vs. placebo group were more likely to have the study drug dose reduced (13% vs. 1%, pdonor management period did not improve donor oxygenation or increase donor lung utilization but did cause tachycardia. High dose aerosolized albuterol should not be used in donors to enhance the resolution of pulmonary edema. PMID:24730050

  10. Beneficial Effect of Extracorporeal Membrane Oxygenation on Organ Perfusion During Management of the Unstable Brain-dead Donor: A Case Series. (United States)

    Kang, J H; Choi, B H; Moon, K M; Park, Y M; Yang, K H; Ryu, J H; Chu, C W


    It is well known that the quality of organs retrieved from brain-dead donors (DBDs) is better than those retrieved from circulatory death donors. However, in situations of organ retrieval from marginal DBDs, who are unstable despite intensive care, transplantation outcomes are not good. Organ ischemia is the most important determining factor in decreased organ quality in circulatory death donors and in some DBDs. Extracorporeal membrane oxygenation (ECMO) for management of DBDs can be an emergency countermeasure. The purpose of this report is to relay our experience with four cases of ECMO for DBD management. In all four cases, the donors were unstable and showed clear signs of ischemia despite intensive care, including ventilator use and administration of inotropic agents. Two donors had acute respiratory distress syndrome, and two exhibited dysfunctional oxygen delivery. ECMO was used to improve organ perfusion. ECMO resulted in an increased partial pressure of arterial oxygen increased and decreased lactic acid levels. Vital signs were stabilized, especially in the donors who were bleeding. The organ was successfully retrieved from each donor. Two livers (one of them was split), eight kidneys, and one pancreas were retrieved from four DBDs. All other organs were transplanted successfully, and there were no cases of primary nonfunction or delayed graft function. The ECMO machine is the most powerful supportive device for management of unstable DBDs. The use of ECMO in unstable DBDs can be beneficial in expanding the donor pool as well as improving the quality of retrieved organs. Copyright © 2016. Published by Elsevier Inc.

  11. Organ Perfusion for Uterus Transplantation in Non-Human Primates With Assumed Procurement of a Uterus From a Brain-Dead Donor. (United States)

    Kisu, I; Kato, Y; Yamada, Y; Matsubara, K; Obara, H; Emoto, K; Adachi, M; Umene, K; Nogami, Y; Banno, K; Kitagawa, Y; Aoki, D


    Clinical studies of uterus transplantation have been performed to treat uterine factor infertility. Because the uterus is a pelvic visceral organ, the method of perfusion for the procurement of vital organs from a brain-dead donor should be modified for removal of the uterus. Herein, we report the results of a preliminary study in cynomolgus monkeys of a new perfusion method for uterus transplantation with assumed procurement of a uterus from a brain-dead donor. Cynomolgus monkeys were used; thoracolaparotomy was performed on the donor. A perfusion catheter was then placed into the unilateral femoral artery and/or external iliac artery. Cross-clamping was performed for the aorta under the diaphragm and the inferior vena cava was divided in the pleural space. The perfusion solution was then administered via the catheter to perfuse all organs in the abdominal cavity, including those in the pelvic cavity. After the perfusion, gross observation and histopathological examination of abdominal organs were conducted. Gross findings showed that all abdominal organs turned white in all specimens, indicating favorable perfusion of the uterus and all other organs in the abdomen. Pathological findings showed that almost no hemocytes were observed in the vessels of each organ. With perfusion via the femoral artery and/or external iliac artery, all organs in the abdominal cavity, including the uterus, could be perfused. It was suggested that this technique could be useful for uterus transplantation assuming the procurement of a uterus from a brain-dead donor. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Changing Patterns of Organ Donation: Brain Dead Donors Are Not Being Lost by Donation After Circulatory Death. (United States)

    Nelson, Helen M; Glazier, Alexandra K; Delmonico, Francis L


    The clinical characteristics of all New England Organ Bank (NEOB) donors after circulatory death (DCD) donors were analyzed between July 1, 2009, and June 30, 2014. During that 5-year period, there were 494 authorized medically suitable potential DCDs that the NEOB evaluated, constituting more than 30% of deceased donors coordinated annually by the NEOB. From the cohort of 494 authorized potential DCDs, 331 (67%) became actual DCD, 82 (17%) were attempted as a DCD but did not progress to donation, and 81 (16%) transitioned to an actual donor after brain death (DBD). Two hundred seventy-six organs were transplanted from the 81 donors that transitioned from DCD to actual DBD, including 24 heart, 70 liver, 12 single and 14 bilateral lung, and 12 pancreas transplants. When patients with devastating brain injury admitted to the intensive care units are registered donors, the Organ Procurement Organization staff should share the patient's donation decision with the health care team and the patient's family, as early as possible after the comfort measures only discussion has been initiated. The experience of the NEOB becomes an important reference of the successful implementation of DCD that enables an expansion of deceased donation (inclusive of DBD).

  13. Understanding the effect of corticosteroid pretreatment in brain-dead organ donors: new mechanistic insights for improvement of organ quality in liver transplantation. (United States)

    Dahrenmöller, Carola; Reding, Raymond


    Transplant surgeons are currently faced with the challenge to accept marginal liver transplants due to steatosis or old age. Improving organ quality by implementing a selective organ protective donor management could be the first step towards a graft of enhanced quality. However, the molecular mechanisms of such treatments are still poorly understood. Glucocorticoid medication in donor medicine has been carried out and discussed for a long time. In a recent study published in Clinical Science , Jiménez-Castro et al. [Clin. Sci. (2017) 131, 733-746] demonstrate how liver histology and transplant liver function can be improved by administration of glucocorticoids to brain-dead donor rats with steatotic livers. This work illustrates the need for further trials in order to selectively improve the quality of steatotic livers with a potential for liver transplantation. © 2017 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  14. Performance of QuantiFERON TB Gold test in detecting latent tuberculosis infection in brain-dead organ donors in Iran: a brief report. (United States)

    Tabarsi, Payam; Yousefzadeh, Amir; Najafizadeh, Katayoun; Droudinia, Atousa; Bayati, Rouzbeh; Marjani, Majid; Shafaghi, Shadi; Farokhzad, Banafsheh; Javanmard, Pedram; Velayati, Ali Akbar


    With regard to the significant morbidity and mortality due to tuberculosis in lung transplant recipients, the identification of brain-dead organ donors with latent tuberculosis by use of the QuantiFERON TB Gold (QFT-G) test may be of help to reduce the risk of TB reactivation and mortality in lung recipients. This study was conducted in the National Research Institute of Tuber-culosis and Lung Diseases (NRITLD) in Iran, from January to March 2013. A total of 38 conse-cutive brain-dead donors, not currently infected with active tuberculosis, were recruited. The medi-cal records of all the study enrollees were reviewed. A whole-blood IFN- release assay (IGRA) in reaction to early secreted antigenic target 6 (ESAT-6), culture filtrate protein 10 (CFP-10), and TB7.7 antigens, was performed and the released Interferon- was measured via enzyme-linked immunosorbent assay (ELISA). The data was analyzed with QFT-G software which was provided by the company. The demographic, characteristics and other variables were entered into SPSS version 11.5. The QFT-G test results of three donors (7.9%) turned out to be positive, negative for 24 donors (63.1%), and indeterminate for 11 cases (28.9%). Our study revealed the potential advantages of QFT-G in lowering the incidence of donor-derived post-transplant tuberculosis among lung recipients. However, a high rate of indeterminate results restricted the performance of QFT-G in this study.

  15. Performance of QuantiFERON TB Gold test in detecting latent tuberculosis infection in brain-dead organ donors in Iran: A brief report

    Directory of Open Access Journals (Sweden)

    Payam Tabarsi


    Full Text Available With regard to the significant morbidity and mortality due to tuberculosis in lung transplant recipients, the identification of brain-dead organ donors with latent tuberculosis by use of the QuantiFERON TB Gold (QFT-G test may be of help to reduce the risk of TB reactivation and mortality in lung recipients. This study was conducted in the National Research Institute of Tuber-culosis and Lung Diseases (NRITLD in Iran, from January to March 2013. A total of 38 conse-cutive brain-dead donors, not currently infected with active tuberculosis, were recruited. The medi-cal records of all the study enrollees were reviewed. A whole-blood IFN- release assay (IGRA in reaction to early secreted antigenic target 6 (ESAT-6, culture filtrate protein 10 (CFP-10, and TB7.7 antigens, was performed and the released Interferon- was measured via enzyme-linked immunosorbent assay (ELISA. The data was analyzed with QFT-G software which was provided by the company. The demographic, characteristics and other variables were entered into SPSS version 11.5. The QFT-G test results of three donors (7.9% turned out to be positive, negative for 24 donors (63.1%, and indeterminate for 11 cases (28.9%. Our study revealed the potential advantages of QFT-G in lowering the incidence of donor-derived post-transplant tuberculosis among lung recipients. However, a high rate of indeterminate results restricted the performance of QFT-G in this study.

  16. Lungs from donation after circulatory death donors: an alternative source to brain-dead donors? Midterm results at a single institution. (United States)

    Zych, Bartlomiej; Popov, Aron-Frederik; Amrani, Mohamed; Bahrami, Toufan; Redmond, Karen Christina; Krueger, Heike; Carby, Martin; Simon, André Ruediger


    Donor organ shortage remains to be the major limitation in lung transplantation, and donation after circulatory death (DCD) might represent one way to alleviate this problem. DCD was introduced to our institution in 2007 and has been a part of our clinical routine since then. Here, we present the mid-term results of lung transplantation from DCD in a single institution and compare the outcomes with the lung recipient cohort receiving lungs from donation after brain death (DBD). Since initiation of the DCD programme in March 2007, of the 157 lung transplantations performed, 26 (16.5%) were retrieved from DCD donors, with 25 double- and 1 single-lung transplants being performed. Results were compared with standard DBD transplantations. Analyses included, amongst others, donor characteristics, survival, prevalence of primary graft dysfunction, acute rejection, lung function tests during follow-up, onset of bronchiolitis obliterans syndrome (BOS) as well as duration of mechanical ventilation, hospital and intensive care unit length of stay. While there was no significant difference between lung function, BOS and survival between the two groups, lungs from DCD donors had a higher PaO(2) (median; interquartile range) 498.3 (451.5; 525) vs. DBD 442.5 (371.25; 502) kPa before retrieval (P = 0.009). There was also a longer total ischaemic time in the DCD vs. DBD group: 320 min (298.75; 393.25) vs. 285.5 min (240; 373) (P = 0.025). All other parameters were comparable. Medium-term results after lung transplantation with organs procured after circulatory death are comparable with those obtained after standard lung transplantation. Therefore, DCD could be used to significantly increase the donor pool.

  17. Successful renal transplantation from a brain-dead deceased donor with head injury, disseminated intravascular coagulation and deranged renal functions

    Directory of Open Access Journals (Sweden)

    P P Ghuge


    Full Text Available Deceased donors (DDs with the brain death due to head injury are the major source of organs for transplantation. The incidence of post-head injury disseminated intravascular coagulation (DIC ranges from 24% to 50%. Many centers do not accept organs from donors with DIC due to increased risk of primary graft non-function and/or high chances of morbidity/mortality. We performed two successful renal transplants from a DD with head injury with DIC and deranged renal function. One of the recipients developed transient thrombocytopenia, but there was no evidence of DIC or delayed graft functions in either of the recipients. Over a follow-up of 1 month, both are doing well with stable graft function and hematological profile. Thus, a carefully selected DD with severe DIC even with deranged renal function is not a contraindication for organ donation if other risk factors for primary non-function are excluded. This approach will also help in overcoming organ shortage.

  18. The dead donor rule, voluntary active euthanasia, and capital punishment. (United States)

    Coons, Christian; Levin, Noah


    We argue that the dead donor rule, which states that multiple vital organs should only be taken from dead patients, is justified neither in principle nor in practice. We use a thought experiment and a guiding assumption in the literature about the justification of moral principles to undermine the theoretical justification for the rule. We then offer two real world analogues to this thought experiment, voluntary active euthanasia and capital punishment, and argue that the moral permissibility of terminating any patient through the removal of vital organs cannot turn on whether or not the practice violates the dead donor rule. Next, we consider practical justifications for the dead donor rule. Specifically, we consider whether there are compelling reasons to promulgate the rule even though its corresponding moral principle is not theoretically justified. We argue that there are no such reasons. In fact, we argue that promulgating the rule may actually decrease public trust in organ procurement procedures and medical institutions generally - even in states that do not permit capital punishment or voluntary active euthanasia. Finally, we examine our case against the dead donor rule in the light of common arguments for it. We find that these arguments are often misplaced - they do not support the dead donor rule. Instead, they support the quite different rule that patients should not be killed for their vital organs.

  19. Complement mediated renal inflammation induced by donor brain death : role of renal C5a-C5aR interaction

    NARCIS (Netherlands)

    van Werkhoven, M. B.; Damman, J.; van Dijk, M. C. R. F.; Daha, M. R.; de Jong, I. J.; Leliveld, A.; Krikke, C.; Leuvenink, H. G.; van Goor, H.; van Son, W. J.; Olinga, P.; Hillebrands, J. -L.; Seelen, M. A. J.

    Kidneys retrieved from brain-dead donors have impaired allograft function after transplantation compared to kidneys from living donors. Donor brain death (BD) triggers inflammatory responses, including both systemic and local complement activation. The mechanism by which systemic activated

  20. The Additional Detrimental Effects of Cold Preservation on Transplantation-Associated Injury in Kidneys from Living and Brain-Dead Donor Rats

    NARCIS (Netherlands)

    Hoeger, Simone; Petrov, Kiril; Reisenbuechler, Anke; Fontana, Johann; Selhorst, Jochen; Hanusch, Christine; Beck, Grietje; Seelen, Marc A.; van Son, Willem J.; Waldherr, Ruediger; Schnuelle, Peter; Yard, Benito A.


    Background. Brain death and cold preservation are major alloantigen-independent risk factors for transplantation Outcome. The present study was conducted to assess the influence of these factors on transplantation-associated injury independently or in combination. Methods. Brain death was induced in

  1. Abandoning the dead donor rule? A national survey of public views on death and organ donation. (United States)

    Nair-Collins, Michael; Green, Sydney R; Sutin, Angelina R


    Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the 'dead donor rule', which states that organ removal must not cause death. Our aim was to evaluate the public's opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional internet survey of the American public (n=1096). Questionnaire domains included opinions about a hypothetical scenario of organ removal described as causing the death of a patient in irreversible coma, and items measuring willingness to donate organs after death. Some 71% of the sample agreed that it should be legal for patients to donate organs in the scenario described and 67% agreed that they would want to donate organs in a similar situation. Of the 85% of the sample who agreed that they were willing to donate organs after death, 76% agreed that they would donate in the scenario of irreversible coma with organ removal causing death. There appears to be public support for organ donation in a scenario explicitly described as violating the dead donor rule. Further, most but not all people who would agree to donate when organ removal is described as occurring after death would also agree to donate when organ removal is described as causing death in irreversible coma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  2. [Totally paralyzed or brain dead?

    NARCIS (Netherlands)

    Dijk, G.W. van; Vos, P.E.; Eurelings, M.; Jansen, G.H.; Gijn, J. van


    In two patients, men aged 23 and 42 years, a condition that mimicked brain death was observed as a consequence of rapidly progressive complete peripheral paralyses, which included the intrinsic and extrinsic eye muscles. However, the EEG revealed a waking pattern. Maximal supportive therapy was

  3. Are Brain Dead Individuals Dead? Grounds for Reasonable Doubt. (United States)

    Brugger, E Christian


    According to the biological definition of death, a human body that has not lost the capacity to holistically organize itself is the body of a living human individual. Reasonable doubt against the conclusion that it has lost the capacity exists when the body appears to express it and no evidence to the contrary is sufficient to rule out reasonable doubt against the conclusion that the apparent expression is a true expression (i.e., when the conclusion that what appears to be holistic organization is in fact holistic organization remains a reasonable explanatory hypothesis in light of the best evidence to the contrary). This essay argues that the evidence and arguments against the conclusion that the signs of complex bodily integration exhibited in ventilated brain dead bodies are true expressions of somatic integration are unpersuasive; that is, they are not adequate to exclude reasonable doubt against the conclusion that BD bodies are dead. Since we should not treat as corpses what for all we know might be living human beings, it follows that we have an obligation to treat BD individuals as if they were living human beings. © The Author 2016. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail:

  4. Role of More Active Identification of Brain-Dead Cases in Increasing Organ Donation. (United States)

    Sadegh Beigee, Farahnaz; Mohsenzadeh, Mojtaba; Shahryari, Shagin; Mojtabaee, Meysam


    Organ donor shortage is a worldwide problem, resulting in 10% to 30% mortality rates for patients on wait lists for organ transplant. For brain-dead patients in Iran, it is mandatory for intensive care unit patients with Glasgow Coma Scale below 5/15 to be reported to an organ procurement unit. However, this process has not been functioning effectively. Here, we present the effects of changing the strategies on detecting brain-dead cases on the organ donor pool. From March 2015 to March 2016, we changed our strategy in active detection of brain-dead cases. Since March 2015, our newly established protocol for active detection of brain-dead cases includes the following changes: (1) instead of calling high-volume intensive care units 3 times per week, we switched to calling every day in the morning; (2) instead of calling low-volume intensive care units 1 time per week, we switched to calling 3 times per week; (3) we included intensive care units (cardiac and general), neurosurgery, and emergency departments, as well as nursing supervisor offices, in our call and visit lists; and (4) we increased visits to wards by our trained staff as inspectors. From March 2015 to March 2016, the number of reported suspected brain-dead cases has increased from 224 to 460 per year, with proven brain death increasing from 180 to 306 cases. The actual number of donors has also increased, from 116 to 165 donations (53% increase) over 1 year. More proactive strategies have had significant effects on brain-dead detection, resulting in significantly increased donor pools and organ donations. In countries with low cooperation of hospital staff, more proactive engagement in detecting brain-dead cases is a good solution to prevent loss of potential organ donors, with a final result of decreasing wait list mortality.

  5. Donor pretreatment with carbamylated erythropoietin in a brain death model reduces inflammation more effectively than erythropoietin while preserving renal function

    NARCIS (Netherlands)

    Nijboer, Willemijn N.; Ottens, Petra J.; van Dijk, Antony; van Goor, Harry; Ploeg, Rutger J.; Leuvenink, Henri G. D.

    Objective: We hypothesized that donor treatment of deceased brain dead donors would lead to a decrease in inflammatory responses seen in brain death and lead to a restoration of kidney function. Design: A standardized slow-induction rat brain death model followed by evaluation of kidney function in

  6. Effect of brain death on gene expression and tissue activation in human donor kidneys

    NARCIS (Netherlands)

    Nijboer, WN; Schuurs, TA; van der Hoeven, JAB; Fekken, S; Wiersema-Buist, J; Leuvenink, HGD; Hofker, Hendrik; Homan van der Heide, J; van Son, WJ; Ploeg, RJ


    Background. After kidney transplantation, decreased graft survival is seen in grafts from brain dead (BD) donors compared with living donors. This might result partly from a progressive nonspecific inflammation in the graft. In this study, we focused on the effects of BD on inflammatory response

  7. Effect of brain death on gene expression and tissue activation in human donor kidneys

    NARCIS (Netherlands)

    Nijboer, Willemijn N.; Schuurs, Theo A.; van der Hoeven, Joost A. B.; Fekken, Susan; Wiersema-Buist, Janneke; Leuvenink, Henri G. D.; Hofker, Sijbrand; Homan van der Heide, Jaap J.; van Son, Willem J.; Ploeg, Rutger J.


    After kidney transplantation, decreased graft survival is seen in grafts from brain dead (BD) donors compared with living donors. This might result partly from a progressive nonspecific inflammation in the graft. In this study, we focused on the effects of BD on inflammatory response (adhesion

  8. Somatic survival and organ donation among brain-dead patients in the state of Qatar. (United States)

    George, Saibu; Thomas, Merlin; Ibrahim, Wanis H; Abdussalam, Ahmed; Chandra, Prem; Ali, Husain Shabbir; Raza, Tasleem


    The Qatari law, as in many other countries, uses brain death as the main criteria for organ donation and cessation of medical support. By contrast, most of the public in Qatar do not agree with the limitation or withdrawal of medical care until the time of cardiac death. The current study aims to examine the duration of somatic survival after brain death, organ donation rate in brain-dead patients as well as review the underlying etiologies and level of support provided in the state of Qatar. This is a retrospective study of all patients diagnosed with brain death over a 10-year period conducted at the largest tertiary center in Qatar (Hamad General Hospital). Among the 53 patients who were diagnosed with brain death during the study period, the median and mean somatic survivals of brain-dead patients in the current study were 3 and 4.5 days respectively. The most common etiology was intracranial hemorrhage (45.3 %) followed by ischemic stroke (17 %). Ischemic stroke patients had a median survival of 11 days. Organ donation was accepted by only two families (6.6 %) of the 30 brain dead patients deemed suitable for organ donation. The average somatic survival of brain-dead patients is less than one week irrespective of supportive measures provided. Organ donation rate was extremely low among brain-dead patients in Qatar. Improved public education may lead to significant improvement in resource utilization as well as organ transplant donors and should be a major target area of future health care policies.

  9. Organ retrieval and banking in brain dead trauma patients: Our experience at level-1 trauma centre and current views (United States)

    Sawhney, Chhavi; Kaur, Manpreet; Lalwani, Sanjeev; Gupta, Babita; Balakrishnan, Ira; Vij, Aarti


    Background: Organ retrieval from brain dead patients is getting an increased attention as the waiting list for organ recipients far exceeds the organ donor pool. In our country, despite a large population the number of brain dead donors undergoing organ donation is very less (2% in our study). Aims: The present study was undertaken to address issues related to organ donation and share our experience for the same. Methods: A retrospective case record analysis of over 5 years from September 2007 to August 2012 was performed and the patients fulfilling brain death criterion as per Transplantation of Human Organs and Tissue (Amendment) Act were included. Patient demographics (age, sex), mode of injury, time from injury to the diagnosis of brain death, time from diagnosis of brain death to organ retrieval and complications were analysed. Statistics Analysis: Student's t test was used for parametric data and Chi square was used for categorical data. Results: Out of 205 patients who were identified as brain dead, only 10 patients became potential organ donors. Conclusion: Aggressive donor management, increasing public awareness about the concept of organ donation, good communication between clinician and the family members and a well-trained team of transplant coordinators can help in improving the number of organ donations. PMID:23983281

  10. Organ retrieval and banking in brain dead trauma patients: Our experience at level-1 trauma centre and current views

    Directory of Open Access Journals (Sweden)

    Chhavi Sawhney


    Full Text Available Background: Organ retrieval from brain dead patients is getting an increased attention as the waiting list for organ recipients far exceeds the organ donor pool. In our country, despite a large population the number of brain dead donors undergoing organ donation is very less (2% in our study. Aims: The present study was undertaken to address issues related to organ donation and share our experience for the same. Methods: A retrospective case record analysis of over 5 years from September 2007 to August 2012 was performed and the patients fulfilling brain death criterion as per Transplantation of Human Organs and Tissue (Amendment Act were included. Patient demographics (age, sex, mode of injury, time from injury to the diagnosis of brain death, time from diagnosis of brain death to organ retrieval and complications were analysed. Statistics Analysis: Student′s t test was used for parametric data and Chi square was used for categorical data. Results: Out of 205 patients who were identified as brain dead, only 10 patients became potential organ donors. Conclusion: Aggressive donor management, increasing public awareness about the concept of organ donation, good communication between clinician and the family members and a well-trained team of transplant coordinators can help in improving the number of organ donations.

  11. [Lean thinking and brain-dead patient assistance in the organ donation process]. (United States)

    Pestana, Aline Lima; dos Santos, José Luís Guedes; Erdmann, Rolf Hermann; da Silva, Elza Lima; Erdmann, Alacoque Lorenzini


    Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

  12. The Brain Dead Patient Is Still Sentient: A Further Reply to Patrick Lee and Germain Grisez. (United States)

    Austriaco, Nicanor Pier Giorgio


    Patrick Lee and Germain Grisez have argued that the total brain dead patient is still dead because the integrated entity that remains is not even an animal, not only because he is not sentient but also, and more importantly, because he has lost the radical capacity for sentience. In this essay, written from within and as a contribution to the Catholic philosophical tradition, I respond to Lee and Grisez's argument by proposing that the brain dead patient is still sentient because an animal with an intact but severed spinal cord can still perceive and respond to external stimuli. The brain dead patient is an unconscious sentient organism. © The Author 2016. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail:

  13. Dead bodies matter: gift giving and the unveiling of body donor monuments in the Netherlands. (United States)

    Bolt, Sophie


    Body donors are people who voluntarily donate their entire body, after death, to anatomical science. Based on anthropological fieldwork in the Netherlands this article explores the construction of body donor monuments since 2007. These developments are analyzed by means of gift-giving theories. Body donation is a practice in which the medical and scientific value of the donor bodies has always been praised. Increasingly the fact that the bodies represent real human beings who have mourning relatives has also been acknowledged. This change in attitude has resulted in a desire on the part of anatomical professionals to give back a monument, not only for the donors themselves but also, in particular, for the donors' relatives. The great public interest in the monuments has revealed that many of the bereaved, in the absence of having the physical body of the donor, need a symbolic final resting place for their loved ones. © 2012 by the American Anthropological Association.

  14. Changes in serum catecholamine levels in patients who are brain dead. (United States)

    Powner, D J; Hendrich, A; Nyhuis, A; Strate, R


    Prospective blood samplings from 15 patients admitted with a Glasgow Coma Score of less than 7 were obtained to observe and compare epinephrine, norepinephrine, and dopamine serum levels in patients with brain injury before, after, and in the absence of brain death. Nine of the patients developed or were admitted after brain death. Wide variations in catecholamine blood levels over time were documented, and subgroup analysis precluded useful statistical comparison or inference of the data. The data are presented therefore as descriptive observations only. No apparent differences were noted between similarly injured patients in whom brain death did not develop and patients before brain death or between patients with penetrating versus nonpenetrating brain injury. Brain death was preceded by hypertension and corresponding elevations in serum catecholamine levels in one patient with complete data. Catecholamine levels appeared to fall after brain death in most patients. Only minimal changes in myocardial histology were present in three donor hearts, and the two transplanted hearts functioned satisfactorily. Serum catecholamine measurement or monitoring does not provide a precise method of determining potential injury to the donor heart before or after brain death. Other experimental data and clinical observation indicate that some hearts may be injured in the donor during the evolution of brain death. Pharmacologic intervention may prevent such injury in experimental animals but must be used before brain death is induced. Such interventions should be studied in selected human donors before brain death to determine whether cardiac function is improved in the donor or recipient.

  15. Dead Bodies Matter: Gift Giving and the Unveiling of Body Donor Monuments in the Netherlands

    NARCIS (Netherlands)

    Bolt, S.H.


    Body donors are people who voluntarily donate their entire body, after death, to anatomical science. Based on anthropological fieldwork in the Netherlands this article explores the construction of body donor monuments since 2007. These developments are analyzed by means of gift-giving theories. Body

  16. Lung Focused Resuscitation at a Specialized Donor Care Facility Improves Lung Procurement Rates. (United States)

    Chang, Stephanie H; Kreisel, Daniel; Marklin, Gary F; Cook, Lindsey; Hachem, Ramsey; Kozower, Benjamin D; Balsara, Keki R; Bell, Jennifer M; Frederiksen, Christine; Meyers, Bryan F; Patterson, G Alexander; Puri, Varun


    Lung procurement for transplantation occurs in about 20% of brain dead donors and is a major impediment to wider application of lung transplantation. We investigated the impact of lung protective management at a specialized donor care facility on lung procurement rates from brain dead donors. Our local organ procurement organization instituted a protocol of lung protective management at a freestanding specialized donor care facility in 2008. Brain dead donors from 2001-07 (early period) were compared to those from 2009-16 (current period) for lung procurement rates and other solid organ procurement rates using a prospectively maintained database. There was an overall increase in the number of brain dead donors over the study period (early, 791 vs. late, 1333, pprocurement rate (lung donors/all brain dead donors) improved markedly after introduction of lung protective management (early group 157/791, 19.8% vs. current group 452/1333, 33.9%, pprocurement rate (total number of organs procured/donor) also increased over the study period (early, 3.5 organs per donor vs. current, 3.8 organs per donor, p=0.006). Lung protective management in brain dead donors at a specialized donor care facility is associated with higher lung utilization rates compared to conventional management. This strategy does not adversely impact the utilization of other organs in a multi-organ donor. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Extracorporeal Membrane Oxygenation for the Support of a Potential Organ Donor with a Fatal Brain Injury before Brain Death Determination

    Directory of Open Access Journals (Sweden)

    Sung Wook Chang


    Full Text Available The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.

  18. Terminating the pregnancy of a brain-dead mother: Does a fetus ...

    African Journals Online (AJOL)

    In the recent Texas case of Munoz v. John Peter Smith Hospital, the court granted a husband an order for the removal of life support from his brain-dead pregnant wife whose body was decaying, after a hospital had tried to keep her on 'life support' until the fetus was born. In South Africa the court would have issued a similar ...

  19. Utilization of intensive care units′ beds occupied by brain-dead patients

    Directory of Open Access Journals (Sweden)

    Mohammed Abdullah Alsultan


    Full Text Available To evaluate the utilization of critical care unit beds occupied by brain-dead patients during the period falling between confirmation of the diagnosis till, either, organ harvesting or patient′s expiration. We studied all the consecutive patients who had been documented brain-dead from January 2001 to December 2009. Death by brain criteria was documented in 232 patients with a median age of 39 ± 18.2 years; 181 (78% were Saudis and 175 (75.5% were males. Only 37 deceased patients diagnosed by brain criteria were consented by their next-of-kin for organ donation; 26 (70.1% of them were non-Saudis. The time from confirming death by brain criteria in the study patients until they were moved to a morgue or to the operating room for retrieval of organs were 93 ± 89.9 vs. 73 ± 48 h, respectively (P = 0.07. In conclusion, I believe a better utilization of the intensive care units′ beds by other than brain-dead patients would not produce great cost savings, but may provide care for more patients with better quality of care.

  20. Modulation of Brain Dead Induced Inflammation by Vagus Nerve Stimulation

    NARCIS (Netherlands)

    Hoeger, S.; Bergstraesser, C.; Selhorst, J.; Fontana, J.; Birck, R.; Waldherr, R.; Beck, G.; Sticht, C.; Seelen, M. A.; van Son, W. J.; Leuvenink, H.; Ploeg, R.; Schnuelle, P.; Yard, B. A.

    Because the vagus nerve is implicated in control of inflammation, we investigated if brain death (BD) causes impairment of the parasympathetic nervous system, thereby contributing to inflammation. BD was induced in rats. Anaesthetised ventilated rats (NBD) served as control. Heart rate variability

  1. Organ Donor Recognition: Practical and Ethical Considerations

    NARCIS (Netherlands)

    Y.J. de Groot (Yorick)


    textabstractThe brain dead patient is the ideal multiorgan donor. Conditions that can lead to the state of brain death are limited. A subarachnoid haemorrhage, intracerebral haemorrhage or traumatic brain injury precede in 83% of the cases the state of brain death. Because of better prevention and

  2. What can we learn about brain donors? Use of clinical information in human postmortem brain research. (United States)

    Sullivan, Kathleen; Pantazopoulos, Harry; Liebson, Elizabeth; Woo, T-U W; Baldessarini, Ross J; Hedreen, John; Berretta, Sabina


    Postmortem studies on the human brain reside at the core of investigations on neurologic and psychiatric disorders. Ground-breaking advances continue to be made on the pathologic basis of many of these disorders, at molecular, cellular, and neural connectivity levels. In parallel, there is increasing emphasis on improving methods to extract relevant demographic and clinical information about brain donors and, importantly, translate it into measures that can reliably and effectively be incorporated in the design and data analysis of postmortem human investigations. Here, we review the main source of information typically available to brain banks and provide examples on how this information can be processed. In particular, we discuss approaches to establish primary and secondary diagnoses, estimate exposure to therapeutic treatment and substance abuse, assess agonal status, and use time of death as a proxy in investigations on circadian rhythms. Although far from exhaustive, these considerations are intended as a contribution to ongoing efforts from tissue banks and investigators aimed at establishing robust, well-validated methods for collecting and standardizing information about brain donors, further strengthening the scientific rigor of human postmortem studies. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Can deceased donor with recurrent primary brain tumor donate kidneys for transplantation?

    Directory of Open Access Journals (Sweden)

    Suresh Kumar


    Full Text Available Kidney transplantation from deceased donors is in its infancy in India. Cadaver organ donation was accepted legally in 1994 by the “Human Organs Transplantation Act.” Marginal donors are now accepted by many centers for kidney transplantation. We report a case of procurement of both kidneys from a young deceased donor having recurrent primary brain tumor, transplanted into two adult recipients with successful outcome.

  4. Assessment of potential heart donors: A statement from the French heart transplant community. (United States)

    Dorent, Richard; Gandjbakhch, Estelle; Goéminne, Céline; Ivanes, Fabrice; Sebbag, Laurent; Bauer, Fabrice; Epailly, Eric; Boissonnat, Pascale; Nubret, Karine; Amour, Julien; Vermes, Emmanuelle; Ou, Phalla; Guendouz, Soulef; Chevalier, Philippe; Lebreton, Guillaume; Flecher, Erwan; Obadia, Jean-François; Logeart, Damien; de Groote, Pascal


    Assessment of potential donors is an essential part of heart transplantation. Despite the shortage of donor hearts, donor heart procurement from brain-dead organ donors remains low in France, which may be explained by the increasing proportion of high-risk donors, as well as the mismatch between donor assessment and the transplant team's expectations. Improving donor and donor heart assessment is essential to improve the low utilization rate of available donor hearts without increasing post-transplant recipient mortality. This document provides information to practitioners involved in brain-dead donor management, evaluation and selection, concerning the place of medical history, electrocardiography, cardiac imaging, biomarkers and haemodynamic and arrhythmia assessment in the characterization of potential heart donors. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. Pharmacists' guide to the management of organ donors after brain death. (United States)

    Korte, Catherine; Garber, Jennifer L; Descourouez, Jillian L; Richards, Katelyn R; Hardinger, Karen


    This article reviews organ donor pathophysiology as it relates to medication use with the goal of maximizing the successful procurement and transplantation of donor organs. The number of patients requiring organ transplantation continues to grow, yet organ donation rates remain flat, making it critical to appropriately manage each organ donor in order to ensure viability of all transplantable organs. The care given to one organ donor is tantamount to the care of several transplant recipients. Aggressive donor management ensures that the largest number of organs can be successfully procured and improves the organs' overall quality. Hospital pharmacists are responsible for processing orders and preparing the medications outlined in donor management algorithms developed by their respective medical systems. It is important that pharmacists understand the details of the medications used in these protocols in order to critically evaluate each medication order and appropriately manage the donor. Typical medications used in organ donors after brain death include medications for blood pressure management and fluid resuscitation, medications necessary for electrolyte management, blood products, vasopressors, hormone replacement therapy, antiinfectives, anticoagulants, paralytics, and organ preservation solutions. It is essential to provide optimal pharmacotherapy for each organ donor to ensure organ recovery and donation. Typical medications used in organ donors include agents for blood pressure management and fluid resuscitation, medications necessary for electrolyte management, blood products, vasopressors, hormone replacement therapy, antiinfectives, anticoagulants, paralytics, and organ preservation solutions. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  6. Clinicians' Perception and Experience of Organ Donation From Brain-Dead Patients. (United States)

    Kentish-Barnes, Nancy; Duranteau, Jacques; Montlahuc, Claire; Charpentier, Julien; Martin-Lefevre, Laurent; Joseph, Liliane; Lefrant, Jean-Yves; Fieux, Fabienne; Renault, Anne; Thuong, Marie; Chevret, Sylvie; Azoulay, Elie


    ICU clinicians are primarily involved in organ donation after brain death of ICU patients. Their perceptions of organ donation may affect outcomes. Our objective was to describe ICU clinician's perceptions and experience of organ donation. Cross-sectional study among physicians and nurses (90 ICUs in France). We used factorial correspondence analysis to describe categories of clinicians regarding their perceptions and experience of organ donation. Factors associated with a positive (motivating) or negative (stressful) experiences were studied using multivariate logistic regression. Physicians and nurses. Three thousand three hundred twenty-five clinicians working in 77 ICUs returned questionnaires. Professionals who experienced organ donation as motivating were younger (odds ratio, 0.41; 95% CI, 0.32-0.53; p organ donors (odds ratio, 1.92; 95% CI, 1.56-2.35; p organ donation was not a priority in their ICU (odds ratio, 0.68; 95% CI, 0.55-0.84), and more likely to have participated in meetings of transplant coordinators with relatives (odds ratio, 1.71; 95% CI, 1.37-2.14; p organ donation was stressful were older (odds ratio, 1.84; 95% CI, 1.34-2.54; p organ donation as emotionally complex (odds ratio, 1.83; 95% CI, 1.52-2.21; p organ donation versus professional activity (odds ratio, 3.25; 95% CI, 1.92-5.53; p organ donors (odds ratio, 1.49; 95% CI, 1.09-2.04). Significant differences exist among ICU clinician's perceptions of organ donation. Whether these differences affect family experience and consent rates deserves investigation.

  7. Circulation stabilizing therapy and pulmonary high-resolution computed tomography in a porcine brain-dead model

    NARCIS (Netherlands)

    Bozovic, G.; Steen, S. van der; Sjoberg, T.; Schaefer-Prokop, C.M.; Verschakelen, J.; Liao, Q.; Hoglund, P.; Siemund, R.; Bjorkman-Burtscher, I.M.


    BACKGROUND: Currently 80% of donor lungs are not accepted for transplantation, often due to fluid overload. Our aim was to investigate if forced fluid infusion may be replaced by a new pharmacological therapy to stabilize circulation after brain death in an animal model, and to assess therapy

  8. Donation after Brain Death versus Donation after Circulatory Death: Lung Donor Management Issues. (United States)

    Snell, Gregory I; Levvey, Bronwyn J; Levin, Kovi; Paraskeva, Miranda; Westall, Glen


    Lung transplantation (LTx) has traditionally been limited by a lack of suitable donor lungs. With the recognition that lungs are more robust than initially thought, the size of the donor pool of available lungs has increased dramatically in the past decade. Donation after brain death (DBD) and donation after circulatory death (DCD) lungs, both ideal and extended are now routinely utilized. DBD lungs can be damaged. There are important differences in the public's understanding, legal and consent processes, intensive care unit strategies, lung pathophysiology, logistics, and potential-to-actual donor conversion rates between DBD and DCD. Notwithstanding, the short- and long-term outcomes of LTx from any of these DBD versus DCD donor scenarios are now similar, robust, and continue to improve. Large audits suggest there remains a large untapped pool of DCD (but not DBD) lungs that may yet further dramatically increase lung transplant numbers. Donor scoring systems that might predict the donor conversion rates and lung quality, the role of ex vivo lung perfusion as an assessment and lung resuscitation tool, as well as the potential of donor lung quality biomarkers all have immense promise for the clinical field. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Thyroid hormone resuscitation after brain death in potential organ donors: A primer for neurocritical care providers and narrative review of the literature. (United States)

    Buchanan, Ian A; Mehta, Vivek A


    Solid organ transplantation has become a mainstay in the contemporary management of end-stage organ failures fueled by advances in immunosuppression, intensive care and surgical technology. Every year, a vast number of transplantable organs is lost on account of hemodynamic instability in potential brain-dead organ donors. Because of a growing organ shortage, measures that increase total donor supply pools are desperately needed. Thyroid hormone has been identified as an adjunctive therapy in donor management due to its potential for increasing organ supply and is currently endorsed by transplant organizations such as United Network for Organ Sharing (UNOS). Much of the evidence in support of thyroid hormone comes from level III studies showing greater donor survival and procurement rates. However, all prospective randomized studies to date have failed to corroborate any such benefit. Here, we describe the role of thyroid hormone in transplantation medicine and summarize data on its putative contributions to circulatory stability, organ yield and long-term graft function. At present, level I studies do not exist and many level II studies, which do not endorse its use, are of poor quality. Further research, particularly large-scale multi-center trials are therefore warranted to shed light on this matter. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Hope for Restoration of Dead Valuable Bulls through Cloning Using Donor Somatic Cells Isolated from Cryopreserved Semen (United States)

    Selokar, Naresh L.; Saini, Monika; Palta, Prabhat; Chauhan, Manmohan S.; Manik, Radheysham; Singla, Suresh K.


    Somatic cells were isolated from cryopreserved semen of 4 buffalo bulls, 3 of which had died over 10 years earlier, and were established in culture. The cells expressed cytokeratin-18, keratin and vimentin indicating that they were of epithelial origin. The cells were used as nuclear donors for hand-made cloning for producing buffalo embryos. The blastocyst rate and quality, as indicated by apoptotic index, were comparable among embryos produced using cells obtained from fresh or frozen-thawed semen or those obtained from conventional cell sources such as skin. Examination of the epigenetic status revealed that the global level of H3K27me3 but not that of H3K9/14ac and H4K5ac differed significantly (Pcloned embryos from different bulls. The relative mRNA abundance of HDAC1, DNMT1, P53 and CASPASE 3 but not that of DNMT3a differed in cells and in cloned embryos. Following transfer of 24 cloned embryos produced from fresh semen-derived cells to 12 recipients, one calf weighing 55 kg, which is now 6 months of age and is normal, was born through normal parturition. Following transfer of 20 embryos produced from frozen-thawed semen-derived cells to 10 recipients, 2 became pregnant, one of which aborted in the first trimester; the calf born was severely underweight (17 kg), and died 12 h after birth. The ability of cells derived from fresh and frozen-thawed semen to produce live offspring confirms the ability of these cells to be reprogrammed. Our findings pave the way for restoration of highly precious progeny-tested bulls, which has immense economic importance, and can also be used for restoration of endangered species. PMID:24614586

  11. Value of whole body C.T.A. in the management of brain-dead patients; Interet de l'angioscanner corps entier dans la prise en charge du patient en etat de mort encephalique

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    Fregeville, A. [CHU Cochin, Service de Radiologie, 75 - Paris (France); Bazelaire, C. de; Zagdanski, A.M.; Albiter, M. [CHU Saint Louis, Service de Radiologie, 75 - Paris (France); Desgrandchamps, F.; Kerviler, E. de [CHU Saint Louis, Service d' Urologie, 75 - Paris (France)


    Purpose To assess the value of whole body C.T.A., as a complement to head C.T.A., in the management of brain-dead patients as potential organ donors. Materials and Methods A total of 27 consecutive brain-dead patients admitted in a center authorized in the harvesting of organs between October 2006 and January 2008 were included. The imaging protocol used was the protocol recommended by the French Society of Neuroradiology, with additional arterial phase helical acquisition of the chest, abdomen and pelvis, and parenchymal phase helical acquisition of the abdomen and pelvis. The imaging findings were then correlated to the surgical reports after organ harvesting. Results C.T.A. readily demonstrates tissue lesions, a contraindication to harvesting (14 cases, including one false positive), and anatomical variants of the vascular system (7 arterial variants and 3 venous variants) and liver (8 patients). Conclusion C.T.A., the gold standard para clinical examination for brain death assessment, allows, in a single examination, the identification of contraindications to organ harvesting that may modify the surgical approach and even avoid unnecessary mobilization of the transplant team. It may also provide valuable preoperative evaluation by detecting anatomical variants of the liver and kidneys. (authors)

  12. Potential organ donor audit in Ireland.

    LENUS (Irish Health Repository)

    Hegarty, M


    As increasing demand for organs is a challenge for transplant services worldwide it is essential to audit the process of organ donation. To address this, a national audit of potential organ donors was undertaken across hospitals with Intensive Care Units (N = 36). Questionnaires were returned on all patients (n = 2073) who died in these units from 1\\/9\\/07-31\\/8\\/08; 200 (10%) of these patients were considered for Brain Stem Testing (BST), 158 patients (79%) were diagnosed Brain Stem Dead (BSD) and 138 patients (87%) became potential donors. Consent for donation was given by 92 (69%) next of kin and 90 potential donors (65%) became organ donors. There was no evidence of a large number of potential organ donors being missed. Recommendations included completion of BSTs on all appropriate patients, development of support on BST, referral of all BSD patients to the Organ Procurement Service; enhanced co-ordination within hospitals and sustained information\\/education campaigns.

  13. Trends in organ donor management: 2002 to 2012. (United States)

    Callahan, Devon S; Kim, Dennis; Bricker, Scott; Neville, Angela; Putnam, Brant; Smith, Jennifer; Bongard, Frederic; Plurad, David


    Refinements in donor management have resulted in increased numbers and quality of grafts after neurologic death. We hypothesize that the increased use of hormone replacement therapy (HRT) has been accompanied by improved outcomes over time. Using the Organ Procurement and Transplant Network donor database, all brain-dead donors procured from July 1, 2001 to June 30, 2012 were studied. Hormone replacement therapy was identified by an infusion of thyroid hormone. An expanded criteria donor was defined as age 60 years or older. Incidence of HRT administration and number of donors and organs recovered were calculated. Using the Organ Procurement and Transplant Network thoracic recipient database transplant list, wait times were examined. There were 74,180 brain-dead donors studied. Hormone replacement therapy use increased substantially from 25.6% to 72.3% of donors. However, mean number of organs procured per donor remained static (3.51 to 3.50; p = 0.083), and the rate of high-yield donors decreased (46.4% to 43.1%; p donors decreased (42.1% to 33.9%; p donors (22.1% to 26%). Despite this, there has been an increase in the raw number of donors (20,558 to 24,308; p organs (5,857 to 6,945; p organs per traumatic brain injury donor (4.02 to 4.12; p = 0.002) and a decrease in days on the waiting list (462.2 to 170.4 days; p donors has been accompanied by increased organ availability overall. Potential mechanisms might include successful conversion of previously unacceptable donors and improved recovery in certain subsets of donors. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  14. A Comparative Study of Organ Donation after Brain Death in Japan and Australia


    TERAO, Kaori; FUJIWARA, Yoshirou


    Objective : (1) To compare the status of organ donation from brain-dead donors in Japan and Australia. (2) To identify the possible reasons for the low rates of organ donation from brain-dead donors. Background : The shortage of available organs for transplantation has prompted many countries to develop a system for the use of organs from brain-dead donors, including Japan and Australia. Yet, there is a wide range of organ donation rates and policies between Japan and Australia in the current...

  15. A Donation After Circulatory Death Program Has the Potential to Increase the Number of Donors After Brain Death. (United States)

    Broderick, Andrew R; Manara, Alex; Bramhall, Simon; Cartmill, Maria; Gardiner, Dale; Neuberger, James


    Donation after circulatory death has been responsible for 75% of the increase in the numbers of deceased organ donors in the United Kingdom. There has been concern that the success of the donation after circulatory death program has been at the expense of donation after brain death. The objective of the study was to ascertain the impact of the donation after circulatory death program on donation after brain death in the United Kingdom. Retrospective cohort study. A national organ procurement organization. Patients referred and assessed as donation after circulatory death donors in the United Kingdom between October and December 2013. None. A total of 257 patients were assessed for donation after circulatory death. Of these, 193 were eligible donors. Three patients were deemed medically unsuitable following surgical inspection, 56 patients did not proceed due to asystole, and 134 proceeded to donation. Four donors had insufficient data available for analysis. Therefore, 186 cases were analyzed in total. Organ donation would not have been possible in 79 of the 130 actual donors if donation after circulatory death was not available. Thirty-six donation after circulatory death donors (28% of actual donors) were judged to have the potential to progress to brain death if withdrawal of life-sustaining treatment had been delayed by up to a further 36 hours. A further 15 donation after circulatory death donors had brain death confirmed or had clinical indications of brain death with clear mitigating circumstances in all but three cases. We determined that the maximum potential donation after brain death to donation after circulatory death substitution rate observed was 8%; however due to mitigating circumstances, only three patients (2%) could have undergone brain death testing. The development of a national donation after circulatory death program has had minimal impact on the number of donation after brain death donors. The number of donation after brain death donors

  16. The End-of-Life Care Experiences of Relatives of Brain Dead Intensive Care Patients


    Lloyd-Williams, Mari; Morton, Juliet; Peters, Sarah


    Brain death is a traumatic and sudden event following a severe injury to the brain. Most patients with brain death spend the last days of life in an intensive care unit (ICU), where some families will be approached to ask for organ donation. This qualitative study was carried out with relatives of patients who had died of brain death in an ICU; all relatives were interviewed six months after the death. Twenty ICUs were recruited for this study. The next of kin of 130 patients who died during ...

  17. Organ donor with unclear primary brain tumor, a contraindication for transplantation? Case report of a one year old child. (United States)

    Rey, J W; Heister, P; Wirges, U; Nadalin, S; Breuer, R; Niehues, T


    BACKGROUND AND CASE REPORT: The use of organs from donors with central nervous systems (CNS) malignancies is controversial discussed. We present a 1 year old boy, who was admitted for torticollis. A computer tomography detected a large tumor in the posterior cranial fossa. The tumor was resected, but postoperatively a malignant brain swelling occurred, being resistant to standard treatment. After brain death was established and permission was given, organ donation was performed. All grafts showed good initial functions and no complications. We investigated the evidence for transplantation of organs from donors with central nervous malignancies. The Australia and New Zealand Combined Dialysis and Transplant Registry, the United Network for Organ Sharing and Hornik et al., reported three transmissions of a glioblastoma multiforme in 958 recipients, who received grafts from donors with CNS tumors. In contrast the Israel Penn International Tumor Registry suggests that transmission is more common: 62 organs were transplanted, 14 cases showed transmission. All cases of medulloblastoma, showing transmission were associated with ventriculoperitoneal shunt. In summary, 1 020 organs of CNS tumors were transplanted, 17 cases were identified with tumors transmission from CNS malignancy. Organ donors where brain death is established suffering from brain tumors should not be generally regarded as contraindications for an organ transplant. Organs from patients with risk factors (e. g. ventriculoperitoneal shunt) should be excluded from the donor pool as transmission is more likely. The risk of donor transmitted malignancies should be weight against the urgency to receive a transplant graft. Georg Thieme Verlag KG Stuttgart.New York.

  18. Mass Spectrometry Based Metabolomics Comparison of Liver Grafts from Donors after Circulatory Death (DCD and Donors after Brain Death (DBD Used in Human Orthotopic Liver Transplantation.

    Directory of Open Access Journals (Sweden)

    Olga Hrydziuszko

    Full Text Available Use of marginal liver grafts, especially those from donors after circulatory death (DCD, has been considered as a solution to organ shortage. Inferior outcomes have been attributed to donor warm ischaemic damage in these DCD organs. Here we sought to profile the metabolic mechanisms underpinning donor warm ischaemia. Non-targeted Fourier transform ion cyclotron resonance (FT-ICR mass spectrometry metabolomics was applied to biopsies of liver grafts from donors after brain death (DBD; n = 27 and DCD (n = 10, both during static cold storage (T1 as well as post-reperfusion (T2. Furthermore 6 biopsies from DBD donors prior to the organ donation (T0 were also profiled. Considering DBD and DCD together, significant metabolic differences were discovered between T1 and T2 (688 peaks that were primarily related to amino acid metabolism, meanwhile T0 biopsies grouped together with T2, denoting the distinctively different metabolic activity of the perfused state. Major metabolic differences were discovered between DCD and DBD during cold-phase (T1 primarily related to glucose, tryptophan and kynurenine metabolism, and in the post-reperfusion phase (T2 related to amino acid and glutathione metabolism. We propose tryptophan/kynurenine and S-adenosylmethionine as possible biomarkers for the previously established higher graft failure of DCD livers, and conclude that the associated pathways should be targeted in more exhaustive and quantitative investigations.

  19. Successful lung transplant from donor after cardiac death: a potential solution to shortage of thoracic organs. (United States)

    McKellar, Stephen H; Durham, Lucian A; Scott, John P; Cassivi, Stephen D


    Lung transplant is an effective treatment for patients with end-stage lung disease but is limited because of the shortage of acceptable donor organs. Organ donation after cardiac death is one possible solution to the organ shortage because it could expand the pool of potential donors beyond brain-dead and living donors. We report the preliminary experience of Mayo Clinic with donation after cardiac death, lung procurement, and transplant.

  20. Successful Lung Transplant From Donor After Cardiac Death: A Potential Solution to Shortage of Thoracic Organs


    McKellar, Stephen H.; Durham, Lucian A.; Scott, John P.; Cassivi, Stephen D.


    Lung transplant is an effective treatment for patients with end-stage lung disease but is limited because of the shortage of acceptable donor organs. Organ donation after cardiac death is one possible solution to the organ shortage because it could expand the pool of potential donors beyond brain-dead and living donors. We report the preliminary experience of Mayo Clinic with donation after cardiac death, lung procurement, and transplant.

  1. The end-of-life care experiences of relatives of brain dead intensive care patients. (United States)

    Lloyd-Williams, Mari; Morton, Juliet; Peters, Sarah


    Brain death is a traumatic and sudden event following a severe injury to the brain. Most patients with brain death spend the last days of life in an intensive care unit (ICU), where some families will be approached to ask for organ donation. This qualitative study was carried out with relatives of patients who had died of brain death in an ICU; all relatives were interviewed six months after the death. Twenty ICUs were recruited for this study. The next of kin of 130 patients who died during the study period were approached, and 30 (22%) agreed to be interviewed; one later withdrew. This paper focuses on the perceived palliative care needs of the 29 families. Participants valued the physical care their relatives had received, but communication and breaking bad news was a cause for concern. The facilities on many ICUs, for example, cramped relatives' rooms and little privacy to be with the patients or to say the final goodbye, was a common theme to emerge. Bereavement follow-up did not routinely occur, and this was an identified factor noted by relatives. Families living through the period of brain death in a loved one may have particular needs in terms of end-of-life care and should be offered the support of a palliative care team through the last days of a patient's life and into the period of bereavement. Staff training on how to communicate bad news also should be implemented as a matter of urgency.

  2. Potential brain death organ donors - challenges and prospects: A single center retrospective review

    Directory of Open Access Journals (Sweden)

    Yousef Al-Maslamani


    Full Text Available Organ donation after brain death (BD is a major source for obtaining transplantable organs for patients with end-stage organ disease (ESOD. This retrospective, descriptive study was carried out on all potential BD patients admitted in different intensive care units (ICUs of the Hamad medical Corporation (HMC, Doha, Qatar during a period from January 2011 to April 2012. Our aim was to evaluate various demographic criteria and challenges of organ donation among potential BD organ donors and plan a strategy to improve the rate of organ donation in Qatar. Various aspects of BD patients in the ICUs and their possible effects on organ donation were studied. The time intervals analyzed to determine the possible causes of delay of organ retrieval were: time of diagnosing fixed dilated pupils in the ICU, to performing the first BD test, then to the second BD test, to family approach, to organ retrieval and/or circulatory death (CD without organ retrieval. There were a total of 116 potential BD organ donors of whom 96 (82.75% were males and 20 (17.25% were females. Brain hemorrhage and head injury contributed to 37 (31.9% and 32 (27.6% BD cases, respectively. Time interval between diagnosing fixed dilated pupil and performing the first test of BD was delayed >24 h in 79% of the cases and between the first and second BD tests was >6 h in 70.8% of the cases. This delay is not compatible with the Hamad Medical Corporation (HMC policy for BD diagnosis and resulted in a low number of organs retrieved. BD organ donation, a potential source for organs to save patients with ESOD has several pitfalls and every effort should be made to increase the awareness of the public as well as medical personnel to optimize donation efficacy.

  3. An investigation into the factors effective in the consent of families with brain-dead patients candidates for organ donation in Isfahan, Iran in 2012-13. (United States)

    Khajooei, Maryam Khalifehsoltani; Zamani, Fereshteh; Mehr, Asieh Maghami


    Studies have shown that, with regard to social, cultural, and institutional contexts, several factors affect family decision-making on organ donation. This study aimed to investigate the effective factors in organ donation by family members with brain-dead patients. This was a descriptive-comparative study in which a researcher-made questionnaire was used to collect data. The reliability of the questionnaire was obtained as 0.81 using Cronbach's alpha. The study sample consisted of 85 members of families with brain-dead patients in Isfahan, Iran in 2012-13. The collected data were analyzed using the Statistical Package for the Social Sciences version 20.0, and the level of significance was considered as factors such as age, marital status, level of education, and cause of brain death did not have any effect on their families consent, whereas factors such as gender, duration of hospitalization, having an organ donation card, personal view of the brain-dead patient, and the number of patient's children had a significant relationship with the consent on organ donation. In addition, the care and treatment team were effective in family decisions regarding organ donation. In general, the necessary culture and increasing the population awareness and their knowledge can be a positive step in this regard and may bring about an easy and rapid acceptance of organ donation by the involved families.

  4. Newborns as potential organ donors: a new perspective?

    Directory of Open Access Journals (Sweden)

    Ilias Chatziioannidis


    Full Text Available Demand for organ donation is increasing over the years in all age groups leading search for alternative sources. Donation pool expansion in newborns necessitates new approaches specifically for brain and circulatory death definition. The “dead donor rule” (the donor must be dead before organ removal starts remains the cornerstone for organ procurement. Brain death definition and time determination of circulatory death need to be uniformly accepted by the scientific community. Technical advances, uniform protocols for death determination and new proceedings in surgical field can maximize donation pool along with establishment of end-of-life care standard procedures and persistent support of the family. Newborns can serve as multivisceral donors in the near future to meet the increasing demand for organs in this age group.

  5. Organ Procurement from Deceased Donors and its Impact on Organ Transplantation in Iran during the First Ten Years of Cadaveric Transplantation. (United States)

    Kazemeyni, S M; Aghighi, M


    The Act of transplantation from deceased and dead-brain donors was ratified in the parliament in 2000. In the subsequent two years, few number of organs were procured from dead-brain patients and transplanted. Later on, a national network was established for organ procurement; units for recognizing brain death were established in Tehran and some other cities to provide the necessary infrastructure for organ transplantation from deceased and dead-brain donors. In this report, we described the outcome of organ procurement from deceased and dead-brain donors after 10 years of its establishment in Iran. To do so, we collected data from some relevant published articles and also reports of the Ministry of Health released between 2001 and 2010. By the year 2010, 3673 organs were harvested from deceased donors and transplanted. The rate of liver transplantation has increased rapidly from 16 cases in 2001 to 280 cases in 2010-almost 18 times. There were 554 cadaveric kidney transplantation in 2010; it comprised 19% of total kidney transplantations that is almost 8 times that in 2001. Over the study period, organ procurement has increased by 6-fold. The rate of organ procurement from deceased and dead-brain donors has increased dramatically over the studied period. Considering the existing potentials for this scheme of organ procurement, it seems that improving the Iranian Network for Transplant Organ Procurement will lead to better results.

  6. An investigation into the factors effective in the consent of families with brain-dead patients candidates for organ donation in Isfahan, Iran in 2012-13 (United States)

    Khajooei, Maryam Khalifehsoltani; Zamani, Fereshteh; Mehr, Asieh Maghami


    Background: Studies have shown that, with regard to social, cultural, and institutional contexts, several factors affect family decision-making on organ donation. This study aimed to investigate the effective factors in organ donation by family members with brain-dead patients. Materials and Methods: This was a descriptive-comparative study in which a researcher-made questionnaire was used to collect data. The reliability of the questionnaire was obtained as 0.81 using Cronbach's alpha. The study sample consisted of 85 members of families with brain-dead patients in Isfahan, Iran in 2012–13. The collected data were analyzed using the Statistical Package for the Social Sciences version 20.0, and the level of significance was considered as death did not have any effect on their families consent, whereas factors such as gender, duration of hospitalization, having an organ donation card, personal view of the brain-dead patient, and the number of patient's children had a significant relationship with the consent on organ donation. In addition, the care and treatment team were effective in family decisions regarding organ donation. Conclusions: In general, the necessary culture and increasing the population awareness and their knowledge can be a positive step in this regard and may bring about an easy and rapid acceptance of organ donation by the involved families. PMID:28194201

  7. The organ preservation and enhancement of donation success ratio effect of extracorporeal membrane oxygenation in circulatory unstable brain death donor. (United States)

    Fan, Xiaoli; Chen, Zhiquan; Nasralla, David; Zeng, Xianpeng; Yang, Jing; Ye, Shaojun; Zhang, Yi; Peng, Guizhu; Wang, Yanfeng; Ye, Qifa


    Between 2010 and 2013, we recorded 66 cases of failed organ donation after brain death (DBD) due to the excessive use of the vasoactive drugs resulting in impaired hepatic and/or renal function. To investigate the effect of extracorporeal membrane oxygenation (ECMO) in donor management, ECMO was used to provide support for DBD donors with circulatory and/or respiratory failure from 2013 to 2015. A retrospective cohort study between circulatory non-stable DBD with vasoactive drugs (DBD-drug) and circulatory non-stable DBD with ECMO (DBD-ECMO) was designed to compare the transplant outcomes. A total of 19 brain death donors were supported by ECMO. The incidence rate of post-transplant liver primary non-function (PNF) was 10% (two of 20) in DBD-drug group and zero in DBD-ECMO group. Kidney function indicators, including creatinine clearance and urine production, were significantly better in DBD-ECMO group, as well as the kidney delayed graft function (DGF) rate was found to be decreased by the use of ECMO in our study. Donation success rate increased steadily from 47.8% in 2011 to 84.6% in 2014 after the ECMO intervention. The use of ECMO in assisting circulatory and respiratory function of DBD can reduce liver and kidney injury from vasoactive drugs, thereby improving organ quality and reducing the organ discard rates. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Optimized donor management and organ preservation before kidney transplantation. (United States)

    Mundt, Heiko M; Yard, Benito A; Krämer, Bernhard K; Benck, Urs; Schnülle, Peter


    Kidney transplantation is a major medical improvement for patients with end-stage renal disease, but organ shortage limits its widespread use. As a consequence, the proportion of grafts procured from extended criteria donors (ECD) has increased considerably, but this comes along with increased rates of delayed graft function (DGF) and a higher incidence of immune-mediated rejection that limits organ and patient survival. Furthermore, most grafts are derived from brain dead organ donors, but the unphysiological state of brain death is associated with significant metabolic, hemodynamic, and pro-inflammatory changes, which further compromise patient and graft survival. Thus, donor interventions to preserve graft quality are fundamental to improve long-term transplantation outcome, but interventions must not harm other potentially transplantable grafts. Several donor pretreatment strategies have provided encouraging results in animal models, but evidence from human studies is sparse, as most clinical evidence is derived from single-center or nonrandomized trials. Furthermore, ethical matters have to be considered especially concerning consent from donors, donor families, and transplant recipients to research in the field of donor treatment. This review provides an overview of clinically proven and promising preclinical strategies of donor treatment to optimize long-term results after kidney transplantation. © 2015 Steunstichting ESOT.

  9. Early outcome of liver transplantation performed with organs procured from brain death donors with transient or sustained cardio-circulatory collapse. (United States)

    Valenza, F; Villa, A; Froio, S; Coppola, S; Barretta, F; Melada, E; Gatti, S; Avalli, L; Citerio, G; Rossi, G E; Gattinoni, L


    Aim of this study was to compare early graft function after transplantation of recipients transplanted with livers procured from donors after brain death who experienced transient or sustained cardio-circulatory collapse. We retrospectively analysed patients who underwent liver transplantation (LTx) at our Institution from January 2010 to May 2012. Recipients were divided into 3 groups: those who received livers from brain death donors who experienced reversible cardio-circulatory arrest before organ procurement (RCA); those who experienced sustained cardio-circulatory collapse, treated with extra-corporeal membrane oxygenation support as rescue therapy of refractory cardiogenic shock (ECMO). Standard donors were considered as reference group (REF). Postoperative graft function, Primary Non-Function (PNF), and complications during the first 30 days were analysed. 102 LTx were analysed (76 REF, 22 RCA and 4 ECMO). The main cause of donor's death was post-anoxic coma in RCA and ECMO, cerebrovascular accident in REF. SGOT in REF, RCA, and ECMO donors were 27 [17-43], 54 [34-92], 716 [190-962] respectively, SGPT 17 [12-34], 46 [27-73], 84 [51-175] UI/L respectively, both Pischemia time and serum lactate levels at the end of surgery. After LTx, Intensive Care Unit stay and the incidence of PNF were similar. The use of livers procured from donors after brain death that experienced transient or sustained cardio-circulatory collapse was associated with early graft function comparable to that of standard donors.

  10. Imminent brain death: Point of departure for potential heart-beating organ donor recognition

    NARCIS (Netherlands)

    Y.J. de Groot (Yorick); N.E. Jansen (Nichon); J. Bakker (Jan); M.A. Kuiper (Michael); S. Aerdts (Stan); A.I.R. Maas (Andrew); E.F.M. Wijdicks (Eelco); H.A. van Leiden (Hendrik); A.J. Hoitsma (Andries); H.P.H. Kremer (Berry); E.J.O. Kompanje (Erwin)


    textabstractPurpose: There is, in European countries that conduct medical chart review of intensive care unit (ICU) deaths, no consensus on uniform criteria for defining a potential organ donor. Although the term is increasingly being used in recent literature, it is seldom defined in detail. We

  11. Imminent brain death : point of departure for potential heart-beating organ donor recognition

    NARCIS (Netherlands)

    de Groot, Yorick J.; Jansen, Nichon E.; Bakker, Jan; Kuiper, Michael A.; Aerdts, Stan; Maas, Andrew I. R.; Wijdicks, Eelco F. M.; van Leiden, Hendrik A.; Hoitsma, Andries J.; Kremer, Berry H. P. H.; Kompanje, Erwin J. O.

    There is, in European countries that conduct medical chart review of intensive care unit (ICU) deaths, no consensus on uniform criteria for defining a potential organ donor. Although the term is increasingly being used in recent literature, it is seldom defined in detail. We searched for criteria

  12. Imminent brain death: point of departure for potential heart-beating organ donor recognition.

    NARCIS (Netherlands)

    Groot, Y.J. de; Jansen, N.E.; Bakker, J.; Kuiper, M.A.; Aerdts, S.; Maas, A.I.; Wijdicks, E.F.; Leiden, H.A. van; Hoitsma, A.J.; Kremer, H.P.H.; Kompanje, E.J.


    PURPOSE: There is, in European countries that conduct medical chart review of intensive care unit (ICU) deaths, no consensus on uniform criteria for defining a potential organ donor. Although the term is increasingly being used in recent literature, it is seldom defined in detail. We searched for

  13. The effect of a protocol of aggressive donor management: Implications for the national organ donor shortage. (United States)

    Salim, Ali; Martin, Matthew; Brown, Carlos; Rhee, Peter; Demetriades, Demetrios; Belzberg, Howard


    The disparity between the number of people awaiting organ transplantation and the number of organs available has become a public health crisis. As many as 25% of potential donors are lost as a result of cardiovascular collapse (CVC) before organ harvest. A policy of aggressive donor management (ADM) may decrease the number of cadaveric donors lost as a result of CVC. Retrospective analysis of potential brain-dead donors evaluated from January 1995 to December 2003 at nine American College of Surgeons-verified Level I trauma centers covered by a regional organ procurement agency. One center (Los Angeles County + University of Southern California Medical Center [LAC]) had an ADM protocol in place instituted January 1999; the remaining eight centers with no ADM protocol were grouped as Center A. The incidence of CVC and organ donation demographics were compared between centers and within LAC before (LAC-Pre) and after (LAC-Post) adoption of ADM. ADM consists of early identification of potential organ donors, a dedicated team that provides medical management, and aggressive fluid resuscitation as well as hormone replacement therapy with solumedrol and thyroxin. The incidence of CVC was significantly higher in LAC-Pre (odds ratio [OR] 15.0, p organs harvested per potential donor for LAC-Post (2.4) was significantly higher than LAC-Pre (2.0, p = 0.02) and Center A (2.1, p organs per potential donor.

  14. Numbers of Brain Deaths and Deceased Donors in Hospitals in Istanbul Region That Have Transplantation Units: A Retrospective Analysis Between the Years 2005 and 2015. (United States)

    Harmanci Seren, A K; Yavuz, H


    Turkey is one of the countries facing a serious organ shortage problem, with thousands of patients with end-stage organ failure. The Social Security Institution started to increase the reimbursement for transplantation operations in 2007 to solve this problem, and this policy has continued since then. Although the number of transplantation centers and operations in Turkey increased in this term, according to organ donation and transplantation statistics from the Ministry of Health, the rate of organ retrieval from deceased organ donors has decreased. This study was performed with the purpose of retrospectively analyzing (between the years 2005 and 2015) the number of brain deaths and donors after brain death in hospitals that are affiliated with the Istanbul Regional Coordination Office and have transplantation units. Data were collected via the website of the Ministry of Health. Hospitals were categorized as those directly affiliated with the Ministry of Health, university hospitals, and private hospitals. This study found that the number of transplantation centers has increased >3 times since 2005, and the number of private transplantation centers has increased 9 times for the same period. We also found that the number of brain deaths, donors after brain death in hospitals, and number of brain deaths and donors after brain death per hospital had varied throughout the study years. Although the number of transplantation centers has increased since 2005, the number of brain deaths and donors after brain death has not increased to the same extent for this period in these hospitals that have transplantation units. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. ICU Nurses’ Knowledge, Attitude, and Practice Towards their Role in the Organ Donation Process from Brain-Dead Patients and Factors Influencing it in Iran (United States)

    Masoumian Hoseini, S. T.; Manzari, Z.; Khaleghi, I.


    Background: Nowadays, ICU nurses play a significant role in the care of brain-dead patients and their families. Therefore, their knowledge, attitude and practice towards this issue are extremely important to the success of organ donation. Objective: To assess ICU nurses’ knowledge, attitude and practice towards their role in the organ donation process from brain-dead patients and factors influencing it in Iran. Methods: In a cross-sectional analytical study, 90 ICU nurses working in Ghaem and Emam Reza Hospitals affiliated to Mashhad University of Medical Sciences were selected through a stratified random sampling. Data were collected from the participants by a questionnaire included demographic information, and factors influencing the nurses knowledge, attitude, and practice towards their roles in the organ donation process. Results: 90 nurses participated in this study. 70% of the research subjects had spoken with their own families about organ donation; 20% had organ donation cards. The mean±SD score of nurses’ knowledge was 49.13±9.6, attitude 21.49±14.32, and practice was 3.66±6.04. 80% of nurses had a mean knowledge about their roles in the organ donation process; 82% agreed with their roles in this process, and 97% showed weak practice in this regard. Conclusion: Nurses did not have adequate knowledge, attitude, and practice towards their role in organ donation process. It is suggested to include nursing courses on the organ donation process and organ transplantation as well as educational programs to acquaint nurses with their roles in the organ donation process. PMID:26306156

  16. Deadly medicine. (United States)

    Bachrach, Susan


    This article discusses the methods the United States Holocaust Memorial Museum used to make an exhibition on the complex history of Nazi eugenics accessible to the museum's mass public and at the same time, provocative for special audiences consisting of professionals and students from the biomedical fields. Deadly Medicine: Creating the Master Race showed how both eugenics and related "euthanasia" programs in Nazi Germany helped pave the road to the Holocaust. The exhibition implicitly evoked the present-day appeal of biological explanations for human behavior and of new visions of human perfection. Educational programs used the exhibition as a springboard for discussions of bioethics and medical ethics.

  17. Organ-Protective Intensive Care in Organ Donors. (United States)

    Hahnenkamp, Klaus; Böhler, Klaus; Wolters, Heiner; Wiebe, Karsten; Schneider, Dietmar; Schmidt, Hartmut H-J


    The ascertainment of brain death (the irreversible, total loss of brain function) gives the physician the opportunity to limit or stop further treatment. Alternatively, if the brain-dead individual is an organ donor, the mode of treatment can be changed from patient-centered to donationcentered. Consensus-derived recommendations for the organ-protective treatment of brain-dead organ donors are not yet available in Germany. This review is based on pertinent publications retrieved by a selective search in PubMed, and on the authors' clinical experience. Brain death causes major pathophysiological changes, including an increase in catecholamine levels and a sudden drop in the concentration of multiple hormones, among them antidiuretic hormone, cortisol, insulin, and triand tetraiodothyronine. These changes affect the function of all organ systems, as well as the hemodynamic state and the regulation of body temperature. The use of standardized donor management protocols might well increase the rate of transplanted organs per donor and improve the quality of the transplanted organs. In addition, the administration of methylprednisolone, desmopressin, and vasopressin could be a useful supplement to treatment in some cases. Randomized controlled trials have not yet demonstrated either improved organ function or prolonged survival of the transplant recipients. The evidence base for organ-protective intensive care is weak; most of the available evidence is on the level of expert opinion. There is good reason to believe, however, that the continuation of intensive care, in the sense of early donor management, can make organ transplantation more successful both by increasing the number of transplantable organs and by improving organ quality.

  18. "Facilis Descensus Averni" Mind, Brain, Education, and Ethics: Highway to Hell, Stairway to Heaven, or Passing Dead End? (United States)

    della Chiesa, Bruno


    Are human beings born unequal when it comes to ethics? Or are ethical standards acquired? Or both nature and nurture? Neuroscience is on its way to discovering biological underpinnings of ethics in our brains. Whatever the upcoming findings on this front will be, our philosophical, political, and educational views, and even the way we look at…

  19. Establishing a deceased donor program in north Indian region: lessons learnt. (United States)

    Gupta, Vivek; Chandra, Abhijit; Rahul; Singh, Manmeet; Shrivastava, Peeyush Kumar; Singhai, Atin; Ojha, Bal Krishna; Chandra, Girish; Khan, Mohammed Parvez; Pandey, Sant; Kant, Ravi


    Living-related donors are the source of almost all organ transplants in India. However, these donations fall far short of current needs, and there remains a huge disparity between demand and supply of organs. In the last five yr, a consistent increase in deceased donor transplant activity has been observed in some southern Indian states. This report describes our experience of establishing a new deceased donor program in the state of Uttar Pradesh in north India. We describe our experience on counseling families of all brain-dead patients admitted to our center from October 2013 to September 2014 and data on retrieving and transplanting organs. A total of 99 brain-dead patients were identified, of which 67 were medically eligible as donors. Fourteen patients developed cardiac arrest before the counseling could begin. Only eight families agreed for multi-organ donation. Lack of consensus among the family members, mistrust of the medical system, fear of mutilation of the body, and delay in the funeral were identified as the main reasons behind negative consent. Conversely, mass media campaign, proper ICU care of brain-dead patients, rapport with the family and streamlining all medico legal processes were associated with positive consent. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Brain death induces renal expression of heme oxygenase-1 and heat shock protein 70

    Directory of Open Access Journals (Sweden)

    van Dullemen Leon FA


    Full Text Available Abstract Background Kidneys derived from brain dead donors have lower graft survival and higher graft-function loss compared to their living donor counterpart. Heat Shock Proteins (HSP are a large family of stress proteins involved in maintaining cell homeostasis. We studied the role of stress-inducible genes Heme Oxygenase-1 (HO-1, HSP27, HSP40, and HSP70 in the kidney following a 4 hour period of brain death. Methods Brain death was induced in rats (n=6 by inflating a balloon catheter in the epidural space. Kidneys were analysed for HSPs using RT-PCR, Western blotting, and immunohistochemistry. Results RT-PCR data showed a significant increase in gene expression for HO-1 and HSP70 in kidneys of brain dead rats. Western blotting revealed a massive increase in HO-1 protein in brain dead rat kidneys. Immunohistochemistry confirmed these findings, showing extensive HO-1 protein expression in the renal cortical tubules of brain dead rats. HSP70 protein was predominantly increased in renal distal tubules of brain dead rats treated for hypotension. Conclusion Renal stress caused by brain death induces expression of the cytoprotective genes HO-1 and HSP70, but not of HSP27 and HSP40. The upregulation of these cytoprotective genes indicate that renal damage occurs during brain death, and could be part of a protective or recuperative mechanism induced by brain death-associated stress.

  1. Using ultrasonography to monitor liver blood flow for liver transplant from donors supported on extracorporeal membrane oxygenation. (United States)

    Zhu, Xian-Sheng; Wang, Sha-Sha; Cheng, Qi; Ye, Chuang-Wen; Huo, Feng; Li, Peng


    Extracorporeal membrane oxygenation (ECMO) has been used to support brain-dead donors for liver procurement. This study investigated the potential role of ultrasonographic monitoring of hepatic perfusion as an aid to improve the viability of liver transplants obtained from brain-dead donors who are supported on ECMO. A total of 40 brain-dead patients maintained on ECMO served as the study population. Hepatic blood flow was monitored using ultrasonography, and perioperative optimal perfusion was maintained by calibrating ECMO. Liver function tests were performed to assess the viability of the graft. The hepatic arterial blood flow was well maintained with no significant changes observed before and after ECMO (206 ± 32 versus 241 ± 45 mL/minute; P = 0.06). Similarly, the portal venous blood flow was also maintained throughout (451 ± 65 versus 482 ± 77 mL/minute; P = 0.09). No significant change in levels of total bilirubin, alanine transaminase, and lactic acid were reported during ECMO (P = 0.17, P = 0.08, and P = 0.09, respectively). Before the liver is procured, ultrasonographic monitoring of hepatic blood flow could be a valuable aid to improve the viability of a liver transplant by allowing for real-time calibration of ECMO perfusion in brain-dead liver donors. In our study, ultrasonographic monitoring helped prevent warm ischemic injury to the liver graft by avoiding both overperfusion and underperfusion of the liver. © 2015 American Association for the Study of Liver Diseases.

  2. Crosstalk between complement and Toll-like receptor activation in relation to donor brain death and renal ischemia-reperfusion injury. (United States)

    Damman, Jeffrey; Daha, Mohamed R; van Son, Willem J; Leuvenink, Henri G; Ploeg, Rutger J; Seelen, Marc A


    Two central pathways of innate immunity, complement and Toll-like receptors (TLRs), play an important role in the pathogenesis of renal injury inherent to kidney transplantation. Recent findings indicate close crosstalk between complement and TLR signaling pathways. It is suggested that mitogen activated protein kinases (MAPKs) might be the key molecules linking both the complement and TLR pathways together. Complement and TLRs are important mediators of renal ischemia-reperfusion injury (IRI). Besides IRI, complement C3 can also be upregulated and activated in the kidney before transplantation as a direct result of brain death (BD) in the donor. This local upregulation and activation of complement in the donor kidney has been proven to be detrimental for renal allograft outcome. Also TLR4 and several of its major ligands are upregulated by donor BD compared to living donors. Important and in line with the observations above, kidney transplant recipients have a benefit when receiving a kidney from a TLR4 Asp299Gly/Thr399Ile genotypic donor. The role of complement and TLRs and crosstalk between these two innate immune systems in relation to renal injury during donor BD and ischemia-reperfusion are focus of this review. Future strategies to target complement and TLR activation in kidney transplantation are considered. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

  3. Deadly progress

    International Nuclear Information System (INIS)

    Nader, R.; Abbotts, J.


    Nuclear power plants are safe, they help to get through the future bottle-neck in the field of energy, nuclear power plants provide for cheap electrical power and support economic growth - these are the sedative formulae which have been used for years to close the populations eyes towards the real problems. In this book, the American lawyer Ralph Nader and the nuclear chemist John Abbots not only oppose this myth of atomic safety, but they also defeat this theory with numerous technical, economic, and political details. Having realized the fact that the development of atomic energy can no longer be prevented by warnings of independent experts, but only by massive protests by the population - i.e. the protest by informed persons-, they give an understandable introduction to the techniques of atomic energy, construction of nuclear power plants, radioactive radiation, safety, etc. Furthermore, they inform about the social, political, and economic background of the nuclear power forcing. Nader and Abbots show the uncertainty of science, they bring secret documents about failures already occured and point out the catastrophic consequences of possible defects. The result of the thorough study: A 'technologic Vietnam' impends both USA and all other nuclear power countries, if the population won't struggle against this dead-end programme of the governments. (orig./HP) [de

  4. Love the dead, fear the dead

    DEFF Research Database (Denmark)

    Seebach, Sophie Hooge


    The dead are everywhere in the landscape in Acholi, northern Uganda. In the homes, the dead are present through their gravesites, situated next to houses and huts, and as spiritual presences in their family’s daily lives. In the bush, the dead are present as a constant potentiality, in the form o...

  5. Potential Pediatric Organ Donors After Cardiac Death. (United States)

    Pregernig, A; Karam, O


    More than 50 people die each year on the Swiss transplant waiting list. To increase their organ donors pool, some centers have developed a post-cardiac death organ donation program. Information about its impact in the pediatric population is still scarce. The aim of this work was to determine the potential impact of a program of organ donation after cardiac in a pediatric population. This was a retrospective study of all children deceased from 2005 to 2014 in a tertiary pediatric and neonatal intensive care unit. The deceased were categorized as brain dead, deceased despite maximal resuscitation, deceased after withholding of care, and deceased after withdrawal of care. Potential organ donors were identified by the absence of medical contraindication and agonal time organ donors. A further 67 (35%) died despite maximal resuscitation, 31 (16%) after withholding of care, and 55 (29%) after withdrawal of care. Regarding the latter category, median agonal time was 16 minutes. Eighteen children could potentially have given ≥1 organ each. Development of organ donation after cardiac death in children could generate a 4-fold increase of the donor population. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Fear, ambivalence, and liminality: key concepts in refusal to donate an organ after brain death. (United States)

    Rassin, Michal; Lowenthal, Miri; Silner, Dina


    The refusal to donate an organ is a phenomenon in need of exploration and explanation. This article refers to the major fear of becoming an organ donor in relation to a global culture perspective and to the Halacha (Jewish law). A theoretical critique about the ambivalence demonstrated by health care providers and families will discuss these concepts in relation to brain death, from the stages of hospitalization, through the period prior to the assertion of brain death, ending with brain death, and its perspective as a liminal situation.Finally, we conclude that nursing practices during the care of the "brain dead" patient, and toward the patient's family, should convey an unequivocal message. That is, brain death describes irreversible cessation of all brain function, and therefore, the patient becomes a dead body and can be treated as a potential organ donor.

  7. Deceased Organ Donor Characteristics and Organ Utilization in Israel, 2004-2013. (United States)

    Cohen, Jonathan; Bistritz, Yael; Ashkenazi, Tamar


    The number of patients awaiting organ transplantation continues to exceed the number of available organs. To document changes in the demographic characteristics of brain-dead, heart-beating organ donors over the past 10 years which may impact on organ utilization. Data were extracted from the Israel Transplant Registry and the Donor Action database for the 10 year period 2004-2013, inclusive. The median age of the donors increased from 44 (range 3-73 years) to 53.5 years (range 1-79 years) (P donors of kidneys (33 to 51 years, P donors dying from trauma decreased (34.5% to 20%, P donors decreased over the study period, from 63% to 53%. An increase was noted in the mean number of organs transplanted per donor, from 3.29 to 3.82 per donor, due mainly to a significant increase in the utilization of lungs (31.5% to 51.3%, P organ donor pool in Israel over the past 10 years reveal significant changes in demographic characteristics which in the future will impact on the number of organs available for transplantation.

  8. Does the Pulsatile Preservation Machine Have Any Impact in the Discard Rate of Kidneys From Older Donors After Brain Death? (United States)

    Paredes-Zapata, D; Ruiz-Arranz, A; Rodriguez-Villar, C; Roque-Arda, R; Peri-Cusi, L; Saavedra-Escobar, S; Vizcaino-Elias, F; Garcia-Rodriguez, X; Bohils-Valle, M; Rodriguez-Peña, S; Quijada-Martorell, M; Gonzalez-Rodriguez, J-J; Oppenheimer-Salinas, F; Alcaraz-Asensio, A; Adalia-Bartolome, R


    Donors after brain death (DBD) older than 60 years have become 46.8% of our current activity, with higher risk of renal discard rate (RDR). Assessment of kidney suitability requires complementary strategies: macroscopic evaluation, kidney biopsy score (KBS), and renal hemodynamic evaluation with the Pulsatile Perfusion Machine (PPM). Descriptive, cross-sectional, comparative study of kidneys procured and RDR, comparing 3 time periods: 2000 to June 2004, when only KBS were used; July 2004 to 2008 (introduction of PPM and learning period); and 2009 to 2013 (experienced use of PPM). Transplantation criteria were KBS 70 mL/min. Between 2000 and 2013, a 59.2% reduction in DBD kidneys was observed. However, older kidneys had an increase from 33.5% to 46.8%. The RDR had increased, comparing the first to the third period from 25.4% to 38.3%. However, the RDR was lower when kidneys were evaluated with PPM than those evaluated only with KBS and preserved in cold storage (CS) (21.4% versus 43.7%). There was a significant difference in cold ischemia time, because CS kidney was grafted before PPM. During the third period, more kidneys with KBS ≥4 were assigned to PPM. Notwithstanding the decrease in DBD-procured kidneys and the increase in older kidneys during last period, the use of PPM allowed low DR compared with CS. A bias in the results of PPM could be generated when kidneys with higher KBS were excluded from PPM. The use of KBS only to decide acceptance could preclude the use of an additional tool to evaluate suitability. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. The 40 donors per million population plan: an action plan for improvement of organ donation and transplantation in Spain. (United States)

    Matesanz, R; Marazuela, R; Domínguez-Gil, B; Coll, E; Mahillo, B; de la Rosa, G


    Spain has been showing the highest rate of deceased donor organ recovery in the world for a whole country, namely, 33-35 donors per million population (pmp) during the last years. This activity is attributed to the so-called Spanish Model of organ donation, an integrated approach to improve organ donation since the start of the Organización Nacional de Trasplantes (ONT) in 1989. However, in 2007 there were 7/17 regions with >40 donors pmp and a marked regional variability. Thus, ONT has set a large-scale, comprehensive strategy to achieve a substantial improvement in donation and transplantation in Spain in the coming years: The 40 Donors pmp Plan. The overall objective is to increase the average rate of deceased donors to 40 pmp between 2008 and 2010. The areas of improvement, specific objectives, and actions have come from deep reflection on the data and the material generated from multidisciplinary discussions and open consultation with the donation and transplantation community. Detection and management of brain-dead donors, with 4 specific subareas: access to intensive care units, new forms of hospital management, foreigners and ethnic minorities, and evaluation/maintenance of thoracic organ donors. Expanded criteria donors, with 3 subareas: aging, donors with positive tests to certain viral serologies, and donors with rare diseases. Special surgical techniques. Donation after cardiac death.

  10. A narrative review of the empirical evidence on public attitudes on brain death and vital organ transplantation: the need for better data to inform policy. (United States)

    Shah, Seema K; Kasper, Kenneth; Miller, Franklin G


    Vital organ transplantation is premised on 'the dead donor rule': donors must be declared dead according to medical and legal criteria prior to donation. However, it is controversial whether individuals diagnosed as 'brain dead' are really dead in accordance with the established biological conception of death-the irreversible cessation of the functioning of the organism as a whole. A basic understanding of brain death is also relevant for giving valid, informed consent to serve as an organ donor. There is therefore a need for reliable empirical data on public understanding of brain death and vital organ transplantation. We conducted a review of the empirical literature that identified 43 articles with approximately 18,603 study participants. These data demonstrate that participants generally do not understand three key issues: (1) uncontested biological facts about brain death, (2) the legal status of brain death and (3) that organs are procured from brain dead patients while their hearts are still beating and before their removal from ventilators. These data suggest that, despite scholarly claims of widespread public support for organ donation from brain dead patients, the existing data on public attitudes regarding brain death and organ transplantation reflect substantial public confusion. Our review raises questions about the validity of consent for vital organ transplantation and suggests that existing data are of little assistance in developing policy proposals for organ transplantation from brain dead patients. New approaches to rigorous empirical research with educational components and evaluations of understanding are urgently needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  11. Ethical issues regarding related and nonrelated living organ donors. (United States)

    Testa, Giuliano


    The ethics of the clinical practice of transplanting human organs for end-stage organ disease is a fascinating topic. Who is the "owner" of the transplantable organs of a deceased, brain-dead patient? Who should have a right to receive these organs? Who set the boundaries between a living donor's autonomy and a "paternalistic" doctor? What constitutes a proper consent? These questions are only some of the ethical issues that have been discussed in the last 60 years. All of these ethical issues are intensified by the fact that supply of human organs does not match demand, and that, as a consequence, living-donor organ transplantation is widely utilized. The aim of this article is not to be exhaustive but to present the general ethical principles of beneficence, nonmaleficence, and justice as applied to organ transplantation. Moreover, the topic of reimbursement for organ donation is also discussed.

  12. The therapeutic protection of a living and dead Lactobacillus strain against aluminum-induced brain and liver injuries in C57BL/6 mice.

    Directory of Open Access Journals (Sweden)

    Fengwei Tian

    Full Text Available Our previous study found that Lactobacillus plantarum CCFM639 had the ability to alleviate acute aluminum (Al toxicity when the strain was introduced simultaneously with Al exposure. This research was designed to elucidate the therapeutic effects of living and dead L. plantarum CCFM639 against chronic Al toxicity and to gain insight into the protection modes of this strain. Animals were assigned into control, Al only, Al + living CCFM639, and Al + dead CCFM639 groups. The Al exposure model was established by drinking water for the first 4 weeks. The strain was given after Al exposure by oral gavage at 109 colony-forming units once per day for 12 weeks. The results show that the Al binding ability of dead CCFM639 was similar to that of living CCFM639 in vitro. The ingestion of living or dead CCFM639 has similar effects on levels of Al and trace element in tissues, but living strains led to more significant amelioration of oxidative stress and improvement of memory deficits in Al-exposed mice. In conclusion, in addition to intestinal Al sequestration, CCFM639 treatment offers direct protection against chronic Al toxicity by alleviation of oxidative stress. Therefore, L. plantarum CCFM639 has a potential as dietary supplement ingredient that provides protection against Al-induced injury.

  13. Effects of new beta-type Ti-40Nb implant materials, brain-derived neurotrophic factor, acetylcholine and nicotine on human mesenchymal stem cells of osteoporotic and non osteoporotic donors. (United States)

    Kauschke, Vivien; Gebert, Annett; Calin, Mariana; Eckert, Jürgen; Scheich, Sebastian; Heiss, Christian; Lips, Katrin Susanne


    Treatment of osteoporotic fractures is still challenging and an urgent need exists for new materials, better adapted to osteoporotic bone by adjusted Young's modulus, appropriate surface modification and pharmaceuticals. Titanium-40-niobium alloys, mechanically ground or additionally etched and titanium-6-aluminium-4-vanadium were analyzed in combination with brain-derived neurotrophic factor, acetylcholine and nicotine to determine their effects on human mesenchymal stem cells in vitro over 21 days using lactate dehydrogenase and alkaline phosphatase assays, live cell imaging and immunofluorescence microscopy. Cell number of human mesenchymal stem cells of osteoporotic donors was increased after 14 d in presence of ground titanium-40-niobium or titanium-6-aluminium-4-vanadium, together with brain-derived neurotrophic factor. Cell number of human mesenchymal stem cells of non osteoporotic donors increased after 21 d in presence of titanium-6-aluminium-4-vanadium without pharmaceuticals. No significant increase was measured for ground or etched titanium-40-niobium after 21 d. Osteoblast differentiation of osteoporotic donors was significantly higher than in non osteoporotic donors after 21 d in presence of etched, ground titanium-40-niobium or titanium-6-aluminium-4-vanadium accompanied by all pharmaceuticals tested. In presence of all alloys tested brain-derived neurotrophic factor, acetylcholine and nicotine increased differentiation of cells of osteoporotic donors and accelerated it in non osteoporotic donors. We conclude that ground titanium-40-niobium and brain-derived neurotrophic factor might be most suitable for subsequent in vivo testing.

  14. Organ Donor Management: Part 1. Toward a Consensus to Guide Anesthesia Services During Donation After Brain Death. (United States)

    Souter, Michael J; Eidbo, E; Findlay, James Y; Lebovitz, Daniel J; Moguilevitch, Marina; Neidlinger, Nikole A; Wagener, Gerhard; Paramesh, Anil S; Niemann, Claus U; Roberts, Pamela R; Pretto, Ernesto A


    Worldwide 715 482 patients have received a lifesaving organ transplant since 1988. During this time, there have been advances in donor management and in the perioperative care of the organ transplant recipient, resulting in marked improvements in long-term survival. Although the number of organs recovered has increased year after year, a greater demand has produced a critical organ shortage. The majority of organs are from deceased donors; however, some are not suitable for transplantation. Some of this loss is due to management of the donor. Improved donor care may increase the number of available organs and help close the existing gap in supply and demand. In order to address this concern, The Organ Donation and Transplantation Alliance, the Association of Organ Procurement Organizations, and the Transplant and Critical Care Committees of the American Society of Anesthesiologists have formulated evidence-based guidelines, which include a call for greater involvement and oversight by anesthesiologists and critical care specialists, as well as uniform reporting of data during organ procurement and recovery.

  15. The effects of donor stage on the survival and function of embryonic striatal grafts in the adult rat brain; II. Correlation between positron emission tomography and reaching behaviour

    Energy Technology Data Exchange (ETDEWEB)

    Dunnett, S.B. [Department of Experimental Psychology and MRC Cambridge Centre for Brain Repair, University of Cambridge, Cambridge (United Kingdom); Brooks, D.J.; Ashworth, S.; Opacka-Juffrey, J.; Myers, R.; Hume, S.P. [PET Methodology Group, Cyclotron Unit, MRC Clinical Science Centre, Hammersmith Hospital, London (United Kingdom); Torres, E.M.; Fricker, R.A. [Department of Experimental Psychology and MRC Cambridge Centre for Brain Repair, University of Cambridge, Cambridge (United Kingdom)


    Grafts of embryonic striatal primordia are able to elicit behavioural recovery in rats which have received an excitotoxic lesion to the striatum, and it is believed that the P zones or striatal-like tissue within the transplants play a crucial role in these functional effects. We performed this study to compare the effects of different donor stage of embryonic tissue on both the morphology (see accompanying paper) and function of striatal transplants. Both the medial and lateral ganglionic eminence was dissected from rat embryos of either 10 mm, 15 mm, 19 mm, or 23 mm crown-rump length, and implanted as a cell suspension into adult rats which had received an ibotenic acid lesion 10 days prior to transplantation. After four months the animals were tested on the 'staircase task' of skilled forelimb use. At 10-14 months rats from the groups which had received grafts from 10 mm or 15 mm donor embryos were taken for positron emission tomography scanning in a small diameter postiron emission tomography scanner, using ligands to the dopamine D{sub 1} and D{sub 2} receptors, [{sup 11}C]SCH 23390 and [{sup 11}C]raclopride, respectively. A lesion-alone group was also scanned with the same ligands for comparison. Animals which had received transplants from the 10 mm donors showed a significant recovery with their contralateral paw on the 'staircase test'. No other groups showed recovery on this task. Similarly, the animals with grafts from the youngest donors showed a significant increase in D{sub 1} and D{sub 2} receptor binding when compared to the lesion-alone group. No increase in signal was observed with either ligand in the group which had received grafts from 15 mm donors. Success in paw reaching showed a strong correlation to both the positron emission tomography signal obtained and the P zone volume of the grafts.These results suggest that striatal grafts from younger donors (10 mm CRL) give greater behavioural recovery than grafts preparedfrom

  16. Simulating detectors dead time

    International Nuclear Information System (INIS)

    Rustom, Ibrahim Farog Ibrahim


    Nuclear detectors are used in all aspects of nuclear measurements. All nuclear detectors are characterized by their dead time i.e. the time needed by a detector to recover from a previous incident. A detector dead time influences measurements taken by a detector and specially when measuring high decay rate (>) where is the detector dead time. Two models are usually used to correct for the dead time effect: the paralayzable and the non-paralayzable models. In the current work we use Monte Carlo simulation techniques to simulate radioactivity and the effect of dead time and the count rate of a detector with a dead time =5x10 - 5s assuming the non-paralayzable model. The simulation indicates that assuming a non -paralayzable model could be used to correct for decay rate measured by a detector. The reliability of the non-paralayzable model to correct the measured decay rate could be gauged using the Monte Carlo simulation. (Author)

  17. Investigating Aquatic Dead Zones (United States)

    Testa, Jeremy; Gurbisz, Cassie; Murray, Laura; Gray, William; Bosch, Jennifer; Burrell, Chris; Kemp, Michael


    This article features two engaging high school activities that include current scientific information, data, and authentic case studies. The activities address the physical, biological, and chemical processes that are associated with oxygen-depleted areas, or "dead zones," in aquatic systems. Students can explore these dead zones through both…

  18. Microinfarcts in an older population-representative brain donor cohort (MRC CFAS): Prevalence, relation to dementia and mobility, and implications for the evaluation of cerebral Small Vessel Disease. (United States)

    Ince, P G; Minett, T; Forster, G; Brayne, C; Wharton, S B


    Microinfarcts, small ischaemic foci common in ageing brain, are associated with dementia and gait dysfunction. We determined their relationship with dementia, mobility and cerebrovascular disease in an older population-representative brain donor cohort. These data on microinfarcts were evaluated in relation to pathological assessments of clinically significant cerebral small vessel disease (SVD). Microinfarcts were assessed in the MRC Cognitive Function and Ageing Study (n = 331). Nine brain areas were staged according to the number of areas affected. 36% of brains showed at least 1 microinfarct. Higher cortical microinfarct stage was associated with dementia at death (OR 1.41, 95% CI 1.02; 1.96, P = 0.038), whilst cortical and subcortical microinfarct stages were associated with impaired mobility (OR 1.36, 95% CI 1.05-1.74; P 0.018) and falls (OR 1.96, 95% CI 1.11-3.43; P = 0.02). Adding data on microinfarcts to a definition of SVD, based on white matter lesions (WMLs), lacunes and significant arteriosclerosis, were assessed by comparing area under ROC curve (AUC) with and without microinfarcts. SVD was significantly related to dementia status with or without inclusion of microinfarcts. Modelling potential pathological definitions of SVD to predict dementia or impaired mobility indicated optimal prediction using combined assessment of WMLs, lacunes and microinfarcts. Cortical (dementia) and subcortical microinfarcts (impaired mobility) are related to diverse clinical outcomes. Optimal pathological assessment of significant SVD in brain ageing is achieved based on WMLs, lacunes and microinfarcts and may not require subjective assessment of the extent and severity of arteriosclerosis. © 2016 The Authors. Neuropathology and Applied Neurobiology published by John Wiley & Sons Ltd on behalf of British Neuropathological Society.

  19. Dead Sea Scrolls (United States)


    A consortium of researchers from Jet Propulsion Laboratory and three other organizations used charged coupled devices (CCDs) and other imaging enhancement technology to decipher previously unreadable portions of the Dead Sea Scrolls. The technique has potentially important implications for archeology.

  20. Request for organ donation without donor registration: a qualitative study of the perspectives of bereaved relatives. (United States)

    de Groot, Jack; van Hoek, Maria; Hoedemaekers, Cornelia; Hoitsma, Andries; Schilderman, Hans; Smeets, Wim; Vernooij-Dassen, Myrra; van Leeuwen, Evert


    In the Netherlands, consent from relatives is obligatory for post mortal donation. This study explored the perspectives of relatives regarding the request for consent for donation in cases without donor registration. A content analysis of narratives of 24 bereaved relatives (14 in-depth interviews and one letter) of unregistered, eligible, brain-dead donors was performed. Relatives of unregistered, brain-dead patients usually refuse consent for donation, even if they harbour pro-donation attitudes themselves, or knew that the deceased favoured organ donation. Half of those who refused consent for donation mentioned afterwards that it could have been an option. The decision not to consent to donation is attributed to contextual factors, such as feeling overwhelmed by the notification of death immediately followed by the request; not being accustomed to speaking about death; inadequate support from other relatives or healthcare professionals, and lengthy procedures. Healthcare professionals could provide better support to relatives prior to donation requests, address their informational needs and adapt their message to individual circumstances. It is anticipated that the number of consenting families could be enlarged by examining the experience of decoupling and offering the possibility of consent for donation after circulatory death if families refuse consent for donation after brain-death.

  1. Human immunology studies using organ donors: Impact of clinical variations on immune parameters in tissues and circulation. (United States)

    Carpenter, D J; Granot, T; Matsuoka, N; Senda, T; Kumar, B V; Thome, J J C; Gordon, C L; Miron, M; Weiner, J; Connors, T; Lerner, H; Friedman, A; Kato, T; Griesemer, A D; Farber, D L


    Organ donors are sources of physiologically healthy organs and tissues for life-saving transplantation, and have been recently used for human immunology studies which are typically confined to the sampling of peripheral blood. Donors comprise a diverse population with different causes of death and clinical outcomes during hospitalization, and the effects of such variations on immune parameters in blood and tissues are not known. We present here a coordinate analysis of innate and adaptive immune components in blood, lymphoid (bone marrow, spleen, lymph nodes), and mucosal (lungs, intestines) sites from a population of brain-dead organ donors (2 months-93 years; n = 291) across eight clinical parameters. Overall, the blood of donors exhibited similar monocyte and lymphocyte content and low serum levels of pro-inflammatory cytokines as healthy controls; however, donor blood had increased neutrophils and serum levels of IL-8, IL-6, and MCP-1 which varied with cause of death. In tissues, the frequency and composition of monocytes, neutrophils, B lymphocytes and T cell subsets in lymphoid or mucosal sites did not vary with clinical state, and was similar in donors independent of the extent of clinical complications. Our results reveal that organ donors maintain tissue homeostasis, and are a valuable resource for fundamental studies in human immunology. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. Clarifying the paradigm for the ethics of donation and transplantation: Was 'dead' really so clear before organ donation?

    Directory of Open Access Journals (Sweden)

    Shemie Sam D


    Full Text Available Abstract Recent commentaries by Verheijde et al, Evans and Potts suggesting that donation after cardiac death practices routinely violate the dead donor rule are based on flawed presumptions. Cell biology, cardiopulmonary resuscitation, critical care life support technologies, donation and transplantation continue to inform concepts of life and death. The impact of oxygen deprivation to cells, organs and the brain is discussed in relation to death as a biological transition. In the face of advancing organ support and replacement technologies, the reversibility of cardiac arrest is now purely related to the context in which it occurs, in association to the availability and application of support systems to maintain oxygenated circulation. The 'complete and irreversible' lexicon commonly used in death discussions and legal statutes are ambiguous, indefinable and should be replaced by accurate terms. Criticism of controlled DCD on the basis of violating the dead donor rule, where autoresuscitation has not been described beyond 2 minutes, in which life support is withdrawn and CPR is not provided, is not valid. However, any post mortem intervention that re-establishes brain blood flow should be prohibited. In comparison to traditional practice, organ donation has forced the clarification of the diagnostic criteria for death and improved the rigour of the determinations.

  3. Clarifying the paradigm for the ethics of donation and transplantation: Was 'dead' really so clear before organ donation? (United States)

    Shemie, Sam D


    Recent commentaries by Verheijde et al, Evans and Potts suggesting that donation after cardiac death practices routinely violate the dead donor rule are based on flawed presumptions. Cell biology, cardiopulmonary resuscitation, critical care life support technologies, donation and transplantation continue to inform concepts of life and death. The impact of oxygen deprivation to cells, organs and the brain is discussed in relation to death as a biological transition. In the face of advancing organ support and replacement technologies, the reversibility of cardiac arrest is now purely related to the context in which it occurs, in association to the availability and application of support systems to maintain oxygenated circulation. The 'complete and irreversible' lexicon commonly used in death discussions and legal statutes are ambiguous, indefinable and should be replaced by accurate terms. Criticism of controlled DCD on the basis of violating the dead donor rule, where autoresuscitation has not been described beyond 2 minutes, in which life support is withdrawn and CPR is not provided, is not valid. However, any post mortem intervention that re-establishes brain blood flow should be prohibited. In comparison to traditional practice, organ donation has forced the clarification of the diagnostic criteria for death and improved the rigour of the determinations. PMID:17718918

  4. The Impact of Ischemia/Reperfusion Injury on Liver Allografts from Deceased after Cardiac Death versus Deceased after Brain Death Donors.

    Directory of Open Access Journals (Sweden)

    Jin Xu

    Full Text Available The shortage of organs for transplantation has led to increased use of organs procured from donors after cardiac death (DCD. The effects of cardiac death on the liver remain poorly understood, however. Using livers obtained from DCD versus donors after brain death (DBD, we aimed to understand how ischemia/reperfusion (I/R injury alters expression of pro-inflammatory markers ceramides and influences graft leukocyte infiltration.Hepatocyte inflammation, as assessed by ceramide expression, was evaluated in DCD (n = 13 and DBD (n = 10 livers. Allograft expression of inflammatory and cell death markers, and allograft leukocyte infiltration were evaluated from a contemporaneous independent cohort of DCD (n = 22 and DBD (n = 13 livers.When examining the differences between transplant stages in each group, C18, C20, C24 ceramides showed significant difference in DBD (p<0.05 and C22 ceramide (p<0.05 were more pronounced for DCD. C18 ceramide is correlated to bilirubin, INR, and creatinine after transplant in DCD. Prior to transplantation, DCD livers have reduced leukocyte infiltration compared to DBD allografts. Following reperfusion, the neutrophil infiltration and platelet deposition was less prevalent in DCD grafts while cell death and recipients levels of serum aspartate aminotransferase (AST of DCD allografts had significantly increased.These data suggest that I/R injury generate necrosis in the absence of a strong inflammatory response in DCD livers with an appreciable effect on early graft function. The long-term consequences of increased inflammation in DBD and increased cell death in DCD allografts are unknown and warrant further investigation.

  5. Practicing on Newly Dead

    Directory of Open Access Journals (Sweden)

    Jewel Abraham


    Full Text Available A newly dead cadaver simulation is practiced on the physical remains of the dead before the onset of rigor mortis. This technique has potential benefits for providing real-life in-situ experience for novice providers in health care practices. Evolving ethical views in health care brings into question some of the ethical aspects associated with newly dead cadaver simulation in terms of justification for practice, autonomy, consent, and the need of disclosure. A clear statement of policies and procedures on newly dead cadaver simulation has yet to be implemented. Although there are benefits and disadvantages to an in-situ cadaver simulation, such practices should not be carried out in secrecy as there is no compelling evidence that suggests such training as imperative. Secrecy in these practices is a violation of honor code of nursing ethics. As health care providers, practitioners are obliged to be ethically honest and trustworthy to their patients. The author explores the ethical aspects of using newly dead cadaver simulation in training novice nursing providers to gain competency in various lifesaving skills, which otherwise cannot be practiced on a living individual. The author explores multiple views on cadaver simulation in relation to ethical theories and practices such as consent and disclosure to family.

  6. Imprecise definitions of starting points in retrospectively reviewing potential organ donors causes confusion: call for a reproducible method like 'imminent brain death'.

    NARCIS (Netherlands)

    Jansen, N.E.; Groot, Y.J. de; Leiden, H.A. van; Haase-Kromwijk, B.J.; Kompanje, E.J.; Hoitsma, A.J.


    Low donor supply and the high demand for transplantable organs is an international problem. The efficiency of organ procurement is often expressed by donor conversion rates (DCRs). These rates differ among countries, but a uniform starting point for defining a potential heart-beating donor is

  7. Pediatric Brain Tumor Foundation (United States)

    ... navigate their brain tumor diagnosis. WATCH AND SHARE Brain tumors and their treatment can be deadly so ... Pediatric Central Nervous System Cancers Read more >> Pediatric Brain Tumor Foundation 302 Ridgefield Court, Asheville, NC 28806 ...

  8. Dead or alive?



    Dead or Alive was a painting and sound exhibition in the National Physical Laboratory (NPL) in Richmond. NPL is the UK’s national standards laboratory for metrology and is one of the world’s leading measurement institutes. \\ud \\ud The exhibition took the form of installations consisting of paintings and soundscapes set up in two spaces, an anechoic chamber (dead) and a reverberation chamber (alive). For the exhibition a new body of work was made including a twenty-seven-metre panoramic painti...

  9. Decreased spontaneous activity in AMPK alpha 2 muscle specific kinase dead mice is not caused by changes in brain dopamine metabolism

    DEFF Research Database (Denmark)

    Møller, Lisbeth Liliendal Valbjørn; Sylow, Lykke; Gøtzsche, Casper René


    It is well known that physical activity has several health benefits, yet many people do not exercise. Dopamine levels in the striatum of the brain are thought to be important for the motivation to exercise. Conversely, we hypothesized that muscle quality can affect the motivation to exercise...... DOPAC and HVA were also similar between genotypes. These findings show that decreased AMPK activity in muscle leads to decreased voluntary activity which is not due to secondary abnormalities in dopamine levels in the ventral striatum or sensitivity to cocaine. Thus, decreased voluntary activity in AMPK...

  10. Addition of direct peritoneal lavage to human cadaver organ donor resuscitation improves organ procurement. (United States)

    Smith, Jason W; Matheson, Paul J; Morgan, Gary; Matheson, Amy; Downard, Cynthia; Franklin, Glen A; Garrison, R Neal


    Brain dead organ donors have altered central hemodynamic performance, impaired hormone physiology, exaggerated systemic inflammatory response, end-organ microcirculatory dysfunction, and tissue hypoxia. A new treatment, direct peritoneal resuscitation (DPR), stabilizes vital organ blood flow after conventionally resuscitated shock to improve these derangements. A prospective case-control study of adjunctive DPR compared 26 experimental patients (brain dead organ donors) to 52 controls (protocolized conventionally resuscitated donors). Actual organ procurement rates were compared with the Scientific Registry of Transplant Recipient predicted organ yield per patient. Achievement of donor management goals and effective hepatic blood flow were recorded. Fourteen of 26 (53.8%) patients treated with DPR achieved all donor management goals compared with 17 of 52 (32.7%) patients treated with conventionally resuscitated (odds ratio = 2.4; 95% CI, 0.92-6.3; p = 0.06). Patients treated with DPR were more than 2 times as likely to achieve final pO2 >100 on 40% FiO2 compared with controls (odds ratio = 2.8; 95% CI, 1-7.69; p = 0.03). Also, DPR-treated patients required less IV crystalloid during the first 12 hours of management (DPR: 3,167 ± 1,893 mL vs 4,154 ± 2,100 mL; p = 0.046) and required less vasopressor agents at 12 hours post resuscitation (odds ratio = 7.7; 95% CI, 0.82-42; p = 0.02). Direct peritoneal resuscitation patients had enhanced effective hepatic blood flow and significantly higher organs transplanted per donor rates compared with controls (3.7 ± 1.7 vs 3.1 ± 1.3; p = 0.024). Direct peritoneal resuscitation reduced IV fluid requirement and IV pressor use as well as increased hepatic blood flow and organs transplanted per donor. Direct peritoneal resuscitation studies show it to be a safe, effective method to augment organ donor resuscitation and additional large-scale trials should be conducted to validate these findings. Copyright © 2015 American

  11. Donor Tag Game (United States)

    ... Donor Community > Games > Donor Tag Game Donor Tag Game This feature requires version 6 or later of ... of Needles LGBTQ+ Donors Blood Donor Community SleevesUp Games Facebook Avatars and Badges Banners eCards Make a ...

  12. Dead reckoner navigation project (United States)

    Ellis, R.; Sweet, L.


    A previous dead reckoner involved a classical gyrocompass, a Hewlett-Packard minicomputer, and a true airspeed sensor. In an effort to bring the cost of this system more in line with the realities of general aviation, recent work was done on replacing the minicomputer with a microcomputer and implementing a fluidic rate sensor in the compass system in place of the directional gyro.

  13. The Dead Sea (United States)


    The Dead Sea is the lowest point on Earth at 418 meters below sea level, and also one of the saltiest bodies of water on Earth with a salinity of about 300 parts-per-thousand (nine times greater than ocean salinity). It is located on the border between Jordan and Israel, and is fed by the Jordan River. The Dead Sea is located in the Dead Sea Rift, formed as a result of the Arabian tectonic plate moving northward away from the African Plate. The mineral content of the Dead Sea is significantly different from that of ocean water, consisting of approximately 53% magnesium chloride, 37% potassium chloride and 8% sodium chloride. In the early part of the 20th century, the Dead Sea began to attract interest from chemists who deduced that the Sea was a natural deposit of potash and bromine. From the Dead Sea brine, Israel and Jordan produce 3.8 million tons potash, 200,000 tons elemental bromine, 45,000 tons caustic soda, 25, 000 tons magnesium metal, and sodium chloride. Both countries use extensive salt evaporation pans that have essentially diked the entire southern end of the Dead Sea. With its 14 spectral bands from the visible to the thermal infrared wavelength region, and its high spatial resolution of 15 to 90 meters (about 50 to 300 feet), ASTER images Earth to map and monitor the changing surface of our planet. ASTER is one of five Earth-observing instruments launched December 18, 1999, on NASA's Terra satellite. The instrument was built by Japan's Ministry of Economy, Trade and Industry. A joint U.S./Japan science team is responsible for validation and calibration of the instrument and the data products. The broad spectral coverage and high spectral resolution of ASTER provides scientists in numerous disciplines with critical information for surface mapping, and monitoring of dynamic conditions and temporal change. Example applications are: monitoring glacial advances and retreats; monitoring potentially active volcanoes; identifying crop stress; determining

  14. Independent organ donor facilities: The future of organ donation? (United States)

    Bruzzone, Paolo


    Since 2001 independent Organ Donor Facilities(OFOs) have been proposed within Organ Procurement Organizations (OPOs) with the aim of reducing organ procurement costs 1, cold ischemia time of donor organs and the flight-related risk 2 for donor surgeons, perfusionists and coordinators. An independent OFO has been established in 2001 in St. Louis 3, half away between the 2 Transplant Centers (TCs) (Washington University School of Medicine and St. Louis University) and now includes a two-bed intensive care facility, a complete laboratory, a cardiac catheterization facility, a Computed Tomography (CT) scanner and an operating room. All brain-dead (BD) patients within OPO (Mid-America Transplant Services), after family's informed consent, are transferred, if necessary by an OPO owned and operated airplane, to this facility, where undergo multiorgan harvesting. By doing so the organ acquisition charges (OACs) apparently decreased, as well as delay in recovery, which can affect organ viability and move families to withdraw consent; also risks and tiring of transplant surgeons were reduced. This independent OFO successfully procured in 2001 not only livers, but also pancreas, kidneys, hearts and lungs 4-6. Cold ischemia time was reduced and there was no Primary Non Function (PNF) of harvested organs, but only kidney delayed graft function (DGF). In the past, heart donors were moved to the recipient's hospital. With the development of multiorgan harvesting, usually donor surgeons are sent by the TCs in order to evaluate liver, pancreas, heart and lungs, while the only local surgeons is the "nephrectomist", that in local hospital is not a transplant surgeon. To move a donor, although hemodinamically stable, is always a risk. Finally, the decrease of OAC must balance the extra expenses to create and operate independent OFOs. In all the papers published by the members of this OFO, the control group of the retrospective analysis consisted of less selected BD donors, requiring

  15. Successful unintentional ABO-incompatible renal transplantation: Blood group A1B donor into an A2B recipient. (United States)

    Fadeyi, Emmanuel A; Stratta, Robert J; Farney, Alan C; Pomper, Gregory J


    To report a successful unintentional transplantation of a deceased donor kidney from an "incompatible" A1B donor into a recipient who was blood group A2B with unsuspected preformed anti-A1 antibodies. The donor and recipient were both typed for ABO antigens. The recipient was tested for ABO and non-ABO antibodies. The recipient was typed for HLA class I and class II antigens, including HLA antibody screen. The T-and B-flow cytometry crossmatch test was performed using standard protocol. The donor-recipient pair was a complete six-antigen human leukocyte antigen mismatch, but final T- and B-flow cytometry cross-match tests were compatible. The recipient was a 65-year-old woman with a medical history of end-stage renal disease secondary to diabetic nephropathy who underwent kidney transplantation from a 46-year-old brain-dead standard criteria donor. The recipient's RBCs were negative with A1 lectin, and the recipient was thus typed as an A2 subgroup. Anti-A1 could be demonstrated in the recipient's plasma. The donor's RBCs were positive with A1 lectin, thereby conferring an A1 blood type. It is safe to transplant across the A1/A2 blood group barrier provided that the preformed antibodies are not reactive at 37°C and with anti-human globulin.

  16. Non heart-beating donors in England

    Directory of Open Access Journals (Sweden)

    Eleazar Chaib


    Full Text Available When transplantation started all organs were retrieved from patients immediately after cardio-respiratory arrest, i.e. from nonheart-beating donors. After the recognition that death resulted from irreversible damage to the brainstem, organ retrieval rapidly switched to patients certified dead after brainstem testing. These heart-beating-donors have become the principal source of organs for transplantation for the last 30 years. The number of heart-beating-donors are declining and this is likely to continue, therefore cadaveric organs from non-heart-beating donor offers a large potential of resources for organ transplantation. The aim of this study is to examine clinical outcomes of non-heart-beating donors in the past 10 years in the UK as an way of decreasing pressure in the huge waiting list for organs transplantation.

  17. Dead-ice environments

    DEFF Research Database (Denmark)

    Krüger, Johannes; Kjær, Kurt H.; Schomacker, Anders


    Kötlujökull transports considerable amounts of supraglacial debris at its snout because of frontal oscillations with frequent ice advances followed by ice-margin stagnation. Kötlujökull provides suitable conditions of studying dead-ice melting and landscape formation in a debris-charged lowland...... under humid, sub-polar conditions? Does this rate differ from rates reported from polar environments of dry continental nature? How will the sedimentary architecture appear in the geological record? How will the final landsystem appear? These key questions are answered in a review of research...... and conclusions on dead-ice melting and landscape formation from Kötlujökull. Processes and landform-sediment associations are linked to the current climate and glacier–volcano interaction....

  18. Dead-ice environments

    DEFF Research Database (Denmark)

    Krüger, Johannes; Kjær, Kurt H.; Schomacker, Anders


    Kötlujökull transports considerable amounts of supraglacial debris at its snout because of frontal oscillations with frequent ice advances followed by ice-margin stagnation. Kötlujökull provides suitable conditions of studying dead-ice melting and landscape formation in a debris-charged lowland...... glacier environment. The scientific challenges are to answer the key questions. What are the conditions for dead-ice formation? From which sources does the sediment cover originate? Which melting and reworking processes act in the ice-cored moraines? What is the rate of de-icing in the ice-cored moraines...... under humid, sub-polar conditions? Does this rate differ from rates reported from polar environments of dry continental nature? How will the sedimentary architecture appear in the geological record? How will the final landsystem appear? These key questions are answered in a review of research...

  19. A study on knowledge and attitude toward brain death and organ retrieval among health care professionals in Korea. (United States)

    Jeon, K O; Kim, B N; Kim, H S; Byeon, N-I; Hong, J J; Bae, S H; Son, S Y


    The practice of retrieving vital organs from brain-dead donors is legally and medically accepted in Korea, but health care professionals' beliefs and opinions regarding these matters have not been sufficiently explored. The purpose of this study was to evaluate the knowledge and attitudes of health care professionals to the concepts of brain death and organ retrieval. Data were collected using a 41-item questionnaire during a week in June 2011. Sixty-one doctors and 109 nurses from five hospitals with more than 2000 beds in Seoul, Korea, participated in the survey. The data was analyzed using SPSS version 17.0 (SPSS Inc. Chicago, Illinois, USA). There were statistically significant differences in the scores on knowledge according to marital status (P = .001) education level (P = .019), whether the participants were informed about organ donation from a brain-dead donor (P = .002), and the participant's experience managing potential brain-dead patients (P = .037). There were statistically significant differences in the scores on the attitude according to gender (P death and organ retrieval were not improved. There are passive attitudes to brain death and organ retrieval. More research must be performed to promote knowledge and understanding toward brain death and organ retrieval among health care professionals. Copyright © 2012 Elsevier Inc. All rights reserved.

  20. The Dead Walk

    Directory of Open Access Journals (Sweden)

    Bill Phillips


    Full Text Available Monsters have always enjoyed a significant presence in the human imagination, and religion was instrumental in replacing the physical horror they engendered with that of a moral threat. Zombies, however, are amoral – their motivation purely instinctive and arbitrary, yet they are, perhaps, the most loathed of all contemporary monsters. One explanation for this lies in the theory of the uncanny valley, proposed by robotics engineer Masahiro Mori. According to the theory, we reserve our greatest fears for those things which seem most human, yet are not – such as dead bodies. Such a reaction is most likely a survival mechanism to protect us from danger and disease – a mechanism even more essential when the dead rise up and walk. From their beginnings zombies have reflected western societies’ greatest fears – be they of revolutionary Haitians, women, or communists. In recent years the rise in the popularity of the zombie in films, books and television series reflects our fears for the planet, the economy, and of death itself

  1. Recruitment of feces donors among blood donors

    DEFF Research Database (Denmark)

    Dahl Jørgensen, Simon Mark; Erikstrup, Christian; Dinh, Khoa Manh


    As the use of fecal microbiota transplantation (FMT) has gained momentum, an increasing need for continuous access to healthy feces donors has developed. Blood donors constitute a healthy subset of the general population and may serve as an appropriate group for recruitment. In this study, we...... investigated the suitability of blood donors as feces donors. In a prospective cohort study, we recruited blood donors onsite at a public Danish blood bank. Following their consent, the blood donors underwent a stepwise screening process: First, blood donors completed an electronic pre-screening questionnaire...... to rule out predisposing risk factors. Second, eligible blood donors had blood and fecal samples examined. Of 155 blood donors asked to participate, 137 (88%) completed the electronic pre-screening questionnaire, 16 declined, and 2 were excluded. Of the 137 donors who completed the questionnaire, 79 (58...

  2. Brain death and related issues

    International Nuclear Information System (INIS)

    Akhtar, M.; Mushtaq, S.; Jamil, K.; Ahmed, S.


    Concerns about the erroneous diagnosis of death and premature burial have been expressed from times immemorial. Patients with brain stem death have absolutely no chance of recovery. Brain death is considered at par with death in most of the countries. General public in most parts of the world shows reluctance to accept this concept due to different social, cultural and religious backgrounds and state of literacy and awareness. The criteria for the diagnosis of brain death have been established which include certain pre-conditions, exclusions and tests of the brain stem function. These criteria are universally accepted. The criteria in children are somewhat different from the adults. The subject is intimately related with organ transplantation. If the patients is registered as organ donor or the family consents, organs can be harvested from brain dead patients for transplantation. Pakistan is amongst the few countries where no legislation exists to accept brain death as being at par with death of an individual, and to facilitate and regulate, cadaveric organ donation and transplantation. (author)

  3. Pensamento Lean e cuidado do paciente em morte encefálica no processo de doação de órgãos Pensamiento Lean y cuidado del paciente con muerte encefálica en el proceso de donación de órganos Lean thinking and brain-dead patient assistance in the organ donation process

    Directory of Open Access Journals (Sweden)

    Aline Lima Pestana


    transplantes.Organ donation is a complex process that challenges health system professionals and managers. This study aimed to introduce a theoretical model to organize brain-dead patient assistance and the organ donation process guided by the main lean thinking ideas, which enable production improvement through planning cycles and the development of a proper environment for successful implementation. Lean thinking may make the process of organ donation more effective and efficient and may contribute to improvements in information systematization and professional qualifications for excellence of assistance. The model is configured as a reference that is available for validation and implementation by health and nursing professionals and managers in the management of potential organ donors after brain death assistance and subsequent transplantation demands.

  4. Youth in Dead End

    Directory of Open Access Journals (Sweden)



    Full Text Available The primary factor to ensure economic and social development and also to build a healthy society is the education system which plays a significant role in human capital formation and shapes the social structure and its outputs. In this context, there are some risks threatening the youth that is trying to position itself on the education-employment line and some critical areas in need of national policy intervention as well. Hence, by analyzing indicators on education and labor force, this study aims to reveal the amount of youth under risk and to identify these critical areas, while targeting to highlight the urgent need for policy development focusing on youth in dead end. Within the study, it is emphasized that the education system causes youth to face with the problems of access and quality, and that there is a significant amount of youth not in education and employment, while underlining the necessity of bringing especially this inactive youth in economy in addition to equipping with required qualifications for their active participation in social life. Thus, in order to hinder human capital loss additionally, there is policy need in two directions, as focusing on the education system to prevent new hopeless generations on the one hand, and on the inclusion of the disadvantaged youth on the other.

  5. Issues in potential organ donor management. (United States)

    Razek, T; Olthoff, K; Reilly, P M


    The shortage of organ donors has become a serious problem in modern medicine. Room for improvement exists in our ability to convert potential donors to actual donors based on the available numbers and a significant amount of recent research. A significant percentage of the potential donors represent head-injured patients, so a significant amount of responsibility falls on surgeons to optimize the opportunity for donation. There are clear steps along the pathway from potential to actual donor where physicians can have a significant effect on the rate of successful donation: 1. Identify all potential donors and institute a review system to verify that all potential donors are being identified in your area. 2. Establish an acceptable method to rapidly and accurately determine brain death in potential donors using the local available services. 3. Approach all potential donor families for consent, decouple death notification and consent request, use a member of the hospital team and an OPO representative to approach the family, and make the request in a private setting. 4. Use an aggressive, proactive approach to the medical management of the potential donor using the techniques described to limit the number of medical failures and maximize the number of organs donated per donor. Institute a review process to evaluate any medical failures that occur. Given the difference between the numbers of potential versus actual donors, the authors' significant contact with potential donors, and the clear opportunities for improvement in their approach, the surgical community must address these issues surrounding the optimal management of potential donors and their families.

  6. Precise measurement of dead time

    International Nuclear Information System (INIS)

    Schoenfeld, E.; Janssen, H.


    Four methods are discussed by which dead times of the non-extending type can be determined experimentally. Two methods using statistical pulses were improved by eliminating uncertainties due to counting statistics. However, it was concluded from a comparison of the four methods that those using periodical pulses are not only less time-consuming but are preferable if high-precision values are aimed at. A dead-time unit with quartz oscillator-based dead times of the non-extending type was tested using all of the four methods. Measurements within a period of three years indicated that the unit investigated here has subnanosecond stability for each of the adjusted dead-time values. (orig.)

  7. Anthrax, People and Dead Hippos

    Centers for Disease Control (CDC) Podcasts


    Epidemiologist, Dr. Melissa Marx, discuses anthrax deaths in people who ate dead hippos.  Created: 11/7/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/7/2017.

  8. And the Dead Remain Behind

    Directory of Open Access Journals (Sweden)

    Peter Read


    Full Text Available In most cultures the dead and their living relatives are held in a dialogic relationship. The dead have made it clear, while living, what they expect from their descendants. The living, for their part, wish to honour the tombs of their ancestors; at the least, to keep the graves of the recent dead from disrepair. Despite the strictures, the living can fail their responsibilities, for example, by migration to foreign countries. The peripatetic Chinese are one of the few cultures able to overcome the dilemma of the wanderer or the exile. With the help of a priest, an Australian Chinese migrant may summon the soul of an ancestor from an Asian grave to a Melbourne temple, where the spirit, though removed from its earthly vessel, will rest and remain at peace. Amongst cultures in which such practices are not culturally appropriate, to fail to honour the family dead can be exquisitely painful. Violence is the cause of most failure.

  9. Organizational model for a national system of donation and transplantation from deceased donors in Nicaragua. (United States)

    García López, A; Gómez, M P


    System organization is one of the principal elements for success of a country's donation and transplantation activities. Nicaragua still does not have a specific institution that organizes and coordinates donation and transplantation; it does not perform transplantations from brain dead donors. With the counsel of the Transplant Coordination Service of the Hospital Clinic, Barcelona, Spain, we documented the current donation and transplant situation of Nicaragua, its health services and institutions, and their relevant demographic aspects. We analyzed some organizational models implemented around the world and in Latin America as well as the essential elements of "The Spanish Model", proposing an organizational model adapted to the Nicaraguan reality. For a small country with specialized services concentrated in the capital, Managua, we envisioned the creation of a two-tier system: First, a national cooordination of transplants who leads a group that is decentralized and subordinate to the hierarchy of the Ministry of Health, to organize and coordinate donation and transplantation activities. Second, a hospital coordinator who works with doctors in intensive care units and neurosurgical intensive care units to detect potential organ donors and communicate with the national coordinator of transplants, who directs the process. Nicaragua has the basic conditions for implementation of donation and transplantation from deceased donor, as well as institutions with the capacity to maintain their function as documented by this viable, functional organizational model. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Climate change and dead zones. (United States)

    Altieri, Andrew H; Gedan, Keryn B


    Estuaries and coastal seas provide valuable ecosystem services but are particularly vulnerable to the co-occurring threats of climate change and oxygen-depleted dead zones. We analyzed the severity of climate change predicted for existing dead zones, and found that 94% of dead zones are in regions that will experience at least a 2 °C temperature increase by the end of the century. We then reviewed how climate change will exacerbate hypoxic conditions through oceanographic, ecological, and physiological processes. We found evidence that suggests numerous climate variables including temperature, ocean acidification, sea-level rise, precipitation, wind, and storm patterns will affect dead zones, and that each of those factors has the potential to act through multiple pathways on both oxygen availability and ecological responses to hypoxia. Given the variety and strength of the mechanisms by which climate change exacerbates hypoxia, and the rates at which climate is changing, we posit that climate change variables are contributing to the dead zone epidemic by acting synergistically with one another and with recognized anthropogenic triggers of hypoxia including eutrophication. This suggests that a multidisciplinary, integrated approach that considers the full range of climate variables is needed to track and potentially reverse the spread of dead zones. © 2014 John Wiley & Sons Ltd.

  11. Factors associated with (un)willingness to be an organ donor: importance of public exposure and knowledge. (United States)

    Haustein, Silke V; Sellers, Marty T


    Transplantation is increasingly limited by the supply of donor organs. Identifying subgroups that do not support organ donation will allow targeted efforts to increase organ donation. A total of 185 non-acutely ill outpatients visiting a community physician's office voluntarily completed a survey designed to capture views and general knowledge/misconceptions about cadaveric organ donation/transplantation. Of 185 patients, 86 were willing to donate, 42 were unwilling, and 57 were unsure. Willingness to donate was significantly associated with: having discussed the topic with family; having known a cadaveric organ donor; age 55 yr; having graduated high school; recognizing the organ shortage as the primary problem in transplantation; having received a post-high school degree; having seen public information within 30 d; and having a family member in health care (all porgan allocation is based on race/income; organ donation is expensive for the donor family; designated donors may not receive full emergency room care; a brain-dead person can recover. Intense efforts to improve public awareness and knowledge about organ donation/transplantation are necessary to maximize donation and the overall success of transplantation.

  12. Process and barriers to organ donation and causes of brain death in northeast of Iran. (United States)

    Bahrami, Abdollah; Khaleghi, Ebrahim; Vakilzadeh, Ali Khorsand; Afzalaghaee, Monavar


    Organ transplantation is the treatment of choice for some diseases. However, the need for cadaveric organ donation has either plateaued or is on a decreasing trend in some countries, especially in developed ones. In this study, we aimed to identify the barriers to organ donation in brain dead patients, who were referred to the organ procurement organizations (OPO) in northeast Iran. In this cross-sectional study during 2006 to 2013, data were collected from medical records of brain dead patients. Demographic information, cause of brain death, the process of obtaining informed consent, and the reasons for declining organ donation were obtained from the OPO records. The data were analyzed using chi-square test by SPSS 13 software. Of 1034 brain dead patients, 751 cases (72.6%) were eligible for organ donation, and, ultimately, 344 cases underwent organ donation. The rate of organ donation increased during the course of the study; medical and legal reasons as well as family refusal to authorize donation were the main barriers to the process. Based on the pattern of mortality, the need for living donors in developing countries, such as Iran and other countries in the Mediterranean region, can be reduced by improving the quality of healthcare, efficient identification of brain death, and obtaining consent with appropriate strategies.

  13. Nyretransplantation med levende donor

    DEFF Research Database (Denmark)

    Kamper, A L; Løkkegaard, H; Rasmussen, F


    In recent years transplantation from living donors has accounted for 25-30% of all kidney transplants in Denmark corresponding to 40-45 per year. Most of these living donors are parents or siblings, although internationally an increasing number are unrelated donors. Donor nephrectomy is associated...

  14. Dead sea asphalts: historical aspects

    Energy Technology Data Exchange (ETDEWEB)

    Nissenbaum, A.


    Asphalts are present in the Dead Sea basin in three forms: (1) huge blocks, up to 100 tons in weight, composed of extremely pure (>99.99%) solid asphalt occasionally found floating on the lake, (2) veins, seepages, and cavity and fissure fillings in Lower Cretaceous to Holocene rocks, and (3) ozocerite veins on the eastern shore of the lake. Dead Sea asphalts probably have been documented over a longer period of time than any other hydrocarbon deposit--from antiquity to the 19th century. Major uses of asphalt from the Dead Sea have been as an ingredient in the embalming process, for medicinal purposes, for fumigation, and for agriculture. The first known war for control of a hydrocarbon deposit was in the Dead Sea area in 312 B.C. between the Seleucid Syrians and the Nabatean Arabs who lived around the lake. Surface manifestations of asphalt are linked closely to tectonic activity. In the lake itself, the asphalt is associated with diapirs During certain historic periods, tectonic and diapiric activity caused frequent liberation to the Dead Sea surface of semiliquid asphalt associated with large amounts of hydrogen sulfide gas. When the tectonic activity was attenuated, as in the 19th and 20th centuries, the rate of asphalt seepage to the bottom sediments of the Dead Sea was much slower and the asphalt solidified on the lake bottom. The release of asphalt to the surface became much more sporadic, and may have resulted in part from earthquakes. Thus, future asphalt prospecting in the Dead Sea area should be conducted along the boundaries of diapirs or their associated faults.

  15. Organ donors: deceased or alive? Quo vadis? (United States)

    Rozental, R


    Irrespectively of universal shortage of donor organs there is a tendency of increasing the number of transplantations from living and deceased donors. Each of these two methods has positive and negative features. The main obstacles using living donors are health hazard, necessity to solve certain donor's social and psychological problems, possibility of organ trade and moving. The main problems connected with organ retrieval from deceased donors are possible conflicts with public opinion: difficulties in interpretation of brain death, legislation, obtaining of informed consent from donor's relatives, etc. Future progress in organ transplantation may take place through activation of organ retrieval from deceased donors. The most perspective ways are change to presumed consent in all countries, establishing of centralized system of donor detection and registration, intensification of transplant coordination, active contacts with mass-media, etc. It is necessary to increase (enhance) participation of the members of the public in organ donation process, to develop solidarity among the public members and to involve public authorities to deal with this problem. Bioethical standards should be put in accordance with common progress and some ethical traditions should be changed.

  16. The Right to be Dead

    DEFF Research Database (Denmark)

    Sabra, Jakob Borrits; Troyer, John Eric


    -mortem handling of their exponentially increased digital data. The European Union Court of Justice ruled that a person has a Right to be Forgotten on the world wide web. The Future Cemetery asks: Does a person have the Right to be Dead on this information superhighway? Our essay pursues these specific lines...

  17. Hypothermic oxygenated machine perfusion (HOPE) for orthotopic liver transplantation of human liver allografts from extended criteria donors (ECD) in donation after brain death (DBD): a prospective multicentre randomised controlled trial (HOPE ECD-DBD) (United States)

    Czigany, Zoltan; Schöning, Wenzel; Ulmer, Tom Florian; Bednarsch, Jan; Amygdalos, Iakovos; Cramer, Thorsten; Rogiers, Xavier; Popescu, Irinel; Botea, Florin; Froněk, Jiří; Kroy, Daniela; Koch, Alexander; Tacke, Frank; Trautwein, Christian; Tolba, Rene H; Hein, Marc; Koek, Ger H; Dejong, Cornelis H C; Neumann, Ulf Peter; Lurje, Georg


    Introduction Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts. Hypothermic oxygenated machine perfusion (HOPE) has been successfully tested in preclinical experiments and in few clinical series of donation after cardiac death OLT. Methods and analysis HOPE ECD-DBD is an investigator-initiated, open-label, phase-II, prospective multicentre randomised controlled trial on the effects of HOPE on ECD allografts in donation after brain death (DBD) OLT. Human whole organ liver grafts will be submitted to 1–2 hours of HOPE (n=23) via the portal vein before implantation and are going to be compared with a control group (n=23) of patients transplanted after conventional cold storage. Primary (peak and Δ peak alanine aminotransferase within 7 days) and secondary (aspartate aminotransferase, bilirubin and international normalised ratio, postoperative complications, early allograft dysfunction, duration of hospital and intensive care unit stay, 1-year patient and graft survival) endpoints will be analysed within a 12-month follow-up. Extent of ischaemia–reperfusion (I/R) injury will be assessed using liver tissue, perfusate, bile and serum samples taken during the perioperative phase of OLT. Ethics and dissemination The study was approved by the institutional review board of the RWTH Aachen University, Aachen, Germany (EK 049/17). The current paper represent the pre-results phase. First results are expected in 2018. Trial registration number NCT03124641. PMID:29018070

  18. 7 CFR 322.29 - Dead bees. (United States)


    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Dead bees. 322.29 Section 322.29 Agriculture..., DEPARTMENT OF AGRICULTURE BEES, BEEKEEPING BYPRODUCTS, AND BEEKEEPING EQUIPMENT Importation and Transit of Restricted Articles § 322.29 Dead bees. (a) Dead bees imported into or transiting the United States must be...

  19. Global risk of deadly heat (United States)

    Mora, Camilo; Dousset, Bénédicte; Caldwell, Iain R.; Powell, Farrah E.; Geronimo, Rollan C.; Bielecki, Coral R.; Counsell, Chelsie W. W.; Dietrich, Bonnie S.; Johnston, Emily T.; Louis, Leo V.; Lucas, Matthew P.; McKenzie, Marie M.; Shea, Alessandra G.; Tseng, Han; Giambelluca, Thomas W.; Leon, Lisa R.; Hawkins, Ed; Trauernicht, Clay


    Climate change can increase the risk of conditions that exceed human thermoregulatory capacity. Although numerous studies report increased mortality associated with extreme heat events, quantifying the global risk of heat-related mortality remains challenging due to a lack of comparable data on heat-related deaths. Here we conducted a global analysis of documented lethal heat events to identify the climatic conditions associated with human death and then quantified the current and projected occurrence of such deadly climatic conditions worldwide. We reviewed papers published between 1980 and 2014, and found 783 cases of excess human mortality associated with heat from 164 cities in 36 countries. Based on the climatic conditions of those lethal heat events, we identified a global threshold beyond which daily mean surface air temperature and relative humidity become deadly. Around 30% of the world's population is currently exposed to climatic conditions exceeding this deadly threshold for at least 20 days a year. By 2100, this percentage is projected to increase to ~48% under a scenario with drastic reductions of greenhouse gas emissions and ~74% under a scenario of growing emissions. An increasing threat to human life from excess heat now seems almost inevitable, but will be greatly aggravated if greenhouse gases are not considerably reduced.

  20. Electronic fingerprinting of the dead. (United States)

    Rutty, G N; Stringer, K; Turk, E E


    To date, a number of methods exist for the capture of fingerprints from cadavers that can then be used in isolation as a primary method for the identification of the dead. We report the use of a handheld, mobile wireless unit used in conjunction with a personal digital assistant (PDA) device for the capture of fingerprints from the dead. We also consider a handheld single-digit fingerprint scanner that utilises a USB laptop connection for the electronic capture of cadaveric fingerprints. Both are single-operator units that, if ridge detail is preserved, can collect a 10-set of finger pad prints in approximately 45 and 90 s, respectively. We present our observations on the restrictions as to when such devices can be used with cadavers. We do, however, illustrate that the images are of sufficient quality to allow positive identification from finger pad prints of the dead. With the development of mobile, handheld, biometric, PDA-based units for the police, we hypothesize that, under certain circumstances, devices such as these could be used for the accelerated acquisition of fingerprint identification data with the potential for rapid near-patient identification in the future.

  1. Noneligible Donors as a Strategy to Decrease the Organ Shortage. (United States)

    Croome, K P; Lee, D D; Keaveny, A P; Taner, C B


    Organ procurement organization (OPO) performance is generally evaluated by the number of organ procurement procedures divided by the number of eligible deaths (donation after brain death [DBD] donors aged donation after cardiac death donors and DBD donors aged >70 years) is not tracked. The present study aimed to investigate the variability in the proportion of noneligible liver donors by the 58 donor service areas (DSAs). Patients undergoing liver transplant (LT) between 2011 and 2015 were obtained from the United Network for Organ Sharing Standard Transplant Analysis and Research file. LTs from noneligible and eligible donors were compared. The proportion of noneligible liver donors by DSA varied significantly, ranging from 0% to 19.6% of total liver grafts used. In transplant programs, the proportion of noneligible liver donors used ranged from 0% to 35.3%. On linear regression there was no correlation between match Model for End-Stage Liver Disease score for programs in a given DSA and proportion of noneligible donors used from the corresponding DSA (p = 0.14). Noneligible donors remain an underutilized resource in many OPOs. Policy changes to begin tracking noneligible donors and learning from OPOs that have high noneligible donor usage are potential strategies to increase awareness and pursuit of these organs. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  2. Nyretransplantation med levende donor

    DEFF Research Database (Denmark)

    Kamper, A L; Løkkegaard, H; Rasmussen, F


    In recent years transplantation from living donors has accounted for 25-30% of all kidney transplants in Denmark corresponding to 40-45 per year. Most of these living donors are parents or siblings, although internationally an increasing number are unrelated donors. Donor nephrectomy is associate...... in cadaver transplantation. The ethical and psychological aspects related to transplantation from a living donor are complex and need to be carefully evaluated when this treatment is offered to the patients.......In recent years transplantation from living donors has accounted for 25-30% of all kidney transplants in Denmark corresponding to 40-45 per year. Most of these living donors are parents or siblings, although internationally an increasing number are unrelated donors. Donor nephrectomy is associated...... with only few complications. The long-term outcome for kidney donors is good without increase in mortality or risk for development of hypertension and renal failure; proteinuria may be seen. Living kidney transplantation is the optimal treatment of end-stage renal disease with better graft survival than...

  3. Higher organ donation consent rates by relatives of potential uncontrolled donors versus potential controlled donors after death. (United States)

    Wind, Jentina; van Mook, Walther N K A; Willems, Monique E C; van Heurn, L W Ernest


    Refusal to consent to organ donation is an important cause of the persisting gap between the number of potential organ donors and effectuated donors. In the Netherlands, organ donors include both uncontrolled donors: donors who die unexpectedly after cardiac death (DCD), after failed resuscitation and donors in whom death can be expected and donors after brain death, and controlled DCD donors: those who die after the withdrawal of treatment. Different donor type implies a different setting in which relatives are requested to consent to organ donation. It is unknown whether the setting influences the eventual decision for donation or not. Therefore, we compared the consent rate in potential donors who died unexpectedly (UD group) and in whom death was expected. A total of 523 potential organ donors between 2003 and 2011 in the 715-bed Maastricht University Medical Centre, the Netherlands were included. Both the patients' registration in the national donor register (DR) and the relatives' refusal rate in the two groups were retrospectively assessed using data from the donation application database. There were 109 unexpected and 414 expected potential donors The potential donors in the UD group were younger (mean age 52 versus 55 years, P = 0.032) and more often male (68 versus 52%, P = 0.003). There were no significant differences in registration in the DR between the groups. The relatives' consent rate in non-registered potential donors, or those who mandated the relatives for that decision, was higher in the UD group (53 versus 29%, P organ donation. The relatives of potential donors who died unexpectedly consented more often to donation than those in whom death was expected.

  4. Laparoscopic donor nephrectomy

    Directory of Open Access Journals (Sweden)

    Gupta Nitin


    Full Text Available Of the various options for patients with end stage renal disease, kidney transplantation is the treatment of choice for a suitable patient. The kidney for transplantation is retrieved from either a cadaver or a live donor. Living donor nephrectomy has been developed as a method to address the shortfall in cadaveric kidneys available for transplantation. Laparoscopic living donor nephrectomy (LLDN, by reducing postoperative pain, shortening convalescence, and improving the cosmetic outcome of the donor nephrectomy, has shown the potential to increase the number of living kidney donations further by removing some of the disincentives inherent to donation itself. The technique of LLDN has undergone evolution at different transplant centers and many modifications have been done to improve donor safety and recipient outcome. Virtually all donors eligible for an open surgical procedure may also undergo the laparoscopic operation. Various earlier contraindications to LDN, such as right donor kidney, multiple vessels, anomalous vasculature and obesity have been overcome with increasing experience. Laparoscopic live donor nephrectomy can be done transperitoneally or retroperitoneally on either side. The approach is most commonly transperitoneal, which allows adequate working space and easy dissection. A review of literature and our experience with regards to standard approach and the modifications is presented including a cost saving model for the developing countries. An assessment has been made, of the impact of LDN on the outcome of donor and the recipient.

  5. Vasopressin serum levels in patients with severe brain lesions and in brain-dead patients Níveis séricos de arginina vasopressina em pacientes com lesão cerebral grave e em pacientes com morte encefálica

    Directory of Open Access Journals (Sweden)

    Eliane de Araújo Cintra


    Full Text Available INTRODUCTION: Patients with severe brain lesions (SBL and brain-dead patients (BD frequently present with vasopressin (AVP secretion disorders. OBJECTIVE: To evaluate AVP serum levels in SBL and BD patients. DESIGN: Prospective, open label, observational trial. SETTING: A general teaching hospital. METHOD: Three groups of adult subjects (age> 18y of both sexes were included in this study: control group: 29 healthy volunteers; SBL group: 17 patients with Glasgow Coma Scale (GCSINTRODUÇÃO: Pacientes com lesão cerebral grave (LCG ou com morte encefálica (ME freqüentemente apresentam alterações na secreção de vasopressina (AVP. OBJETIVO: Avaliar os níveis séricos de AVP em pacientes com LCG e ME. DESENHO: Estudo prospectivo, aberto, observacional. LOCAL: Um hospital geral universitário. MÉTODO: Sujeitos adultos (idade >18 anos, de ambos os sexos, foram divididos em três grupos: grupo controle: 29 voluntários sadios; grupo LCG: 17 pacientes com pontuação na Escala de Coma de Glasgow (ECG<8; grupo ME: 11 pacientes com diagnóstico de ME. Amostras de sangue venoso foram colhidas pela manhã, em repouso, nos pacientes do grupo controle, e de 8/8h, por 24h, nos pacientes dos grupos LCG e ME, para dosagens de AVP. Variáveis clínicas e laboratoriais de interesse foram anotadas concomitantemente. RESULTADOS: Os valores da AVP (pg/ml foram [média (DP; mediana]: grupo controle [2,2(1,1; 2,0]; grupo LCG [5,7(6,3; 2,9] e grupo ME [2,6(1,0; 2,8]. Observou-se maior variação dos níveis séricos de AVP no grupo LCG, mas sem diferença estatisticamente significativa em relação aos demais (p=0,06. Hipotensão (p=0,02, hipernatremia (p=0,0001, hiperosmolaridade sérica (p=0,0001 e hiposmolaridade urinária (p=0,003 foram proeminentes no grupo ME em relação ao grupo LCG. CONCLUSÃO: Não foram encontradas diferenças estatisticamente significativas nos níveis de AVP entre os grupos, notando-se apenas uma maior variação de seus níveis s

  6. Dead time of dual detector tools

    International Nuclear Information System (INIS)

    Czubek, J.A.


    A theory of the dead time for the dual detector nuclear tool with the analogue signal transmission is given in the paper. At least two different times exist in such tools: the dead time of detectors (for final computation they assumed identical to each other) and the dead time of the signal transmission set-up. A method of two radioactive sources is proposed to measure these two different dead times. When the times used for measuring every countrate needed in the dead time determination algorithm are taken into account, the statistical accuracy of the dead time determination can be obtained. These estimations are performed by the computer simulation method. Two codes have been designed: DEADT2D (DEAD Time for 2 Detectors) and DEADT2DS (DEAD Time for 2 Detectors with Statistics). The first code calculates the dead time based on the recorded countrates only, the second is doing a 'simulation job' and provides information on the statistical distribution of the observed dead times. The theory and the numerical solutions were checked both by the simulation calculations and by the experiments performed with the ODSN-102 tool (the experiments were performed by T. Zorski). (Author)

  7. Systems of donor transfer

    NARCIS (Netherlands)

    F.T. de Charro (Frank); J.E.M. Akveld (Hans); E. Hessing (Ellen)


    textabstractThe development of medical knowledge has resulted in a demand in society for donor organs, but the recruitment of donor organs for transplantation is difficult. This paper aims to provide some general insights into the complex interaction processes involved. A laissez-faire policy, in

  8. Dealing with Donor Anger. (United States)

    McNamee, Mike


    Techniques that reduce donors' resistance to college fund-raising requests, either direct mail or telephone solicitations, are offered. These include: respecting the prospects' concerns about privacy; offering nonintrusive giving options; honesty and clarity of communication; reinforcing donor sense of control; connecting with prospects'…

  9. The impact of meeting donor management goals on the number of organs transplanted per donor: results from the United Network for Organ Sharing Region 5 prospective donor management goals study. (United States)

    Malinoski, Darren J; Patel, Madhukar S; Daly, Michael C; Oley-Graybill, Chrystal; Salim, Ali


    donor management goals achieved from consent to 12-18 hrs later (odds ratio=1.13 per additional donor management goal). Meeting donor management goals prior to consent and prior to organ recovery were both associated with achieving ≥4 organs transplanted per donor. However, only 15% of donors have donor management goals met at the time of consent. The donor hospital management of patients with catastrophic brain injuries, before the intent to donate organs is known, affects outcomes and should remain a priority in the intensive care unit.

  10. Donor-derived aspergillosis from use of a solid organ recipient as a multiorgan donor. (United States)

    Mueller, N J; Weisser, M; Fehr, T; Wüthrich, R P; Müllhaupt, B; Lehmann, R; Imhof, A; Aubert, J-D; Genoni, M; Kunz, R; Weber, M; Steiger, J


    The growing need for organs and the scarcity of donors has resulted in an increased use of extended criteria donors. We report a case where a recipient of a cardiac graft was used as an organ donor. Death of the recipient occurred 9 days after transplantation and was attributed to presumed cerebral hemorrhage, which post mortem was diagnosed as invasive aspergillosis of the brain. One recipient of a kidney transplant lost the graft due to infection with Aspergillus fumigatus, whereas prompt initiation of therapy successfully prevented disseminated aspergillosis in the other recipients. Despite the pressure to extend the use of organs by lowering the acceptance criteria, organs should only be accepted if the cause of death of the donors is unequivocally explained.

  11. Marginal kidney donor

    Directory of Open Access Journals (Sweden)

    Ganesh Gopalakrishnan


    Full Text Available Renal transplantation is the treatment of choice for a medically eligible patient with end stage renal disease. The number of renal transplants has increased rapidly over the last two decades. However, the demand for organs has increased even more. This disparity between the availability of organs and waitlisted patients for transplants has forced many transplant centers across the world to use marginal kidneys and donors. We performed a Medline search to establish the current status of marginal kidney donors in the world. Transplant programs using marginal deceased renal grafts is well established. The focus is now on efforts to improve their results. Utilization of non-heart-beating donors is still in a plateau phase and comprises a minor percentage of deceased donations. The main concern is primary non-function of the renal graft apart from legal and ethical issues. Transplants with living donors outnumbered cadaveric transplants at many centers in the last decade. There has been an increased use of marginal living kidney donors with some acceptable medical risks. Our primary concern is the safety of the living donor. There is not enough scientific data available to quantify the risks involved for such donation. The definition of marginal living donor is still not clear and there are no uniform recommendations. The decision must be tailored to each donor who in turn should be actively involved at all levels of the decision-making process. In the current circumstances, our responsibility is very crucial in making decisions for either accepting or rejecting a marginal living donor.

  12. Coincidence-counting corrections for accidental coincidences, set dead time and intrinsic dead time

    International Nuclear Information System (INIS)

    Wyllie, H.A.


    An equation is derived for calculating the radioactivity of a source from the results of coincidence counting, taking into account dead-time losses and accidental coincidences. The corrections allow for the extension of the set dead time in the p channel by the intrinsic dead time. Experimental verification shows improvement over a previous equation. (author)

  13. Raising the Dead without a Red Sea-Dead Sea project? Hydro-economics and governance

    Directory of Open Access Journals (Sweden)

    D. E. Rosenberg


    Full Text Available Seven decades of extractions have dramatically reduced Jordan River flows, lowered the Dead Sea level, opened sink holes, and caused other environmental problems. The fix Jordan, Israel, and the Palestinians propose would build an expensive multipurpose conveyance project from the Red Sea to the Dead Sea that would also generate hydropower and desalinate water. This paper compares the Red-Dead project to alternatives that may also raise the Dead Sea level. Hydro-economic model results for the Jordan-Israel-Palestinian inter-tied water systems show two restoration alternatives are more economically viable than the proposed Red-Dead project. Many decentralized new supply, wastewater reuse, conveyance, conservation, and leak reduction projects and programs in each country can together increase economic benefits and reliably deliver up to 900 MCM yr−1 to the Dead Sea. Similarly, a smaller Red-Dead project that only generates hydropower can deliver large flows to the Dead Sea when the sale price of generated electricity is sufficiently high. However, for all restoration options, net benefits fall and water scarcity rises as flows to the Dead Sea increase. This finding suggests (i each country has no individual incentive to return water to the Dead Sea, and (ii outside institutions that seek to raise the Dead must also offer countries direct incentives to deliver water to the Sea besides building the countries new infrastructure.

  14. Brain Tumors and Fatigue (United States)

    ... can help calm the mind. Meditation, guided imagery, music therapy, and yoga are just a few worth investigating. Home Donor and Privacy Policies Find Resources Disclaimer Donate Subscribe Login American Brain Tumor Association 8550 W. Bryn Mawr Ave. Ste ...

  15. Pregnant, dead, and on a ventilator: A few thoughts in response to ...

    African Journals Online (AJOL)

    these procedures prove life-saving, and the patient recovers fully; at other times, however, life-extending treatment is futile, such as when the patient is declared brain dead. Advances in reproductive technologies, similarly, have been able bring hope by treating and curing infertility. This article responds to an article by ...

  16. A deadly combination of AIDS, TB and cardiac tumour. (United States)

    Sahasrabudhe, Tushar Ramesh


    Immunocompromised status in AIDS makes differential diagnosis of any symptom very difficult for a clinician. Sharp clinical judgement and plenty of investigations may be needed to reach the diagnosis, as in this case. We hereby present a case of AIDS and active tuberculosis (TB) under treatment. The patient developed acute onset multifocal neurological symptoms following an episode of fever and diarrhoea. The MRI scan revealed numerous large cerebral infarcts. On investigations to evaluate brain infarcts, we made a diagnosis of left atrial cardiac tumour. Association of cardiac tumours with AIDS has only been rarely reported. It is uncertain if these can be opportunistic tumours in AIDS. The patient successfully came out of this deadly combination of diseases, viz AIDS, TB and large brain infarcts due to atrial tumour; with almost complete recovery.

  17. Independent donor ethical assessment: aiming to standardize donor advocacy. (United States)

    Choudhury, Devasmita; Jotterand, Fabrice; Casenave, Gerald; Smith-Morris, Carolyn


    Living organ donation has become more common across the world. To ensure an informed consent process, given the complex issues involved with organ donation, independent donor advocacy is required. The choice of how donor advocacy is administered is left up to each transplant center. This article presents the experience and process of donor advocacy at University of Texas Southwestern Medical Center administered by a multidisciplinary team consisting of physicians, surgeons, psychologists, medical ethicists and anthropologists, lawyers, a chaplain, a living kidney donor, and a kidney transplant recipient. To ensure that advocacy remains fair and consistent for all donors being considered, the donor advocacy team at University of Texas Southwestern Medical Center developed the Independent Donor Ethical Assessment, a tool that may be useful to others in rendering donor advocacy. In addition, the tool may be modified as circumstances arise to improve donor advocacy and maintain uniformity in decision making.

  18. Measurement of the Dead-Time in a Multichannel Analyser

    DEFF Research Database (Denmark)

    Mortensen, L.; Olsen, J.


    By means of two simple measurements three different dead-times are determined: the normal dead-time, a dead-time coming from the pile-up, and a dead-time due to the finite width of the timing pulses.......By means of two simple measurements three different dead-times are determined: the normal dead-time, a dead-time coming from the pile-up, and a dead-time due to the finite width of the timing pulses....

  19. Dead pixel replacement in LWIR microgrid polarimeters. (United States)

    Ratliff, Bradley M; Tyo, J Scott; Boger, James K; Black, Wiley T; Bowers, David L; Fetrow, Matthew P


    LWIR imaging arrays are often affected by nonresponsive pixels, or "dead pixels." These dead pixels can severely degrade the quality of imagery and often have to be replaced before subsequent image processing and display of the imagery data. For LWIR arrays that are integrated with arrays of micropolarizers, the problem of dead pixels is amplified. Conventional dead pixel replacement (DPR) strategies cannot be employed since neighboring pixels are of different polarizations. In this paper we present two DPR schemes. The first is a modified nearest-neighbor replacement method. The second is a method based on redundancy in the polarization measurements.We find that the redundancy-based DPR scheme provides an order-of-magnitude better performance for typical LWIR polarimetric data.

  20. Surviving Sepsis: Taming a Deadly Immune Response (United States)

    ... Issues Subscribe August 2014 Print this issue Surviving Sepsis Taming a Deadly Immune Response En español Send ... Mouth? Looking at Lupus Wise Choices Signs of Sepsis Sepsis can be hard to spot, because its ...

  1. Dead Trees Bring Life to Forest Critters (United States)

    Thomas Nicholls; Mike Ostry


    What good is a dying or dead tree in a forest? Dead and dying trees don't awe us with their beauty; they just stand or lie there on the forest floor, offering no promise of lumber or other wood products we need. But if we look more closely at such trees, we may see lots of life in them: a raccoon family huddled in a burrow, a downy woodpecker excavating another...

  2. Dead reckoning and distributed interactive simulation (United States)

    Lin, Kuo-Chi


    This paper analyzes the use of dead reckoning in Distributed Interactive Simulation. The purpose of dead reckoning is to reduce the updates required by each simulator on the network to better utilize the available bandwidth. Extrapolation formulas are derived and discussed based on network communication traffic and the amount of computation performed by simulators. Smoothing and delay compensation algorithms are also discussed. Numerical and human perspective experiment are conducted. A software tool that assesses the performance of the read reckoning algorithm is introduced.


    CERN Document Server


    Wednesday 13 November 2002 in restaurant nr 2, from 8.30 to 16.30 hrs will be held a blood donors campaign, organized by the Etablissement de Transfusion de Haute-Savoie If you already have a card giving your blood group, please bring this with you.


    CERN Multimedia

    Medical Service


    Tuesday 19 March 2002 in restaurant nr 2, from 9.00 to 16.30 hrs A blood donors campaign, organized by the Centre de Transfusion sanguine of Geneva If you already have a card giving your blood group, please bring this with you.


    CERN Document Server


    A blood donors campaign, organized by the Centre de Transfusion Sanguine of Geneva will be held at CERN on Tuesday 13 March 2001 in restaurant nr 2, from 9.00 to 16.30 hrs If you already have a card giving your blood group, please bring this with you.


    CERN Document Server


    A blood donors campaign, organized by the Centre de Transfusion d'Annemasse will be held at CERN on Tuesday 14 November 2001 in restaurant nr 2, from 9.00 to 16.30 hrs If you already have a card giving your blood group, please bring this with you.


    CERN Document Server


    A blood donors campaign, organized by the Établissement de Transfusion de Rhône-Alpes will be held at CERN on Tuesday 14 November 2000 in restaurant nr 2, from 8.30 to 16.30 hrs If you already have a card giving your blood group, please bring this with you.

  8. Is the Aluminum Hypothesis Dead? (United States)


    The Aluminum Hypothesis, the idea that aluminum exposure is involved in the etiology of Alzheimer disease, dates back to a 1965 demonstration that aluminum causes neurofibrillary tangles in the brains of rabbits. Initially the focus of intensive research, the Aluminum Hypothesis has gradually been abandoned by most researchers. Yet, despite this current indifference, the Aluminum Hypothesis continues to attract the attention of a small group of scientists and aluminum continues to be viewed with concern by some of the public. This review article discusses reasons that mainstream science has largely abandoned the Aluminum Hypothesis and explores a possible reason for some in the general public continuing to view aluminum with mistrust. PMID:24806729

  9. Donor transplant programme

    International Nuclear Information System (INIS)

    Abu Bakar Sulaiman


    The transplantation of organs and tissues from one human to another human has become an essential and well established form of therapy for many types of organ and tissue failure. In Malaysia, kidney, cornea and bone marrow transplantation are well established. Recently, liver, bone and heart transplanation have been performed. Unfortunately, because of the lack of cadaveric organ donation, only a limited number of solid organ transplantation have been performed. The cadaveric organ donor rate in Malaysia is low at less than one per million population. The first tissue transplanted in Malaysia was the cornea which was performed in the early 1970s. At that time and even now the majority of corneas came from Sri Lanka. The first kidney transplant was performed in 1975 from a live related donor. The majority of the 629 kidney transplants done at Hospital Kuala Lumpur to date have been from live related donors. Only 35 were from cadaver donors. Similarly, the liver transplantation programme which started in 1995 are from live related donors. A more concerted effort has been made recently to increase the awareness of the public and the health professionals on organ and tissue donation. This national effort to promote organ and tissue donation seems to have gathered momentum in 1997 with the first heart transplant successfully performed at the National Heart Institute. The rate of cadaveric donors has also increased from a previous average of I to 2 per year to 6 per year in the last one year. These developments are most encouraging and may signal the coming of age of our transplantati on programme. The Ministry of Health in conjunction with various institutions, organizations and professional groups, have taken a number of proactive measures to facilitate the development of the cadaveric organ donation programme. Efforts to increase public awareness and to overcome the negative cultural attitude towards organ donation have been intensified. Equally important are efforts

  10. Generation of viable progeny from dead brooders of endangered catfish Clarias magur (Hamilton, 1822

    Directory of Open Access Journals (Sweden)

    Sullip Kumar Majhi


    Full Text Available The obligatory air-breathing catfish Clarias magur is a prime candidate for aquaculture owing to its unique taste, high growth rate, and hardy nature. However, recently the IUCN has listed the species under the endangered category because the population has critically declined in the wild. The sexually mature C. magur brooders are often collected from their natural habitats for seed production in captivity. In many cases, the brooder dies due to handling injuries or confinement stress. In this study, we demonstrated that viable progeny could be generated from freshly dead sexually mature C. magur. Three hours after death, the gonads were excised, macroscopically examined and gamete viability was evaluated. Artificial fertilization was performed by mixing the sperm suspension with the eggs. Water was added after 1 min of mixing to activate the fertilization process. We observed 85%-93% fertilization success from gametes derived from dead donors as opposed to 90%-95% from those derived from live control donors. The embryos showed normal development and resulted in the generation of 88%-92% viable progeny, which was similar to the progeny derived from control donors (92%-93%. The results obtained in this study will have profound implications in enhancing the seed production of endangered C. magur and could potentially be applied to other key commercially or endangered fish species. Keywords: Biological sciences, Developmental biology, Zoology

  11. Generation of viable progeny from dead brooders of endangered catfish Clarias magur (Hamilton, 1822). (United States)

    Majhi, Sullip Kumar; Kumar, Santosh


    The obligatory air-breathing catfish Clarias magur is a prime candidate for aquaculture owing to its unique taste, high growth rate, and hardy nature. However, recently the IUCN has listed the species under the endangered category because the population has critically declined in the wild. The sexually mature C. magur brooders are often collected from their natural habitats for seed production in captivity. In many cases, the brooder dies due to handling injuries or confinement stress. In this study, we demonstrated that viable progeny could be generated from freshly dead sexually mature C. magur . Three hours after death, the gonads were excised, macroscopically examined and gamete viability was evaluated. Artificial fertilization was performed by mixing the sperm suspension with the eggs. Water was added after 1 min of mixing to activate the fertilization process. We observed 85%-93% fertilization success from gametes derived from dead donors as opposed to 90%-95% from those derived from live control donors. The embryos showed normal development and resulted in the generation of 88%-92% viable progeny, which was similar to the progeny derived from control donors (92%-93%). The results obtained in this study will have profound implications in enhancing the seed production of endangered C. magur and could potentially be applied to other key commercially or endangered fish species.

  12. Donor conversion and procurement failure: the fate of our potential organ donors. (United States)

    Branco, Bernardino C; Inaba, Kenji; Lam, Lydia; Salim, Ali; Barmparas, Galinos; Teixeira, Pedro G R; Talving, Peep; Demetriades, Demetrios


    Donor availability remains the primary limiting factor for organ transplantation today. The purpose of this study was to examine the causes of procurement failure amongst potential organ donors. After Institutional Review Board approval, all surgical intensive care unit (SICU) patients admitted to the LAC+USC Medical Center from 01/2006 to 12/2008 who became potential organ donors were identified. Demographics, clinical data, and procurement data were abstracted. In non-donors, the causes of procurement failure were documented. During the 3-year study period, a total of 254 patients were evaluated for organ donation. Mean age was 44.8±18.7 years; 191 (75.2%) were male, 136 (53.5%) were Hispanic, and 148 (58.3%) were trauma patients. Of the 254 patients, 116 (45.7%) were not eligible for donation: 34 had multi-system organ failure, 24 did not progress to brain death and had support withdrawn, 18 had uncontrolled sepsis, 15 had malignancy, 6 had human immunodeficiency virus or hepatitis B or C, and 19 patients had other contraindications to organ donation. Of the remaining 138 eligible patients, 83 (60.2%) did not donate: 56 because the family denied consent, 9 by their own choice. In six, next of kin could not be located, five died because of hemodynamic instability before organ procurement was possible, four had organs that could not be placed, and three had their organs declined by the organ procurement organization. The overall consent rate was 57.5% (n=67). From the 55 donors, 255 organs were procured (yield 4.6 organs/donor). Of all patients screened for organ donation, only a fifth actually donated. Denial of consent was the major potentially preventable cause of procurement failure, whereas hemodynamic instability accounted for only a small percentage of donor losses. With such low conversion rates, the preventable causes of procurement failure warrant further study.

  13. All Eyes on Egypt: Islam and the Medical Use of Dead Bodies Amidst Cairo's Political Unrest. (United States)

    Hamdy, Sherine


    Using dead bodies for medical purposes has long been considered taboo in Egypt. Public health campaigns, physicians' pleas, and the urgings of religious scholars all failed to alter public opinion regarding the donation of dead bodies either for instructional material or for therapeutic treatments. Yet in 2011, amid revolutionary turmoil in Egypt, a campaign was launched for people to donate their eyes upon death; this time, people readily signed up to be donors. Focusing on mass eye trauma that occurred in Egypt amid the political uprisings of 2011, I raise questions about when and why Islam can explain people's attitudes and behaviors, particularly toward death and medicine. The case of mass eye trauma in Egypt and citizens' reformulations of questions once jealously controlled by state-aligned doctors, politicians, and religious scholars unsettles the boundaries between 'religion' and 'secularism' in medical practice. [Formula: see text].

  14. Virtually Dead: Digital Public Mortuary Archaeology

    Directory of Open Access Journals (Sweden)

    Howard Williams


    Full Text Available Over recent decades, the ethics, politics and public engagements of mortuary archaeology have received sustained scrutiny, including how we handle, write about and display the archaeological dead. Yet the burgeoning use of digital media to engage different audiences in the archaeology of death and burial have so far escaped attention. This article explores categories and strategies by which digital media create virtual communities engaging with mortuary archaeology. Considering digital public mortuary archaeology (DPMA as a distinctive theme linking archaeology, mortality and material culture, we discuss blogs, vlogs and Twitter as case studies to illustrate the variety of strategies by which digital media can promote, educate and engage public audiences with archaeological projects and research relating to death and the dead in the human past. The article then explores a selection of key critical concerns regarding how the digital dead are currently portrayed, identifying the need for further investigation and critical reflection on DPMA’s aims, objectives and aspired outcomes.

  15. Dead Zone Accretion Flows in Protostellar Disks (United States)

    Turner, Neal; Sano, T.


    Planets form inside protostellar disks in a dead zone where the electrical resistivity of the gas is too high for magnetic forces to drive turbulence. We show that much of the dead zone nevertheless is active and flows toward the star while smooth, large-scale magnetic fields transfer the orbital angular momentum radially outward. Stellar X-ray and radionuclide ionization sustain a weak coupling of the dead zone gas to the magnetic fields, despite the rapid recombination of free charges on dust grains. Net radial magnetic fields are generated in the magnetorotational turbulence in the electrically conducting top and bottom surface layers of the disk, and reach the midplane by ohmic diffusion. A toroidal component to the fields is produced near the midplane by the orbital shear. The process is similar to the magnetization of the solar tachocline. The result is a laminar, magnetically driven accretion flow in the region where the planets form.

  16. Dead sea transform fault system reviews

    CERN Document Server

    Garfunkel, Zvi; Kagan, Elisa


    The Dead Sea transform is an active plate boundary connecting the Red Sea seafloor spreading system to the Arabian-Eurasian continental collision zone. Its geology and geophysics provide a natural laboratory for investigation of the surficial, crustal and mantle processes occurring along transtensional and transpressional transform fault domains on a lithospheric scale and related to continental breakup. There have been many detailed and disciplinary studies of the Dead Sea transform fault zone during the last?20 years and this book brings them together.This book is an updated comprehensive coverage of the knowledge, based on recent studies of the tectonics, structure, geophysics, volcanism, active tectonics, sedimentology and paleo and modern climate of the Dead Sea transform fault zone. It puts together all this new information and knowledge in a coherent fashion.

  17. Profile of effective donors from organ and tissue procurement services (United States)

    Rodrigues, Simey de Lima Lopes; Ferraz Neto, Jose Ben-Hur de Escobar; Sardinha, Luiz Antonio da Costa; Araujo, Sebastião; Zambelli, Helder Jose Lessa; Boin, Ilka de Fátima Santana Ferreira; Athayde, Maria Valeria de Omena; Montone, Eliete Bombarda Bachega; Panunto, Marcia Raquel


    Objective To characterize the profile of effective organ and tissue donors and to understand which organs and tissues were donated for transplantation. Methods This was a quantitative, descriptive, exploratory, retrospective study that analyzed clinical data from 305 donors between January 2006 to December 2010. The data were then analyzed using descriptive analyses, generating frequency tables, measures of position (mean, minimum and maximum) and measures of dispersion (standard deviation) for data that was social and clinical in nature. Results There was an overall predominance of white (72%) and male (55%) individuals between the ages of 41 and 60 years (44%). The primary cause of brain death was cerebrovascular accident (55%). In the patient history, 31% of the patients were classified as overweight, 27% as hypertensive and only 4.3% as having diabetes mellitus. Vasoactive drugs were used in 92.7% of the donors, and the main drug of choice was noradrenaline (81.6%). Hyperglycemia and hypernatremia were diagnosed in 78% and 71% of the donors, respectively. Conclusion Significant hemodynamic changes were found, and the results indicate that the use of vasoactive drugs was the main strategy used to control these changes. Furthermore, most donors presented with hyperglycemia and hypernatremia, which were frequently reported in association with brain death. The persistent nature of these findings suggests that the organ donors were inadequately maintained. PMID:24770685

  18. Donor attention to reading materials. (United States)

    O'Brien, S F; Osmond, L; Choquet, K; Yi, Q-L; Goldman, M


    Mandatory predonation reading materials inform donors about risk factors for transmissible disease, possible complications of donation and changes to the donation process. We aimed to assess the attention to predonation reading materials and factors which may affect attention. A national survey in 2008 of 18,108 blood donors asked about self-assessed attention to reading the materials. In face-to-face interviews, 441 donors completed additional questions about reading the materials and a literacy test. Qualitative interviews of 27 donors assessed their approach to reading. In the national survey, most of the first-time donors said they read all or most of the materials (90.9% first-time vs. 57.6% repeat donors, P reading them carefully (P read materials carefully, skimmed or did not read, most knew that donors are informed of positive transmissible disease test results (97.1%, 95.5, 98.0 P > 0.05), but fewer recalled seeing the definition of sex (77.2%, 56.9, 24.2 P read materials carefully, skimmed or did not read were compared (P > 0.05). Qualitative interviews showed that donors are reluctant to read any more than necessary and decide based on perceived importance or relevance. Attention to predonation reading materials tends to be better among first-time donors. The effectiveness is limited by low motivation to read, especially for repeat donors, as well as poor literacy. © 2015 International Society of Blood Transfusion.

  19. Tunnel Diode Discriminator with Fixed Dead Time

    DEFF Research Database (Denmark)

    Diamond, J. M.


    A solid state discriminator for the range 0.4 to 10 V is described. Tunnel diodes are used for the discriminator element and in a special fixed dead time circuit. An analysis of temperature stability is presented. The regulated power supplies are described, including a special negative resistance...

  20. Swimming obstructed by dead-water

    NARCIS (Netherlands)

    Ganzevles, S.P.M; Nuland, F.S.W.; Maas, L.; Toussaint, H.M.


    In nautical literature, ‘dead-water’ refers to the obstructive effect encountered by ships moving in stratified water due to the ship generating waves on an interface that separates different water masses. To investigate the hypothesis that open water swimming may also be obstructed by an encounter

  1. Swimming obstructed by dead-water

    NARCIS (Netherlands)

    Ganzevles, S.P.; Nuland, F.S.; Maas, L.R.; Toussaint, H.M.


    In nautical literature, 'dead-water' refers to the obstructive effect encountered by ships moving in stratified water due to the ship generating waves on an interface that separates different water masses. To investigate the hypothesis that open water swimming may also be obstructed by an encounter

  2. Cheatgrass Dead Zones in Northern Nevada (United States)

    Reports of areas of cheatgrass die-off are becoming more frequent. In 2009, we investigated cheatgrass die-off in north-central Nevada. Dead zones ranged from several to hundreds of acres in size and were largely unvegetated and covered by cheatgrass litter with a distinct gray cast. We collected re...

  3. Dinosaurs of India: Dead but Alive

    Indian Academy of Sciences (India)

    Table of contents. Dinosaurs of India: Dead but Alive · Fossils · Evolution and O2 PAL · The Science in Dinosaurs · Origin/ Extinction of Dinosaurs · PowerPoint Presentation · India –94my + 50my · Icehouse /Greenhouse through time · Global Mean Annual Temperature Distributions at 100 my · Global Mean Annual ...

  4. Stretching the Limits of Renal Transplantation in Elderly Recipients of Grafts from Elderly Deceased Donors

    NARCIS (Netherlands)

    Peters-Sengers, Hessel; Berger, Stefan P; Heemskerk, Martin B A; Al Arashi, Doaa; Homan van der Heide, Jaap J; Hemke, Aline C; Ten Berge, Ineke J M; Idu, Mirza M; Betjes, Michiel G H; van Zuilen, Arjan D; Hilbrands, Luuk B; de Vries, Aiko P J; Nurmohamed, Azam S; Christiaans, Maarten H; Ernest van Heurn, L W; de Fijter, Johan W; Bemelman, Frederike J

    An increasing number of elderly patients (>= 65 years) receive a donor kidney from elderly donors after brain death (DBD) or after circulatory death (DCD). These organs are allocated within the Eurotransplant Senior Program, but outcomes must be evaluated. From the Dutch Organ Transplantation

  5. Stretching the Limits of Renal Transplantation in Elderly Recipients of Grafts from Elderly Deceased Donors

    NARCIS (Netherlands)

    Peters-Sengers, H.; Berger, S.P.; Heemskerk, M.B.; Arashi, D. Al; Heide, J.J. van der; Hemke, A.C.; Berge, I.J. Ten; Idu, M.M.; Betjes, M.G.; Zuilen, A.D. van; Hilbrands, L.B.; Vries, A.P. de; Nurmohamed, A.S.; Christiaans, M.H.; Heurn, L.W. van; Fijter, J.W. de; Bemelman, F.J.


    An increasing number of elderly patients (>/=65 years) receive a donor kidney from elderly donors after brain death (DBD) or after circulatory death (DCD). These organs are allocated within the Eurotransplant Senior Program, but outcomes must be evaluated. From the Dutch Organ Transplantation

  6. Successful Kidney and Lung Transplantation From a Deceased Donor With Blunt Abdominal Trauma and Intestinal Perforation

    NARCIS (Netherlands)

    van Smaalen, Tim C.; Krikke, Christina; Haveman, Jan Willem; van Heurn, L. W. Ernest


    The number of organ donors is limited by many contraindications for donation and poor quality of potential organ donors. Abdominal infection is a generally accepted contraindication for donation of abdominal organs. We present a 43-year-old man with lethal brain injury, blunt abdominal trauma, and

  7. Gulf of Mexico dead zone - the last 150 years (United States)

    Osterman, Lisa; Swarzenski, P.W.; Poore, R.Z.


    'Gulf of Mexico Dead Zone-The Last 150 Years' discusses the dead zone that forms seasonally in the northern Gulf of Mexico when subsurface waters become depleted in dissolved oxygen and cannot support most life.

  8. International collaborative donor project. (United States)

    Ríos Zambudio, Antonio


    The International Donor Collaborative Project (PCID) research group was created in 1996 in Spain with the aim of promoting research in the field of organ donation and transplantation, led by Spanish surgeons. During this period they have developed the questionnaires of the PCID, both the attitude towards cadaver and live donation, which are the most used questionnaires in publications in indexed journals. They have been the driving group of stratified studies representative of the populations under study, and of the performance of multivariate statistical analyzes in the field of psycho-social research in organ donation and transplantation. The main contributions of the group focus on the analysis of health center professionals and emerging migrant groups. In recent years, studies have been extended to the United States, Latin America (mainly Mexico) and Europe. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Standing dead tree resources in forests of the United States (United States)

    Christopher W. Woodall; Karen L. Waddell; Christopher M. Oswalt; James E. Smith


    Given the importance of standing dead trees to numerous forest ecosystem attributes/ processes such as fuel loadings and wildlife habitat, the Forest Inventory and Analysis (FIA) Program of the Forest Service, U.S. Department of Agriculture, initiated a consistent nationwide inventory of standing dead trees in 1999. As the first cycle of annual standing dead tree...

  10. The zero inflation of standing dead tree carbon stocks (United States)

    Christopher W. Woodall; David W. MacFarlane


    Given the importance of standing dead trees in numerous forest ecosystem attributes/processes such as carbon (C) stocks, the USDA Forest Service’s Forest Inventory and Analysis (FIA) program began consistent nationwide sampling of standing dead trees in 1999. Modeled estimates of standing dead tree C stocks are currently used as the official C stock estimates for the...

  11. Survey of U.S. Organ Procurement Organizations Regarding Pediatric Organ Donor Management. (United States)

    Ream, Robert S; Armbrecht, Eric S


    To describe the current practice of pediatric organ donor management in the United States for donors declared dead based upon neurologic criteria. The study directs particular attention to how pediatric donors are defined, the use of donor management guidelines, the use of donor management goals, and the involvement of pediatric critical care or transplantation expertise. Cross-sectional observational study using a web-based survey and follow-up telephone interview with respondents from U.S. organ procurement organizations. The study also incorporated organ procurement organization-specific data on organ yield for the 4-year period (2010-2013) preceding the study. The 58 U.S. organ procurement organizations. Respondents chosen by each organ procurement organization. None. All 58 U.S. organ procurement organizations participated in the study. Fifty-two respondents (90%) indicated that their organ procurement organization distinguished pediatric from adult donors resulting in 28 unique pediatric definitions. Thirty-nine organ procurement organizations utilized some form of written pediatric management guidelines, and 27 (47%) maintained pediatric donor management goals; compliance was infrequently monitored for both guidelines (28%) and goals (33%). A pediatric intensivist was always or usually involved in pediatric donor management at 47 organ procurement organizations (81%); transplant/organ recovery surgeons were always or usually involved at 12 organ procurement organizations (21%). There was an increase in the number of organs transplanted per donor among donors 11-17 years old for organ procurement organizations that used donor management goals for the duration of the period studied (p organs transplanted among donors of 0-10 years old for organ procurement organizations that always or usually consulted a transplant/organ recovery surgeon (p = 0.02) although this did not reach our threshold for statistical significance.. There is little consensus among organ

  12. Potential Evaporite Biomarkers from the Dead Sea (United States)

    Morris, Penny A.; Wentworth, Susan J.; Thomas-Keprta, Kathie; Allen, Carlton C.; McKay, David S.


    The Dead Sea is located on the northern branch of the African-Levant Rift systems. The rift system, according to one model, was formed by a series of strike slip faults, initially forming approximately two million years ago. The Dead Sea is an evaporite basin that receives freshwater from springs and from the Jordan River. The Dead Sea is different from other evaporite basins, such as the Great Salt Lake, in that it possesses high concentrations of magnesium and has an average pH of 6.1. The dominant cation in the Great Salt Lake is sodium, and the pH is 7.7. Calcium concentrations are also higher in the Dead Sea than in the Great Salt Lake. Both basins are similar in that the dominant anion is chlorine and the salinity levels are approximately 20 %. Other common cations that have been identified from the waters of the Dead Sea and the Great Salt Lake include sodium and potassium. A variety of Archea, Bacteria, and a single genus of a green algal, Dunaliella, has been described from the Dead Sea. Earlier studies concentrated on microbial identification and analysis of their unique physiology that allows them to survive in this type of extreme environment. Potential microbial fossilization processes, microbial fossils, and the metallic ions associated with fossilization have not been studied thoroughly. The present study is restricted to identifying probable microbial morphologies and associated metallic ions. XRD (X Ray Diffraction) analysis indicates the presence of halite, quartz, and orthoclase feldspar. In addition to these minerals, other workers have reported potassium chloride, magnesium bromide, magnesium chloride, calcium chloride, and calcium sulfate. Halite, calcium sulfate, and orthoclase were examined in this report for the presence of microbes, microbially induced deposits or microbial alteration. Neither the gypsum nor the orthoclase surfaces possesses any obvious indications of microbial life or fossilization. The sand-sized orthoclase particles are

  13. Anisakis simplex: dangerous--dead and alive? (United States)

    Audicana, María Teresa; Ansotegui, Ignacio J; de Corres, Luis Fernández; Kennedy, Malcolm W


    The risk of infection with Anisakis simplex and related parasites of fish has been recognized for some time, but it is now emerging that ingestion of material from dead parasites in food is also potentially dangerous. The resulting allergic reactions range from rapid onset and potentially lethal anaphylactic reactions to chronic, debilitating conditions. This review discusses the problems and clinical implications associated with A. simplex, other related conditions, and the way in which disease manifestations vary from person to person.

  14. Donor selection criteria and procurement

    International Nuclear Information System (INIS)

    Agcaoili, N.R.


    Donor selection is one of the most important aspects of tissue banking practice. Without a good donor selection criteria, the results of any effort of trying to preserve tissues will have disastrous outcome for the recipient of these tissues. While with a very good and strict donor selection the Tissue Bank can guarantee safe and effective tissue allografts. There are significant aspects in the history and physical examination of the donor that must be emphasized. A donor exclusion criteria has also been formulated together with a list of all the needed laboratory examinations to eliminate possible diseases that may be transferred from the donor. The methods of procurement of tissue allografts from living and cadaver donors will be described. The limitations and advantages of each will be taken.There are also special restrictions that are important in the practice of removing the tissues from the donors. All the necessary equipment should be ready and the potential risk on the personnel should be known to all doing Tissue Banking

  15. Surviving deadness in the analytic experience. (United States)

    Koritar, Endre


    The transference/countertransference (third space) analysis is considered to be central in the therapeutic effectiveness of the analytic process. Less emphasis has been placed on the actual experiences of analyst and analysand in the conflictual reenactment of third space experience and its resolution. This paper recounts the shared experience of a patient who was silent throughout most of the analysis, and my reaction, in fantasy and enactment, to this disturbing experience-both for him and for myself. I argue that it is the affective re-experiencing of past repressed trauma in the analytic space that has a therapeutic impact, leading to growth in the patient and also the therapist. I contrast Freud's emphasis on insight, making the unconscious conscious, with Ferenczi's suggestion that the therapeutic impact lies in the repetition of past traumatic experience in the analysis but with the possibility of a different outcome with a more benign object, leading to symbolic representation of repressed trauma. Re-experiencing and symbolization, in the third space, of past traumatic experience can be an exit point from the endless repetition of trauma in internal and external object relations, leading to a new beginning in the patient's life. Immersed in the experience of deadness in the analysis, which had become a dead womb, the struggle to remain alive and thinking led to a rupture out of the dead womb, like the Caesura of birth, into aliveness and the ability to mentalize what had previously remained unmentalized.

  16. Heart transplantation from older donors

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov


    Full Text Available In the current situation of the shortage of suitable donor organs, heart transplantation from older donors is one of the ways to increase the performance of more heart transplants, particularly, in patients with urgent need of transplantation. While planning a heart transplantation from older donor one should consider increased risk of early cardiac allograft dysfunction, preexisting coronary artery disease, accelerated transplant vasculopathy which may adversely affect early and long-term survival of recipients. Subject to careful selection of donor–recipient pairs, effective prevention and treatment of early cardiac allograft dysfunction, pre-existing atherosclerosis and transplant vasculopathy the early and long-term survival of heart transplant recipients from older donors is comparable to heart transplantation from young donors.

  17. Visualization of deuterium dead layer by atom probe tomography

    KAUST Repository

    Gemma, Ryota


    The first direct observation, by atom probe tomography, of a deuterium dead layer is reported for Fe/V multilayered film loaded with D solute atoms. The thickness of the dead layers was measured to be 0.4-0.5 nm. The dead layers could be distinguished from chemically intermixed layers. The results suggest that the dead layer effect occurs even near the interface of the mixing layers, supporting an interpretation that the dead layer effect cannot be explained solely by electronic charge transfer but also involves a modulation of rigidity. © 2012 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  18. The concept of brain death did not evolve to benefit organ transplants (United States)

    Machado, Calixto; Korein, Julius; Ferrer, Yazmina; Portela, Liana; de la C García, Maria; Manero, José M


    Although it is commonly believed that the concept of brain death (BD) was developed to benefit organ transplants, it evolved independently. Transplantation owed its development to advances in surgery and immunosuppressive treatment; BD owed its origin to the development of intensive care. The first autotransplant was achieved in the early 1900s, when studies of increased intracranial pressure causing respiratory arrest with preserved heartbeat were reported. Between 1902 and 1950, the BD concept was supported by the discovery of EEG, Crile's definition of death, the use of EEG to demonstrate abolition of brain potentials after ischaemia, and Crafoord's statement that death was due to cessation of blood flow. Transplantation saw the first xenotransplant in humans and the first unsuccessful kidney transplant from a cadaver. In the 1950s, circulatory arrest in coma was identified by angiography, and the death of the nervous system and coma dépassé were described. Murray performed the first successful kidney transplant. In the 1960s, the BD concept and organ transplants were instantly linked when the first kidney transplant using a brain‐dead donor was performed; Schwab proposed to use EEG in BD; the Harvard Committee report and the Sydney Declaration appeared; the first successful kidney, lung and pancreas transplants using cadaveric (not brain‐dead) donors were achieved; Barnard performed the first human heart transplant. This historical review demonstrates that the BD concept and organ transplantation arose separately and advanced in parallel, and only began to progress together in the late 1960s. Therefore, the BD concept did not evolve to benefit transplantation. PMID:17400615

  19. A Cost Evaluation of a Donation after Cardiac Death Program: How Cost per Organ Compares to Other Donor Types. (United States)

    Lindemann, Jessica; Dageforde, Leigh Anne; Vachharajani, Neeta; Stahlschmidt, Emily; Brockmeier, Diane; Wellen, Jason R; Khan, Adeel; Chapman, William C; Doyle, Majella


    Donation after cardiac death (DCD) is one method of organ donation. Nationally, more than half of evaluated DCD donors do not yield transplantable organs. There is no algorithm for predicting which DCD donors will be appropriate for organ procurement. DCD program costs from an organ procurement organization (OPO) accounting for all evaluated donors have not been reported. Hospital, transportation, and supply costs of potential DCD donors evaluated at a single OPO from January 2009 to June 2016 were collected. Average costs per donor and per organ were calculated. Cost of DCD donors that did not yield a transplantable organ were included in cost analyses resulting in total cost of the DCD program. DCD donor costs were compared to costs of in hospital donation after brain death (DBD) donors. There were 289 organs transplanted from 264 DCD donors evaluated. Average cost per DCD donor yielding transplantable organs was $9,306. However, 127 donors yielded no organs at an average cost of $8,794 per donor. The total cost of the DCD program was $32,020 per donor and $15,179 per organ. The average cost for an in hospital DBD donor was $33,546 and $9,478 per organ transplanted. Average organ yield for DBD donors was 3.54 versus 2.21 for DCD donors (porgan 63% of the cost of a DCD organ. The average cost per DCD donor is comparable to DBD donors however, individual cost of DCD organs increases by almost forty percent when all costs of an entire DCD program are included. Copyright © 2018. Published by Elsevier Inc.

  20. Voluntary whole-blood donors, and compensated platelet donors and plasma donors: motivation to donate, altruism and aggression. (United States)

    Trimmel, Michael; Lattacher, Helene; Janda, Monika


    To establish if voluntary whole-blood donors and compensated platelet donors and plasma donors may differ in their motivation to donate, altruism, aggression and autoaggression. Whole-blood (n=51), platelet (n=52) and plasma donors (n=48) completed a battery of validated questionnaires while waiting to donate. Bivariate and multivariate analyses of variance and t-tests were performed to detect differences between groups as noted. Altruism (mean=40.2) was slightly higher in whole-blood donors than in platelet (mean=38.3) and plasma donors (mean=39.1) (p=0.07). Blood donors (mean=2.8) scored lower in the spontaneous aggression measure than platelet (mean=4.1) and plasma donors (mean=4.4) (p=0.01). Plasma donors (mean=4.9) had higher auto-aggression than whole-blood donors and platelet donors (mean for both groups=3.4) (p=0.01). Differences between the three groups were mediated by sociodemographic variables (MANCOVA). Whole-blood donors donated to help others, platelet and plasma donors mostly to receive the compensation. However, those platelet and plasma donors, who would continue to donate without compensation were similar in altruism and aggression to whole-blood donors. While most platelet donors and plasma donors were motivated by the compensation, those who stated that they would continue to donate without compensation had altruism and aggression scores similar to voluntary whole-blood donors.

  1. A philosophical assessment of TK's autopsy report: Implications for the debate over the brain death criteria. (United States)

    Austriaco, Nicanor Pier Giorgio


    In recent years, there has been increasing evidence that the totally brain-dead patient is able to continue to live and to maintain some integrated functions, albeit with the necessary assistance of mechanical ventilation. Several years ago, the autopsy report of a totally brain-dead patient named TK who was kept on life support for nearly twenty years was published in the Journal of Child Neurology. He remains the individual kept on life support the longest after suffering total brain failure. In this essay, I argue that the clinical data described in the autopsy report demonstrate that TK's long-term survival after total brain failure supports the claim acknowledged by the President's Council on Bioethics that the brain-dead patient retains his bodily integrity. As such, he is not dead. He is still a living, though severely disabled, human organism, a human person made in the image and likeness of God. Traditionally, the presence or absence of bodily integration has been used to definitively discern the presence or absence of life in the human being where decomposition of the body is the surest sign of death. The autopsy report of a patient named TK who was brain-dead for nearly twenty years demonstrates that brain-dead patients retain their bodily integrity. As such, TK and other brain-dead patients are not dead. They are living, though severely disabled, human organisms, who are human persons made in the image and likeness of God.

  2. MRI of 'brain death'

    International Nuclear Information System (INIS)

    Nishino, Shigeki; Itoh, Takahiko; Tuchida, Shohei; Kinugasa, Kazushi; Asari, Shoji; Nishimoto, Akira; Sanou, Kazuo.


    Magnetic resonance imaging (MRI) was undertaken for two patients who suffered from severe cerebrovascular diseases and were clinically brain dead. The MRI system we used was Resona (Yokogawa Medical Systems, superconductive system 0.5 T) and the CT apparatus was Toshiba TCT-300. Initial CT and MRI were undertaken as soon as possible after admission, and repeated sequentially. After diagnosis of brain death, we performed angiography to determine cerebral circulatory arrest, and MRI obtained at the same time was compared with the angiogram and CT. Case 1 was a 77-year-old man who was admitted in an unconscious state. CT and MRI on the second day after hospitalization revealed cerebellar infarction. He was diagnosed as brain dead on day 4. Case 2 was a 35-year-old man. When he was transferred to our hospital, he was in cardiorespiratory arrested. Cardiac resuscitation was successful but no spontaneous respiration appeared. CT and MRI on admission revealed right intracerebral hemorrhage. Angiography revealed cessation of contrast medium in intracranial vessels in both of the patients. We found no 'flow signal void sign' in the bilateral internal carotid and basilar arteries on MRI images in both cases after brain death. MRI, showing us the anatomical changes of the brain, clearly revealed brain herniations, even though only nuclear findings of 'brain tamponade' were seen on CT. But in Case 1, we could not see the infarct lesions in the cerebellum on MR images obtained after brain death. This phenomenon was caused by the whole brain ischemia masking the initial ischemic lesions. We concluded that MRI was useful not only the anatomical display of lesions and brain herniation with high contrast resolution but for obtaining information on cerebral circulation of brain death. (author)

  3. Comet 'Bites the Dust' Around Dead Star (United States)


    [figure removed for brevity, see original site] Infrared Spectrometer Graph This artist's concept illustrates a comet being torn to shreds around a dead star, or white dwarf, called G29-38. NASA's Spitzer Space Telescope observed a cloud of dust around this white dwarf that may have been generated from this type of comet disruption. The findings suggest that a host of other comet survivors may still orbit in this long-dead solar system. The white dwarf G29-38 began life as a star that was about three times as massive as our sun. Its death involved the same steps that the sun will ultimately undergo billions of years from now. According to theory, the G29-38 star became brighter and brighter as it aged, until it bloated up into a dying star called a red giant. This red giant was large enough to engulf and evaporate any terrestrial planets like Earth that happened to be in its way. Later, the red giant shed its outer atmosphere, leaving behind a shrunken skeleton of star, called a white dwarf. If the star did host a planetary system, outer planets akin to Jupiter and Neptune and a remote ring of icy comets would remain. The Spitzer observations provide observational evidence for this orbiting outpost of comet survivors. Astronomers speculate that one such comet was knocked into the inner regions of G29-38, possibly by an outer planet. As the comet approached very close to the white dwarf, it may have been torn apart by the star's tidal forces. Eventually, all that would be left of the comet is a disk of dust. This illustration shows a comet in the process of being pulverized: part of it still exists as a chain of small clumps, while the rest has already spread out into a dusty disk. Comet Shoemaker-Levy 9 broke apart in a similar fashion when it plunged into Jupiter in 1994. Evidence for Comets Found in Dead Star's Dust The graph of data, or spectrum, from NASA's Spitzer Space Telescope indicates that a dead star, or white dwarf, called G29-38, is shrouded by a cloud

  4. Donor milk: current perspectives

    Directory of Open Access Journals (Sweden)

    Giuliani F


    Full Text Available Francesca Giuliani,1 Ilaria Rovelli,1 Chiara Peila,1 Stefania Alfonsina Liguori,2 Enrico Bertino,1 Alessandra Coscia1 1SCDU Neonatologia, Dipartimento di Scienze Pediatriche e dell'Adolescenza, Università degli Studi di Torino, Torino, Italy; 2SC Neonatologia, Ospedale Maria Vittoria, Torino, Italy Abstract: Mother's own milk is widely recognized as the optimal feeding for term infants, but increasing evidence exists of its benefits also for sick and preterm infants in neonatal intensive care units. However, the nutritional needs for appropriate growth and neurodevelopmental outcomes of such a particular population of infants should be attentively evaluated, considering also the indication to an appropriate fortification of human milk. The target is to achieve growth potential for preterm newborns while ensuring good metabolic outcomes and normal neurological development. When mother's milk is unavailable or in short supply, donor human milk (DHM represents the second best choice and, although somewhat modified by the Holder pasteurization process, it preserves many benefits when compared to formula, as documented by more and more reports, randomized controlled trials, and meta-analyses published in the past few years. Evidence exists of the protection exerted by DHM from necrotizing enterocolitis, while further studies are required to look at possible beneficial effects regarding infections, bronchopulmonary dysplasia, long-term cardiovascular risk factors, feeding tolerance, neurological outcome, and allergy. Finally, the concern that the use of DHM might decrease preterm infant breastfeeding is being raised. Conversely, publications exist showing that the use of DHM in the neonatal unit increases breastfeeding rates at discharge for infants of very low birth weight. Keywords: human milk, preterm infant feeding, milk bank, breast milk, mother's own milk, pasteurized human milk, fortification

  5. [A case of lycanthropy with deadly violence]. (United States)

    Bénézech, M; De Witte, J; Etchepare, J J; Bourgeois, M


    After a short historical review of the contemporary medical literature, the authors analyze a new and original observation of lycanthropy. He is a 28 years old man, imprisoned for deadly violence, who has been showing, for many years, the belief of being transformed into a werewolf during depersonalization episodes when he presents a lycanthropic behaviour. Our observation is closer to hysteria and mythomania on an antisocial personality, although it seems difficult to place the mental pathology of this alcoholic recidivist delinquent into a nosographical frame.

  6. Simplified Dead Reckoning on a Tortuous Path (United States)

    Robertson, David

    An approximation procedure is described, which greatly simplifies dead reckoning on a tortuous path. The journey is divided into N segments of equal length, L. The overall direction is approximately the average direction of the segments. The net distance is approximately NL[1-var() is the variance (in radians squared) of bearings, 7. Propagation of random errors is discussed. In a case study in sub-tropical rainforest the technique gives an estimated position whose associated circle of 68% confidence has a radius of about 10% of the net distance.

  7. De Plein Fouet: Is Strategy Dead? (United States)


    discuss strategy. Judging by the title you chose, I assume you have a point of view.Richard Szafranski (RS): Yes, sir . Le tir de plein fouet is one of...quarters, neither strategic thinking nor strategy is dead in the NGA. RS: I’m not sure that what you’re describing, sir , is a strategy as much as it is the...correcting like a self-driving car . I don’t see that coming, or coming very soon, though. Remember, we exist because we support people in harm’s way

  8. Iron deficiency among blood donors

    DEFF Research Database (Denmark)

    Rigas, A S; Pedersen, O B; Magnussen, K


    and menopausal status are the strongest predictors of iron deficiency. Only little information on the health effects of iron deficiency in blood donors exits. Possibly, after a standard full blood donation, a temporarily reduced physical performance for women is observed. However, iron deficiency among blood...... donors is not reflected in a reduced self-perceived mental and physical health. In general, the high proportion of iron-deficient donors can be alleviated either by extending the inter-donation intervals or by guided iron supplementation. The experience from Copenhagen, the Capital Region of Denmark......, is that routine ferritin measurements and iron supplementation are feasible and effective ways of reducing the proportion of donors with low haemoglobin levels....

  9. Research Award: Donor Partnerships Division

    International Development Research Centre (IDRC) Digital Library (Canada)

    Corey Piccioni


    . The successful candidate must be willing to work as a member of the DPD team in its ongoing acvies, including providing research analysis and coordinang the producon and disseminaon of informaon related to donor.

  10. When the dead are alive! The influence of the living dead in the letter of Jude

    Directory of Open Access Journals (Sweden)

    Stephan J. Joubert


    Full Text Available This essay investigates the impact of the deceased on  the audience to which the letter of Jude was originally addressed. A construct of the influence of the “living dead” in ancient Babylon, Israel, the Graeco-Roman world and in African tradition serves as a basic cognitive map to come to terms with Jude’s views on the dead. It is argued that, since the wicked dead, who are being physically punished in  the underworld,  are kept alive  in the collective memory of Jude’s community and since their deeds are re-enacted in the sinful behavior  of intruders in their midst, their lives are influenced by  the “presence” of these living dead. On the other hand and, although Jude does not deal with the physical whereabouts of the righteous death, he and his readers know that their postmortem honour is still intact. The righteous in this community is assured that God protects the integrity of the faithful dead.

  11. Ethics of practicing medical procedures on newly dead and nearly dead patients. (United States)

    Berger, Jeffrey T; Rosner, Fred; Cassell, Eric J


    To examine the ethical issues raised by physicians performing, for skill development, medically nonindicated invasive medical procedures on newly dead and dying patients. Literature review; issue analysis employing current normative ethical obligations, and evaluation against moral rules and utilitarian assessments manifest in other common perimortem practices. Practicing medical procedures for training purposes is not uncommon among physicians in training. However, empiric information is limited or absent evaluating the effects of this practice on physician competence and ethics, assessing public attitudes toward practicing medical procedures and requirements for consent, and discerning the effects of a consent requirement on physicians' clinical competence. Despite these informational gaps, there is an obligation to secure consent for training activities on newly and nearly dead patients based on contemporary norms for informed consent and family respect. Paradigms of consent-dependent societal benefits elsewhere in health care support our determination that the benefits from physicians practicing procedures does not justify setting aside the informed consent requirement. Current ethical norms do not support the practice of using newly and nearly dead patients for training in invasive medical procedures absent prior consent by the patient or contemporaneous surrogate consent. Performing an appropriately consented training procedure is ethically acceptable when done under competent supervision and with appropriate professional decorum. The ethics of training on the newly and nearly dead remains an insufficiently examined area of medical training.

  12. Breathing Life Into Dead-Zones

    Directory of Open Access Journals (Sweden)

    Gressel Oliver


    Full Text Available The terrestrial planet formation regions of protoplanetary disks are generally sufficiently cold to be con- sidered non-magnetized and, consequently, dynamically inactive. However, recent investigations of these so-called “Dead-Zones” indicate the possibility that disks with strong mean radial temperature gradients can support instabilities associated with disk-normal gradients of the basic Keplerian shear profile. This process, known as the Goldreich-Schubert-Fricke (GSF instability, is the instability of short radial wavelength inertial modes and depends wholly on the presence of vertical gradients of the mean Keplerian (zonal flow. We report here high resolution fully nonlinear axisymmetric numerical studies of this instability and find a number of features including how, in the nonlinear saturated state, unstable discs become globally distorted, with strong vertical oscillations occurring at all radii due to local instability. We find that nonaxisymmetric numerical experiments are accompanied by significant amounts angular momentum transport (α ~ 0001. This instability should be operating in the Dead-Zones of protoplanetary disks at radii greater than 10-15 AU in minimum mass solar nebula models.

  13. Absence of beta-amyloid in cortical cataracts of donors with and without Alzheimer's disease. (United States)

    Michael, Ralph; Rosandić, Jurja; Montenegro, Gustavo A; Lobato, Elvira; Tresserra, Francisco; Barraquer, Rafael I; Vrensen, Gijs F J M


    Eye lenses from human donors with and without Alzheimer's disease (AD) were studied to evaluate the presence of amyloid in cortical cataract. We obtained 39 lenses from 21 postmortem donors with AD and 15 lenses from age-matched controls provided by the Banco de Ojos para Tratamientos de la Ceguera (Barcelona, Spain). For 17 donors, AD was clinically diagnosed by general physicians and for 4 donors the AD diagnosis was neuropathologically confirmed. Of the 21 donors with AD, 6 had pronounced bilateral cortical lens opacities and 15 only minor or no cortical opacities. As controls, 7 donors with pronounced cortical opacities and 8 donors with almost transparent lenses were selected. All lenses were photographed in a dark field stereomicroscope. Histological sections were analyzed using a standard and a more sensitive Congo red protocol, thioflavin staining and beta-amyloid immunohistochemistry. Brain tissue from two donors, one with cerebral amyloid angiopathy and another with advanced AD-related changes and one cornea with lattice dystrophy were used as positive controls for the staining techniques. Thioflavin, standard and modified Congo red staining were positive in the control brain tissues and in the dystrophic cornea. Beta-amyloid immunohistochemistry was positive in the brain tissues but not in the cornea sample. Lenses from control and AD donors were, without exception, negative after Congo red, thioflavin, and beta-amyloid immunohistochemical staining. The results of the positive control tissues correspond well with known observations in AD, amyloid angiopathy and corneas with lattice dystrophy. The absence of staining in AD and control lenses with the techniques employed lead us to conclude that there is no beta-amyloid in lenses from donors with AD or in control cortical cataracts. The inconsistency with previous studies of Goldstein et al. (2003) and Moncaster et al. (2010), both of which demonstrated positive Congo red, thioflavin, and beta

  14. Kidney donor profile in Spain: risks factors and characteristics of the organs rejected for transplantation. (United States)

    Miranda, B; Cañón, J; Naya, M T; Cuende, N; Garrido, G; Fernández-Zincke, E


    During recent years organ donation in Spain has increased by 100%, with important changes seen in the donor profile. Mean age has increased by more than 10 years, being nowadays more than 33% of our donors over 60 years. Ten years ago road traffic trauma was the main cause of death, while now most of our donors die due to stroke and only 21% die in a traffic accident. This changes lead to an increase in the number of kidneys discarded for transplantation every year. Among the 2517 kidneys retrieved during 2001, 567 were discarded, mainly due to different glomerular, interstitial or vascular pathologic damage. The older is the donor the higher is the percentage of kidneys discarded. It has to be underlined that an increased number of livers from donors, whose kidneys could not be used, are being grafted (141 in 2001 over 281 donors from whom no kidney could be grafted and over a total number of 1335 donors). Only 5% of kidneys were discarded due to technical problems. An important number of kidneys were discarded due to malignancy suspicion or diagnosis (12.3%). Organ donation has improved but kidney transplantation did not in parallel, due to the increasing number of kidneys discarded for transplantation in close relation with the evolution of donor's characteristics. Organ donation rate is around 33 donors per million population while efficient organ donation rate is around 30 donors per million. Only from 67% of donors both kidneys can be grafted and from 20% of donors no kidney can be used. These data will not change our policy, at least by the moment, we will continue to evaluate every potential brain death donor with the aim of studying if organs can be used. It is true that in 50% of cases over 70 years no organ can be used after retrieval and microscopic exam, but in the other 50% we can proceed.

  15. A new G-M counter dead time model

    International Nuclear Information System (INIS)

    Lee, S.H.; Gardner, R.P.


    A hybrid G-M counter dead time model was derived by combining the idealized paralyzable and non-paralyzable models. The new model involves two parameters, which are the paralyzable and non-paralyzable dead times. The dead times used in the model are very closely related to the physical dead time of the G-M tube and its resolving time. To check the validity of the model, the decaying source method with 56 Mn was used. The corrected counting rates by the new G-M dead time model were compared with the observed counting rates obtained from the measurement and gave very good agreement within 5% up to 7x10 4 counts/s for a G-M tube with a dead time of about 300 μs

  16. Photographic Study Of A Dead-Pressed Explosive (United States)

    Swallowe, G. M.; Field, J. E.


    High speed photography in conjunction with electron microscopy and a pressure measuring technique have been used to investigate the differences between dead-pressed and non-dead-pressed samples of the primary explosive Mercury Fulminate (Hg Ful). Photographs of reaction propagation were taken in transmitted light using a specially adapted drop-weight machine with transparent anvils. The results of these experiments suggested a mechanism for dead-pressing in Hg Ful based on the microscopic internal structure of the compacted explosive.

  17. Respect for the dead and the ethics of anatomy. (United States)

    Wilkinson, T M


    Dead bodies are not persons but nor are they just things. What, ethically speaking, do the living owe the dead when it comes to using their bodies in anatomy? The article begins with the general question of respect for the dead. It distinguishes between why we should respect the dead, how we should respect them, and the weight to be given to respect. It sets out an account of the reason to respect the dead based on their interests. The article then turns to how the dead should be respected and the importance of doing so. Specifically, it considers three ethical issues in anatomy: the role of the family, the use of unclaimed bodies, and the public display of bodies donated for that purpose. This article claims that what it is to respect the dead is substantially determined by their wishes. Nonetheless the article argues that respect is consistent with allowing the family to veto anatomical use even when the deceased has consented because respect for the dead does not require following all their possible wishes. Respect is also consistent with using unclaimed bodies to which no one--deceased or family--has consented because the interests of the dead do not directly require consent and the interests of the family are unlikely to be relevant. Finally, the article does not see anything disrespectful in the public display of the bodies of those who have consented. Copyright © 2013 Wiley Periodicals, Inc.

  18. Living related donor liver transplantation. (United States)

    Chen, C L; Chen, Y S; Liu, P P; Chiang, Y C; Cheng, Y F; Huang, T L; Eng, H L


    Living related liver transplantation (LRLT) has been developed in response to the paediatric organ donor shortage. According to the International Living Donor Registry, 521 transplants had been performed in 515 patients between December 8 1988 and January 19 1996 in 30 centres worldwide. The overall actuarial patient and graft survival rates were 82.7 and 80%, respectively. Between June 17 1994 and November 30 1996, the authors performed 11 LRLT at the Chung Gung Memorial Hospital. The living donors consisted of 10 mothers and one father. The mean graft weight was 303 g and the mean graft recipient weight ratio was 2.2%. Donor hepatectomy was performed without vascular inflow occlusion. The intra-operative blood loss ranged from 30 mL to 120 mL with an average of 61 mL, and blood transfusion was not required in all donors both intra-operatively and during the postoperative period. Underlying diseases of the recipients were biliary atresia (n = 10) and glycogen storage disease (n = 1). The mean graft cold ischaemia time was 106 min, the mean second warm ischaemia time was 51 min and the mean interval between portal and arterial reperfusion was 81 min. The initial LRLT results were promising with all donors having been discharged without complication. The recipients experienced a few complications, all of which were manageable with early intervention. All 11 recipients are alive and well. These are encouraging results and the authors hope to expand the use of live donors for liver transplantation to cope with demand.

  19. [Hormone modulation of organ donor. Utility of the steroids]. (United States)

    Michelena, Juna C; Chamorro, Carlos; Falcón, Juan A; Garcés, Sandra


    Recently, the work group made up of the National Transplant Organization (Organización Nacional de Trasplantes, ONT), Spanish Society of Intensive, Critical Medicine and Coronary Units (Sociedad Española de Medicina Intensiva, Crítica y de Unidades Coronarias, SEMICYUC) and other Scientific Societies have recommended using 15 mg/kg of methyl prednisolone during the management of lung donors after brain death. This recommendation is based on descriptive and retrospective studies. However, the review of different experimental and clinical studies also suggests a potential benefit of using steroids in either thoracic or abdominal organ donors during management strategies. In brain death management, early steroid administration may decrease cytokine production and also may prevent alterations induced by proinflammatoy mediators, stabilize cell membranes, reduce expression of cell surface adhesion molecules and avoid lipid peroxidation after the ischemic period. This could be beneficial in increasing number and quality of organs harvested and in decreasing rejection episodes after transplant. It would be very recommendable to carry out prospective and comparative studies to demonstrate these potential utilities. Meanwhile and knowing the deleterious effects of inflammatory activity arising during and after brain death, we recommend using 15 mg/kg of methyl prednisolone in the organ donor management, as soon as possible. The potential benefit of its immunomodulation effects, its low cost and the absence of major side effects can justify this recommendation.

  20. Why Should Donors Care about Corruption?


    Kolstad, Ivar


    Corruption is bad for donor business. Corruption reduces popular support for aid in donor countries. However, aid agencies should pay attention to corruption because it is the right thing to do, rather than just the smart thing to do. Donor anti-corruption policies require a strong grounding in ethics. Corruption produces bad development outcomes. This is the reasoning largely underlying donor anti-corruption efforts. The focus on consequences of corruption makes donor anticorruptioneffo...

  1. Kidney transplant outcomes from older deceased donors

    DEFF Research Database (Denmark)

    Pippias, Maria; Jager, Kitty J; Caskey, Fergus


    As the median age of deceased kidney donors rises, updated knowledge of transplant outcomes from older deceased donors in differing donor-recipient age groups is required. Using ERA-EDTA Registry data we determined survival outcomes of kidney allografts donated from the same older deceased donor ...... transplanted into differing donor-recipient age groups are better than previously reported. These allografts remain a valuable transplant resource, particularly for similar-aged recipients....

  2. Shortage of Donors for Intestinal Transplantation in São Paulo, Brazil. (United States)

    Calil, I L; Andrade, G M; Galvao, F H; Leite, A Z A; Pecora, R A; Lee, A W; D'Albuquerque, L A C


    The number of deceased organ donors has decreased slightly over the past 4 years. Although the pool of intestinal transplantation candidates is relatively small, donor allocation is challenging because of the inability to maintain the donor in a good condition and the complexities involved in making a suitable weight match between donors and recipients. Our goal was to analyze the epidemiologic profile of potential donors based on the organs offered by the regional Organ Procurement Organization from Hospital das Clinicas-USP (OPO/HC-USP) and attempt to estimate possible matches and program viability. We retrospectively analyzed information from the OPO/HC-USP database regarding organs offered over the past 7 years as well as patients listed in our program. Data were collected regarding donor characteristics (eg, sex, age, race, body mass index, blood type, cause of death) and medical care details (eg, intensive care unit stay, use of vasopressor agents and antibiotics). In this time period, there were 18,103 brain death notifications in the state of São Paulo; 5,202 (35%) became viable donors, resulting in 5,201 (99%) effectively used livers and kidneys. Most potential donors were male, in their 40s, white, and had blood type O. Only 3 potential donors from OPO/HC-USP would have reached the established minimum criteria for intestinal donation over these 7 years. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Donor Hemovigilance with Blood Donation (United States)

    Diekamp, Ulrich; Gneißl, Johannes; Rabe, Angela; Kießig, Stephan T.


    Background Reports on unexpected events (UEs) during blood donation (BD) inadequately consider the role of technical UEs. Methods Defined local and systemic UEs were graded by severity; technical UEs were not graded. On January 1, 2008, E.B.P.S.-Logistics (EBPS) installed the UE module for plasma management software (PMS). Donor room physicians entered UEs daily into PMS. Medical directors reviewed entries quarterly. EBPS compiled data on donors, donations, and UEs from January 1, 2008 to June 30, 2011. Results 6,605 UEs were observed during 166,650 BDs from 57,622 donors for a corrected incidence of 4.30% (0.66% local, 1.59% systemic, 2.04% technical UEs). 2.96% of BDs were accompanied by one UE and 0.45% by >1 UE (2-4). 6.3% of donors donating blood for their first time, 3.5% of those giving blood for their second time, and 1.9% of donors giving their third or more BD experienced UEs. Most common UEs were: discontinued collections due to venous access problems, repeated venipuncture, and small hematomas. Severe circulatory UEs occurred at a rate of 16 per 100,000 BDs. Conclusions Technical UEs were common during BD. UEs accompanied first and second donations significantly more often than subsequent donations. PMID:26195932

  4. Hospital characteristics associated with increased conversion rates among organ donors in New England. (United States)

    Rios-Diaz, Arturo J; Olufajo, Olubode A; Stinebring, Jill; Endicott, Samantha; McKown, Brandon T; Metcalfe, David; Zogg, Cheryl K; Salim, Ali


    It is unknown whether hospital characteristics affect institutional performance with regard to organ donation. We sought to determine which hospital- and patient-level characteristics are associated with high organ donor conversion rates after brain death (DBD). Data were extracted from the regional Organ Procurement Organization (2011-2014) and other sources. Hospitals were stratified into high-conversion hospitals (HCH; upper-tertile) and low-conversion hospitals (LCH; lower-tertile) according to conversion rates. Hospital- and patient-characteristics were compared between groups. There were 564 potential DBD donors in 27 hospitals. Conversion rates differed between hospitals in different states (p donors differed between HCH and LCH in race (p organ donor conversion rates. This suggests that there is a pool of potential donors in large specialized hospitals that are not successfully converted to DBD. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Dead time corrections using the backward extrapolation method

    Energy Technology Data Exchange (ETDEWEB)

    Gilad, E., E-mail: [The Unit of Nuclear Engineering, Ben-Gurion University of the Negev, Beer-Sheva 84105 (Israel); Dubi, C. [Department of Physics, Nuclear Research Center NEGEV (NRCN), Beer-Sheva 84190 (Israel); Geslot, B.; Blaise, P. [DEN/CAD/DER/SPEx/LPE, CEA Cadarache, Saint-Paul-les-Durance 13108 (France); Kolin, A. [Department of Physics, Nuclear Research Center NEGEV (NRCN), Beer-Sheva 84190 (Israel)


    Dead time losses in neutron detection, caused by both the detector and the electronics dead time, is a highly nonlinear effect, known to create high biasing in physical experiments as the power grows over a certain threshold, up to total saturation of the detector system. Analytic modeling of the dead time losses is a highly complicated task due to the different nature of the dead time in the different components of the monitoring system (e.g., paralyzing vs. non paralyzing), and the stochastic nature of the fission chains. In the present study, a new technique is introduced for dead time corrections on the sampled Count Per Second (CPS), based on backward extrapolation of the losses, created by increasingly growing artificially imposed dead time on the data, back to zero. The method has been implemented on actual neutron noise measurements carried out in the MINERVE zero power reactor, demonstrating high accuracy (of 1–2%) in restoring the corrected count rate. - Highlights: • A new method for dead time corrections is introduced and experimentally validated. • The method does not depend on any prior calibration nor assumes any specific model. • Different dead times are imposed on the signal and the losses are extrapolated to zero. • The method is implemented and validated using neutron measurements from the MINERVE. • Result show very good correspondence to empirical results.

  6. 10 CFR 1047.7 - Use of deadly force. (United States)


    ... explosives). (3) Nuclear weapons or nuclear explosive devices. When deadly force reasonably appears to be necessary to prevent the theft, sabotage, or unauthorized control of a nuclear weapon or nuclear explosive device. (4) Special nuclear material. When deadly force reasonably appears to be necessary to prevent the...

  7. Recipe for Hypoxia: Playing the Dead Zone Game (United States)

    Kastler, Jessica A.


    Dead zones--areas experiencing low levels of dissolved oxygen--are growing in shallow ocean waters around the world. Research has shown that dead zones form as a result of a specific type of pollution, called nutrient enrichment or eutrophication, and are found in almost every coastal zone where humans have large populations. Concepts related to…

  8. Dead wood inventory and assessment in South Korea (United States)

    Jong-Su Yim; Rae Hyun Kim; Sun-Jeong Lee; Yeongmo. Son


    Dead wood (DW) plays a critical role not only in maintaining biodiversity but also in stocking carbon under UNFCCC. From the 5th national forest inventory (NFI5; 2006-2010) in South Korea, field data relevant to the DW including standing and downed dead trees by four decay class, etc. were collected. Based on the NFI5 data,...

  9. Quantifying carbon stores and decomposition in dead wood: A review (United States)

    Matthew B. Russell; Shawn Fraver; Tuomas Aakala; Jeffrey H. Gove; Christopher W. Woodall; Anthony W. D’Amato; Mark J. Ducey


    The amount and dynamics of forest dead wood (both standing and downed) has been quantified by a variety of approaches throughout the forest science and ecology literature. Differences in the sampling and quantification of dead wood can lead to differences in our understanding of forests and their role in the sequestration and emissions of CO2, as...

  10. Scintigraphic evaluation of brain death

    International Nuclear Information System (INIS)

    Park, C. H.; Bai, M. S.; Cho, K. K.; Kim, S. J.; Yoon, S. N.; Cho, C. W.


    A law recognizing brain death is a life saving legal measure in patients suffering from badly diseased organs such as kidney, liver, heart, and lung. Such law is being discussed for legalization at the Korean National Assembly. There are various criteria used for brain death in western world and brain scintiscan is one of them. However, the scintiscan is not considered in establishing brain death in the draft of the law. The purpose of this report is to spread this technique in nuclear medicine society as well as in other medical societies. We evaluated 7 patients with clinical suspicion of brain death by various causes. The patient's age ranged from 5 to 39 years. We used 5-20mCi 99m Tc-HMPAO (d.1-hexamethyl propylene amine oxime) or ECD (Ethyl Cysteinate Dimer), lipophilic agents that cross BBB (blood brain barrier). A dynamic study followed by static or SPECT (single photon emission tomography) was performed. Interpretive criteria used for brain death were 1) no intracranial circulation 2) no brain uptake. The second criteria is heavily used. Five of 7 patients were scintigraphically brain dead and the remaining 2 had some brain uptake excluding the diagnosis of scintigraphic brain death. In conclusion, cerebral perfusion study using a lipophilic brain tracer offers a noninvasive, rapid, easy, accurate and reliable mean in the diagnosis of brain death. We believe that this modality should be included in the criteria of brain death in the draft of the proposed Korean law

  11. Evaluation of Nucleic Acid Preservation Cards for West Nile Virus Testing in Dead Birds.

    Directory of Open Access Journals (Sweden)

    Leslie Foss

    Full Text Available The California West Nile virus (WNV Dead Bird Surveillance Program (DBSP is an important component of WNV surveillance in the state. We evaluated FTA™ and RNASound™ cards as an alternative method for sampling dead birds for WNV molecular testing as these cards allow for more cost effective, rapid, and safer diagnostic sampling than the shipment of bird carcasses. To evaluate accuracy of results among avian sampling regimes, Reverse-Transcription Polymerase Chain Reaction (RT-PCR results from FTA™ and RNASound™ cards were compared with results from kidney tissue, brain tissue, or oral swabs in lysis buffer in 2012-2013. In addition, RT-PCR results were compared with results from oral swabs tested by rapid antigen tests (RAMP™ and VecTOR™. While test results from the cards were not as sensitive as kidney tissue testing, they were more likely to provide accurate results than rapid antigen tests, and detected WNV in corvids as well as in other passerines, raptors, and waterfowl. Overall, WNV RT-PCR cycle threshold (Ct scores from the cards were higher than those from tissue testing, but both card products displayed high sensitivity and specificity. American Crow samples provided the highest sensitivity. The cards also proved to be easier and more convenient vehicles for collecting and shipping samples, and in 2014 our program launched use of RNASound™ cards in the DBSP. Both FTA™ and RNASound™ products displayed 96% agreement with tissue results and are an adequate alternative sampling method for WNV dead bird testing.

  12. Cascades of pile-up and dead time

    International Nuclear Information System (INIS)

    Pomme, S.


    Count loss through a cascade of pile-up and dead time is studied. Time interval density-distribution functions and throughput factors are presented for counters with a series arrangement of pile-up and extending or non-extending dead time. A counter is considered, where an artificial dead time is imposed on every counted event, in order to control the length and type of dead time. For such a system, it is relatively easy to determine an average count-loss correction factor via a live-time clock gated by the imposed dead-time signal ('live-time mode'), or otherwise to apply a correction factor based on the inversion of the throughput function ('real-time mode'). However, these techniques do not account for additional loss through pulse pile-up. In this work, counting errors associated with neglecting cascade effects are calculated for measurements in live-time and real-time mode

  13. [Routine hormonal therapy in the heart transplant donor]. (United States)

    Zetina-Tun, Hugo; Lezama-Urtecho, Carlos; Careaga-Reyna, Guillermo


    Successful heart transplantation depends largely on donor heart function. During brain death many hormonal changes occur. These events lead to the deterioration of the donor hearts. The 2002 Crystal Consensus advises the use of a triple hormonal scheme to rescue marginal cardiac organs. A prospective, longitudinal study was conducted on potential donor hearts during the period 1 July 2011 to 31 May 2013. All donor hearts received a dual hormonal rescue scheme, with methylprednisolone 15mg/kg IV and 200mcg levothyroxine by the enteral route. There was at least a 4 hour wait prior to the harvesting. The preload and afterload was optimised. The variables measured were: left ventricular ejection fraction cardiac graft recipient; immediate and delayed mortality. A total of 30 orthotopic heart transplants were performed, 11 female and 19 male patients, with age range between 19 and 63 years-old (Mean: 44.3, SD 12.92 years). The donor hearts were 7 female and 23 male, with age range between 15 and 45 years-old (mean 22.5, SD 7.3 years). Immediate mortality was 3.3%, 3.3% intermediate, and delayed 3.3%, with total 30 day-mortality of 10%. Month survival was 90%. The immediate graft left ventricular ejection fraction was 45%, 60% intermediate, and 68% delayed. The causes of death were: 1 primary graft dysfunction, one massive pulmonary embolism, and one due to nosocomial pneumonia. It was concluded that the use of double rescue scheme hormonal therapy is useful for the recovery and preservation of the donor hearts. This scheme improves survival within the first 30 days after transplantation. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  14. No Time for Dead Time: Use the Fourier Amplitude Differences to Normalize Dead-time-affected Periodograms (United States)

    Bachetti, Matteo; Huppenkothen, Daniela


    Dead time affects many of the instruments used in X-ray astronomy, by producing a strong distortion in power density spectra. This can make it difficult to model the aperiodic variability of the source or look for quasi-periodic oscillations. Whereas in some instruments a simple a priori correction for dead-time-affected power spectra is possible, this is not the case for others such as NuSTAR, where the dead time is non-constant and long (∼2.5 ms). Bachetti et al. (2015) suggested the cospectrum obtained from light curves of independent detectors within the same instrument as a possible way out, but this solution has always only been a partial one: the measured rms was still affected by dead time because the width of the power distribution of the cospectrum was modulated by dead time in a frequency-dependent way. In this Letter, we suggest a new, powerful method to normalize dead-time-affected cospectra and power density spectra. Our approach uses the difference of the Fourier amplitudes from two independent detectors to characterize and filter out the effect of dead time. This method is crucially important for the accurate modeling of periodograms derived from instruments affected by dead time on board current missions like NuSTAR and Astrosat, but also future missions such as IXPE.

  15. Being a Living Donor: Risks (United States)

    ... to know FAQ Living donation What is living donation? Organs Types Being a living donor First steps Being ... are considering one of these types of living donation, please talk to your transplant center about the organ-specific risks. Psychological concerns You may also have ...

  16. Factors Influencing Donor Partnership Effectiveness

    International Development Research Centre (IDRC) Digital Library (Canada)

    (UN Global Compact Office, 2007); and “an alliance between organizations from two or more ... programs related to the environment, global health, and ..... partnering process and the factors of influence, drawing on an example of a flagship initiative with a bilateral donor for an environment-focused program. As in most joint ...

  17. Physician migration: donor country impact. (United States)

    Aluwihare, A P R


    Physician migration from the developing to developed region of a country or the world occurs for reasons of financial, social, and job satisfaction. It is an old phenomenon that produces many disadvantages for the donor region or nation. The difficulties include inequities with the provision of health services, financial loss, loss of educated families, potential employers, and role models and diminished resources with which to conduct medical education. Staff for undergraduate and postgraduate education is depleted. The critical mass for research and development becomes difficult to achieve or maintain, and these disadvantages are not compensated for adequately by increased contacts, the introduction of new ideas, or financial inflow to the donor region or country. The political will of governments and international organizations regarding treaties about the ethics of physician recruitment is called into question by discrepancies between the text of agreements and the ground realities. Amelioration of this situation requires economic development and imaginative schemes by the donors and, ideally, ethical considerations from recipient governments. At the very least, adequate compensation should be made to the donor country for the gain obtained by the host country.

  18. Micro-facies of Dead Sea sediments (United States)

    Neugebauer, Ina; Schwab, Markus J.; Brauer, Achim; Frank, Ute; Dulski, Peter; Kitagawa, Hiroyuki; Enzel, Yehouda; Waldmann, Nicolas; Ariztegui, Daniel; Drilling Party, Dsddp


    Lacustrine sediments infilling the Dead Sea basin (DSB) provide a rare opportunity to trace changing climates in the eastern Mediterranean-Levant region throughout the Pleistocene and Holocene. In this context, high-resolution investigation of changes in sediment micro- facies allow deciphering short-term climatic fluctuations and changing environmental conditions in the Levant. The Dead Sea is a terminal lake with one of the largest drainage areas in the Levant, located in the Mediterranean climate zone and influenced also by the Saharo-Arabian deserts. Due to drastic climatic changes in this region, an exceptionally large variety of lacustrine sediments has been deposited in the DSB. These sediments, partially the results of changing lake levels, primarily represent changes in precipitation (e.g. Enzel et al., 2008). Evaporites (halite and gypsum) reflect dry climatic conditions during interglacials, while alternated aragonite-detritus (AAD) is deposited during glacial lake level high-stands. Here we present the first micro-facies inventory of a ~450 m long sediment profile from the deepest part of the northern DSB (ICDP site 5017-1, ~300 m water depth). The sediment record comprises the last two glacial-interglacial cycles, with mainly AAD facies in the upper part of the Amora Formation (penultimate glacial) and the last glacial Lisan Formation. The last interglacial Samra and the Holocene Zeelim Formations are predominantly characterized by thick bedded halite deposits, intercalated by partly laminated detrital marl sequences. Representative sections of the different facies types have been analyzed for micro-facies on petrographic thin sections, supported by high-resolution µXRF element scanning, magnetic susceptibility measurements and microscopic fluorescence analysis. Furthermore, Holocene sediments retrieved at the deep basin core site have been compared to their shallow-water counterpart at the western margin of the lake (core DSEn; Migowski et al., 2004

  19. Psychosocial counselling of identifiable sperm donors. (United States)

    Visser, M; Mochtar, M H; de Melker, A A; van der Veen, F; Repping, S; Gerrits, T


    What do identifiable sperm donors feel about psychosocial counselling? Identifiable sperm donors found it important that psychosocial counselling focused on emotional consequences and on rules and regulations and they expected to have access to psychosocial counselling at the time that donor-offspring actually sought contact. Most studies on sperm donors are on anonymous donors and focus on recruitment, financial compensation, anonymity and motivations. There is limited knowledge on the value that identifiable sperm donors place on psychosocial counselling and what their needs are in this respect. We performed a qualitative study from March until June 2014 with 25 identifiable sperm donors, who were or had been a donor at the Centre for Reproductive Medicine of the Academic Medical Centre in Amsterdam any time between 1989 and 2014. We held semi-structured in-depth interviews with identifiable sperm donors with an average age of 44 years. The interviews were fully transcribed and analysed using the constant comparative method of grounded theory. Twelve out of 15 donors (former donors ITALIC! n = 8, active donors ITALIC! n = 7) who had received a counselling session during their intake procedure found it important that they had been able to talk about issues such as the emotional consequences of donation, disclosure to their own children, family and friends, future contact with donor-offspring and rules and regulations. Of the 10 former donors who had received no counselling session, 8 had regretted the lack of intensive counselling. In the years following their donation, most donors simply wanted to know how many offspring had been born using their sperm and had no need for further counselling. Nevertheless, they frequently mentioned that they were concerned about the well-being of 'their' offspring. In addition, they would value the availability of psychosocial counselling in the event that donor-offspring actually sought contact. A limitation of our study is its

  20. Personal Identity and Resurrection from the Dead

    Directory of Open Access Journals (Sweden)

    Gasparov Igor


    Full Text Available The paper examines arguments of the “Christian materialist” Trenton Merricks that he provided in support of the claim that the Christian doctrine of resurrection from the dead is compatible with the materialist understanding of the nature of human beings. In his paper The Resurrection of the Body, Merricks discussed two aspects of the materialist interpretation of the traditional religious doctrine of the bodily resurrection. On the one hand, he analyses and tries to overcome objections against the possibility of the general resurrection in case the materialist understanding of the nature of human personality should be true (mainly the problem of the temporal gap. On the other hand, he provides some reasons why the materialist understanding of human nature is more relevant than its dualist counterpart to the doctrine of the bodily resurrection. The present paper evaluates his arguments and discusses the suggestion that the doctrine of resurrection is not only compatible with materialism, but is also tenable if human beings are identical with their physical bodies. The conclusion of the paper is that Merricks’ apologetic arguments achieve their aims in defending the doctrine of resurrection only partially; the resurrection doctrine appears more tenable if we accept the dualistic conception of human nature.

  1. Autopsies of the real: Resurrecting the dead

    Directory of Open Access Journals (Sweden)

    Valis, Noël


    Full Text Available The sense of the real, or the material—the dead body—as an inextricable part of the sacred does not disappear in the secular environment of the nineteenth and twentieth centuries. This article analyzes specific humanitarian narratives centered on the practice of autopsy and mummification, in which the traces of Catholicism act as a kind of spectral discourse of the imagination, where the real is configured in forms of the uncanny, the monstrous or the sacred.

    El sentido de lo real, de lo material —el cuerpo sin vida— como una inextricable parte de lo sagrado, no desaparece del ambiente secular de los siglos XIX y XX. En los relatos analizados en este artículo se estudia cómo en determinadas narrativas humanitarias centradas en la práctica de la autopsia y la momificación, las huellas del catolicismo actúan como una suerte de discurso espectral de la imaginación, en que lo real se configura en formas de lo siniestro, lo monstruoso o lo sagrado.


    Directory of Open Access Journals (Sweden)

    Ida Ayu Basmatika


    Full Text Available Secondary brain injury is a condision that occurs at some times after the primary impact and can be largely prevented and treated. Most brain injury ends with deadly consequences which is caused by secondary damage to the brain. Traumatic brain injured still represents the leading cause of morbidity and mortality in individuals under the age of 45 years in the world. The classification of secondary brain injured is divided into extracranial and intracranial causes. The cause of extracranial such as hipoxia, hypotensi, hyponatremia, hypertermia, hypoglycemia or hyperglycemia. The cause of intracranial such as extradural, subdural, intraserebral, intraventrikular, dan subarachnoid hemorrhage. Beside that secondary injury can also be caused by edema and infection. Post-traumatic cerebral injured is characterized by direct tissue damage, impaired regulation of cerebral blood flow (cerebral blood flow / CBF, and disruption of metabolism. Manifestations of secondary brain injured include increased intracranial pressure, ischemic brain damage, cerebral hypoxia and hypercarbi, as well as disruption of cerebral autoregulation. The first priority is to stabilize the patient's cervical spine injury, relieve and maintain airway, ensure adequate ventilation (breathing, and making venous access for fluid resuscitation pathways (circulation and assessing the level of awareness and disability. This steps is crucial in patients with head injured to prevent hypoxia and hypotension, which is the main cause of secondary brain injury.

  3. Case of 24-week Fetus Delivered from Mother on Life Support with Brain-death from Suicide Attempt: Ethical Issues Associated with Severe Complications. (United States)

    Nishimura, Takeshi; Kohama, Keisuke; Osako, Takaaki; Yamada, Taihei; Tanaka, Hiroyuki; Nakao, Atsunori; Kotani, Joji


    Advances in critical care medicine have made it possible to sustain vital organ systems in brain-dead patients. One clinical scenario besides donor organ retrieval in which a benefit may be gained from continuing life support is pregnancy. A pregnant woman in her late 30's at 23 weeks gestation exhibiting worsening depression was referred to the Department of Psychiatry. One day after admission she attempted suicide by hanging and suffered a cardiopulmonary arrest. A fetal heart beat and fetal motion was confirmed immediately after resuscitation. Three days after admission, an emergency Cesarean section (CS) was performed because of her unstable hemodynamic situation. The baby was born and the mother died after delivery. The baby presented neurological complications. Such a case should be managed collaboratively among professional experts in several medical teams. Consensus and recommendations for the management of similar scenarios may also be adjusted.

  4. Fault-tolerant dead reckoning system for a modular vehicle (United States)

    Hashimoto, Masafumi; Oba, Fuminori; Takahashi, Kazuhiko


    A fault-tolerant dead reckoning system is presented for a modular vehicle, which consists of one chassis unit and several wheel units. The units locally estimate the vehicle position based on their own internal sensors. The local estimates are exchanged among the units via an inter-communication system, and they are fused in a decentralized manner. The units can then determine the vehicle position accurately. The decentralized dead reckoning algorithm is formulated based on the information filter and the covariance Intersection method. For enhancing the reliability of the dead reckoning a multi-model based fault detection and diagnosis (FDD) of the internal sensors is incorporated into the dead reckoning system. The units diagnose their sensors with the FDD system, and they apply only the normal sensors for the vehicle localization. In this paper two fault modes (hard fault and noise fault modes) of the sensors are handled; on the hard fault the sensor output is stuck at a constant value. On the noise fault it is disturbed by a large noise. The FDD algorithm is based on the variable structure interacting multiple-model estimator. The fault-tolerant dead reckoning algorithm was implemented on our indoor test-vehicle, which consists of one chassis unit and four wheel units. Experimental results show that our dead reckoning provided better localization accuracy than the conventional one (i.e., the dead reckoning without sensor FDD system) did even though the sensors partially failed.

  5. Psychosocial counselling of identifiable sperm donors

    NARCIS (Netherlands)

    Visser, M.; Mochtar, M.H.; de Melker, A.A.; van der Veen, F.; Repping, S.; Gerrits, T.


    STUDY QUESTION: What do identifiable sperm donors feel about psychosocial counselling? SUMMARY ANSWER: Identifiable sperm donors found it important that psychosocial counselling focused on emotional consequences and on rules and regulations and they expected to have access to psychosocial

  6. Psychosocial counselling of identifiable sperm donors

    NARCIS (Netherlands)

    Visser, M. [=Marja; Mochtar, M. H.; de Melker, A. A.; van der Veen, F.; Repping, S.; Gerrits, T.


    What do identifiable sperm donors feel about psychosocial counselling? Identifiable sperm donors found it important that psychosocial counselling focused on emotional consequences and on rules and regulations and they expected to have access to psychosocial counselling at the time that

  7. Dead-Time Generation in Six-Phase Frequency Inverter

    Directory of Open Access Journals (Sweden)

    Aurelijus Pitrėnas


    Full Text Available In this paper control of multi-phase induction drives is discussed. Structure of six-phase frequency inverter is examined. The article deals with dead-time generation circuits in six-phase frequency inverter for transistor control signals. Computer models of dead-time circuits is created using LTspice software package. Simulation results are compared with experimental results of the tested dead-time circuits. Parameters obtained in simulation results are close to the parameters obtained in experimental results.

  8. Adaptive control with variable dead-zone nonlinearities (United States)

    Orlicki, D.; Valavani, L.; Athans, M.; Stein, G.


    It has been found that fixed error dead-zones as defined in the existing literature result in serious degradation of performance, due to the conservativeness which characterizes the determination of their width. In the present paper, variable width dead-zones are derived for the adaptive control of plants with unmodeled dynamics. The derivation makes use of information available about the unmodeled dynamics both a priori as well as during the adaptation process, so as to stabilize the adaptive loop and at the same time overcome the conservativeness and performance limitations of fixed-dead zone adaptive or fixed gain controllers.

  9. Are We the Walking Dead? Burnout as Zombie Apocalypse (United States)

    Doolittle, Benjamin R.


    The Walking Dead, one of the most popular television shows in recent history, uses the plot of a zombie apocalypse as a lens into exploring the human condition. Amidst a particularly dangerous moment, the show’s hero references the human struggle to survive by remarking, “We are the walking dead.” This offhand comment sheds light upon physicians’ struggles in medicine, in particular the high prevalence of burnout and the challenge to cultivate compassion and meaning. This is an important question for our age and for our profession. Are we the walking dead? PMID:28376445

  10. First report of the United Network for Organ Sharing Transplant Tumor Registry: donors with a history of cancer. (United States)

    Kauffman, H M; McBride, M A; Delmonico, F L


    Severe organ shortages have led to donor pool expansion to include older individuals, patients with hypertension, diabetes, and a past history of cancer. Transmission of cancer from cadaveric donors is a risk of transplantation and carries a high mortality rate. During a 33 month period, UNOS recorded 14,705 cadaveric donors of which 257 had a past history of cancer (PHC). A total of 650 organs (397 kidneys, 178 livers, and 75 hearts) were transplanted from these 257 donors. Type of cancer, tumor-free interval at organ procurement, and whether any PHC donor transmitted a tumor to the recipient were analyzed. Three PHC donor tumor types (skin, brain, genitourinary) were associated with 549 of the transplanted organs (85%). Twenty-eight recipients of PHC donor organs developed posttransplantation tumors (18 skin, 2 PTLD, 8 solid cancers). During a mean follow-up of 45 months (range 30-61 months), no recipients of organs from PHC donors developed a donor derived cancer. The majority (71.5%) of all non-skin and non-CNS system cancer donors had a cancer-free interval of greater than five years. Risks of cancer transmission from donors with a history of non-melanoma skin cancer and selected cancers of the CNS appear to be small. Risks of tumor transmission with certain other types of cancer may be acceptable, particularly if the donor has a long cancer-free interval prior to organ procurement while certain other cancers pose a high transmission risk. Selective use of PHC donors may permit expansion of the donor pool.

  11. Screening Donors for Rare Antigen Constellations. (United States)

    Wagner, Franz F


    SCREENING BLOOD DONORS FOR RARE ANTIGEN CONSTELLATIONS HAS BEEN IMPLEMENTED USING SIMPLE PCR METHODS: PCR with enzyme digestion has been used to type donor cohorts for Dombrock antigens, and PCR with sequence-specific priming to identify donors negative for antigens of high frequency. The advantages and disadvantages of the methods as well as their current state is discussed.

  12. Predictors of hemoglobin in Danish blood donors

    DEFF Research Database (Denmark)

    Kotze, Sebastian Ranzi; Pedersen, Ole B; Petersen, Mikkel S


    BACKGROUND: It is well known that blood donors are at increased risk of iron deficiency and subsequent development of iron deficiency anemia. We aimed to investigate the effect of factors influencing hemoglobin (Hb) levels. STUDY DESIGN AND METHODS: Initiated in 2010, the Danish Blood Donor Study...... measurement as a method of risk assessment among blood donors....

  13. Groundwater-Lake Interaction in the Dead Sea Area (United States)

    Kiro, Y.; Weinstein, Y.; Starinsky, A.; Yechieli, Y.


    The Dead Sea hypersaline water system is unique in terms of its unusual geochemical composition, rapid lake level changes and water composition of the brines discharging along its shoreline. The Dead Sea can be used as a natural lab for studying groundwater-seawater interaction and saline water hydrological circulation along the aquifer-sea boundary. It provides an opportunity to follow the geochemical processes along a flow path from the lake into the aquifer and back into the lake. The lake level has been dropping since the 1960's due to human interference in its water budget, reaching a rate of 1 m/yr in recent years. Saline water circulation in coastal aquifers may be a major process that governs trace element mass balances in coastal areas. This study uses radium isotopes in order to quantify the lake water circulation in the Dead Sea aquifer. There are four naturally-occurring radium isotopes, with half-lives ranging from 3.7 days to 1600 years which are chain products of uranium and thorium isotopes. Radium isotopes are usually enriched in saline groundwater and therefore are good candidates for estimating seawater or hypersaline lake water circulation in the aquifer. Compared to most natural water bodies, the Dead Sea is extremely enriched in radium and barium, where both 226Ra and 228Ra activities and Ba concentration (145, 1-2 dpm/L and 5 mg/L, respectively) are 2-3 orders of magnitude higher than in ocean water, whereas the salinity of the Dead Sea is only 10 times higher. Circulated Dead Sea water in the aquifer contains decreased concentrations of 226Ra (60 dpm/L), Ba (1.5 mg/L), Sr (300 relative to 340 mg/L in the Dead Sea) and Sulfate (250 relative to 392 mg/L). We suggest that the low 226Ra and Ba concentrations are due to precipitation of barite and celestine from the supersaturated Dead Sea water on entering the aquifer. 228Ra and the shorter-lived 224Ra and 223Ra, which have much lower activities in the Dead Sea (up to 1.8, 3 and 0.8 dpm

  14. 75 FR 58400 - Donor Management Research: Improvements in Clinical Management of Deceased Organ Donors (United States)


    ... generally focused on specific organ systems and not on donor management approaches with the goal of... donor management. A Donor Management Task Force was convened in August 2010 to address relevant issues... Management Research: Improvements in Clinical Management of Deceased Organ Donors AGENCY: Health Resources...

  15. Donor conversion rates depend on the assessment tools used in the evaluation of potential organ donors

    NARCIS (Netherlands)

    Y.J. de Groot (Yorick); E.F.M. Wijdicks (Eelco); M. van der Jagt (Mathieu); J. Bakker (Jan); B. Roozenbeek (Bob); J.N.M. IJzermans (Jan); E.J.O. Kompanje (Erwin)


    textabstractPurpose: It is desirable to identify a potential organ donor (POD) as early as possible to achieve a donor conversion rate (DCR) as high as possible which is defined as the actual number of organ donors divided by the number of patients who are regarded as a potential organ donor. The

  16. Alterações fisiológicas da morte encefálica em potenciais doadores de órgãos e tecidos para transplantes Los cambios fisiológicos de la muerte cerebral en potenciales donadores de órganos y tejidos para trasplante Physiological changes of brain death in potential donors of organs and tissues for transplantation

    Directory of Open Access Journals (Sweden)

    Sarah Gabriel Freire


    órnea (3,1%. Se cree que el conocimiento de estos cambios permite al equipo de atención de la salud dirigir sus acciones al potencial donador de acuerdo a sus necesidades y así mantener los órganos/tejidos viables para el trasplante.The objective was to describe the physiologic changes of brain death in potential donors of organs and tissues for transplantation. Exploratory descriptive study with prospective data and quantitative approach carried out in emergency and intensive care units hospital adult, in the period from April to October 2011. The population consisted of 32 potential donors of organs and tissues for transplantation. After approval of Ethics Committee, data were collected, tabulated and analyzed by descriptive statistics by SPSS 15.0 software and presented in tables. Physiological changes were: hypotension (100%, hypothermia (75%, hypernatremia (62,5%, diabetes insipidus (37,5%, hyperglycemia (32,3%, infection (25,0%, hypertension (9,4% and corneal ulcer (3,1%. It was found that knowledge of these changes allows the team of health care to direct the potential donors according to their needs and thus keep the organ/tissue viable for transplant.

  17. Hyperbilirubinemia in normal healthy donors

    Directory of Open Access Journals (Sweden)

    Arora Veena


    Full Text Available The present study was carried out in B.A.R.C. Hospital Blood Bank over a span of five years, and includes 2734 donors. All the bags were screened for HIV, HBsAg, HCV and VDRL and the plasma in the pilot tubes of the blood bags was observed to detect any abnormality in color. In 27 cases plasma was found to be icteric and liver function tests were carried out on these samples. Two donors showed higher SGPT level, and were excluded. No significant increases in liver enzymes were recorded in the others. Causes of icteric plasma in these apparently healthy donors are discussed. Differential diagnosis includes Gilbert′s disease, hemolytic anemia, drug-induced anemia and other hepatic causes of hyperbilirubinemia, of which Gilbert′s disease is most probable cause with a prevalence of 0.91% in our population. As there are no studies to document the safety of the recipients receiving such abnormal colored plasma as well as to document the hazards in its transfusion, the question arises whether to transfuse such units or not. This study highlights this dilemma. A reassessment of existing policies and regulations is merited.

  18. Probable Carbonate Fossilization Processes Within Dead Sea Microbial Remains (United States)

    Morris, P. A.; Wentworth, S. J.; Thomas-Keprta, K. L.; Allen, C. C.; McKay, D. S.


    Microbial fossilization processes in the Dead Sea is primarily associated with the calcium cation. The putative fossilized microbes do not represent the reported living microbial population. Additional information is contained in the original extended abstract.

  19. Dead zone area at the downstream flow of barrages

    Directory of Open Access Journals (Sweden)

    Mohamed F. Sauida


    Full Text Available Flow separation is a natural phenomenon encountered at some cases downstream of barrages. The main flow is divided into current and dead zone flows. The percentage area of dead zone flow must be taken into consideration downstream of barrages, due to its negative effect on flow characteristics. Experimental studies were conducted in the Hydraulic Research Institute (HRI, on a physical regulator model with five vents. Theoretically the separation zone is described as a part of an ellipse which is practically verified by plotting velocity vectors. The results show that the percentage area of dead zone to the area through length of separation depends mainly on the expansion ratio [channel width to width of opened vents], with maximum value of 81% for operated side gates. A statistical analysis was derived, to predict the percentage area of dead zone flow to the area through length of separation.

  20. In the Event of Bioterrorism: Protecting Families from Deadly Diseases (United States)

    ... Español Text Size Email Print Share In the Event of Bioterrorism: Protecting Families from Deadly Diseases Page ... exposure. Talking to Children about Bioterrorism In the event of bioterrorism, knowing how to talk to your ...

  1. Management of the dead in Tacloban City after Typhoon Haiyan


    Julius Erving Ballera; Vikki Carr de los Reyes; Ma Nemia Sucaldito; Alethea De Guzman; Luis Sy, Jr; Ma Justina Zapanta; Ferchito Avelino; Joselito Feliciano; Enrique Tayag


    Introduction: The post-disaster management of the dead involves a series of steps including on-site identification, transfer, storage and examination of bodies and delivery to families for burial. Two weeks after Typhoon Haiyan, a team from the Department of Health (DOH) was tasked with identifying the dead in Tacloban City. Methods: A suitable site for the collection of bodies was identified and an algorithm and standard data collection form developed. The retrieval of bodies was coordi...

  2. Beta-Adrenergic Receptor Polymorphisms and Cardiac Graft Function in Potential Organ Donors (United States)

    Khush, K.K.; Pawlikowska, L.; Menza, R.L.; Goldstein, B.A.; Hayden, V.; Nguyen, J.; Kim, H.; Poon, A.; Sapru, A.; Matthay, M.A.; Kwok, P.Y.; Young, W.L.; Baxter-Lowe, L.A.; Zaroff, J.G.


    Prior studies have demonstrated associations between β-adrenergic receptor polymorphisms and left ventricular dysfunction—an important cause of allograft non-utilization for transplantation. We hypothesized that βAR polymorphisms predispose donor hearts to LV dysfunction after brain death. 1,043 organ donors managed from 2001-2006 were initially studied. The following βAR single nucleotide polymorphisms were genotyped: β1AR 1165C/G (Arg389Gly), β1AR 145A/G (Ser49Gly), β2AR 46G/A (Gly16Arg), and β2AR 79C/G (Gln27Glu). In multivariable regression analyses, the β2AR46 SNP was significantly associated with LV systolic dysfunction, with each minor allele additively decreasing the odds for LV ejection fractiondonor management period: donors with the GG and AA genotypes had ORs of 2.64 (95% CI 1.52-4.57) and 2.70 (1.07-2.74) respectively for requiring >10 mcg/kg/min of dopamine compared to those with the CC and GG genotypes. However, no significant associations were found between βAR SNPs and cardiac dysfunction in 364 donors managed from 2007-2008, perhaps due to changes in donor management, lack of power in this validation cohort, or the absence of a true association. βAR polymorphisms may be associated with cardiac dysfunction after brain death, but these relationships require further study in independent donor cohorts. PMID:22994654

  3. Simulation shows that HLA-matched stem cell donors can remain unidentified in donor searches (United States)

    Sauter, Jürgen; Solloch, Ute V.; Giani, Anette S.; Hofmann, Jan A.; Schmidt, Alexander H.


    The heterogeneous nature of HLA information in real-life stem cell donor registries may hamper unrelated donor searches. It is even possible that fully HLA-matched donors with incomplete HLA information are not identified. In our simulation study, we estimated the probability of these unnecessarily failed donor searches. For that purpose, we carried out donor searches in several virtual donor registries. The registries differed by size, composition with respect to HLA typing levels, and genetic diversity. When up to three virtual HLA typing requests were allowed within donor searches, the share of unnecessarily failed donor searches ranged from 1.19% to 4.13%, thus indicating that non-identification of completely HLA-matched stem cell donors is a problem of practical relevance. The following donor registry characteristics were positively correlated with the share of unnecessarily failed donor searches: large registry size, high genetic diversity, and, most strongly correlated, large fraction of registered donors with incomplete HLA typing. Increasing the number of virtual HLA typing requests within donor searches up to ten had a smaller effect. It follows that the problem of donor non-identification can be substantially reduced by complete high-resolution HLA typing of potential donors.

  4. Brain Basics

    Medline Plus

    Full Text Available ... About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain Brain ... called the hypothalamic-pituitary-adrenal (HPA) axis. Brain Basics in Real Life Brain Basics in Real Life— ...

  5. Exercising is like flogging a dead horse

    International Nuclear Information System (INIS)

    Molhoek, W.


    - FR (NPP Gravelines) was conducted (22-23th of May 2001). The main objectives of the INEX series of exercises were focused on: decision making based on limited information and uncertain plant conditions; the use of real time communications with actual equipment and procedures; public information and interaction with media; the use of real weather for real time forecasts. For real further improvement of (nuclear) emergency management and response, not only national and international exercises such as INEX, CONVEX, JINEX etc. are needed, but the efforts to improve personal performance of key-persons involved is crucial. Structural plans to train and exercise individuals and teams should therefore be developed as well. To move the dead horse and create a racehorse need a lot of personal skills and attention. It is also recognized that often the carrot is better than the whip. (author)

  6. Liver transplantation using organs from deceased organ donors: a single organ transplant center experience. (United States)

    Han, Ming; Guo, Zhi-Yong; Zhao, Qiang; Wang, Xiao-Ping; Yuan, Xiao-Peng; Jiao, Xing-Yuan; Yang, Chun-Hua; Wang, Dong-Ping; Ju, Wei-Qiang; Wu, Lin-Wei; Hu, An-Bin; Tai, Qiang; Ma, Yi; Zhu, Xiao-Feng; He, Xiao-Shun


    In 2011, a pilot program for deceased organ donation was initiated in China. We describe the first successful series of liver transplants in the pilot program. From July 2011 to August 2012, our center performed 26 liver transplants from a pool of 29 deceased donors. All organ donation and allograft procurement were conducted according to the national protocol. The clinical data of donors and recipients were collected and summarized retrospectively. Among the 29 donors, 24 were China Category II donors (organ donation after cardiac death), and five were China Category III donors (organ donation after brain death followed by cardiac death). The recipients were mainly the patients with hepatocellular carcinoma. The one-year patient survival rate was 80.8% with a median follow-up of 422 (2-696) days. Among the five mortalities during the follow-up, three died of tumor recurrence. In terms of post-transplant complications, 9 recipients (34.6%) experienced early allograft dysfunction, 1 (3.8%) had non-anastomotic biliary stricture, and 1 (3.8%) was complicated with hepatic arterial thrombosis. None of these complications resulted in patient death. Notably, primary non-function was not observed in any of the grafts. With careful donor selection, liver transplant from deceased donors can be performed safely and plays a critical role in overcoming the extreme organ shortage in China.

  7. Impact of a quality improvement project on deceased organ donor management (United States)

    Olmos, Andrea; Feiner, John; Hirose, Ryutaro; Swain, Sharon; Blasi, Annabel; Roberts, John P.; Niemann, Claus U.


    Context Donors showed poor glucose control in the period between declaration of brain death and organ recovery. The level of hyperglycemia in the donors was associated with a decline in terminal renal function. Objective To determine whether implementation of a quality improvement project improved glucose control and preserved renal function in deceased organ donors. Methods Data collected retrospectively included demographics, medical history, mechanism of death, laboratory values, and data from the United Network for Organ Sharing. Results After implementation of the quality improvement project, deceased donors had significantly lower mean glucose concentrations (mean [SD], 162 [44] vs 212 [42] mg/dL; P donor cohorts from before and after the quality improvement project were analyzed together, mean glucose concentration remained a significant predictor of terminal creatinine level (P donors indicated that higher terminal creatinine level was associated with delayed graft function in recipients (P donor glucose homeostasis, and the data confirm that poor glucose homeostasis is associated with worsening terminal renal function. PMID:26645930

  8. Love and death: microglia, NLRP3 and the Alzheimer's brain. (United States)

    Goldmann, Tobias; Tay, Tuan Leng; Prinz, Marco


    Microglia were previously attributed to be vital brain guardians for neuronal survival and synaptic pruning during development as well as for the brain's fight against environmental pathogens. A new report in Nature by the Heneka, Latz and Golenbock groups, however, sheds new light on these distinct myeloid cells by revealing their deadly nature for mature neurons during neurodegeneration.

  9. Laparoscopic nephrectomy in live donor

    Directory of Open Access Journals (Sweden)

    Mitre Anuar I.


    Full Text Available OBJECTIVE: To present the initial experience of videolaparoscopic nephrectomy in live renal donor. MATERIALS AND METHODS: In the period from April 2000 to August 2003, 50 left nephrectomies in live donor were performed by videolaparoscopy for transplantation. Twenty-eight patients were male (56% and 22 female (44%. Mean age was 37.2 years, and the mean body mass index (BMI was 27.1 kg/m². RESULTS: Mean surgical time was 179.5 minutes, and warm ischemia time of the graft was 3.79 minutes. The mean estimated bleeding was 141 mL. There was no need of blood transfusion or conversion to open surgery. In 42 cases (84%, the vascular portion of the graft was considered good by the recipient's surgical team and in all cases, the ureter was considered of proper size, though in one of them (2% its vascularization was considered improper. The transplanted kidneys produced urine still in the surgical room in 46 of the 50 transplantations considered. In only 2 cases opioid was required for analgesia. In average, 3.1 doses of dipyrone were used for each patient during hospital stay, and hospital discharge occurred, in average, after 3.2 days post-operatively. Two patients required re-operations and one of them evolved to death. CONCLUSIONS: The laparoscopic nephrectomy in live donor for renal transplantation is an alternative to conventional open surgery. In relation to the graft, no alteration, either anatomic or functional, was detected. Though there is already a large documentation in the international literature regarding this procedure, in our setting a prospective randomized study with the usual surgical study is still necessary in order to prove the advantages and disadvantages of the method.

  10. Options for reducing HIV transmission related to the dead space in needles and syringes. (United States)

    Zule, William A; Pande, Poonam G; Otiashvili, David; Bobashev, Georgiy V; Friedman, Samuel R; Gyarmathy, V Anna; Des Jarlais, Don C


    When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing. Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles. The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.

  11. Gray Matter-White Matter De-Differentiation on Brain Computed Tomography Predicts Brain Death Occurrence. (United States)

    Vigneron, C; Labeye, V; Cour, M; Hannoun, S; Grember, A; Rampon, F; Cotton, F


    Previous studies have shown that a loss of distinction between gray matter (GM) and white matter (WM) on unenhanced CT scans was predictive of poor outcome after cardiac arrest. The aim of this study was to identify a marker/predictor of imminent brain death. In this retrospective study, 15 brain-dead patients after anoxia and cardiac arrest were included. Patients were paired (1:1) with normal control subjects. Only patients' unenhanced CT scans performed before brain death and during the 24 hours after initial signs were analyzed. WM and GM densities were measured in predefined regions of interest (basal ganglia level, centrum semi-ovale level, high convexity level, brainstem level). At each level, GM and WM density and GM/WM ratio for brain-dead patients and normal control subjects were compared using the Wilcoxon signed-rank test. At each level, a lower GM/WM ratio and decreased GM and WM densities were observed in brain-dead patients' CT scans when compared with normal control subject CT scans. A cut-off value of 1.21 at the basal ganglia level was identified, below which brain death systematically occurred. GM/WM dedifferentiation on unenhanced CT scan is measurable before the occurrence of brain death, highlighting its importance in brain death prediction. The mechanism of GM/WM differentiation loss could be explained by the lack of oxygen caused by ischemia initially affecting the mitochondrial system. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Factors Associated with a Family's Delay of Decision for Organ Donation After Brain Death. (United States)

    Han, Sang Youb; Kim, Jae Il; Lee, Eun-Woo; Jang, Hye-Yeon; Han, Kum Hyun; Oh, Se Won; Roh, Young-Nam


    BACKGROUND This study aimed to explore the factors associated with a family's delay of decision for organ donation after brain death, and to investigate the effect of such a delay on organ donation. MATERIAL AND METHODS Medical records and data on counseling about organ donation with the families of 107 brain-dead potential donors between September 2012 and March 2016 at a single tertiary medical center were retrospectively reviewed. RESULTS The final consent rate was 58% (62/107), and successful donation was performed in 40% (43/107). Ninety-two families (86%) made a decision within 48 hours, whereas 15 (14%) required more than 48 hours for a final decision. In univariate and multivariate analyses, the independent factors associated with a decision delay were mean arterial pressure ≤60 mm Hg and coma therapy. In the early decision group (donation rates were 55% (51/92) and 39% (36/92), respectively, whereas in the delayed decision group (≥48 hours), these rates were 73% (11/15) and 47% (7/15), respectively. The consent and successful donation rates were not inferior in the delayed decision group. CONCLUSIONS These findings justify continuous efforts to maintain organ viability and to extend counseling to encourage donation even if the family cannot decide immediately.

  13. The Netherlands Brain Bank for Psychiatry. (United States)

    Rademaker, Marleen C; de Lange, Geertje M; Palmen, Saskia J M C


    The Netherlands Brain Bank (NBB) performs rapid autopsies of donors who gave written informed consent during life for the use of their brain tissue and medical files for research. The NBB initiated the Netherlands Brain Bank for Psychiatry (NBB-Psy), a prospective donor program for psychiatric diseases. NBB-Psy wants to expand the tissue collections in order to provide a strong incentive to increase research in psychiatry. The ultimate goal of NBB-Psy is to reduce the burden of psychiatric disorders for patients, their families, and for society as a whole. NBB-Psy consists of an antemortem and postmortem donor program. This chapter focuses on the design of NBB-Psy and the antemortem donor program, where patients and relatives are actively informed on the possibility to become a brain donor. Since the initiation of NBB-Psy, the number of registered donors with a psychiatric diagnosis has increased from 149 in 2010 to 1018 in May 2016. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Assessment and management of dead-wood habitat (United States)

    Hagar, Joan


    The Bureau of Land Management (BLM) is in the process of revising its resource management plans for six districts in western and southern Oregon as the result of the settlement of a lawsuit brought by the American Forest Resource Council. A range of management alternatives is being considered and evaluated including at least one that will minimize reserves on O&C lands. In order to develop the bases for evaluating management alternatives, the agency needs to derive a reasonable range of objectives for key issues and resources. Dead-wood habitat for wildlife has been identified as a key resource for which decision-making tools and techniques need to be refined and clarified. Under the Northwest Forest Plan, reserves were to play an important role in providing habitat for species associated with dead wood (U.S. Department of Agriculture Forest Service and U.S. Department of the Interior Bureau of Land Management, 1994). Thus, the BLM needs to: 1) address the question of how dead wood will be provided if reserves are not included as a management strategy in the revised Resource Management Plan, and 2) be able to evaluate the effects of alternative land management approaches. Dead wood has become an increasingly important conservation issue in managed forests, as awareness of its function in providing wildlife habitat and in basic ecological processes has dramatically increased over the last several decades (Laudenslayer et al., 2002). A major concern of forest managers is providing dead wood habitat for terrestrial wildlife. Wildlife in Pacific Northwest forests have evolved with disturbances that create large amounts of dead wood; so, it is not surprising that many species are closely associated with standing (snags) or down, dead wood. In general, the occurrence or abundance of one-quarter to one-third of forest-dwelling vertebrate wildlife species, is strongly associated with availability of suitable dead-wood habitat (Bunnell et al., 1999; Rose et al., 2001). In

  15. Effects of brain death on donor organ viability in transplantation

    NARCIS (Netherlands)

    Hoeven, Joost Alexander Boreas van der


    Organ transplantation has evolved from an experimental procedure in the 1950's and 60's to the therapy of choice for end-stage organ failure. The first solid organ to outgrow the experimental transplantation setting was the kidney. At that time the succesful transplant programs were those in which

  16. Proceedings of the symposium on the ecology and management of dead wood in western forests (United States)

    William F. Laudenslayer; Patrick J. Shea; Bradley E. Valentine; C. Phillip Weatherspoon; Thomas E. Lisle


    Dead trees, both snags (standing dead trees) and logs (downed dead trees), are critical elements of healthy and productive forests. The “Symposium on the Ecology and Management of Dead Wood in Western Forests” was convened to bring together forest researchers and managers to share the current state of knowledge relative to the values and interactions of dead wood to...

  17. Vestibular information is required for dead reckoning in the rat. (United States)

    Wallace, Douglas G; Hines, Dustin J; Pellis, Sergio M; Whishaw, Ian Q


    Dead reckoning is an on-line form of spatial navigation used by an animal to identify its present location and return directly to a starting location, even after circuitous outward trips. At present, it is not known which of several self-movement cues (efferent copy from movement commands, proprioceptive information, sensory flow, or vestibular information) are used to compute homeward trajectories. To determine whether vestibular information is important for dead reckoning, the impact of chemical labyrinthectomy was evaluated in a test that demanded on-line computation of a homeward trajectory. Rats were habituated to leave a refuge that was visible from all locations on a circular table to forage for large food pellets, which they carried back to the refuge to eat. Two different probe trials were given: (1) the rats foraged from the same spatial location from a hidden refuge in the light and so were able to use visual cues to navigate; (2) the same procedure took place in the dark, constraining the animals to dead reckon. Although control rats carried food directly and rapidly back to the refuge on both probes, the rats with vestibular lesions were able to do so on the hidden refuge but not on the dark probe. The scores of vestibular reflex tests predicted the dead reckoning deficit. The vestibular animals were also impaired in learning a new piloting task. This is the first unambiguous demonstration that vestibular information is used in dead reckoning and also contributes to piloting.

  18. The Dead Sea, The Lake and Its Setting (United States)

    Brink, Uri ten

    I cannot think of a subject more befitting the description of interdisciplinary research with societal relevance than the study of the Dead Sea, a terminal lake of the Jordan River in Israel and Jordan. The scientific study of the Dead Sea is intimately connected with politics, religion, archeology, economic development, tourism, and environmental change.The Dead Sea is a relatively closed geologic and limnologic system with drastic physical changes often occurring on human timescales and with a long human history to observe these changes. Research in this unique area covers diverse aspects such as active subsidence and deformation along strike-slip faults; vertical stratification and stability of the water column; physical properties of extremely saline and dense (1234 kg/m3) water; spontaneous precipitation of minerals in an oversaturated environment; origin of the unusual chemical composition of the brine; existence of life in extreme environments; use of lake level fluctuations as a paleoclimatic indicator; and effects on the environment of human intervention versus natural climatic variability. Although the Dead Sea covers a small area on a global scale, it is nevertheless one of the largest natural laboratories for these types of research on Earth. These reasons make the Dead Sea a fascinating topic for the curious mind.

  19. Accuracy in gamma spectrometry: Pileup, dead time, and fast electornics

    International Nuclear Information System (INIS)

    Lindstrom, R.M.


    An important source of inaccuracy in neutron activation analysis is the nonlinear throughput of the counting system, especially at high counting rates. Losses, due to the finite time needed for events to happen, occur in all parts of the spectrometer system: the germanium detector crystal, preamplifier, amplifier, analog-digital converter (ADC), and MCA or computer. The slowest unbuffered units are the ADC and the amplifier, followed by the crystal. Even with modern fast electronics, losses can be important, although compensating circuits can greatly improve accuracy if they are used correctly. The ADC dead time is less of a problem than it was a decade ago. For example, a modern successive-approximation ADC in the author's laboratory takes 6 μs to digitize a gamma ray in the middle of an 8192-channel spectrum, compared with 60 μs for the Wilkinson device that it replaced. Dead-time circuits in MCAs for many years have compensated very well for this dead time. Pulse pileup is as important as ADC dead time. Random coincidence, the accidental arrival of the signal from two nonrelated gamma rays at the amplifier in a time short compared to the shaping time, results in a composite pulse that distorts the spectrum. For accurate spectrometry, each such random-sum pulse should be excluded from the spectrum (pileup rejection), and the system dead time must be adjusted to compensate for the time the system is busy analyzing this rejected event (pileup live-time correction)

  20. Attitudes of sperm, egg and embryo donors and recipients towards genetic information and screening of donors. (United States)

    Amor, David J; Kerr, Annabelle; Somanathan, Nandini; McEwen, Alison; Tome, Marianne; Hodgson, Jan; Lewis, Sharon


    Gamete and embryo donors undergo genetic screening procedures in order to maximise the health of donor-conceived offspring. In the era of genomic medicine, expanded genetic screening may be offered to donors for the purpose of avoiding transmission of harmful genetic mutations. The objective of this study was to explore the attitudes of donors and recipients toward the expanded genetic screening of donors. Qualitative interview study with thematic analysis, undertaken in a tertiary fertility centre. Semi-structured in-depth qualitative interviews were conducted with eleven recipients and nine donors from three different cohorts (sperm, egg and embryo donors/recipients). Donors and recipients acknowledged the importance of genetic information and were comfortable with the existing level of genetic screening of donors. Recipients recognised some potential benefits of expanded genetic screening of donors; however both recipients and donors were apprehensive about extended genomic technologies, with concerns about how this information would be used and the ethics of genetic selectivity. Participants in donor programs support some level of genetic screening of donors, but are wary of expanding genetic screening beyond current levels.

  1. Donor risk factors for graft failure in the cornea donor study. (United States)

    Sugar, Joel; Montoya, Monty; Dontchev, Mariya; Tanner, Jean Paul; Beck, Roy; Gal, Robin; Gallagher, Shawn; Gaster, Ronald; Heck, Ellen; Holland, Edward J; Kollman, Craig; Malling, Jackie; Mannis, Mark J; Woody, Jason


    The purpose of this study was to assess the relationship between donor factors and 5-year corneal graft survival in the Cornea Donor Study. Donor corneas met criteria established by the Eye Bank Association of America, had an endothelial cell density of 2300 to 3300/mm, and were determined to be of good to excellent quality by the eye banks. Donor corneas were assigned using a random approach and surgeons were masked to information about the donor cornea including donor age. Surgery and postoperative care were performed according to the surgeons' usual routines and subjects were followed for 5 years. Donor and donor cornea factors were evaluated for their association with graft failure, which was defined as a regraft or a cloudy cornea that was sufficiently opaque to compromise vision for a minimum of 3 consecutive months. Graft failure was not significantly associated with the type of tissue retrieval (enucleation versus in situ), processing factors, timing of use of the cornea, or characteristics of the donor or the donor cornea. Adjusting for donor age did not affect the results. Donor and donor cornea characteristics do not impact graft survival rates for corneas comparable in quality to those used in this study.

  2. The Walking Dead: sequential nuclear and organelle destruction during hair development. (United States)

    Jones, L A; Harland, D P; Jarrold, B B; Connolly, J E; Davis, M G


    Transition of hair shaft keratinocytes from actively respiring, nucleated cells to structural cells devoid of nucleus and cytoplasm, is key to hair production. This form of cell "death", or cornification, requires cellular organelle removal to allow the cytoplasm to become packed with keratin filament bundles that further require cross-linking to create a strong hair fibre. Although these processes are well described in epidermal keratinocytes, there is a lack of understanding of such mechanisms specifically in the hair follicle. To gain insights into cornification mechanisms within the hair follicle and thus improve our understanding of normal hair physiology. Scalp biopsies and hair pluck samples were obtained from healthy human donors and analysed microscopically following immunohistochemical staining. A focal point of respiratory activity was evident in keratogenous zone cells within the hair shaft that also exhibited nuclear damage. Nuclear degradation occurred via both caspase-dependant and -independent pathways. Conversely, mitophagy was driven by Bnip3L and restricted to the boundary of the keratogenous zone at Adamson's Fringe. We propose a model of stepwise living-dead transition within the first 1 mm of hair formation, whereby fully functional, nucleated cells first consolidate required functions by degrading nuclear DNA, yet continue to respire and provide the source of ROS required for keratin cross-linking. Finally, as the cells become packed with keratin bundles, Bnip3L expression triggers mitophagy to rid the cells of the last remaining "living" characteristic thus completing the march from "living" to "dead" within the hair follicle. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. Assistência de enfermagem ao potencial doador de órgãos em morte encefálica Atención de enfermería al potencial donante de órganos en muerte encefálica Nursing assistance to the potential organ donor with brain death

    Directory of Open Access Journals (Sweden)

    Nancy Ramos Guetti


    maintenance of potential organ donors. This is a non-structured bibliographic review that considered current publications having as basis the publications of the Brazilian Organ Transplant Association and of the Brazilian Intensive Medicine Association. Results are organized according to the following structure: ethical issues related to organ and tissue removal, physiological repercussions of brain death (BD, clinical and technological signs of BD, and nursing assistance in the physiological maintenance of potential organ donors. It was concluded that it is essential for the nurse to have enough knowledge about possible physiological alterations resulting from BD. When that knowledge is put into practice, nurse's role will contribute for changes in transplants scenario.

  4. Organ Donation and Transplantation From Donors With Systemic Infection: A Single-Center Experience. (United States)

    Yuan, X; Chen, C; Zhou, J; Han, M; Wang, X; Wang, C; He, X


    Donors with bacteremia and sepsis are often considered to be controversial for organ retrieval due to potential transmission of an infectious agent to the recipient. Herein we report our initial experience of organ donation and transplantation results from donors with systemic infection. From January 2013 to December 2014, 125 cases of donation were completed in our organ procurement organization including 90 cases of donation after brain death (DBD) and 35 cases of donation after circulatory death (DCD). The results of bacterial culture of the donor's peripheral venous blood (PVB), blood from central venous catheter (BCVC), urine, bronchial aspiration, and tip of central venous catheter (TCVC; Maki's semiquantitative culture) were retrospectively reviewed. All liver transplant recipients received specific antibiotics according the susceptibility profiles of the PVB cultures, and all kidney transplant recipients received specific antibiotics according the susceptibility profiles of the PVB and urine cultures. Bacterial infection diseases transmission from donors of the liver and kidney transplant recipients were also retrospectively reviewed. The positive rates of the bacterial culture of the donor's bronchial aspiration, PVB, BCVC, TCVC, and urine were 46.4% (39/84), 20.2% (24/119), 15.8% (12/76), 11.1% (3/27), and 7.0% (8/115), respectively. Only 28.1% (9/32) of donors with positive cultures of PVB or urine received specific antimicrobial therapy before harvesting. Twenty-two livers and 46 kidneys from donors with systemic infection (positive PVB culture) were transplanted, and no case of bacterial infection diseases transmission occurred in the recipients. In the circumstance of donor systemic infection with positive bacterial culture of PVB, the liver and kidney can be transplanted safely with prophylactic antibiotics. Donors with systemic infection are not a contraindication for organ donation. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Prisoners as Living Donors: A Vulnerabilities Analysis. (United States)

    Ross, Lainie Friedman; Thistlethwaite, J Richard


    Although national guidelines exist for evaluating the eligibility of potential living donors and for procuring their informed consent, no special protections or considerations exist for potential living donors who are incarcerated. Human research subject protections in the United States are codified in the Federal Regulations, 45 CFR 46, and special protections are given to prisoners. Living donor transplantation has parallels with human subject research in that both activities are performed with the primary goal of benefiting third parties. In this article, we describe what special considerations should be provided to prisoners as potential living donors using a vulnerabilities approach adapted from the human research subject protection literature.

  6. Transperitoneal laparoscopic live donor nephrectomy: Current status

    Directory of Open Access Journals (Sweden)

    A Srivastava


    Full Text Available Renal transplantation is the treatment of choice for a suitable patient with end stage renal disease. Unfortunately, the supply of donor organs is greatly exceeded by demand. In many countries the use of kidneys from living donors has been widely adopted as a partial solution. Traditionally donor nephrectomy has been performed via a open flank incision however with some morbidity like pain and a loin scar. Currently, the donor nephrectomy is increasingly being performed laparoscopically with the objective of reducing the morbidity. It is also hoped that this will lead to increasing acceptance of living donation. The first minimally invasive living donor nephrectomy was carried out in 1995 at the Johns Hopkins Medical Center and since then many centers have undertaken laparoscopic living donor nephrectomy. The laparoscopic approach substantially reduces the donor morbidity and wound related problems associated with open nephrectomy. The laparoscopic techniques thus have the potential to increase the number of living kidney donors. The present article attempts to review the safety and efficacy of transperitoneal laparoscopic donor nephrectomy.

  7. Improving syphilis screening in deceased organ donors. (United States)

    Theodoropoulos, Nicole; Jaramillo, Andrés; Penugonda, Sudhir; Wasik, Carol; Brooks, Katarzyna; Ladner, Daniela P; Jendrisak, Martin D; Ison, Michael G


    Current U.S. policy requires screening of all deceased organ donors for syphilis infection. To date, information on syphilis test performance in this population is limited. All donors with a positive rapid plasma reagin (RPR) and matched donors with negative RPR who were evaluated by one organ procurement organization from January 1, 2000, to September 30, 2012, were retrospectively tested, using retained, residual serum, with two alternate RPR tests and four treponemal-specific tests: A fluorescent treponemal antibody absorption test, a microhemagglutination test, a chemiluminescence immunoassay (CLIA), and a Treponema pallidum particle agglutination (TP-PA) test. Thirty-two of 3,555 (0.9%) potential deceased organ donors screened during the study period showed a positive RPR; 61 RPR-negative matched donor samples were studied as well. Thirteen (40.6%) of the RPR-positive donors were found to be false-positive based on confirmatory TP-PA. As compared to TP-PA, the sensitivity of the fluorescent treponemal antibody absorption, microhemagglutination, and CLIA was 87.5%, 91.7% and 100%, respectively. The CLIA and TP-PA results were 100% concordant. Only 17 (53.1%) of the RPR-positive donors had a total of 46 organs recovered for transplantation. Current screening of deceased organ donors by RPR yields a significant number of false-positive results. Use of alternative tests or the routine use of confirmatory tests may reduce the frequency of false-positive results in deceased organ donors.

  8. Alternative Donor Transplantation for Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Nelli Bejanyan


    Full Text Available Allogeneic hematopoietic cell transplantation (allo-HCT is a potentially curative therapy for adult patients with acute myeloid leukemia (AML, but its use for consolidation therapy after first remission with induction chemotherapy used to be limited to younger patients and those with suitable donors. The median age of AML diagnosis is in the late 60s. With the introduction of reduced-intensity conditioning (RIC, many older adults are now eligible to receive allo-HCT, including those who are medically less fit to receive myeloablative conditioning. Furthermore, AML patients commonly have no human leukocyte antigen (HLA-identical or medically suitable sibling donor available to proceed with allo-HCT. Technical advances in donor matching, suppression of alloreactivity, and supportive care have made it possible to use alternative donors, such as unrelated umbilical cord blood (UCB and partially HLA-matched related (haploidentical donors. Outcomes after alternative donor allo-HCT are now approaching the outcomes observed for conventional allo-HCT with matched related and unrelated donors. Thus, with both UCB and haploidentical donors available, lack of donor should rarely be a limiting factor in offering an allo-HCT to adults with AML.

  9. Presence of brain pathology in deceased subjects with and without chronic obstructive pulmonary disease. (United States)

    Cleutjens, Fiona A H M; Spruit, Martijn A; Beckervordersandforth, Jan; Franssen, Frits M E; Dijkstra, Jeanette B; Ponds, Rudolf W H M; Wouters, Emiel F B; Janssen, Daisy J A


    Patients with chronic obstructive pulmonary disease (COPD) have extrapulmonary co-morbidities, such as cardiovascular disease, musculoskeletal wasting and neuropsychological conditions. To date, it remains unknown whether and to what extent COPD is associated with a higher prevalence of brain pathology. Therefore, the aim of this retrospective study was to compare the prevalence of neuropathological brain changes between deceased donors with and without COPD. Brain autopsy reports of age-matched donors with (n = 89) and without COPD (n = 89) from the Netherlands Brain Bank were assessed for demographics, cause of death, co-morbidities and brain pathology. The prevalence of degenerative brain changes was comparable for donors with and without COPD (50.6% vs. 61.8%, p > 0.05). Neoplastic brain changes were reported in a minority of the donors (5.6% vs. 10.1%, p > 0.05). After correction for cerebrovascular accident or cardiac cause of death and Charlson co-morbidity index score, the prevalence of vascular brain changes was higher among control versus COPD donors (27.0% vs. 11.2%, adjusted p = 0.013, odds ratio = 2.98). Brain autopsy reports of donors with and without COPD did not reveal differences in the presence of degenerative or neoplastic brain changes. Vascular brain changes were described more often in controls. Prospective studies including spirometry and structural and functional brain imaging should corroborate our findings. © The Author(s) 2015.

  10. The Dead Sea Transform and the Dead Sea Basin - Structure and dynamics (United States)

    Weber, M.; Desire Groups, D A


    DESERT and DESIRE, two multi-national, interdisciplinary research efforts by teams from Germany, Israel, Jordan and Palestine focused on the Dead Sea Transform (DST) and the Dead Sea Basin (DSB), respectively. The DST has accommodated left-lateral transform motion of 105 km between the African and Arabian plates since early Miocene (ca. 20 My), creating during this process also the prime example of a pull-apart basin, the DSB. Within DESERT the DST segment between the Dead Sea and the Red Sea called Arava/Araba Fault (AF) was studied with the following results. On plate tectonic scale the AF is a narrow, sub-vertical zone cutting through crust and lithosphere to more than 50 km depth, while the Moho depth increases smoothly from 26 km to 39 km from W to E under the DST. Several faults exist in the upper crust in a ca. 40 km wide zone around the AF, but none has kilometer-size zones of decreased seismic velocities/zones of high electrical conductivities typical for damage zones. Across the sub-vertical AF abrupt changes in lithology can be identified to a depth of 4 kilometers. The AF also acts as a barrier to fluids. The AF is the main active fault of the DST system but it has only accommodated a limited part (up to 60 km) of the overall 105 km of sinistral plate motion. Now inactive fault strands in the vicinity of the present day AF took up lateral motion until about 5 Ma ago, when the main, active fault trace shifted ca. 1 km westward to its present position. In the top few hundred meters of the AF a locally transpressional regime occurs in a 100 to 300 m wide zone of deformed and displaced material, bordered by sub-parallel faults forming positive flower structures. The damage zones of the individual faults are only 5 to 20 m wide. This narrow width is significantly smaller than at other major strike-slip faults of similar magnitude. Most of these findings are corroborated by thermo-mechanical modeling that show shear deformation in the lithosphere under the

  11. Brain Basics

    Medline Plus

    Full Text Available ... Events About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain ... to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits Neurons are ...

  12. Brain Basics

    Medline Plus

    Full Text Available ... Brain Basics provides information on how the brain works, how mental illnesses are disorders of the brain, ... learning more about how the brain grows and works in healthy people, and how normal brain development ...

  13. Brain Basics

    Medline Plus

    Full Text Available ... Brain Research Glossary Brain Basics (PDF, 10 pages) Introduction Watch the Brain Basics video Welcome. Brain Basics provides information on how the brain works, how mental illnesses ...

  14. The living dead: fiction, horror, and bioethics. (United States)

    Belling, Catherine


    Popular fiction responds to, and may exacerbate, public anxieties in ways that more highbrow literary texts may not. Robin Cook's 1977 novel Coma exemplifies the ways in which medical thrillers participate in the public discourse about health care. Written shortly after the medical establishment promoted "irreversible coma," or brain death, as a new definition of dying, and at a time when the debate over the removal of Karen Ann Quinlan from life support was the subject of popular attention, Coma crystallized public fears over the uses of medical technology. While Cook hoped that Coma would encourage public participation in health-care decision-making, the book may have fueled public concerns about medicine in ways that he did not anticipate. The public engagement that accompanied the rise of bioethics and that led to increased transparency and patient autonomy in medical decision-making had its birth, in part, in the distrust and paranoia reflected in the medical thriller. Because fiction can shape public perceptions of health-care dilemmas and may affect decision-making on bioethical issues, bioethicists need to pay attention to popular fictional accounts of medicine.

  15. Differences in social representation of blood donation between donors and non-donors: an empirical study. (United States)

    Guarnaccia, Cinzia; Giannone, Francesca; Falgares, Giorgio; Caligaris, Aldo Ozino; Sales-Wuillemin, Edith


    Both donors and non-donors have a positive image of blood donation, so donors and non-donors do not differ regarding their views on donation but do differ in converting their opinion into an active deed of donation. Several studies have identified altruism and empathy as the main factors underlying blood donation. However, a mixture of various motivational factors mould the complex behaviour of donation. This paper presents an exploratory study on differences of social representations of blood donation between blood donors and non-donors, in order to understand the reasons that bring someone to take the decision to become a blood donor. Participants filled in the Adapted Self-Report Altruism Scale, Toronto Empathy Questionnaire and answered a test of verbal association. Descriptive and correlation analyses were carried out on quantitative data, while a prototypic analysis was used for qualitative data. The study was carried out on a convenience sample of 786 individuals, 583 donors (mean age: 35.40 years, SD: 13.01 years; 39.3% female) and 203 non-donors (mean age: 35.10 years, SD: 13.30 years; 67.5% female). Social representations of donors seem to be more complex and articulated than those of non-donors. The terms that appear to be central were more specific in donors (life, needle, blood, help, altruism were the words most associated by non-donors; life, aid, altruism, solidarity, health, love, gift, generosity, voluntary, control, needed, useful, needle were the words most associated by donors). Furthermore, non-donors associated a larger number of terms referring to negative aspects of blood donation. Aspects related to training and the accuracy of any information on blood donation seem to be important in the decision to become a donor and stabilise the behaviour of donation over time, thus ensuring the highest levels of quality and safety in blood establishments.

  16. Deadly Choices empowering Indigenous Australians through social networking sites. (United States)

    McPhail-Bell, Karen; Appo, Nathan; Haymes, Alana; Bond, Chelsea; Brough, Mark; Fredericks, Bronwyn


    The potential for health promotion through social networking sites (SNSs) is widely recognized. However, while health promotion prides itself in focusing on the social determinants of health, its partiality for persuading individuals to comply with health behaviours dominates the way health promotion utilizes SNSs. This paper contributes to an understanding of collaborative ways SNSs can work for health promotion agendas of self-determination and empowerment in an Indigenous Australia context. An ethnographic study was undertaken with Deadly Choices, an Indigenous-led health promotion initiative. The study involved participant observation of interactions on Deadly Choices SNSs between Deadly Choices and its online community members. Deadly Choices provides an example of SNSs providing a powerful tool to create a safe, inclusive and positive space for Indigenous people and communities to profile their healthy choices, according to Indigenous notions of health and identity. The study found five principles that underpin Deadly Choices' use of SNSs for health promotion. These are: create a dialogue; build community online and offline; incentivise healthy online engagement; celebrate Indigenous identity and culture; and prioritize partnerships. Deadly Choices SNSs empowers Indigenous people and communities to be health promoters themselves, which represents a power shift from health promotion practitioner to Indigenous people and communities and more broadly, an enactment of Indigenous self-determination on SNSs. Mainstream health promotion can learn from Indigenous health promotion practice regarding the use of SNSs for health promotion agendas. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  17. Donor/recipient enhancement of memory in rat hippocampus (United States)

    Deadwyler, Sam A.; Berger, Theodore W.; Sweatt, Andrew J.; Song, Dong; Chan, Rosa H. M.; Opris, Ioan; Gerhardt, Greg A.; Marmarelis, Vasilis Z.; Hampson, Robert E.


    The critical role of the mammalian hippocampus in the formation, translation and retrieval of memory has been documented over many decades. There are many theories of how the hippocampus operates to encode events and a precise mechanism was recently identified in rats performing a short-term memory task which demonstrated that successful information encoding was promoted via specific patterns of activity generated within ensembles of hippocampal neurons. In the study presented here, these “representations” were extracted via a customized non-linear multi-input multi-output (MIMO) mathematical model which allowed prediction of successful performance on specific trials within the testing session. A unique feature of this characterization was demonstrated when successful information encoding patterns were derived online from well-trained “donor” animals during difficult long-delay trials and delivered via online electrical stimulation to synchronously tested naïve “recipient” animals never before exposed to the delay feature of the task. By transferring such model-derived trained (donor) animal hippocampal firing patterns via stimulation to coupled naïve recipient animals, their task performance was facilitated in a direct “donor-recipient” manner. This provides the basis for utilizing extracted appropriate neural information from one brain to induce, recover, or enhance memory related processing in the brain of another subject. PMID:24421759

  18. BLOODR: blood donor and requester mobile application. (United States)

    Tatikonda, Vamsi Krishna; El-Ocla, Hosam


    With rapid increase in the usage of social networks sites across the world, there is also a steady increase in blood donation requests as being noticed in the number of posts on these sites such as Facebook and twitter seeking blood donors. Finding blood donor is a challenging issue in almost every country. There are some blood donor finder applications in the market such as Blood app by Red Cross and Blood Donor Finder application by Neologix. However, more reliable applications that meet the needs of users are prompted. Several software technologies including languages and framework are used to develop our blood-donor web application known as BLOODR application. These technologies comprise Ruby programming language (simply known as Ruby) along with JavaScript and PostgreSQL for database are used. Ruby on Rails (simply known as Rails) is an open source Web framework that makes it possible to quickly and easily create data-based web applications. We show screenshots for the BLOODR application for different types of users including requester, donor, and administrator. Various features of the application are described and their needs of use are analyzed. If a patient needs a blood at a clinic, blood donors in vicinity can be contacted through using a clinic management service provided in this application. Registered donors will get notification for the blood requests only if their blood group is compatible with the requested blood type and in the same city/region. Then matching blood donors can go to the requesting clinic and donate. BLOODR application provides a reliable platform to connect local blood donors with patients. BLOODR creates a communication channel through authenticated clinics whenever a patient needs blood donation. It is a useful tool to find compatible blood donors who can receive blood request posts in their local area. Clinics can use this web application to maintain the blood donation activity. Future improvement of the BLOODR is explained.

  19. Tourism development challenges on the Dead Sea shore

    Directory of Open Access Journals (Sweden)

    Wendt Jan A.


    Full Text Available The Dead Sea along with Jerusalem belongs to one of the most well-known spots visited by tourists in Israel. Because of many factors, such as the water level of the Dead Sea at a depth of 430 m b.s.l. (in 2015, average salinity of 26%, hot springs and many healing salts located there, it is a unique tourist attraction on a global level. Its attractiveness is heightened by its proximity to other sites of interest, such as the Jewish fortress at Masada, Jericho, Qumran, where the Dead Sea Scrolls were found, as well as Petra, Madaba and Al-Karak on the Jordanian side of the Dead Sea. High salinity and a microclimate create perfect conditions for the development of health resorts and medical tourism. Extracting healing salts from its waters for the needs of the chemical industry is important for both the economy and medical tourism. However, as a consequence of the agricultural and urban use of the waters of the River Jordan, which flows into the Dead Sea, a persistent decrease in the lake water level has been observed over the last century. This has created a number of economic and political issues. The problems which still have to be resolved are associated with the Red Sea-Dead Sea Conduit (Canal, the division of Jordan’s water resources, conservation of the unique reservoir of the Dead Sea and the threat of hindering the development of tourism within the region. The presentation of these issues is the main aim of this research paper. The study is based on the analysis of changes in tourism flows, results of research studies and the prognosis of changes in the water level of the Dead Sea. It presents an assessment of the effects of this phenomenon on the tourist economy. At the current level of tourism flows within the region, the tourist capacity of local beaches will be exceeded in areas where the most popular tourist resorts are located. Increased expenditure on development of tourism infrastructure in the coastal zone can also be observed

  20. Simplified dead-time compensator for multiple delay SISO systems. (United States)

    Torrico, Bismark Claure; Correia, Wilkley Bezerra; Nogueira, Fabrício Gonzalez


    This paper presents a dead-time compensation structure able to deal with stable and unstable multiple delay single input single output (SISO) systems. The proposed method aims to simplify the primary controller by replacing it for FIR filters placed at the feedback path. Such modification reduces the total number of parameters to be tuned which facilitates the overall design in comparison with other primary controllers normally considered. Simulation results show a better performance for the proposed control approach compared with other dead-time compensator (DTC) recently proposed in the literature. Copyright © 2015 ISA. Published by Elsevier Ltd. All rights reserved.

  1. Homer and the cult of the dead in Helladic times

    Directory of Open Access Journals (Sweden)

    Odysseus Tsagarakis


    Full Text Available This paper discusses the Homeric bothros (Odyssey X 517 ff. as a possible source of information for the ritual and function of various bothroi (grave pits which are considered to be an important archaeological source. It seems that the bothroi were, by their nature, best suited to a cult of the dead and served as altars. The paper also discusses the possible reasons for the existence of the cult and argues against the view that fear of the dead motivated the cult in Helladic times.

  2. Exchange living-donor kidney transplantation: diminution of donor organ shortage. (United States)

    Park, K; Lee, J H; Huh, K H; Kim, S I; Kim, Y S


    To alleviate the organ shortage, the use of more living donors is strongly recommended world wide. A living donor exchange (swap) program was launched in Korea. After the success of a direct swap program between two families, we have developed the swap-around program to expand the donor pool by enrolling many kinds of unrelated donors. Herein, we report our results of a living donor exchange program. This retrospectively review of 978 recipients of kidney transplants from living donors, included analysis of donor-recipient relationships, mode of donor recruitment, episodes of acute rejection, and 5-year patient/graft survivals. Transplantation was performed in 101 patients (10.3%) by way of the swap program. The proportion of swap patients among the number of unrelated donor renal transplants has been increasing from 4.2% to 46.6%. The incidence of acute rejection and 5-year patient/graft survival rates were comparable between the groups. We have achieved some success in reducing the organ shortage with a swap program in addition to our current unrelated living donor programs without jeopardizing graft survival. Potentially exchangeable donors should undergo strict medical evaluation by physicians and social evaluation by social workers and coordinators as a pre-requisite for kidney transplantation. Expanding the swap around program to a regional or national pool could be an option to reduce the organ donor shortage in the future.

  3. Dedicated donor unit transfusions reduces donor exposure in pediatric surgery patients

    Directory of Open Access Journals (Sweden)

    Satyam Arora


    Full Text Available Background: Many strategies have been explored to reduce multiple donor exposures in neonates such as use of restrictive transfusion protocols, limiting iatrogenic blood loss, use of recombinant erythropoietin and single donor programs. Method: In our study we assessed the feasibility of dedicating single donor units with reserving all the components from the same donor for the specified neonates/ infants undergoing surgery and estimating reduction of donor exposure. Fifty neonates undergoing surgery were included in the prospective study group and the transfusion details were compared with 50 retrospective cases with same inclusion criteria. Results: An intra-operative blood loss of >13 ml/Kg was significantly associated with transfusion (P<0.05 which was most frequently administered in the intra-operative period. Donor exposure rate of overall transfusion was 1.15 in the study group as compared to 4.03 in the retrospective control group. In study group Donor Exposure Rate (DER: Transfusion Rate (TR ratio was 1:1.5 and Transfusion per Donor Unit (TPDU of 1.5, means that one donor unit contributed to 1.5 transfusions in each patient and contributed to 50% reduction in donor exposure in each patient as compared to retrospective control group. Conclusion: Our study showed that by practicing dedicated donor unit transfusion policy, for neonates undergoing surgery we could significantly reduce the donor exposure.

  4. Dedicated donor unit transfusions reduces donor exposure in pediatric surgery patients (United States)

    Arora, Satyam; Marwaha, Neelam; Dhawan, Hari Krishan; Rao, K. L. N.


    BACKGROUND: Many strategies have been explored to reduce multiple donor exposures in neonates such as use of restrictive transfusion protocols, limiting iatrogenic blood loss, use of recombinant erythropoietin and single donor programs. METHOD: In our study we assessed the feasibility of dedicating single donor units with reserving all the components from the same donor for the specified neonates/infants undergoing surgery and estimating reduction of donor exposure. Fifty neonates undergoing surgery were included in the prospective study group and the transfusion details were compared with 50 retrospective cases with same inclusion criteria. RESULTS: An intra-operative blood loss of >13 ml/Kg was significantly associated with transfusion (P <0.05) which was most frequently administered in the intra-operative period. Donor exposure rate of overall transfusion was 1.15 in the study group as compared to 4.03 in the retrospective control group. In study group Donor Exposure Rate (DER): Transfusion Rate (TR) ratio was 1:1.5 and Transfusion per Donor Unit (TPDU) of 1.5, means that one donor unit contributed to 1.5 transfusions in each patient and contributed to 50% reduction in donor exposure in each patient as compared to retrospective control group. CONCLUSION: Our study showed that by practicing dedicated donor unit transfusion policy, for neonates undergoing surgery we could significantly reduce the donor exposure. PMID:28970679

  5. Negotiating boundaries: Accessing donor gametes in India. (United States)

    Widge, A; Cleland, J


    This paper documents how couples and providers access donor materials for conception in the Indian context and perceptions about using them. The objective is to facilitate understanding of critical issues and relevant concerns. A postal survey was conducted with a sample of 6000 gynaecologists and in-depth interviews were -conducted with 39 gynaecologists in four cities. Donor gametes are relatively more acceptable than a few years ago, especially if confidentiality can be -maintained, though lack of availability of donor materials is sometimes an impediment to infertility treatment. Donor sperms are usually accessed from in-house or commercial sperm banks, pathology laboratories, IVF centres, -professional donors, relatives or friends. There is scepticism about screening procedures of sperm banks. Donor eggs are usually accessed from voluntary donors, friends, relatives, egg sharing programmes, donation from other patients, advertising and commercial donors. There are several concerns regarding informed consent for using donated gametes, using -relatives and friends gametes, the unregulated use of gametes and embryos, record keeping and documentation, -unethical and corrupt practices and commercialisation. These issues need to be addressed by patients, providers and regulatory authorities by providing -information, counselling, ensuring informed consent, addressing exploitation and commercialisation, ensuring -monitoring, proper documentation and transparency.

  6. Normothermic machine perfusion for donor liver preservation

    NARCIS (Netherlands)

    Tolboom, H.


    Currently, liver transplantation is the only treatment for end-stage liver failure. Unfortunately, a sever shortage of donor organs causes significant mortality amongst patients awaiting transplantation. The donor organ shortage could be alleviated by using organs that are normally not accepted for

  7. and Tetradentate N,O-donor Ligands

    African Journals Online (AJOL)


    )], derived from the oxidation reactions (by O2) of trans-[ReCl3(MeCN)(PPh3)2] with the tridentate N2O-donor chelate 2-[((2-pyridinylmethyl)amino)methyl]phenol (Hham) and the N2O2-donor N,N-bis(2-hydroxybenzyl)-aminomethyl- pyridine ...

  8. Posttransplantation Disseminated Coccidioidomycosis Acquired from Donor Lungs


    Miller, Melissa B.; Hendren, Ryan; Gilligan, Peter H.


    A North Carolinian developed fatal coccidioidomycosis immediately after bilateral lung transplantation. The donor had previously traveled to Mexico, and the recipient had no travel history to an area where Coccidioides immitis is endemic. Immunosuppresive therapy of the transplant recipient likely reactivated latent Coccidioides infection in the donor lungs, leading to posttransplant coccidioidomycosis.

  9. Research Award: Donor Partnership Division | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)


    Sep 7, 2016 ... IDRC's Donor Partnerships division (DPD) initiates, builds, and maintains relationships with donors, international organizations, and research funders ... We are particularly interested in research related to public-private partnerships for development, bilateral investments in research, trends in private ...

  10. Psychosocial counselling in donor sperm treatment

    NARCIS (Netherlands)

    Visser, M.


    For decades, donor sperm treatment is offered to men and women to build a family. In daily life, parents, children and donors have to deal with the consequences of this treatment. The studies of this thesis show that there are gaps in knowledge about specialist psychosocial counselling and guidance

  11. Extreme Dead Sea drying event during the last interglacial from the ICDP Dead Sea Deep Drill Core (United States)

    Goldstein, S.; Stein, M.; Ben-Avraham, Z.; Agnon, A.; Ariztegui, D.; Brauer, A.; Haug, G.; Ito, E.; Kitagawa, H.; Torfstein, A.; Yasuda, Y.


    The ICDP funded Dead Sea Deep Drilling Project (DSDDP) recovered the longest and most complete paleo-environmental record in the Middle East, drilling holes in a deep and a shallow site extending to ~450 meters. The Dead Sea expands during the glacials and contracts during interglacials, and the sediments are an archive of the evolving climatic conditions. During glacials the sediments comprise intervals of marl (aragonite, gypsum and detritus) and during interglacials they are salts and marls. We estimate that the deep site core spans ~200 kyr (to early MIS 7). A dramatic discovery is a ~40 cm interval of rounded pebbles at ~235 m below the lake floor, the only clean pebbly unit in the entire core. It appears to be a beach layer, near the deepest part of the Dead Sea, lying above ~35 meters of mainly salt. If it is a beach layer, it implies an almost complete dry-down of the paleo-Dead Sea. The pebble layer lies within the last interglacial interval. Our initial attempt to estimate the age of the possible dry down shows an intriguing correlation between the salt-mud stratigraphy of the Dead Sea core and the oxygen isotope record of Soreq Cave, whereby excursions to light oxygen in the speleothems correspond to periods of salt deposition. Through this comparison, we estimate that the dry down occurred during MIS 5e. The occurrence of ~35 meters of mainly salt along with the pebble layer demonstrates a severe dry interval during MIS 5. This observation has implications for the Middle East today, where the Dead Sea level is dropping as all the countries in the area use the runoff. GCM models indicate a more arid future in the region. The core shows that the runoff nearly stopped during a past warm period without human intervention.


    Directory of Open Access Journals (Sweden)

    Y.. A. Shcherbuk


    Full Text Available Deficit of donor organs is the limiting factor in organ transplantation. One way of solving this problem is the use of donors with sudden irreversible circulatory arrest. Obtaining organs from this category of donors is pos- sible only through the use of normothermic extracorporal perfusion in situ (NECP with oxygenation and leu- cocyte depletion. The article presents the implementation of NECP in 11 uncontrolled non heart beating donor (uNHBD kidneys (age of 43,1 ± 2,98 years and the results of transplantation in 22 recipients of such transplants in comparison with the results of the 20 recipients of kidney transplants from 20 donors to the death of the brain (age 45,65 ± 1,8 years. Despite the initially high rate of delayed function and more significant number of hemo- dialysis in uNHBD group (group of investigation, serum creatinine at 21st day was the same level as in BDD group (comparison group: 0,198 ± 0,002 mmol/L and 0,151 ± 0,002 mmol/L (p > 0,05. The use of NECP with oxygenation and leucocyte depletion is an effective practice for recovery kidney from donors with a sudden ir- reversible circulatory arrest with warm ischemic time one hour and more before the operation explantation. 


    Directory of Open Access Journals (Sweden)

    M. L. Arefjev


    Full Text Available There is well known fact that kidney transplants from Extended Criteria Donors may increase risk of De- layed Graft Function and Primary Non-Function of transplants. We have collected and tested 65 «zero» kidney biopsies from cadaver donors aged from 19 to 71 years old. In the pool of elderly donors who died from cerebrovascular accident the frequency of nephrosclerosis presentation was higher than in donors of yonger age who died from craniocephalic trauma. Nevertheless in the general donor pool the number of sclerosed glomeruli was no more than 12%. We did not meet at all in the whole volume of material any bi- opsy with the severe degree of arteriosclerosis. The «zero» biopsies of cadaver kidneys is quite usable and unexpensive tool to measure the degree of nephrosclerosis in order to exclude kidneys which are not fitable for transplantation. 

  14. Living with the Dead or Communicating with the dead: media practices of continuing bonds among bereaved parents

    DEFF Research Database (Denmark)

    Sandvik, Kjetil; Christensen, Dorthe Refslund

    in the shape of everyday parental activities such as playing with the child, reading bedtime stories, celebrating birthdays or just bearing the dead child in mind, the purpose of which are to keep the dead child as a present part of the parents’ and family’s continuing life. We argue that these practices...... when getting a memory tattoo. Based on observation studies and qualitative contents analysis performed since 2008 on children’s graves and on online memorial sites (Christensen & Sandvik 2013, 2014a, 2014b, 2015a) and furthermore including interviews with bereaved parents (Christensen & Sandvik...

  15. Brain Basics

    Medline Plus

    Full Text Available ... at NIMH News & Events About Us Home > Health & Education > Educational Resources Brain Basics Introduction The Growing Brain The Working Brain Brain Basics in Real Life Brain Research Glossary Brain Basics (PDF, 10 pages) Introduction Watch the Brain Basics video ...

  16. Accuracy of a probabilistic record-linkage methodology used to track blood donors in the Mortality Information System database. (United States)

    Capuani, Ligia; Bierrenbach, Ana Luiza; Abreu, Fatima; Takecian, Pedro Losco; Ferreira, João Eduardo; Sabino, Ester Cerdeira


    The probabilistic record linkage (PRL) is based on a likelihood score that measures the degree of similarity of several matching variables. Screening test results for different diseases are available for the blood donor population. In this paper, we describe the accuracy of a PRL process used to track blood donors from the Fundação Pró-Sangue (FPS) in the Mortality Information System (SIM), in order that future studies might determine the blood donor's cause of death. The databases used for linkage were SIM and the database made up of individuals that were living (200 blood donors in 2007) and dead (196 from the Hospital das Clinicas de São Paulo that died in 2001-2005). The method consists of cleaning and linking the databases using three blocking steps comparing the variables "Name/Mother's Name/ Date of Birth" to determine a cut-off score. For a cut-off score of 7.06, the sensitivity and specificity of the method is 94.4% (95%CI: 90.0-97.0) and 100% (95%CI: 98.0-100.0), respectively. This method can be used in studies that aim to track blood donors from the FPS database in SIM.

  17. Donor Conception and "Passing," or; Why Australian Parents of Donor-Conceived Children Want Donors Who Look Like Them. (United States)

    Wong, Karen-Anne


    This article explores the processes through which Australian recipients select unknown donors for use in assisted reproductive technologies and speculates on how those processes may affect the future life of the donor-conceived person. I will suggest that trust is an integral part of the exchange between donors, recipients, and gamete agencies in donor conception and heavily informs concepts of relatedness, race, ethnicity, kinship, class, and visibility. The decision to be transparent (or not) about a child's genetic parentage affects recipient parents' choices of donor, about who is allowed to "know" children's genetic backgrounds, and how important it is to be able to "pass" as an unassisted conception. In this way, recipients must trust the process, institutions, and individuals involved in their treatment, as well as place trust in the future they imagine for their child. The current market for donor gametes reproduces normative conceptions of the nuclear family, kinship, and relatedness by facilitating "matching" donors to recipients by phenotype and cultural affinities. Recipient parents who choose not to prioritize "matching," and actively disclose the process of children's conceptions, may embark on a project of queering heteronormative family structures and place great trust in both their own children and changing social attitudes to reduce stigma and generate acceptance for non-traditional families.

  18. Dead Zones in LX-17 and PBX 9502

    Energy Technology Data Exchange (ETDEWEB)

    Souers, P C; Andreski, H G; Batteux, J; Bratton, B; Cabacungan, C; Cook, III, C F; Fletcher, S; Garza, R; Grimsley, D; Handly, J; Hernandez, A; McMaster, P; Molitoris, J D; Palmer, R; Prindiville, J; Rodriguez, J; Schneberk, D; Wong, B; Vitello, P


    Pin and X-ray corner-turning data have been taken on ambient LX-17 and PBX 9052, and the results are listed in tables as an aid to future modeling. The results have been modeled at 4 zones/mm with a reactive flow approach that varies the burn rate as a function of pressure. A single rate format is used to simulate failure and detonation in different pressure regimes. A pressure cut-off must also be reached to initiate the burn. Corner-turning and failure are modeled using an intermediate pressure rate region, and detonation occurs at high pressure. The TATB booster is also modeled using reactive flow, and X-ray tomography is used to partition the ram-pressed hemisphere into five different density regions. The model reasonably fits the bare corner-turning experiment but predicts a smaller dead zone with steel confinement, in contradiction with experiment. The same model also calculates the confined and unconfined cylinder detonation velocities and predicts the failure of the unconfined cylinder at 3.75 mm radius. The PBX 9502 shows a smaller dead zone than LX-17. An old experiment that showed a large apparent dead zone in Comp B was repeated with X-ray transmission and no dead zone was seen. This confirms the idea that a variable burn rate is the key to modeling. The model also produces initiation delays, which are shorter than those found in time-to-detonation.

  19. "The Northern Lights" Investigative Reporting Covers Deadly Decisions. (United States)

    Srour, George


    Presents a story package from the high school newspaper "The Northern Lights," called "Deadly Decisions." Includes an editorial, an eyewitness account, a timeline of the coverage itself, an interview with a local TV reporter, photographs, and a graph of the events the stories covered. (SR)

  20. Eating the dead in Madagascar | Campbell | South African Medical ...

    African Journals Online (AJOL)

    They may be supported in societies under stress or in times of famine, to reflect aggression and antisocial behaviour (in cases where the bodies of enemies killed in battle or people who have harmed the family are eaten), or to honour a dead kinsman. It was, for example, noted in Madagascar during the imperial campaigns ...

  1. [Forensic Analysis of 20 Dead Cases Related to Heroin Abuse]. (United States)

    Huang, W Q; Li, L H; Li, Z; Hong, S J


    To perform retrospective analysis on 20 dead cases related to heroin abuse, and to provide references for the forensic assessment of correlative cases. Among 20 dead cases related to heroin abuse, general situation, using method of drug, cause of death and result of forensic examination were analyzed by statistical analysis for summarizing the cause of death and pathologic changes. The dead were mostly young adults, with more male than female. The results of histopathological examinations showed non-specific pathological changes. There were four leading causes of death, including acute poisoning of heroin abuse or leakage (13 cases, 65%), concurrent diseases caused by heroin abuse (3 cases, 15%), inspiratory asphyxia caused by taking heroin (2 cases, 10%), and heroin withdrawal syndrome (2 cases, 10%). The forensic identification on dead related to heroin abuse must base on the comprehensive autopsy, and combine with the qualitative and quantitative analysis of heroin and its metabolites in death and the case information, as well as the scene investigation. Copyright© by the Editorial Department of Journal of Forensic Medicine

  2. Dead Metaphor in Selected Advertisements in Nigerian Dailies ...

    African Journals Online (AJOL)

    Dead metaphors and images are often enlivened and empowered by advertisers to help their commUlzication and to achieve bewitching effects. It is interesting to see words and phrases that may be presumed to have been drained of their linguistic strength being brought back to currency and made to act fast in aiding ...

  3. Theory of precipitation effects on dead cylindrical fuels (United States)

    Michael A. Fosberg


    Numerical and analytical solutions of the Fickian diffusion equation were used to determine the effects of precipitation on dead cylindrical forest fuels. The analytical solution provided a physical framework. The numerical solutions were then used to refine the analytical solution through a similarity argument. The theoretical solutions predicted realistic rates of...

  4. Dead Reckoning Localization Technique for Mobile Wireless Sensor Networks


    Rashid, Haroon; Turuk, Ashok Kumar


    Full paper at: paper shows how a mobile node can be localized with less than three beacon nodes. It uses a technique known as dead-reckoning for localization of nodes at specific intervals

  5. Stylistic Variation In Three English Translations Of The Dead Sea ...

    African Journals Online (AJOL)

    Since the discovery of the Dead Sea Scrolls in 1947 different English translations were published. In this article the stylistic variation of three of these translations are analysed. It is suggested that the issue of stylistic variation boils down to linguistically inscribed preference in the choice and construction of discourses in the ...

  6. Piecing Together the Past: The Dead Sea Schools. (United States)

    Ulrich, Eugene; And Others


    Illustrates the astonishing coordination of archaeological and scholarly activities surrounding the Dead Sea Scrolls. First discovered by Bedouin nomads in 1947, the Scrolls consist of a few complete manuscripts and over 80,000 fragments. Discusses the early Christian sect that produced the Scrolls, and provides current perspectives on the…

  7. Literary Genres in Poetic Texts from the Dead Sea Scrolls (United States)

    Pickut, William Douglas


    Among the texts of the Dead Sea Scrolls, there are four literary compositions that bear the superscriptional designations shir and mizmor. These designations correspond directly to superscriptional designations provided many times in both the now-canonical Psalter and the various witnesses to those texts unearthed at Qumran. On its face, this fact…

  8. Comparison of burning characteristics of live and dead chaparral fuels (United States)

    L. Sun; X. Zhou; S. Mahalingam; D.R. Weise


    Wildfire spread in living vegetation, such as chaparral in southern California, often causes significant damage to infrastructure and ecosystems. The effects of physical characteristics of fuels and fuel beds on live fuel burning and whether live fuels differ fundamentally from dead woody fuels in their burning characteristics are not well understood. Toward this end,...

  9. Brought in Dead: An Avoidable Delay in Maternal Deaths. (United States)

    Kumar, Aruna; Agrawal, Neha


    Maternal brought in dead are the patient who dies in the need of adequate medical care. These deaths are often not analyzed sincerely as they are not institutional deaths. Our aim is to find out actual life threatening cause of delay leading to death. Patients brought dead to casualty were seen by the doctors on duty in Department of Obstetrics and Gynaecology,Gandhi Medical College, Bhopal round the clock. Cause of death was analyzed by verbal autopsy of attendants and referral letter from the institute. In this analytical study a complete evaluation of brought deaths from January 2011 to Decmeber 2014 was done. A total of 64 brought in deaths were reported in this 4 year duration. Most common cause of death was postpartum hemorrhage (54.68 %) followed by hypertension (15.62 %) and the most common cause of delay was delay in getting adequate treatment (56.25 %). The brought in dead are the indicator of the three delays in getting health care. Challenges appear to be enormous to be tackled. Timely management proves to be critical in preventing maternal death. Thus it appears that community education about pregnancy and its complications, EmOC training at FRU and strict adherence to referral protocol may help us to reduce the brought dead burden.

  10. Gastric necrosis four years after fundoplication causing a dead foetus

    DEFF Research Database (Denmark)

    Thinggaard, Ebbe; Skovsen, Anders Peter; Kildsig, Jeppe


    A 31-year-old pregnant woman was admitted and treated for diabetic ketoacidosis. As the patient deteriorated and the viability of the foetus was uncertain a CT scan was done which showed free fluid and air intraabdominally. Surgery was performed. A dead foetus was delivered and a 2 × 5 cm necrotic...

  11. Dead wood in European beech (Fagus sylvatica) forest reserves

    NARCIS (Netherlands)

    Christensen, M.; Hahn, K.; Mountford, E.P.; Ódor, P.; Standovár, T.; Rozenbergar, D.; Diaci, J.; Wijdeven, S.M.J.; Meyer, P.; Winter, S.; Vrska, T.


    Data were analysed on the volume of dead wood in 86 beech forest reserves, covering most of the range of European beech forests. The mean volume was 130 m3/ha and the variation among reserves was high, ranging from almost nil to 550 m3/ha. The volume depended significantly on forest type, age since

  12. Bipolar disorder, childhood bereavement, and the return of the dead ...

    African Journals Online (AJOL)

    Upon its head, with red extended mouth and solitary eye of fire, sat the hideous beast whose craft had seduced me into murder ...' From 'The Black Cat', written c. age 35 (Poe 1975:230). Keywords: Edgar Allan Poe; bipolar disorder, childhood bereavement, and the return of the dead; literary criticism; American poetry; ...

  13. Remembering Important People On The Day Of The Dead (United States)

    Curriculum Review, 2005


    This article describes a project that can help students learn more about historic figures-or remember lost loved ones--with this Day of the Dead project from Frida Kahlo and Diego Rivera. The purpose is to remember the wonderful things the person did, and to celebrate his or her life. Directions for construction, as well as a suggested list of…

  14. The prevalence and challenges of abandoned dead neonates in an ...

    African Journals Online (AJOL)

    %) cases, as depicted in Table 1. The parents/caregivers of 618 (56.5%) dead babies were illiterate and of a low socioeconomic class. Financial constraint experienced by the parents/caregivers of 309. (28.3%) babies, repulsion toward obvious ...

  15. Preparedness of Response to Deadly Outbreaks: Lessons Learnt ...

    African Journals Online (AJOL)

    Some of the lessons learnt included improved work efficiency, built staff resilience to work long hours under stressful conditions and consciously managing aseptic techniques. Conclusion: Exposure to some adverse conditions such as managing work operations in the midst of a deadly outbreak such as Ebola may have a ...

  16. Antimicrobial properties of Dead Sea black mineral mud. (United States)

    Ma'or, Zeev; Henis, Yigal; Alon, Yaacov; Orlov, Elina; Sørensen, Ketil B; Oren, Aharon


    The unique, black, hypersaline mud mined from the Dead Sea shores is extensively used in mud packs, masks, and topical body and facial treatments in spas surrounding the lake, and in cosmetic preparations marketed worldwide, but little is known about its antimicrobiological properties. We performed detailed microbial and chemical analysis of Dead Sea mineral mud compounded in dermatological and cosmetic preparations. Using conventional bacteriological media (with or without salt augmentation), we found surprisingly low numbers of colony-forming microorganisms in the mud. The highest counts (up to 20,000 colonies per gram, mostly consisting of endospore-forming bacteria) were obtained on sheep blood agar. Test microorganisms (i.e. Escherichia coli, Staphylococcus aureus, Propionibacterium acnes, Candida albicans) rapidly lost their viability when added to the mud. Zones of growth inhibition were observed around discs of Dead Sea mud placed on agar plates inoculated with Candida or with Propionibacterium, but not with Staphylococcus or Escherichia. The effect was also found when the mud was sterilized by gamma irradiation. Using (35)S-labeled sulfate as a tracer, bacterial dissimilatory sulfate reduction could be demonstrated at a low rate (0.13 +/- 0.03 nmol/cm(3).d). The antibacterial properties of Dead Sea mud are probably owing to chemical and/or physical phenomena. Possible modes of antimicrobial action of the mud in relation to its therapeutic properties are discussed.

  17. Necrotizing fasciitis: A deadly disease | Cree | East and Central ...

    African Journals Online (AJOL)

    Background: Knowledge of the diagnosis, cause, course and required treatment of this deadly disease among physicians and surgeons around the world is limited. Methods: A study was undertaken at University Teaching Hospital (UTH), Lusaka Zambia to review the incidence, associated pathology, management given, ...

  18. Book Review Lifeblood: How to Change the World, One Dead ...

    African Journals Online (AJOL)

    Book Review Lifeblood: How to Change the World, One Dead Mosquito at a Time By Alex Perry (2011). Melissa Raemaekers. Abstract. Pp xiv + 219. R210. Picador Africa, Pan Macmillan, South Africa. 2011. ISBN 978-1-77010-146-3. February 2012, Vol. 102, No. 2 SAMJ. Full Text: EMAIL FREE FULL TEXT EMAIL FREE ...

  19. Assessment of biofuel potential of dead neem leaves ( Azadirachta ...

    African Journals Online (AJOL)

    Dead leaves of neem trees in the Sahelian urban zone are among the wastes that are underutilized, since it is either buried or burnt, and thus, contribute to increased environmental pollution. Unfortunately, the lack of information on the biomass and energy potentials of these wastes empedes any initiative for its industrial ...

  20. Cowboys and zombies: destabilizing patriarchal discourse in The Walking Dead

    NARCIS (Netherlands)

    Hassler-Forest, D.


    The serialized comic book The Walking Dead, written by Robert Kirkman and drawn by Charlie Adlard, has been published by Image Comics from October 2003, and is still being released in monthly instalments as of this writing. It has won numerous awards, including the prestigious Eisner Award for Best


    NARCIS (Netherlands)



    In a case-control study, the relevance of donor parameters used for donor selection on final transplant outcome was studied. Two matched groups of 17 donors were created: one group of 'ideal' donors and a control group not meeting the criteria for 'ideal' donors. Recipients of livers from both

  2. Higher organ donation consent rates by relatives of potential uncontrolled donors versus potential controlled donors after death

    NARCIS (Netherlands)

    Wind, J.; Mook, W.N. van; Willems, M.E.; Heurn, L.W. van


    BACKGROUND: Refusal to consent to organ donation is an important cause of the persisting gap between the number of potential organ donors and effectuated donors. In the Netherlands, organ donors include both uncontrolled donors: donors who die unexpectedly after cardiac death (DCD), after failed

  3. Brain herniation (United States)

    ... herniation; Uncal herniation; Subfalcine herniation; Tonsillar herniation; Herniation - brain ... Brain herniation occurs when something inside the skull produces pressure that moves brain tissues. This is most ...

  4. Estimating the Number of Organ Donors in Australian Hospitals—Implications for Monitoring Organ Donation Practices (United States)

    Pilcher, David; Gladkis, Laura; Arcia, Byron; Bailey, Michael; Cook, David; Cass, Yael; Opdam, Helen


    Background The Australian DonateLife Audit captures information on all deaths which occur in emergency departments, intensive care units and in those recently discharged from intensive care unit. This information provides the opportunity to estimate the number of donors expected, given present consent rates and contemporary donation practices. This may then allow benchmarking of performance between hospitals and jurisdictions. Our aim was to develop a method to estimate the number of donors using data from the DonateLife Audit on the basis of baseline patient characteristics alone. Methods All intubated patient deaths at contributing hospitals were analyzed. Univariate comparisons of donors to nondonors were performed. A logistic regression model was developed to estimate expected donor numbers from data collected between July 2012 and December 2013. This was validated using data from January to April 2014. Results Between July 2012 and April 2014, 6861 intubated patient deaths at 68 hospitals were listed on the DonateLife Audit of whom 553 (8.1%) were organ donors. Factors independently associated with organ donation included age, brain death, neurological diagnoses, chest x-ray findings, PaO2/FiO2, creatinine, alanine transaminase, cancer, cardiac arrest, chronic heart disease, and peripheral vascular disease. A highly discriminatory (area under the receiver operatory characteristic, 0.940 [95% confidence interval, 0.924-0.957]) and well-calibrated prediction model was developed which accurately estimated donor numbers. Three hospitals appeared to have higher numbers of actual donors than expected. Conclusions It is possible to estimate the expected number of organ donors. This may assist benchmarking of donation outcomes and interpretation of changes in donation rates over time. PMID:25919766

  5. Estimating the Number of Organ Donors in Australian Hospitals--Implications for Monitoring Organ Donation Practices. (United States)

    Pilcher, David; Gladkis, Laura; Arcia, Byron; Bailey, Michael; Cook, David; Cass, Yael; Opdam, Helen


    The Australian DonateLife Audit captures information on all deaths which occur in emergency departments, intensive care units and in those recently discharged from intensive care unit. This information provides the opportunity to estimate the number of donors expected, given present consent rates and contemporary donation practices. This may then allow benchmarking of performance between hospitals and jurisdictions. Our aim was to develop a method to estimate the number of donors using data from the DonateLife Audit on the basis of baseline patient characteristics alone. All intubated patient deaths at contributing hospitals were analyzed. Univariate comparisons of donors to nondonors were performed. A logistic regression model was developed to estimate expected donor numbers from data collected between July 2012 and December 2013. This was validated using data from January to April 2014. Between July 2012 and April 2014, 6861 intubated patient deaths at 68 hospitals were listed on the DonateLife Audit of whom 553 (8.1%) were organ donors. Factors independently associated with organ donation included age, brain death, neurological diagnoses, chest x-ray findings, PaO2/FiO2, creatinine, alanine transaminase, cancer, cardiac arrest, chronic heart disease, and peripheral vascular disease. A highly discriminatory (area under the receiver operatory characteristic, 0.940 [95% confidence interval, 0.924-0.957]) and well-calibrated prediction model was developed which accurately estimated donor numbers. Three hospitals appeared to have higher numbers of actual donors than expected. It is possible to estimate the expected number of organ donors. This may assist benchmarking of donation outcomes and interpretation of changes in donation rates over time.

  6. Swedish sperm donors are driven by altruism, but shortage of sperm donors leads to reproductive travelling. (United States)

    Ekerhovd, Erling; Faurskov, Anders; Werner, Charlotte


    Swedish legislation requires that sperm donors are identifiable to offspring. In Denmark sperm donors remain anonymous. The aim of this study was to examine sperm donation in Sweden by identifying socio-demographic backgrounds, motivations and attitudes among donors and to describe options and plans of sperm recipients. Furthermore, the willingness of Swedish health care providers to assist in treatment abroad, where sperm from an anonymous donor were to be used, was assessed. The extent of travelling to Denmark for reproductive purposes was also examined. Thirty Swedish sperm donors completed a questionnaire and were interviewed about their backgrounds, motivations and attitudes. Thirty couples where the infertility workup had shown azoospermia were interviewed about their options for achieving parenthood. The willingness to assist in fertility treatment abroad and the extent of reproductive cross border travelling were assessed by interviewing health care providers and by contacting Danish clinics. Almost all donors were Caucasian. The main motivation for sperm donors was to help others. Owing to shortage of sperm donors many Caucasian recipients intended to have treatment abroad. For most non-Caucasian recipients sperm from a donor of appropriate ethnicity were not available in Sweden. Whether the sperm donor was anonymous or identifiable was not of major importance to most sperm recipients. Health care providers expressed unanimous willingness to assist in treatment with sperm from an anonymous donor. Our inquiry indicated that more than 250 Swedish sperm recipients travel to Denmark annually. Identifiable sperm donors are driven by altruistic motives, but shortage of sperm donors leads to reproductive travelling. Recruitment strategies to increase the number of sperm donors in Sweden are therefore warranted.

  7. Development of Organ-Specific Donor Risk Indices (United States)

    Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.


    Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in developing new kidney allocation algorithms. The Liver Donor Risk Index allows for greater appreciation of the importance of donor factors, particularly for hepatitis C-positive recipients; as the donor risk index increases, rates of allograft and patient survival among these recipients decrease disproportionately. Use of livers with high donor risk index is associated with increased hospital costs independent of recipient risk factors, and transplanting livers with high donor risk index into patients with Model for End-Stage Liver Disease scores Significant regional variation in donor quality, as measured by the Liver Donor Risk Index, remains in the United States. We also review other potential indices for liver transplant, including donor-recipient matching and the retransplant donor risk index. While substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. PMID:22287036

  8. Extreme drying event in the Dead Sea basin during MIS5 from the ICDP Dead Sea Deep Drill Core (United States)

    Goldstein, S. L.; Stein, M.; Ben-Avraham, Z.; Agnon, A.; Ariztegui, D.; Brauer, A.; Haug, G. H.; Ito, E.; Kitagawa, H.; Torfstein, A.; Yasuda, Y.; The Icdp-Dsddp Scientific Party


    The ICDP funded Dead Sea Deep Drilling Project (DSDDP) recovered the longest and most complete paleo-environmental record in the Middle East, drilling holes of ~450 and ~350 meters in length in deep (~300 m below the lake level) and shallow sites (~3 mbll) respectively. The Dead Sea expands during the glacials and contracts during interglacials, and the sediments comprise a geological archive of the evolving environmental conditions (e.g. rains, floods, dust-storms, droughts). Dead Sea sediments include inorganic aragonite, allowing for dating by U-series (e.g. Haase-Schramm et al. GCA 2004). The deep site cores were opened and described in June 2011. The cores are composed mainly of alternating intervals of marl (aragonite, gypsum and detritus) during glacials, and salts and marls during interglacials. From this stratigraphy we estimate that the deep site core spans ~200 kyr (to the boundary of MIS 6 and 7). A dramatic discovery is a ~40 cm thick interval of partly rounded pebbles at ~235 m below the lake floor. This is the only clean pebbly unit in the entire core. It appears to be a beach layer, near the deepest part of the Dead Sea, lying above ~35 meters of mainly salt. If it is a beach layer, it implies an almost complete dry-down of the paleo-Dead Sea. The pebble layer lies within the last interglacial interval. Our initial attempt to more precisely estimate the age of the possible dry down shows an intriguing correlation between the salt-mud stratigraphy of the Dead Sea core and the oxygen isotope record of Soreq Cave, whereby excursions to light oxygen in the speleothems correspond to periods of salt deposition. Through this comparison, we estimate that the possible dry down occurred during MIS 5e. The occurrence of ~35 meters of mainly salt along with the pebble layer demonstrates a severe dry interval during MIS 5. This observation has implications for the Middle East today, where the Dead Sea level is dropping as all the countries in the area use the

  9. [Rare blood donors with irregular antibodies]. (United States)

    Milanović, Mirjana Krga; Bujandrić, Nevenka; Knezević, Natasa Milosavljević


    Blood groups are inherited biological characteristics that do not change throughout life in healthy people. Blood groups represent antigens found on the surface of red blood cells. Kell blood group system consists of 31 antigens. Kell antigen (K) is present in 0.2% of the population (the rare blood group). Cellano antigen is present in more than 99% (the high-frequency antigen). These antigens have a distinct ability to cause an immune response in the people after blood transfusion or pregnancy who, otherwise, did not have them before. This paper presents a blood donor with a rare blood group, who was found to have an irregular antibody against red blood cells by indirect antiglobulin test. Further testing determined the specificity of antibody to be anti-Cellano. The detected antibody was found in high titers (1024) with erythrocyte phenotype Kell-Cellano+. The blood donor was found to have a rare blood group KellKell. This donor was excluded from further blood donation. It is difficult to find compatible blood for a person who has developed an antibody to the high-frequency antigen. The donor's family members were tested and Cellano antigen was detected in her husband and child. A potential blood donor was not found among the family members. There was only one blood donor in the Register of blood donors who was compatible in the ABO and Kell blood group system. For the successful management of blood transfusion it is necessary to establish a unified national register of donors of rare blood groups and cooperate with the International Blood Group Reference Laboratory in Bristol with the database that registers donors of rare blood groups from around the world.

  10. Adult-to-Adult Living Donor Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Shimul A Shah


    Full Text Available The present review outlines the principles of living donor liver transplantation, donor workup, procedure and outcomes. Living donation offers a solution to the growing gap between the need for liver transplants and the limited availability of deceased donor organs. With a multidisciplinary team focused on donor safety and experienced surgeons capable of performing complex resection/reconstruction procedures, donor morbidity is low and recipient outcomes are comparable with results of deceased donor transplantation.

  11. Brain Health (United States)

    ... Brain Health Brain Health Home 10 Ways to Love Your Brain Stay Physically Active Adopt a Healthy Diet Stay ... risk factors slowed cognitive decline. 10 Ways to Love Your Brain > 10 tips to help reduce your risk of ...

  12. Donor policy rules and aid effectiveness

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars


    The present paper examines the macroeconomic impact of aid, by introducing endogenous aid allocations into a neoclassical growth framework. On this basis it is shown that donor policies can have important implications for the trajectory of recipients' GDP per capita. Depending on specific donor...... policy choices, aid disbursements may lead to faster transitional growth, stagnation or cyclical growth. Moreover, the analysis also suggests that donor policies may be part of the reason why foreign aid is not found to be uniformly effective in raising long-run productivity across recipients...

  13. Shallow hydrogen-related donors in silicon

    International Nuclear Information System (INIS)

    Hartung, J.; Weber, J.


    Photothermal ionization spectroscopy on neutron-irradiated and subsequently hydrogen-plasma-treated silicon reveals the existence of new shallow donors. The binding energies of the observed effective-mass-like donors are between 34 and 53 meV. The optical dipole transitions of the different donors are shifted towards higher energies by ΔE=0.1--0.2 cm -1 , when deuterium is used in the plasma instead of hydrogen. This isotope shift of the optical dipole transitions between the electronic levels of the defects is direct proof of the incorporation of hydrogen in these defects

  14. Simulation Model for DMEK Donor Preparation. (United States)

    Mittal, Vikas; Mittal, Ruchi; Singh, Swati; Narang, Purvasha; Sridhar, Priti


    To demonstrate a simulation model for donor preparation in Descemet membrane endothelial keratoplasty (DMEK). The inner transparent membrane of the onion (Allium cepa) was used as a simulation model for human Descemet membrane (DM). Surgical video (see Video, Supplemental Digital Content 1, demonstrating all the steps was recorded. This model closely simulates human DM and helps DMEK surgeons learn the nuances of DM donor preparation steps with ease. The technique is repeatable, and the model is cost-effective. The described simulation model can assist surgeons and eye bank technicians to learn steps in donor preparation in DMEK.

  15. Kidney for sale by live donor. (United States)

    Brahams, D


    The capacity to consent to bodily harm is explored in relation to the trade in kidneys obtained from impoverished healthy live donors for cash. The British medical profession has unambiguously condemned the practice, but the law in Britain allows a donor to consent to serious injury where the act had some social purpose, recognized by the law as valid. Allegations against the private Humana Hospital Wellington that indigent Turks were brought to Britain to be paid kidney donors, and similar practices elsewhere, are discussed. Questions are raised about the illegality of such contracts in Britain and the possibility of a Parliamentary Act making brokerage and involvement with such cash transactions a criminal offense.

  16. Donor-derived HLA antibody production in patients undergoing SCT from HLA antibody-positive donors. (United States)

    Taniguchi, K; Yoshihara, S; Maruya, E; Ikegame, K; Kaida, K; Hayashi, K; Kato, R; Inoue, T; Fujioka, T; Tamaki, H; Okada, M; Onuma, T; Fujii, N; Kusunoki, Y; Soma, T; Saji, H; Ogawa, H


    Pre-existing donor-specific HLA antibodies in patients undergoing HLA-mismatched SCT have increasingly been recognized as a risk factor for primary graft failure. However, the clinical implications of the presence of HLA antibodies in donors remain unknown. We prospectively examined 123 related donors for the presence of HLA antibodies by using a Luminex-based single antigen assay. Of these, 1/57 (1.8%) male, 6/27 (22%) parous female and 0/39 (0%) nonparous female donors were HLA antibody-positive. Then, we determined the presence of HLA antibodies in seven patients who received SCT from antibody-positive donors. Of these, four became HLA antibody-positive after SCT. The specificities of the antibodies that emerged in the patients closely resembled those of the antibodies found in the donors, indicating their production by donor-derived plasma cells. Moreover, the kinetics of the HLA antibody levels were similar in all four patients: levels started increasing within 1 week after SCT and peaked at days 10-21, followed by a gradual decrease. These results suggest that donor-derived HLA antibody production frequently occurs in patients undergoing SCT from antibody-positive donors. Further studies are warranted for clarifying the clinical significance of donor-derived HLA antibodies, including the role of these antibodies in post transplant platelet transfusion refractoriness.

  17. Responses to recipient and donor B cells by genetically donor T cells from human haploidentical chimeras

    International Nuclear Information System (INIS)

    Schiff, S.; Sampson, H.; Buckley, R.


    Following administration of haploidentical stem cells to infants with severe combined immunodeficiency (SCID), mature T cells of donor karyotype appear later in the recipient without causing graft-versus-host disease. To investigate the effect of the host environment on the responsiveness of these genetically donor T cells, blood B and T lymphocytes from 6 SCID recipients, their parental donors and unrelated controls were purified by double SRBC rosetting. T cells were stimulated by irradiated B cells at a 1:1 ratio in 6 day cultures. Engrafted T cells of donor karyotype gave much smaller responses to irradiated genetically recipient B cells than did fresh donor T cells. Moreover, engrafted T cells of donor karyotype from two of the three SCIDs who are longest post-transplantation responded more vigorously (14,685 and 31,623 cpm) than fresh donor T cells (5141 and 22,709 cpm) to donor B cells. These data indicate that T lymphocytes which have matured from donor stem cells in the recipient microenvironment behave differently from those that have matured in the donor

  18. Donor Retention in Online Crowdfunding Communities: A Case Study of (United States)

    Althoff, Tim; Leskovec, Jure


    Online crowdfunding platforms like and Kick-starter allow specific projects to get funded by targeted contributions from a large number of people. Critical for the success of crowdfunding communities is recruitment and continued engagement of donors. With donor attrition rates above 70%, a significant challenge for online crowdfunding platforms as well as traditional offline non-profit organizations is the problem of donor retention. We present a large-scale study of millions of donors and donations on, a crowdfunding platform for education projects. Studying an online crowdfunding platform allows for an unprecedented detailed view of how people direct their donations. We explore various factors impacting donor retention which allows us to identify different groups of donors and quantify their propensity to return for subsequent donations. We find that donors are more likely to return if they had a positive interaction with the receiver of the donation. We also show that this includes appropriate and timely recognition of their support as well as detailed communication of their impact. Finally, we discuss how our findings could inform steps to improve donor retention in crowdfunding communities and non-profit organizations.

  19. Human decellularized bone scaffolds from aged donors show improved osteoinductive capacity compared to young donor bone.

    Directory of Open Access Journals (Sweden)

    Christopher A Smith

    Full Text Available To improve the safe use of allograft bone, decellularization techniques may be utilized to produce acellular scaffolds. Such scaffolds should retain their innate biological and biomechanical capacity and support mesenchymal stem cell (MSC osteogenic differentiation. However, as allograft bone is derived from a wide age-range, this study aimed to determine whether donor age impacts on the ability an osteoinductive, acellular scaffold produced from human bone to promote the osteogenic differentiation of bone marrow MSCs (BM-MSC. BM-MSCs from young and old donors were seeded on acellular bone cubes from young and old donors undergoing osteoarthritis related hip surgery. All combinations resulted in increased osteogenic gene expression, and alkaline phosphatase (ALP enzyme activity, however BM-MSCs cultured on old donor bone displayed the largest increases. BM-MSCs cultured in old donor bone conditioned media also displayed higher osteogenic gene expression and ALP activity than those exposed to young donor bone conditioned media. ELISA and Luminex analysis of conditioned media demonstrated similar levels of bioactive factors between age groups; however, IGF binding protein 1 (IGFBP1 concentration was significantly higher in young donor samples. Additionally, structural analysis of old donor bone indicated an increased porosity compared to young donor bone. These results demonstrate the ability of a decellularized scaffold produced from young and old donors to support osteogenic differentiation of cells from young and old donors. Significantly, the older donor bone produced greater osteogenic differentiation which may be related to reduced IGFBP1 bioavailability and increased porosity, potentially explaining the excellent clinical results seen with the use of allograft from aged donors.

  20. 76 FR 63341 - Culturally Significant Objects Imported for Exhibition Determinations: “The Dead Sea Scrolls... (United States)


    ... for Exhibition Determinations: ``The Dead Sea Scrolls: Life and Faith in Biblical Times'' SUMMARY... objects to be included in the exhibition ``The Dead Sea Scrolls: Life and Faith in Biblical Times...

  1. Analysis of archaeal communities in Gulf of Mexico dead zone sediments. (United States)

    Sediments may contribute significantly to Louisiana continental shelf “dead zone” hypoxia but limited information hinders comparison of sediment biogeochemistry between norm-oxic and hypoxic seasons. Dead zone sediment cores collected during hypoxia (September 2006) had higher l...

  2. Smoking Out a Deadly Threat: Tobacco Use in the LGBT Community (United States)

    ... Out a Deadly Threat: Tobacco Use in the LGBT Community Disparities in Lung Health Series "Smoking Out a Deadly Threat: Tobacco Use in the LGBT Community" is part of the American Lung Association's ...

  3. Occurrence of organohalogens at the Dead Sea Basin (United States)

    Tubbesing, Christoph; Kotte, Karsten; Keppler, Frank; Krause, Torsten; Bahlmann, Enno; Schöler, Heinfried


    Most arid and semi-arid regions are characterized by evaporites, which are assured sources for volatile organohalogens (VOX) [1]. These compounds play an important role in tropospheric and stratospheric chemistry. The Dead Sea between Israel and Jordan is the world's most famous and biggest all-season water covered salt lake. In both countries chemical plants like the Dead Sea Works and the Arab Potash Company are located at the southern part of the Dead Sea and mine various elements such as bromine and magnesium. Conveying sea water through constructed evaporation pans multifarious salts are enriched and precipitated. In contrast, the Northern basin and main part of the Dead Sea has remained almost untouched by industrial salt production. Its fresh water supply from the Jordan River is constantly decreasing, leading to further increased salinity. During a HALOPROC campaign (Natural Halogenation Processes in the Environment) we collected various samples including air, soils, sediments, halophytic plants, ground- and seawater from the Northern and Southern basin of the Israeli side of the Dead Sea. These samples were investigated for the occurrence of halocarbons using different analytical techniques. Most samples were analyzed for volatile organohalogens such as haloalkanes using gas chromatography- mass spectrometry (GC-MS). Interestingly, there is a strong enrichment of trihalomethanes (THM), especially all chlorinated and brominated ones and also the iodinated compound dichloroiodomethane were found in the Southern basin. In addition, volatile organic carbons (VOC) such as ethene and some other alkenes were analyzed by a gas chromatography-flame ionisation detector (GC-FID) to obtain further information about potential precursors of halogenated compounds. Halophytic plants were investigated for their potential to release chloromethane and bromomethane but also for their stable carbon and hydrogen isotope composition. For this purpose, a plant chamber was


    CERN Document Server

    SC Unit


    Responding to the HUG (Hôpitaux Universitaires de Genève) hospitals’ urgent appeal for blood donations during this summer season, the CERN medical staff organised a day of blood donations for the Swiss bloodbank CTS on 30 July. They were supported by NOVAE (Restaurant No. 1), who provided donors with a free snack. This specially arranged campaign was a success, as the 135 volunteers included 66 first-time donors, and a total of 99 standard bags of blood were collected. (Swiss hospitals need 1300 bags every day!) The CTS and CERN’s medical staff wish to thank the donors and all others who helped make the event a success. Upcoming blood donor days at CERN: 12 November 2008 and 10 March 2009.


    CERN Multimedia

    SC Unit


    Responding to the HUG (Hôpitaux Universitaires de Genève) hospitals’ urgent appeal for blood donations during this summer season, the CERN medical staff organised a day of blood donations for the Swiss bloodbank CTS on 30 July. They were supported by NOVAE (Restaurant No. 1), who provided donors with a free snack. This specially arranged campaign was a success, as the 135 volunteers included 66 first-time donors, and a total of 99 standard bags of blood was collected. (Swiss hospitals need 1300 bags every day!) The CTS and CERN’s medical staff want to thank the donors and all others who helped make the event a success. Upcoming blood donor days at CERN: 12 November 2008 and 10 March 2009.

  6. Dead space and slope indices from the expiratory carbon dioxide tension-volume curve

    NARCIS (Netherlands)

    A.H. Kars (Alice); J.M. Bogaard (Jan); Th. Stijnen (Theo); J. de Vries; A.F.M. Verbraak (Anton); C. Hilvering


    textabstractThe slope of phase 3 and three noninvasively determined dead space estimates derived from the expiratory carbon dioxide tension (PCO2) versus volume curve, including the Bohr dead space (VD,Bohr), the Fowler dead space (VD,Fowler) and pre-interface expirate

  7. Application of Optical Flow Sensors for Dead Reckoning, Heading Reference, Obstacle Detection, and Obstacle Avoidance (United States)



  8. 78 FR 16565 - Culturally Significant Objects Imported for Exhibition Determinations: “The Dead Sea Scrolls... (United States)


    ... Culturally Significant Objects Imported for Exhibition Determinations: ``The Dead Sea Scrolls: Life and Faith in Ancient Times'' Formerly Titled ``The Dead Sea Scrolls: Life and Faith in Biblical Times'' ACTION... exhibition ``The Dead Sea Scrolls: Life and Faith in Biblical Times.'' The referenced notice was corrected on...

  9. 78 FR 62354 - Culturally Significant Objects Imported for Exhibition Determinations: “The Dead Sea Scrolls... (United States)


    ... Culturally Significant Objects Imported for Exhibition Determinations: ``The Dead Sea Scrolls: Life and Faith in Ancient Times'' Formerly Titled ``The Dead Sea Scrolls: Life and Faith in Biblical Times'' ACTION... exhibition ``The Dead Sea Scrolls: Life and Faith in Biblical Times.'' The referenced notice was corrected on...

  10. 77 FR 64373 - Culturally Significant Objects Imported for Exhibition Determinations: “The Dead Sea Scrolls... (United States)


    ... Culturally Significant Objects Imported for Exhibition Determinations: ``The Dead Sea Scrolls: Life and Faith in Ancient Times,'' Formerly Titled ``The Dead Sea Scrolls: Life and Faith in Biblical Times... the exhibition ``The Dead Sea Scrolls: Life and Faith in Biblical Times.'' The referenced notice is...

  11. 78 FR 24462 - Culturally Significant Objects Imported for Exhibition; Determinations: “The Dead Sea Scrolls... (United States)


    ... Culturally Significant Objects Imported for Exhibition; Determinations: ``The Dead Sea Scrolls: Life and Faith in Ancient Times'' Formerly Titled ``The Dead Sea Scrolls: Life and Faith in Biblical Times... the exhibition ``The Dead Sea Scrolls: Life and Faith in Biblical Times.'' The referenced notice was...

  12. El Dia de los Muertos -- Libreto. (The Day of the Dead -- Notebook.) (United States)

    Espinoza, Delia; Lopez, Santiago, III

    On November 2, all Mexican Americans remember their dead as Mexico does on that same day. Called "El Dia de los Muertos" (Day of the Dead), the dead are remembered posthumously with flowers, candles, music, prayers, chants, and wreaths. The people go to cemeteries to clean tombs, lay fresh or artificial flowers on them, and pray for…

  13. Microclimate and habitat heterogeneity as the major drivers of beetle diversity in dead wood (United States)

    Sebastian Seibold; Claus Bassler; Roland Brandl; Boris Buche; Alexander Szallies; Simon Thorn; Michael D. Ulyshen; Jorg Muller; Christopher Baraloto


    1. Resource availability and habitat heterogeneity are principle drivers of biodiversity, but their individual roles often remain unclear since both factors are usually correlated. The biodiversity of species dependent on dead wood could be driven by either resource availability represented by dead-wood amount or habitat heterogeneity characterized by dead-wood...

  14. 9 CFR 309.3 - Dead, dying, disabled, or diseased and similar livestock. (United States)


    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Dead, dying, disabled, or diseased and... AND VOLUNTARY INSPECTION AND CERTIFICATION ANTE-MORTEM INSPECTION § 309.3 Dead, dying, disabled, or diseased and similar livestock. (a) Livestock found to be dead or in a dying condition on the premises of...

  15. Proportional Derivative Control with Inverse Dead-Zone for Pendulum Systems


    Rubio, José de Jesús; Zamudio, Zizilia; Pacheco, Jaime; Mújica Vargas, Dante


    A proportional derivative controller with inverse dead-zone is proposed for the control of pendulum systems. The proposed method has the characteristic that the inverse dead-zone is cancelled with the pendulum dead-zone. Asymptotic stability of the proposed technique is guaranteed by the Lyapunov analysis. Simulations of two pendulum systems show the effectiveness of the proposed technique.

  16. Self-Interaction Chromatography of mAbs: Accurate Measurement of Dead Volumes. (United States)

    Hedberg, S H M; Heng, J Y Y; Williams, D R; Liddell, J M


    Measurement of the second virial coefficient B22 for proteins using self-interaction chromatography (SIC) is becoming an increasingly important technique for studying their solution behaviour. In common with all physicochemical chromatographic methods, measuring the dead volume of the SIC packed column is crucial for accurate retention data; this paper examines best practise for dead volume determination. SIC type experiments using catalase, BSA, lysozyme and a mAb as model systems are reported, as well as a number of dead column measurements. It was observed that lysozyme and mAb interacted specifically with Toyopearl AF-Formyl dead columns depending upon pH and [NaCl], invalidating their dead volume usage. Toyopearl AF-Amino packed dead columns showed no such problems and acted as suitable dead columns without any solution condition dependency. Dead volume determinations using dextran MW standards with protein immobilised SIC columns provided dead volume estimates close to those obtained using Toyopearl AF-Amino dead columns. It is concluded that specific interactions between proteins, including mAbs, and select SIC support phases can compromise the use of some standard approaches for estimating the dead volume of SIC columns. Two other methods were shown to provide good estimates for the dead volume.

  17. Laparoscopic donor nephrectomy increases the supply of living donor kidneys: a center-specific microeconomic analysis. (United States)

    Kuo, P C; Johnson, L B


    A tenet of microeconomics is that new technology will shift the supply curve to the right. Laparoscopic donor nephrectomy (LDN) is a new technique for removal of living donor kidneys. Centers performing this procedure have noted an increased number of patients presenting for donor evaluation. This has not been previously studied. The records of all LDN performed from May 1998 to February 1999 were reviewed. The following variables were examined: sex, age, related vs. unrelated donation, estimated blood loss, i.v. analgesia, length of stay, and time out of work. Donors undergoing traditional open donor nephrectomy during January 1997 to May 1998 served as the control group. A composite cost index was constructed. LDN significantly decreased length of stay, pain, and time out of work; the supply function shifted to the right. Telephone interviews revealed that 47% donated solely because of the LDN procedure. LDN increases the supply of living donor kidneys.

  18. Donor-Derived Myeloid Sarcoma in Two Kidney Transplant Recipients from a Single Donor

    Directory of Open Access Journals (Sweden)

    Amudha Palanisamy


    Full Text Available We report the rare occurrence of donor-derived myeloid sarcoma in two kidney transplant patients who received organs from a single deceased donor. There was no evidence of preexisting hematologic malignancy in the donor at the time of organ recovery. Both recipients developed leukemic involvement that appeared to be limited to the transplanted organ. Fluorescence in situ hybridization (FISH and molecular genotyping analyses confirmed that the malignant cells were of donor origin in each patient. Allograft nephrectomy and immediate withdrawal of immunosuppression were performed in both cases; systemic chemotherapy was subsequently administered to one patient. Both recipients were in remission at least one year following the diagnosis of donor-derived myeloid sarcoma. These cases suggest that restoration of the immune system after withdrawal of immunosuppressive therapy and allograft nephrectomy may be sufficient to control HLA-mismatched donor-derived myeloid sarcoma without systemic involvement.

  19. Not to declare dead someone still alive: Case reports

    Directory of Open Access Journals (Sweden)

    Anđelić Slađana


    Full Text Available Introduction. Diagnosing death represents an activity that carries a great deal of public responsibility for medical professionals and is continually exposed to the control of citizens and media. Although this is a taboo subject in medical circles, unfortunately in medical practice there are situations when the physician issues a death diagnosis form without even examining the person or for an already buried person. Such physician’s action is impermissible and it leads to the possibility of professional and criminal law punishment. Case Outline. By giving examples from practice, we wish to point out the need for exceptional caution when confirming and diagnosing death in order to diagnose the true, i.e. rule out apparent death and consequently avoid the mistake of declaring dead someone still alive. Conclusion. When confirming and declaring death, exceptional caution of the physician is necessary so as not to declare dead someone still alive!

  20. Awakening the "Walking Dead": Zombie Pedagogy for Millennials

    Directory of Open Access Journals (Sweden)

    Nancy Dawn Wadsworth


    Full Text Available This article lays out the pedagogical benefits of using popular zombie productions, particularly AMC's The Walking Dead, to teach a critical introduction to modern political theory. Based on my undergraduate course: "Political Theory, Climate Change, and the Zombie Apocalypse," the article outlines how The Walking Dead can be used to critique the mythic assumptions built into modern social contract theory; to introduce other political ideologies, including conservatism, anarchism, fascism, and communism; and to consider the political challenges raised by a global problem such as climate change in an increasingly neoliberal environment. Zombie productions are offered as a particularly salient pedagogical tool that can help awaken critical political analysis for the Millennial Generation.

  1. The death effect in literary evaluation: reverence for the dead? (United States)

    Green, Joseph P; Mohler, Eric W

    It is commonly believed that the value of art and other creative works increases after the death of the artist. In an attempt to examine this so-called death effect we presented a short story to N = 431 undergraduate students asking how much money they would hypothetically spend to purchase a literary work. We experimentally manipulated: 1) whether the author died or moved after publishing a short story, and, 2) the gender of the author. Participants randomly received one of four possible biographical descriptions about the author. We predicted that participants would offer higher purchase prices and subjectively evaluate the work more positively when they believed the author was dead. Results were consistent with this hypothesis perhaps reflecting a certain reverence for the dead. We also found that evaluations of the story were more favorable when the purported gender of the author matched that of the participant.

  2. Pulsed optically pumped atomic clock with zero-dead-time (United States)

    Lin, Haixiao; Lin, Jinda; Deng, Jianliao; Zhang, Song; Wang, Yuzhu


    By alternatively operating two pulsed optically pumped (POP) atomic clocks, the dead time in a single clock can be eliminated, and the local oscillator can be discriminated continuously. A POP atomic clock with a zero-dead-time (ZDT) method is then insensitive to the microwave phase noise. From τ = 0.01 to 1 s, the Allan deviation of the ZDT-POP clock is reduced as nearly τ-1, which is significantly faster than τ-1/2 of a conventional clock. During 1-40 s, the Allan deviation returns to τ-1/2. Moreover, the frequency stability of the ZDT-POP clock is improved by one order of magnitude compared with that of the conventional POP clock. We also analyze the main factors that limit the short-term frequency stability of the POP atomic clock.

  3. The Dead Mother, the Uncanny, and the Holy Ghost

    Directory of Open Access Journals (Sweden)

    Gal Ventura


    Full Text Available Recurrent portrayals of dead mothers frequently appeared in French art from 1800 to 1850. This essay focuses on one of the latest manifestations of this image, namely, the French Realist Jules Breton's (1827-1906 painting The Hunger of 1850, in order to examine the psycho-historical elements associated with the mother's death. Through an analysis of the "Uncanny" as formulated by both Ernst Jentsch and Sigmund Freud, we will address the undissolvable link between the structuralization of "homeliness" in the late eighteenth century and the dread it evoked in the early nineteenth century, as two sides of the same coin. We will simultaneously consider the inherent conflictuality embodied by the dead mother according to the French psychoanalyst André Green, who dealt with the experience of "nothingness" that characterizes children of mothers-who-refuse-to-die.

  4. Promoting Organ Donor Registries Through Public Education: What Is the Cost of Securing Organ Donors? (United States)

    Razdan, Manik; Smith, Kenneth J; Bryce, Cindy L; Degenholtz, Howard B


    Transplant medicine's impact on America's public health is seriously limited by acute shortage of transplantable organs. Consequently, the United Sates has witnessed considerable investment in the promotion of organ donor registries. Although there is no evidence to support that donor registry promotion alleviates organ shortage, this belief continues to drive investments into registry promotion. In this study, return on investment in donor registry promotion was examined using cost-outcomes analysis. Cost of promoting the donor registry was estimated in US dollars whereas the outcome was measured as the number of individuals who join the registry (registrants) and their value in terms of organ donors. The study was conducted from the perspective of a regional Organ Procurement Organization (OPO). Costs were directly obtained from the OPO. The number of new registrants was obtained from the OPO and the departments of motor vehicles that maintain the donor registry. The value of registrants in terms of organ donors was computed based on a registrant's age-dependent risk of dying and age-dependent probability of becoming an organ donor. Six thousand seven hundred eight individuals joined the organ donor registry (95% confidence interval [95% CI], 5429-7956) at a cost of $455 per registrant (95% CI, US $383-US $562). These individuals result in 4.2 present-day donors (95% CI, 2.5-6.6) at a cost of US $726 000 (95% CI, US $462000-US $1.2 million). Because the cost per registrant and cost per donor is less than society's willingness to pay, donor registry promotion offers positive return on investment. Investment in registry promotion should at the minimum be maintained at current levels.

  5. AntReckoning: Dead Reckoning using Interest Modeling by Pheromones


    Yahyavi , Amir; Huguenin , Kévin; Kemme , Bettina


    International audience; In games, the goals and interests of players are key factors in their behavior. However, techniques used by networked games to cope with infrequent updates and message loss, such as dead reckoning, estimate a player's movements based on previous observations only. The estimations are typically done using dynamics of motion, taking only inertia and external factors (e.g., gravity, wind) into account while completely ignoring the player's goals (e.g., chasing other playe...

  6. Strong tracking adaptive Kalman filters for underwater vehicle dead reckoning (United States)

    Xiao, Kun; Fang, Shao-Ji; Pang, Yong-Jie


    To impove underwater vehicle dead reckoning, a developed strong tracking adaptive kalman filter is proposed. The filter is improved with an additional adaptive factor and an estimator of measurement noise covariance. Since the magnitude of fading factor is changed adaptively, the tracking ability of the filter is still enhanced in low velocity condition of underwater vehicles. The results of simulation tests prove the presented filter effective.

  7. Modification in amino acids of Dead Sea Scroll Parchments. (United States)

    Sobel, H; Ajie, H


    Fragments of Dead Sea Scroll Parchments were extracted for collagen and subjected to amino acid analysis. In modern parchment samples, 90% or more of the protein could be extracted in hot aqueous solution as collagen. In the ancient specimens, 70% or less was extractable. The hot-solution insoluble material was analyzed for collagen. In the soluble extract, the quantity of tyrosine, histidine, and methionine was reduced. Dityrosine was detected. The need to extend such studies is discussed.

  8. Interest Modeling in Games: The Case of Dead Reckoning


    Yahyavi, Amir; Huguenin, Kévin; Kemme, Bettina


    Special Issue on Network and Systems Support for Games; International audience; In games, the goals and interests of players are key factors in their behavior. However, techniques used by networked games to cope with infrequent updates and message loss, such as dead reckoning, estimate a player's movements based mainly on previous observations. The estimations are typically made by using dynamics of motion, taking only inertia and some external factors (e.g., gravity, wind) into account while...

  9. Vector Graph Assisted Pedestrian Dead Reckoning Using an Unconstrained Smartphone


    Qian, Jiuchao; Pei, Ling; Ma, Jiabin; Ying, Rendong; Liu, Peilin


    The paper presents a hybrid indoor positioning solution based on a pedestrian dead reckoning (PDR) approach using built-in sensors on a smartphone. To address the challenges of flexible and complex contexts of carrying a phone while walking, a robust step detection algorithm based on motion-awareness has been proposed. Given the fact that step length is influenced by different motion states, an adaptive step length estimation algorithm based on motion recognition is developed. Heading estimat...

  10. Thermodynamics of the dead zone inner edge in protoplanetary disks

    International Nuclear Information System (INIS)

    Faure, Julien


    The dead zone, a quiescent region enclosed in the turbulent flow of a protoplanetary disk, seems to be a promising site for planet formation. Indeed, the development of a density maximum at the dead zone inner edge, that has the property to trap the infalling dust, is a natural outcome of the accretion mismatch at this interface. Moreover, the flow here may be unstable and organize itself into vortical structures that efficiently collect dust grains. The inner edge location is however loosely constrained. In particular, it depends on the thermodynamical prescriptions of the disk model that is considered. It has been recently proposed that the inner edge is not static and that the variations of young stars accretion luminosity are the signature of this interface displacements. This thesis address the question of the impact of the gas thermodynamics onto its dynamics around the dead zone inner edge. MHD simulations including the complex interplay between thermodynamical processes and the dynamics confirmed the dynamical behaviour of the inner edge. A first measure of the interface velocity has been realised. This result has been compared to the predictions of a mean field model. It revealed the crucial role of the energy transport by density waves excited at the interface. These simulations also exhibit a new intriguing phenomenon: vortices forming at the interface follow a cycle of formation-migration-destruction. This vortex cycle may compromise the formation of planetesimals at the inner edge. This thesis claims that thermodynamical processes are at the heart of how the region around the dead zone inner edge in protoplanetary disks works. (author) [fr

  11. Impact of the cornea donor study on acceptance of corneas from older donors. (United States)

    Sugar, Alan; Montoya, Monty M; Beck, Roy; Cowden, John W; Dontchev, Mariya; Gal, Robin L; Kollman, Craig; Malling, Jackie; Mannis, Mark J; Tennant, Bradley


    To evaluate retrospectively whether the findings from the Cornea Donor Study (CDS) led to changes in the transplantation of corneas from older donors. Eye banks in United States provided complete data on donor age and placement (domestic or international) for 86,273 corneas from 1998 to 2009. The data were analyzed by 3 periods, preceding CDS (1998-1999), during CDS (2000-2007), and after publication of CDS 5-year results (2008-2009), and separately for corneas placed within versus outside the United States. For corneal tissues transplanted in the United States, the percentage of donors who were 66 years or older increased from 19% before CDS to 21% during CDS and 25% after CDS (Pcorneas distributed outside the United States, with the percentage of donors 66 years and older decreasing from 56% to 42% to 34%, respectively. Donor age trends over time varied by eye bank. There was a modest overall increase in the donor age of corneas transplanted in the United States from 1998 to 2009, but the retrospective nature of the study limits our ability to attribute this change to the CDS. The modest increases in the donor age of corneas transplanted is a positive finding, but wider acceptance of older corneal donor tissue should be encouraged based on the 5-year evidence generated by the CDS.

  12. Impact of the Cornea Donor Study (CDS) on Acceptance of Corneas from Older Donors (United States)

    Sugar, Alan; Montoya, Monty M.; Beck, Roy; Cowden, John W.; Dontchev, Mariya; Gal, Robin L.; Kollman, Craig; Malling, Jackie; Mannis, Mark J.; Tennant, Bradley


    Purpose Evaluate retrospectively whether findings from the Cornea Donor Study (CDS) led to changes in the transplantation of corneas from older donors. Methods United States eye banks provided complete data on donor age and placement (domestic or international) for 86,273 corneas from 1998 to 2009. The data were analyzed by 3 time periods: preceding CDS (1998–1999), during CDS (2000–2007) and after publication of CDS 5 year results (2008–2009), and separately for corneas placed within vs. outside the United States. Results For corneal tissues transplanted in the United States, the percentage of donors ≥66 years old increased from 19% before CDS to 21% during CDS and 25% after CDS (pcorneas distributed outside the United States with the percentage of donors ≥66 years old decreasing from 56% to 42% to 34%, respectively. Donor age trends over time varied by eye bank. Conclusions There was a modest overall increase in the donor age of corneas transplanted in the United States from 1998 to 2009, but the retrospective nature of the study limits our ability to attribute this change to the CDS. The modest increases in the donor age of corneas transplanted is a positive finding, but wider acceptance of older corneal donor tissue should be encouraged based on the five-year evidence generated by the CDS. PMID:22262218

  13. Short Term Donor Outcomes After Hepatectomy in Living Donor Liver Transplantation

    International Nuclear Information System (INIS)

    Dar, F. S.; Zia, H.; Bhatti, A. B. H.; Kazmi, R.; Rana, A.; Nazer, R.; Khan, E. U. D.; Khan, N. A.; Salih, M.; Shah, N. H.


    Objective: To determine the outcome of living-donor liver transplant (LDLT) donors from the first liver transplant program in Pakistan. Study Design: Cohort study. Place and Duration of Study: Shifa International Hospital, Islamabad, from April 2012 to August 2014. Methodology: A total of 100 live donors who underwent hepatectomy were included. Demographics, etiologies, graft characteristics and operative variables were retrospectively assessed. Outcome was assessed based on morbidity and mortality. Results: Median donor age was 28 (17 - 45) years and median body mass index (BMI) was 24 kg/m2 (15 - 36). Male to female ratio was 1.5:1. Hepatitis B and C were the most common underlying etiologies and accounted for 79/100 (79%) of LDLT's. Overall, 93/100 (93%) donors donated a right lobe graft. Median estimated graft weight to recipient body weight (GW/BW) ratio was 1.03 (0.78 - 2). Standard arterial anatomy was present in 56% donors. The 90-day morbidity was 13/100 (13%) and overall morbidity was 17/100 (17%). Bile leak was encountered in 3 (3%) patients. There was no donor mortality. Conclusion: Acceptable short-term donor outcomes were achieved in an LDLT program in Pakistan with careful donor selection and planning. (author)

  14. Donor registries, first-person consent legislation, and the supply of deceased organ donors. (United States)

    Callison, Kevin; Levin, Adelin


    In this paper, we exploit the varied timing in state adoption of organ donor registries and first-person consent (FPC) legislation to examine corresponding changes in the supply of deceased organ donors. Results indicate that the establishment of a state organ donor registry leads to an increase in donation rates of approximately 8%, while the adoption of FPC legislation has no effect on the supply of organ donors. These results reinforce the need to encourage individuals to communicate their donation preferences, either explicitly via a registry or by discussing them with family. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Cooperation Between Dead Reckoning (Path Integration) and External Position Cues (United States)

    Etienne, Ariane S.; Maurer, Roland; Berlie, Joëlle; Derivaz, Valérie; Georgakopoulos, Joséphine; Griffin, Andrea; Rowe, Tiffany

    Dead reckoning (also called path integration) is the process by which a navigating organism derives its current position relative to an Earthbound reference point from its own locomotion. Dead reckoning requires the continuous estimation of changes in direction and location through self-generated signals and the computation of position on the basis of these signals.(i) Hymenopterous insects measure rotations and translations mainly with the help of optical references such as the Sun and translational visual flow. By contrast, mammals are able to estimate their position on the basis of purely 'internal' information; that is, signals generated in the vestibular system by inertial forces, somatosensory feedback, and efference copies (copies of central commands that control the performance of rotations and translations). Obviously, the assessment of the angular and linear components of locomotion is much more precise if it is assisted by external references than if this is not the case.(ii) Only man-made dead reckoning systems yield precise position information through the twofold integration over time of inertial signals deriving from angular and linear acceleration. On the biological level, all species tested so far seem to rely on a simplified form of path 'integration': in certain test situations, arthropods and mammals (including humans) commit similar systematic errors. This suggests that species from unrelated taxa update position according to a similar algorithm.

  16. Identifying location by dead reckoning and external cues. (United States)

    Georgakopoulos, J; Etienne, A S


    Golden hamsters can orient towards specific points in their environment using location- based visual cues and/or dead reckoning based on vestibular and proprioceptive signals. The relative weight of these different kinds of information was investigated in an apparatus consisting of three identical, square compartments joined by tunnels, with the subject's own nest box at one end. Each compartment contained a feeding site and a weak light spot, the relation between the feeding site and the light spot being different in the three compartments. The animals were trained to hoard food in succession from the three feeding locations, in darkness. During test trials, the light spots were either suppressed or moved to new locations, thus being set in conflict with other kinds of spatial information. In the majority of trials, the subjects proceeded fairly directly to the feeding places, independently of the presence and position of the light spots. This performance may be explained through rote motor learning, which may be initiated with respect to tactile cues previously associated to the goal. However, more flexible, indirect trajectories towards the goal suggest that the subjects kept track of their location within the test space and therefore depended simultaneously on dead reckoning and a map. A control experiment in which the goals were moved along with the visual cues excluded the use of olfactory cues from the food source and confirmed the role of dead reckoning. Copyright © 1994. Published by Elsevier B.V.

  17. Water Quality Modeling in the Dead End Sections of Drinking ... (United States)

    Dead-end sections of drinking water distribution networks are known to be problematic zones in terms of water quality degradation. Extended residence time due to water stagnation leads to rapid reduction of disinfectant residuals allowing the regrowth of microbial pathogens. Water quality models developed so far apply spatial aggregation and temporal averaging techniques for hydraulic parameters by assigning hourly averaged water demands to the main nodes of the network. Although this practice has generally resulted in minimal loss of accuracy for the predicted disinfectant concentrations in main water transmission lines, this is not the case for the peripheries of a distribution network. This study proposes a new approach for simulating disinfectant residuals in dead end pipes while accounting for both spatial and temporal variability in hydraulic and transport parameters. A stochastic demand generator was developed to represent residential water pulses based on a non-homogenous Poisson process. Dispersive solute transport was considered using highly dynamic dispersion rates. A genetic algorithm was used to calibrate the axial hydraulic profile of the dead-end pipe based on the different demand shares of the withdrawal nodes. A parametric sensitivity analysis was done to assess the model performance under variation of different simulation parameters. A group of Monte-Carlo ensembles was carried out to investigate the influence of spatial and temporal variations

  18. Gulf of Mexico dead zone - 1000 year record (United States)

    Osterman, L.E.; Poore, R.Z.; Swarzenski, P.W.


    An area of oxygen-depleted bottom- and subsurfacewater (hypoxia = dissolved oxygen Since systematic measurement of the extent of the dead zone was begun in 1985, the overall pattern indicates that the area of the dead zone is increasing. Several studies have concluded that the expansion of the Louisiana shelf dead zone is related to increased nutrients (primarily nitrogen, but possibly also phosphorous) in the Mississippi River drainage basin and is responsible for the degradation of Gulf of Mexico marine habitats. The goal of this research is to augment information on the recent expansion of Louisiana shelf hypoxia and to investigate the temporal and geographic extent of the lowoxygen bottom-water conditions prior to 1985 in sediment cores collected from the Louisiana shelf. We use a specific low-oxygen faunal proxy termed the PEB index based on the cumulative percentage of three foraminifers (= % Protononion atlanticum, + % Epistominella vitrea, + % Buliminella morgani) that has been shown statistically to represent the modern seasonal Louisiana hypoxia zone. Our hypothesis is that the increased relative abundance of PEB species in dated sediment cores accurately tracks past seasonal low-oxygen conditions on the Louisiana shelf.

  19. Hypertension in standard criteria deceased donors is associated with inferior outcomes following kidney transplantation. (United States)

    Singh, Rajinder P; Farney, Alan C; Rogers, Jeffrey; Gautreaux, Michael; Reeves-Daniel, Amber; Hartmann, Erica; Doares, William; Iskandar, Samy; Adams, Patricia; Stratta, Robert J


    Hypertension may be a either a cause or an effect of kidney disease. Although hypertension is an important component of the expanded criteria donor definition, risks of transplanting deceased donor kidneys from hypertensive standard criteria donors (SCD) are less well understood. Retrospective single-center study in all adult patients who received a deceased donor kidney transplant from a SCD to evaluate the role of donor hypertension as a pre-transplant risk factor for death-censored graft loss (DCGL) and renal function. From October 2001 through May 2008, 297 kidney transplants were performed from donation after brain death SCDs. A total of 47 (15.8%) grafts were lost, including 19 (6.4%) deaths with functioning grafts. Univariate analysis of death-censored cases (n = 278) identified history of donor hypertension, cold ischemia time (CIT) >30 h, and African American (AA) recipients as significant pre-transplant risk factors predictive for DCGL at five yr follow-up (mean 38 months, all p hypertension (relative risk 2.2, p = 0.04) to be a significant risk factor for DCGL, whereas CIT >30 h and AA recipient ethnicity showed only trends toward DCGL. Renal function as determined by serum creatinine levels was significantly higher in recipients of hypertensive compared with non-hypertensive SCD kidneys at all time points out to 48 months follow-up and the disparity in renal function increased over time. Transplanting SCD kidneys from hypertensive donors is associated with worse graft function and an increased risk of graft loss. © 2011 John Wiley & Sons A/S.

  20. Donor-derived metastatic melanoma in a liver transplant recipient established by DNA fingerprinting. (United States)

    Bilal, Muhammad; Eason, James D; Das, Kanak; Sylvestre, Pamela B; Dean, Amanda G; Vanatta, Jason M


    Metastatic melanoma is a donor-derived malignancy that has rarely been reported in liver allograft recipients. We present a case of a transmitted donor-derived melanoma to a liver allograft recipient in whom the diagnosis was established by polymerase chain reaction-based DNA fingerprinting. A 52-year-old African-American man underwent a successful orthotropic liver transplant for alcohol-induced cirrhosis. One year after the orthotropic liver transplant, he presented at our institution with diffuse abdominal pain, and a computed tomography scan of the abdomen and chest showed innumerable masses diffusely involving the liver and multiple subcutaneous nodules in the abdominal and chest wall. A liver biopsy confirmed the diagnosis of metastatic melanoma. The origin of melanoma was traced to the donor by DNA fingerprinting of the native liver, the donor liver, and the donor gallbladder. Chemotherapy was initiated with temozolomide (75 mg/m² daily) and thalidomide (50 mg daily), to which he responded within 8 weeks with radiologic improvement in metastatic lesions. Tacrolimus was switched to sirolimus because of renal insufficiency as well as reported effectiveness against melanoma. Our patient survived for 9 months after the diagnosis of metastatic melanoma. He ultimately died of brain metastases. Donor-derived metastatic melanoma is a rare cancer with the highest transmission and mortality rates, which requires better recognition. Prompt diagnosis of donor-derived melanoma is critical and can be achieved reliably with polymerase chain reaction-based DNA analysis. Management options after diagnosis include de-escalation of immunosuppression, with or without urgent organ removal or retransplant. The roles of chemotherapy, immunotherapy, and radiotherapy require further study.

  1. Long-term results after transplantation of pediatric liver grafts from donation after circulatory death donors.

    Directory of Open Access Journals (Sweden)

    Rianne van Rijn

    Full Text Available Liver grafts from donation after circulatory death (DCD donors are increasingly accepted as an extension of the organ pool for transplantation. There is little data on the outcome of liver transplantation with DCD grafts from a pediatric donor. The objective of this study was to assess the outcome of liver transplantation with pediatric DCD grafts and to compare this with the outcome after transplantation of livers from pediatric donation after brain death (DBD donors.All transplantations performed with a liver from a pediatric donor (≤16 years in the Netherlands between 2002 and 2015 were included. Patient survival, graft survival, and complication rates were compared between DCD and DBD liver transplantation.In total, 74 liver transplantations with pediatric grafts were performed; twenty (27% DCD and 54 (73% DBD. The median donor warm ischemia time (DWIT was 24 min (range 15-43 min. Patient survival rate at 10 years was 78% for recipients of DCD grafts and 89% for DBD grafts (p = 0.32. Graft survival rate at 10 years was 65% in recipients of DCD versus 76% in DBD grafts (p = 0.20. If donor livers in this study would have been rejected for transplantation when the DWIT ≥30 min (n = 4, the 10-year graft survival rate would have been 81% after DCD transplantation. The rate of non-anastomotic biliary strictures was 5% in DCD and 4% in DBD grafts (p = 1.00. Other complication rates were also similar between both groups.Transplantation of livers from pediatric DCD donors results in good long-term outcome especially when the DWIT is kept ≤30 min. Patient and graft survival rates are not significantly different between recipients of a pediatric DCD or DBD liver. Moreover, the incidence of non-anastomotic biliary strictures after transplantation of pediatric DCD livers is remarkably low.

  2. Correction for intrinsic and set dead-time losses in radioactivity counting

    International Nuclear Information System (INIS)

    Wyllie, H.A.


    Equations are derived for the determination of the intrinsic dead time of the components which precede the paralysis unit in a counting system for measuring radioactivity. The determination depends on the extension of the set dead time by the intrinsic dead time. Improved formulae are given for the dead-time correction of the count rate of a radioactive source in a single-channel system. A variable in the formulae is the intrinsic dead time which is determined concurrently with the counting of the source. The only extra equipment required in a conventional system is a scaler. 5 refs., 2 tabs., 21 figs

  3. Recruitment of aged donor heart with pharmacological stress echo. A case report

    Directory of Open Access Journals (Sweden)

    Bombardini Tonino


    Full Text Available Abstract Background The heart transplant is a treatment of the heart failure, which is not responding to medications, and its efficiency is already proved: unfortunately, organ donation is a limiting step of this life-saving procedure. To counteract heart donor shortage, we should screen aged potential donor hearts for initial cardiomyopathy and functionally significant coronary artery disease. Donors with a history of cardiac disease are generally excluded. Coronary angiography is recommended for most male donors older than 45 years and female donors older than 50 years to evaluate coronary artery stenoses. A simpler way to screen aged potential donor hearts for initial cardiomyopathy and functionally significant coronary artery disease should be stress echocardiography. Case report A marginal donor (A 57 year old woman meeting legal requirements for brain death underwent a transesophageal (TE Dipyridamole stress echo (6 minutes accelerated protocol to rule out moderate or severe heart and coronary artery disease. Wall motion was normal at baseline and at peak stress (WMSI = 1 at baseline and peak stress, without signs of stress inducible ischemia. The pressure/volume ratio was 9.6 mmHg/ml/m2 at baseline, increasing to 14 mmHg/ml/m2 at peak stress, demonstrating absence of latent myocardial dysfunction. The marginal donor heart was transplanted to a recipient "marginal" for co-morbidity ( a 63 year old man with multiple myeloma and cardiac amyloidosis , chronic severe heart failure, NYHA class IV. Postoperative treatment and early immunosuppressant regimen were performed according to standard protocols. The transplanted heart was assessed normal for dimensions and ventricular function at transthoracic (TT echocardiography on post-transplant day 7. Coronary artery disease was ruled out at coronary angiography one month after transplant; left ventriculography showed normal global and segmental LV function of the transplanted heart. Conclusion For

  4. CT findings as confirmatory criteria of brain death

    International Nuclear Information System (INIS)

    Shiogai, Toshiyuki; Takeuchi, Kazuo


    The absence of cerebral circulation and electrocerebral silence have served as an accurate index of irreversible brain death. It is proposed that computed tomography (CT) findings be evaluated as confirmatory criteria of brain death. To this end, CT evaluation of 14 patients satisfying the conventional criteria of brain death was performed. A CT finding of severe compression or dissappearance of the ventricular system, or so called ''brain tamponade'', was seen in 7 (50 %) of the 14 patients. Enhanced contrast CT, especially dynamic CT, usually distinctly reveals the cerebral vessels whenever the cerebral blood flow is preserved; conversely, the lack of enhanced brain structures, even comparing attenuation values, indicates the absence of cerebral blood flow. In 7 (70 %) of 10 patients, however, there was enhanced contrast of vascular brain structures, especially the circle of Willis, major cerebral arteries, choroid plexuses, and venous sinuses. It is suggested that this result is due to the improvement of demonstrability by CT. The usefulness of CT in the confirmation of brain death lies in visualization of the pathological changes associated with a dead brain, such as ''brain tamponade'', and the lack of enhanced contrast indicating the absence of cerebral blood flow. The latter point is still problematic as angiography revealed an extremely low cerebral blood flow in a few cases of ''dead brain'' patients. It is recommended that cerebral blood flow in brain death be evaluated by dynamic CT scanning and correlated with other methods of cerebral blood flow determination (e.g., intravenous digital subtraction angiography). (Author)

  5. Parvovirus B19 viraemia in Dutch blood donors

    NARCIS (Netherlands)

    Zaaijer, H. L.; Koppelman, M. H. G. M.; Farrington, C. P.


    Blood, donated by asymptomatic donors, may contain and transmit parvovirus B19. To investigate the dynamics of parvovirus viraemia in asymptomatic blood donors, we studied the amounts of parvovirus DNA in pools of donor plasma, the prevalence of parvovirus antibodies among blood donors in relation

  6. Prevalence of malaria parasitaemia among blood donors in Owerri ...

    African Journals Online (AJOL)

    A study of the prevalence of malaria parasitaemia among blood donors in the Federal Medical Centre, Owerri, Imo State, was carried out between December, 2003 and April, 2004. A total of 500 blood samples were collected from blood donors consisting of 262 commercial donors and 238 relation-donors, using ...

  7. Feasibility of liver graft procurement with donor gallbladder preservation in living donor liver transplantation. (United States)

    Dong, Jia-Hong; Ye, Sheng; Duan, Wei-Dong; Ji, Wen-Bing; Liang, Yu-Rong


    Cholecystectomy is routinely performed at most transplant centers during living donor liver transplantation (LDLT). This study was performed to evaluate the feasibility of liver graft procurement with donor gallbladder preservation in LDLT. Eighty-nine LDLTs (from June 2006 to Dec 2012) were retrospectively analyzed at our hospital. The surgical approach for liver graft procurement with donor gallbladder preservation was assessed, and the anatomy of the cystic artery, the morphology and contractibility of the preserved gallbladder, postoperative symptoms, and vascular and biliary complications were compared among donors with or without gallbladder preservation. Twenty-eight donors (15 right and 13 left-liver grafts) successfully underwent liver graft procurement with gallbladder preservation. Among the 15 right lobectomy donors, for 12 cases (80.0 %) the cystic artery originated from right hepatic artery. From the left hepatic artery and proper hepatic artery accounted for 6.7 % (1/15), respectively. Postoperative symptoms among these 28 donors were slight, although donors with cholecystectomy often complained of fatty food aversion, dyspepsia, and diarrhea during an average follow-up of 58.6 (44-78) months. The morphology and contractibility of the preserved gallbladders were comparable with normal status; the rate of contraction was 53.8 and 76.7 %, respectively, 30 and 60 min after ingestion of a fatty meal. Biliary and vascular complications among donors and recipients, irrespective of gallbladder preservation, were not significantly different. These data suggest that for donors compliant with anatomical requirements, liver graft procurement with gallbladder preservation for the donor is feasible and safe. The preserved gallbladder was assessed as functioning well and postoperative symptoms as a result of cholecystectomy were significantly reduced during long-term follow-up.

  8. Expanding the Donor Pool Through Intensive Care to Facilitate Organ Donation: Results of a Spanish Multicenter Study. (United States)

    Domínguez-Gil, Beatriz; Coll, Elisabeth; Elizalde, José; Herrero, Jaime E; Pont, Teresa; Quindós, Brígida; Marcelo, Bella; Bodí, María A; Martínez, Adolfo; Nebra, Agustín; Guerrero, Francisco; Manciño, José M; Galán, Juan; Lebrón, Miguel; Miñambres, Eduardo; Matesanz, Rafael


    Intensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. Achieving Comprehensive Coordination in Organ Donation (ACCORD)-Spain consisted of an audit of the donation pathway from patients who died as a result of a devastating brain injury (possible donors) in 68 hospitals during November 1, 2014, to April 30, 2015. We focused on possible donors whose families were interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome. Of the 1970 possible donors in ACCORD-Spain, in 257, the family was interviewed once the decision had been made not to intubate/ventilate (n = 105), with the patient under intubation/ventilation outside of the intensive care unit (n = 59), or with the patient intubated/ventilated within the intensive care unit (n = 93).Consent to ICOD was obtained in 174 cases. Consent was higher when the donor coordinator participated in the interview (odds ratio, 2.32; 95% confidence interval, 1.33-4.11; P = 0.003). One hundred thirty-one patients developed BD, of whom 117 transitioned to actual donation after BD. Of the 35 patients who did not develop BD, 2 transitioned to actual donation after circulatory death. Sixteen patients subject to ICOD were finally medically unsuitable organ donors.ICOD contributed to 24% of the 491 actual donors registered in ACCORD-Spain. Despite the complexity of the interview, the majority of families consented to ICOD. Estimating the probability of BD and assessing medical suitability are additional challenges of the practice. ICOD represents a clear opportunity to increase the donor pool and ensures organ donation is posed at every end-of-life care pathway.

  9. Brain banking: opportunities, challenges and meaning for the future. (United States)

    Kretzschmar, Hans


    Brain banks collect post-mortem human brains to foster research into human CNS function and disease. They have been indispensable for uncovering the secrets of many diseases, including Alzheimer's and Parkinson's. At a time when there are so many open questions in neuroscience and the incidence of brain diseases continues to increase in parallel with the aging of the population, brain banking remains at the heart of brain research. However, the major source of brain banks, the clinical autopsy, is rapidly falling into limbo. New strategies, including donor programmes, medico-legal autopsies and banking in networks, as well as fresh considerations of the ethics and public relations, are required.

  10. Brain Tumors (United States)

    A brain tumor is a growth of abnormal cells in the tissues of the brain. Brain tumors can be benign, with no cancer cells, ... cancer cells that grow quickly. Some are primary brain tumors, which start in the brain. Others are ...


    NARCIS (Netherlands)


    Objective: To determine a safe maximum number of artificial insemination (donor insemination [DI]) children per anonymous sperm donor. Design: Multiparameter calculation model of contribution of DI to inbreeding. Setting: Data of the collaborative DI centers and demographic population data of The

  12. The blood donor identity survey: a multidimensional measure of blood donor motivations. (United States)

    France, Christopher R; Kowalsky, Jennifer M; France, Janis L; Himawan, Lina K; Kessler, Debra A; Shaz, Beth H


    Evidence indicates that donor identity is an important predictor of donation behavior; however, prior studies have relied on diverse, unidimensional measures with limited psychometric support. The goals of this study were to examine the application of self-determination theory to blood donor motivations and to develop and validate a related multidimensional measure of donor identity. Items were developed and administered electronically to a sample of New York Blood Center (NYBC) donors (n=582) and then to a sample of Ohio University students (n=1005). Following initial confirmatory factor analysis (CFA) on the NYBC sample to identify key items related to self-determination theory's six motivational factors, a revised survey was administered to the university sample to reexamine model fit and to assess survey reliability and validity. Consistent with self-determination theory, for both samples CFAs indicated that the best fit to the data was provided by a six-motivational-factor model, including amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic regulation. The Blood Donor Identity Survey provides a psychometrically sound, multidimensional measure of donor motivations (ranging from unmotivated to donate to increasing levels of autonomous motivation to donate) that is suitable for nondonors as well as donors with varying levels of experience. Future research is needed to examine longitudinal changes in donor identity and its relationship to actual donation behavior. © 2014 AABB.

  13. Extracorporeal life support and multiorgan donation in a severe polytrauma patient: A case report

    Directory of Open Access Journals (Sweden)

    Paolo Balsorano


    Conclusion: : Besides it’ role in non heart beating donors, ECLS is emerging as an adjunctive tool for brain dead donors management when standard treatment fails, potentially allowing a substantial increase in organ availability.

  14. Oocyte cryopreservation for donor egg banking. (United States)

    Cobo, Ana; Remohí, José; Chang, Ching-Chien; Nagy, Zsolt Peter


    Oocyte donation is an efficient alternative to using own oocytes in IVF treatment for different indications. Unfortunately, 'traditional' (fresh) egg donations are challenged with inefficiency, difficulties of synchronization, very long waiting periods and lack of quarantine measures. Given the recent improvements in the efficiency of oocyte cryopreservation, it is reasonable to examine if egg donation through oocyte cryopreservation has merits. The objective of the current manuscript is to review existing literature on this topic and to report on the most recent outcomes from two established donor cryobank centres. Reports on egg donation using slow freezing are scarce and though results are encouraging, outcomes are not yet comparable to a fresh egg donation treatment. Vitrification on the other hand appears to provide high survival rates (90%) of donor oocytes and comparable fertilization, embryo development, implantation and pregnancy rates to traditional (fresh) egg donation. Besides the excellent outcomes, the ease of use for both donors and recipients, higher efficiency, lower cost and avoiding the problem of synchronization are all features associated with the benefit of a donor egg cryobank and makes it likely that this approach becomes the future standard of care. Oocyte donation is one of the last resorts in IVF treatment for couples challenged with infertility problems. However, traditional (fresh) egg donation, as it is performed today, is not very efficient, as typically all eggs from one donor are given to only one recipient, it is arduous as it requires an excellent synchronization between the donor and recipient and there are months or years of waiting time. Because of the development of an efficient oocyte cryopreservation technique, it is now possible to cryo-store donor (as well as non-donor) eggs, maintaining their viability and allowing their use whenever there is demand. Therefore, creating a donor oocyte cryobank would carry many advantages

  15. Donor type semiconductor at low temperature as maser active medium


    Kornyushin, Yuri


    In some semiconductors donor impurity atoms can attract additional electrons, forming negative donor impurity ions. Thus we have 3 energy levels for electrons: zero energy levels at the bottom of the conductivity band, negative energy levels of the bounded electrons of the negative donor impurity ions, and deeper negative energy levels of the outer electrons of the neutral donor impurity atoms. So the donor impurity atoms could serve as active centres for a maser. The maximum achievable relat...

  16. Early declaration of death by neurologic criteria results in greater organ donor potential. (United States)

    Resnick, Shelby; Seamon, Mark J; Holena, Daniel; Pascual, Jose; Reilly, Patrick M; Martin, Niels D


    Aggressive management of patients prior to and after determination of death by neurologic criteria (DNC) is necessary to optimize organ recovery, transplantation, and increase the number of organs transplanted per donor (OTPD). The effects of time management are understudied but potentially pivotal component. The objective of this study was to analyze specific time points (time to DNC, time to procurement) and the time intervals between them to better characterize the optimal timeline of organ donation. Using data over a 5-year time period (2011-2015) from the largest US OPO, all patients with catastrophic brain injury and donated transplantable organs were retrospectively reviewed. Active smokers were excluded. Maximum donor potential was seven organs (heart, lungs [2], kidneys [2], liver, and pancreas). Time from admission to declaration of DNC and donation was calculated. Mean time points stratified by specific organ procurement rates and overall OTPD were compared using unpaired t-test. Of 1719 Declaration of Death by Neurologic Criteria organ donors, 381 were secondary to head trauma. Smokers and organs recovered but not transplanted were excluded leaving 297 patients. Males comprised 78.8%, the mean age was 36.0 (±16.8) years, and 87.6% were treated at a trauma center. Higher donor potential (>4 OTPD) was associated with shorter average times from admission to brain death; 66.6 versus 82.2 hours, P = 0.04. Lung donors were also associated with shorter average times from admission to brain death; 61.6 versus 83.6 hours, P = 0.004. The time interval from DNC to donation varied minimally among groups and did not affect donation rates. A shorter time interval between admission and declaration of DNC was associated with increased OTPD, especially lungs. Further research to identify what role timing plays in the management of the potential organ donor and how that relates to donor management goals is needed. Copyright © 2017 Elsevier Inc. All rights

  17. Increasing the donor pool in Chile. (United States)

    Palacios, J M


    The purpose of this study was to evaluate organ donation in Chile following the creation of the "Corporación Nacional de Fomento de Trasplantes." The corporation was created in 1991 as a private, nonprofit organization whose main purpose was to increase the number of actual donors and multiorgan procurement. The organization is independent of the national government and acts as a link between the needs of patients and society and those of the National Ministry of Health. Following the creation of the corporation, the number of actual donors increased from 32 to 98. The number of potential donors increased 3-fold. Family refusal for organ donation was between 28% and 53.4%. Pediatric and marginal donors increased from 2% to 15%. Ninety-five percent of the donors came from Santiago, where 33% of the population lives and most of the efforts were concentrated. The corporation is working to increase organ donation throughout the rest of the country by organizing public campaigns; promoting knowledge about transplantation among medical and nursing personnel at hospitals, schools, universities, and social gatherings; evaluating technical and financial results; and helping with the processes of organ procurement.

  18. [Is syphilis test necessary in blood donors?]. (United States)

    Rivera-López, María Rebeca F; Arenas-Esqueda, Alfonso; Ambriz-Fernández, Raúl


    A syphilis test is performed in blood donors because the national transfusion law makes it mandatory, nevertheless the blood has not been found as an important vehicle of transmission for Treponema pallidum infection. Our objective was to know the prevalence of syphilis in blood donors. we reviewed tests from blood donors of the "Banco Central de Sangre del Centro Médico Nacional Siglo XXI" in two periods, the first from July 2001 to April 2003, and the second from March 2005 to June 2006. Both groups went through screening tests, such as VDRL or USR. and a second test for confirmation, FTA-ABS for the first group and TPHA for the second group. in the first group 111 030 blood donors were included. In this group the positive results from VDRL or USR tests were 471 (0.42 %). One hundred and ninety six were confirmed (0.17 %) with FTA-ABS. In the second group results from 80 578 blood donors were included; the positive results from VDRL or USR tests were 279 (0.34 %). In this group, only 0.08 % were confirmed for a syphilis infection.

  19. Ex-vivo partial nephrectomy after living donor nephrectomy: Surgical technique for expanding kidney donor pool

    Directory of Open Access Journals (Sweden)

    Yaw A Nyame


    Full Text Available Renal transplantation has profound improvements in mortality, morbidity, and overall quality of life compared to renal replacement therapy. This report aims to illustrate the use of ex-vivo partial nephrectomy in a patient with a renal angiomyolipoma prior to living donor transplantation. The surgical outcomes of the donor nephrectomy and recipient transplantation are reported with 2 years of follow-up. Both the donor and recipient are healthy and without any significant comorbidities. In conclusion, urologic techniques such as partial nephrectomy can be used to expand the living donor pool in carefully selected and well informed transplant recipients. Our experience demonstrated a safe and positive outcome for both the recipient and donor, and is consistent with other reported outcomes in the literature.

  20. Blood donation and blood donor mortality after adjustment for a healthy donor effect

    DEFF Research Database (Denmark)

    Ullum, Henrik; Rostgaard, Klaus; Kamper-Jørgensen, Mads


    investigated the relation between blood donation frequency and mortality within a large cohort of blood donors. In addition, our analyses also took into consideration the effects of presumed health differences linked to donation behavior. STUDY DESIGN AND METHODS: Using the Scandinavian Donation......BACKGROUND: Studies have repeatedly demonstrated that blood donors experience lower mortality than the general population. While this may suggest a beneficial effect of blood donation, it may also reflect the selection of healthy persons into the donor population. To overcome this bias, we...... and Transfusion database (SCANDAT), we assessed the association between annual number of donations in 5-year windows and donor mortality by means of Poisson regression analysis. The analyses included adjustment for demographic characteristics and for an internal healthy donor effect, estimated among elderly...

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    Full Text Available ... brain's structure, studies show that brain growth in children with autism appears to peak early. And as ... grow there are differences in brain development in children who develop bipolar disorder than children who do ...

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    Full Text Available ... Real Life Brain Basics in Real Life—How Depression affects the Brain Meet Sarah Sarah is a ... brain. DNA —The "recipe of life," containing inherited genetic information that helps to define physical and some ...

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    Full Text Available ... can lead to mental disorders, such as depression. The Growing Brain Inside the Brain: Neurons & Neural Circuits ... tailored treatments, and possibly prevention of such illnesses. The Working Brain Neurotransmitters Everything we do relies on ...

  11. Space Radar Image of Jerusalem and the Dead Sea (United States)


    This space radar image shows the area surrounding the Dead Sea along the West Bank between Israel and Jordan. This region is of major cultural and historical importance to millions of Muslims, Jews and Christians who consider it the Holy Land. The yellow area at the top of the image is the city of Jericho. A portion of the Dead Sea is shown as the large black area at the top right side of the image. The Jordan River is the white line at the top of the image which flows into the Dead Sea. Jerusalem, which lies in the Judaean Hill Country, is the bright, yellowish area shown along the left center of the image. Just below and to the right of Jerusalem is the town of Bethlehem. The city of Hebron is the white, yellowish area near the bottom of the image. The area around Jerusalem has a history of more than 2,000 years of settlement and scientists are hoping to use these data to unveil more about this region's past. The Jordan River Valley is part of an active fault and rift system that extends from southern Turkey and connects with the east African rift zone. This fault system has produced major earthquakes throughout history and some scientists theorize that an earthquake may have caused the fall of Jericho's walls. The Dead Sea basin is formed by active earthquake faulting and contains the lowest place on the Earth's surface at about 400 meters (1,300 feet) below sea level. It was in caves along the northern shore of the Dead Sea that the Dead Sea Scrolls were found in 1947. The blue and green areas are generally regions of undeveloped hills and the dark green areas are the smooth lowlands of the Jordan River valley. This image is 73 kilometers by 45 kilometers (45 miles by 28 miles) and is centered at 31.7 degrees north latitude, 35.4 degrees east longitude. North is toward the upper left. The colors are assigned to different radar frequencies and polarizations as follows: red is L-band, horizontally transmitted and vertically received; green is L-band, horizontally

  12. The Auckland experience with laparoscopic donor nephrectomy. (United States)

    Muthu, Carl; McCall, John; Windsor, John; Harman, Richard; Dittmer, Ian; Smith, Pat; Munn, Stephen


    To examine the initial experience of laparoscopic donor nephrectomy (LDN) in New Zealand and compare it with open donor nephrectomy (ODN). All LDNs performed between June 2000 and June 2002 were reviewed. An equal number of ODNs were reviewed. Data were also collected on the recipients of the grafts. Key clinical data were prospectively collected; remaining data were collected by retrospectively reviewing patient charts. Auckland Hospital databases were accessed for costing analysis. Thirty five cases of each procedure had been performed. There has been 100% LDN graft survival. There was no significant difference in graft function (serum creatinine) at one and 12 months (p = 0.25 and 0.35) between the two groups. There was no significant difference in donor morbidity (26% vs 31%, p = 0.59). LDN resulted in a shorter hospital stay (3 vs 6.5 days, p disadvantage of LDN is its higher cost compared with ODN.

  13. Eye bank procedures: donor selection criteria. (United States)

    Sousa, Sidney Júlio de Faria E; Sousa, Stella Barretto de Faria E


    Eye banks use sterile procedures to manipulate the eye, antiseptic measures for ocular surface decontamination, and rigorous criteria for donor selection to minimize the possibility of disease transmission due to corneal grafting. Donor selection focuses on analysis of medical records and specific post-mortem serological tests. To guide and standardize procedures, eye bank associations and government agencies provide lists of absolute and relative contraindications for use of the tissue based on donor health history. These lists are guardians of the Hippocratic principle "primum non nocere." However, each transplantation carries risk of transmission of potentially harmful agents to the recipient. The aim of the procedures is not to eliminate risk, but limit it to a reasonable level. The balance between safety and corneal availability needs to be maintained by exercising prudence without disproportionate rigor.

  14. Mapping human whole-brain structural networks with diffusion MRI.

    Directory of Open Access Journals (Sweden)

    Patric Hagmann

    Full Text Available Understanding the large-scale structural network formed by neurons is a major challenge in system neuroscience. A detailed connectivity map covering the entire brain would therefore be of great value. Based on diffusion MRI, we propose an efficient methodology to generate large, comprehensive and individual white matter connectional datasets of the living or dead, human or animal brain. This non-invasive tool enables us to study the basic and potentially complex network properties of the entire brain. For two human subjects we find that their individual brain networks have an exponential node degree distribution and that their global organization is in the form of a small world.

  15. Is Schrödinger's cat dead oa alive?

    Directory of Open Access Journals (Sweden)

    Wojciech Grygiel


    Full Text Available The Schrödinger's Cat paradox was proposed in 1935 by Edwin Schrodinger, one of the founders of quantum mechanics, as an attempt to visualize the macroscopic realization of a quantum superposition state. A cat is placed in a sealed box together with a vial of poison. A two-state particle (e.g. an electron is sent into a detector in the box resulting either in a broken or an intact vial and a dead or live cat, respectively. The main problem consists in whether the superposition state of a microscopic particle can be transferred upon the macroscopic cat, that is, whether the cat can exist in a superposition state, being simultaneously dead and alive. Since the standard Copenhagen interpretation is unable to assign any reality to the quantum superposition state, the paradox finds no resolution within the regime of this interpretation. Von Neumann's insistence on the uniform treatment of both microscopic (quantum and macroscopic (classical objects according to the laws of quantum mechanics provides a more consistent framework for the resolution of the paradox. In particular, the discovery of the phenomenon of decoherence, whereby the disappearance of the quantum interferences at the macro level is accounted for, suggests the onset of an extremely efficient interference relaxation process (10-23 s upon the interaction of the two state particle with the detector. As a result, Schrodinger's cat can exist macroscopically either as dead or alive and never as a combination of both. Decoherence not only aids the resolution of the Schrodinger's Cat paradox but also sheds light upon the mechanisms by which the macro-world emerges from the microscopic quantum realm.

  16. Compensatory Hypertrophy After Living Donor Nephrectomy. (United States)

    Chen, K W; Wu, M W F; Chen, Z; Tai, B C; Goh, Y S B; Lata, R; Vathsala, A; Tiong, H Y


    Previous studies have shown that kidney volume enhances the estimation of glomerular filtration rate (eGFR) in kidney donors. This study aimed to describe the phenomenon of compensatory hypertrophy after donor nephrectomy as measured on computerized tomographic (CT) scans. An institutional Domain Specific Review Board (DSRB)-approved study involved approaching kidney donors to have a follow up CT scan from 6 months to 1 year after surgery; 29 patients participated; 55% were female. Clinical chart review was performed, and the patient's remaining kidney volume was measured before and after surgery based on CT scans. eGFR was determined with the use of the Modification of Diet in Renal Disease equation. Mean parenchymal volume of the remaining kidney for this population (mean age, 44.3 ± 8.5 y) was 204.7 ± 82.5 cc before surgery and 250.5 ± 113.3 cc after donor nephrectomy. Compensatory hypertrophy occurred in 79.3% of patients (n = 23). Mean increase in remaining kidney volume was 22.4 ± 23.2% after donor nephrectomy in healthy individuals. Over a median follow-up of 52.9 ± 19.8 months, mean eGFR was 68.9 ± 12.4 mL/min/1.73 m(2), with 24.1% of patients (n = 7) in chronic kidney disease grade 3. Absolute and relative change in kidney volume was not associated with sex, race, surgical approach, or background of hypertension (P = NS). There was a trend of decreased hypertrophy with increasing age (P = .5; Spearman correlation, -0.12). In healthy kidney donors, compensatory hypertrophy of the remaining kidney occurs in 79.3% of the patients, with an average increment of about 22.4%. Older patients may have a blunted compensatory hypertrophy response after surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Analysis of Excitation and Dead Vibration Modes of Quartz Resonators

    Directory of Open Access Journals (Sweden)

    Zi-Gui Huang


    Full Text Available This study uses the finite element method (FEM to analyze the excitation and dead vibration modes of two-dimensional quartz plates. We first simplify three-dimensional quartz plates with plane strain simplification and then compare the modes of the simplified three-dimensional plates to those of two-dimensional plates. We then analyze quartz vibrating elements of AT-cut plates and SC-cut plates. To understand the regularity of the resonance frequency of plates that are excitable by voltage loading, we compare the natural vibrations of quartz plates with the excitation frequency generated after the plates are excited by voltage loading.

  18. Resonant power converter comprising adaptive dead-time control

    DEFF Research Database (Denmark)


    The invention relates in a first aspect to a resonant power converter comprising: a first power supply rail for receipt of a positive DC supply voltage and a second power supply rail for receipt of a negative DC supply voltage. The resonant power converter comprises a resonant network with an input...... terminal for receipt of a resonant input voltage from a driver circuit. The driver circuit is configured for alternatingly pulling the resonant input voltage towards the positive and negative DC supply voltages via first and second semiconductor switches, respectively, separated by intervening dead...

  19. Some remarks on dead-time losses of coincidences

    International Nuclear Information System (INIS)

    Mueller, J.W.


    Dead-time effects for coincident pulses are known to be a very difficult subject. Apart from some trivial cases, no rigorous results are yet known. For all practical applications, approximate solutions are used, the quality of which is difficult to judge. Whereas in general they seem to be sufficiently reliable, their deficiency begins to show up clearly for very high count rates. Unfortunately, the present small note will not really improve this situation. It may, however, provide some guideline for the credibility of the various approaches which have been suggested

  20. Analysis and compensation for the cascade dead-zones in the proportional control valve. (United States)

    Xu, Bing; Su, Qi; Zhang, Junhui; Lu, Zhenyu


    The four-way proportional directional control valve has been widely used as the main stage spring constant for the two-stage proportional control valve (PDV). Since a tradeoff should be made between manufacturing costs and static performance, two symmetry dead-zones are introduced in the main stage spring constant: the center dead-zone caused by the center floating position and the intermediate dead-zone caused by the intermediate position. Though the intermediate dead-zone is much smaller than the center dead-zone, it has significant effect on the dynamic position tracking performance. In this paper, the cascade dead-zones problem in a typical two-stage PDV is analyzed and a cascade dead-zones model is proposed for the main stage spring constant. Then, a cascade dead-zones inverse method is improved with gain estimation and dead-zone detection to compensate the dead-zone nonlinearity. Finally, a digital controller is designed for verification. The comparative experimental results indicate that it is effective to reduce the large position tracking error when the proposed method is applied. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

  1. Initial experience with purely laparoscopic living-donor right hepatectomy. (United States)

    Hong, S K; Lee, K W; Choi, Y; Kim, H S; Ahn, S W; Yoon, K C; Kim, H; Yi, N J; Suh, K S


    There may be concerns about purely laparoscopic donor right hepatectomy (PLDRH) compared with open donor right hepatectomy, especially when performed by surgeons accustomed to open surgery. This study aimed to describe technical tips and pitfalls in PLDRH. Data from donors who underwent PLDRH at Seoul National University Hospital between December 2015 and July 2017 were analysed retrospectively. Endpoints analysed included intraoperative events and postoperative complications. All operations were performed by a single surgeon with considerable experience in open living donor hepatectomy. A total of 26 donors underwent purely laparoscopic right hepatectomy in the study interval. No donor required transfusion during surgery, whereas two underwent reoperation. In two donors, the dissection plane at the right upper deep portion of the midplane was not correct. One donor experienced portal vein injury during caudate lobe transection, and one developed remnant left hepatic duct stenosis. One donor experienced remnant portal vein angulation owing to a different approach angle, and one experienced arterial damage associated with the use of a laparoscopic energy device. One donor had postoperative bleeding due to masking of potential bleeding foci owing to intra-abdominal pressure during laparoscopy. Two donors experienced right liver surface damage caused by a xiphoid trocar. Purely laparoscopic donor hepatectomy differs from open donor hepatectomy in terms of angle and caudal view. Therefore, surgeons experienced in open donor hepatectomy must gain adequate experience in laparoscopic liver surgery and make adjustments when performing PLDRH. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

  2. Peer-to-peer milk donors' and recipients' experiences and perceptions of donor milk banks. (United States)

    Gribble, Karleen D


    To explore the intersection of peer-to-peer milk sharing and donor milk banks. A descriptive survey design containing closed and open-ended questions was used to examine women's perceptions of peer-to-peer milk sharing and milk banking. Closed-ended questions were analyzed using descriptive statistics and conventional qualitative content analysis was used to analyze open-ended responses. Participants were recruited via the Facebook sites of two online milk-sharing networks (Human Milk 4 Human Babies and Eats on Feet). Ninety-eight milk donors and 41 milk recipients who had donated or received breast milk in an arrangement that was facilitated via the Internet. One half of donor recipients could not donate to a milk bank because there were no banks local to them or they did not qualify as donors. Other respondents did not donate to a milk bank because they viewed the process as difficult, had philosophical objections to milk banking, or had a philosophical attraction to peer sharing. Most donor respondents felt it was important to know the circumstances of their milk recipients. No recipient respondents had obtained milk from a milk bank; it was recognized that they would not qualify for banked milk or that banked milk was cost prohibitive. Peer-to-peer milk donors and recipients may differ from milk bank donors and recipients in significant ways. Cooperation between milk banks and peer sharing networks could benefit both groups. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  3. Methyl donor supplementation in rats reverses the deleterious effect of maternal separation on depression-like behaviour. (United States)

    Paternain, Laura; Martisova, Eva; Campión, Javier; Martínez, J Alfredo; Ramírez, Maria J; Milagro, Fermin I


    Adverse early life events are associated with altered stress responsiveness and metabolic disturbances in the adult life. Dietary methyl donor supplementation could be able to reverse the negative effects of maternal separation by affecting DNA methylation in the brain. In this study, maternal separation during lactation reduced body weight gain in the female adult offspring without affecting food intake, and altered total and HDL-cholesterol levels. Also, maternal separation induced a cognitive deficit as measured by NORT and an increase in the immobility time in the Porsolt forced swimming test, consistent with increased depression-like behaviour. An 18-week dietary supplementation with methyl donors (choline, betaine, folate and vitamin B12) from postnatal day 60 also reduced body weight without affecting food intake. Some of the deleterious effects induced by maternal separation, such as the abnormal levels of total and HDL-cholesterol, but especially the depression-like behaviour as measured by the Porsolt test, were reversed by methyl donor supplementation. Also, the administration of methyl donors increased total DNA methylation (measured by immunohistochemistry) and affected the expression of insulin receptor in the hippocampus of the adult offspring. However, no changes were observed in the DNA methylation status of insulin receptor and corticotropin-releasing hormone (CRH) promoter regions in the hypothalamus. In summary, methyl donor supplementation reversed some of the deleterious effects of an early life-induced model of depression in rats and altered the DNA methylation profile in the brain. Copyright © 2015 Elsevier B.V. All rights reserved.

  4. Comparison of donor, and early and late recipient outcomes following hand assisted and laparoscopic donor nephrectomy. (United States)

    Lucas, Steven M; Liaw, Aron; Mhapsekar, Rishi; Yelfimov, Daniel; Goggins, William C; Powelson, John A; Png, Keng Siang; Sundaram, Chandru P


    While laparoscopic donor nephrectomy has encouraged living kidney donation, debate exists about the safest laparoscopic technique. We compared purely laparoscopic and hand assisted laparoscopic donor nephrectomies in terms of donor outcome, early graft function and long-term graft outcome. We reviewed the records of consecutive laparoscopic and hand assisted laparoscopic donor nephrectomies performed by a single surgeon from 2002 to 2011. Donor operative time and perioperative morbidity were compared. Early graft function for kidneys procured by each technique was evaluated by rates of delayed graft function, need for dialysis and recipient discharge creatinine. Long-term outcomes were evaluated by graft function. A total of 152 laparoscopic donor nephrectomies were compared with 116 hand assisted laparoscopic donor nephrectomies. Hand assisted procedures were more often done for the right kidney (41.1% vs 17.1%, p recipient outcomes were also similar. Delayed function occurred after 0% hand assisted vs 0.9% purely laparoscopic nephrectomies, dialysis was required in 0.9% vs 1.7% and rejection episodes developed in 9.7% vs 18.4% (p >0.05). At last followup the organ was nonfunctioning in 6.1% of hand assisted and 7.7% of purely laparoscopic cases (p >0.05). The recipient glomerular filtration rate at discharge home was similar in the 2 groups. Hand assisted laparoscopic donor nephrectomy had shorter warm ischemia time but perioperative donor morbidity and graft outcome were comparable. The choice of technique should be based on patient and surgeon preference. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. [Survey of blood donors on the topic of "reimbursement for blood donors"]. (United States)

    Zeiler, T; Kretschmer, V


    Remuneration for blood donors, in the way as presently handled by governmental and communal blood transfusion services in Germany, is not generally accepted. It is feared that donors are recruited with increased risk to transmit infectious diseases, especially AIDS. Alternative incentives are discussed. After the so-called AIDS scandal in Germany, a change in the donor motivation was to be expected, associated with an increased willingness to renounce remuneration. Therefore, we performed the present survey, in which we evaluated the donor's willingness to renounce remuneration, possibilities of cashless remuneration and other alternative incentives. During March and April 1994, a total of 1,157 blood donors of the University Blood Bank Marburg were questioned anonymously by a questionnaire in the framework of whole-blood donations. Beside the above-mentioned aspects demoscopic data were included (age, sex, profession, journey). Cutting of remuneration without any other compensation was refused by 86.1% of the donors, 77% would not want to further donate blood in this case. Transfer of money to a bank account instead of cash payment was accepted by 78.6%, the use of non-negotiable cheques by 68.7%. Alternative compensation by tickets for theater, concert, cinema or coupons for restaurants met with the approval of only 27.3%; under these circumstances, 36.9% would be willing to continue blood donation. With increasing age and number of donations, but largely independent of social status, donors attached greater importance to retention of remuneration. Cutting of remuneration would result in a considerable reduction of the willingness to donate blood within the population of donors of the governmental and communal blood transfusion services. However, an increase of virus safety of the blood products would not be reached in this way, since especially the long-term donors would be driven away. Considerable bottlenecks, particularly in the specific blood supply of

  6. Living related versus deceased donor liver transplantation for maple syrup urine disease. (United States)

    Feier, Flavia; Schwartz, Ida Vanessa D; Benkert, Abigail R; Seda Neto, Joao; Miura, Irene; Chapchap, Paulo; da Fonseca, Eduardo Antunes; Vieira, Sandra; Zanotelli, Maria Lúcia; Pinto e Vairo, Filippo; Camelo, Jose Simon; Margutti, Ana Vitoria Barban; Mazariegos, George V; Puffenberger, Erik G; Strauss, Kevin A


    Maple syrup urine disease (MSUD) is an inherited disorder of branched chain ketoacid (BCKA) oxidation associated with episodic and chronic brain disease. Transplantation of liver from an unrelated deceased donor restores 9-13% whole-body BCKA oxidation capacity and stabilizes MSUD. Recent reports document encouraging short-term outcomes for MSUD patients who received a liver segment from mutation heterozygous living related donors (LRDT). To investigate effects of living related versus deceased unrelated grafts, we studied four Brazilian MSUD patients treated with LRDT who were followed for a mean 19 ± 12 postoperative months, and compared metabolic and clinical outcomes to 37 classical MSUD patients treated with deceased donor transplant. Patient and graft survival for LRDT were 100%. Three of 4 MSUD livers were successfully domino transplanted into non-MSUD subjects. Following LRDT, all subjects resumed a protein-unrestricted diet as mean plasma leucine decreased from 224 ± 306 μM to 143 ± 44 μM and allo-isoleucine decreased 91%. We observed no episodes of hyperleucinemia during 80 aggregate postoperative patient-months. Mean plasma leucine:isoleucine:valine concentration ratios were ~2:1:4 after deceased donor transplant compared to ~1:1:1.5 following LRDT, resulting in differences of predicted cerebral amino acid uptake. Mutant heterozygous liver segments effectively maintain steady-state BCAA and BCKA homeostasis on an unrestricted diet and during most catabolic states, but might have different metabolic effects than grafts from unrelated deceased donors. Neither living related nor deceased donor transplant affords complete protection from metabolic intoxication, but both strategies represent viable alternatives to nutritional management. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Roald Dahl and the complete locked-in syndrome: "Cold dead body, living brain"

    DEFF Research Database (Denmark)

    Kondziella, Daniel


    they no longer have any motor output at all. Of note, Roald Dahl, the internationally acclaimed children book author, described this complete locked-in syndrome in one of his short stories, William and Mary (1959), almost half a century before the medical community became aware of this devastating condition...

  8. Treatment of psoriatic arthritis at the Dead Sea. (United States)

    Sukenik, S; Giryes, H; Halevy, S; Neumann, L; Flusser, D; Buskila, D


    To evaluate the effectiveness of balneotherapy (mud packs and sulfur baths) on patients with psoriasis and psoriatic arthritis (PsA). One hundred and sixty-six patients with psoriasis and PsA were treated at the Dead Sea for a period of 3 weeks. The patients were divided into 2 groups. Both groups had the regular regimen of bathing in Dead Sea water and exposure to the sun's ultraviolet rays. The study group, which consisted of 146 patients also was treated with mud packs and sulfur baths. The control group, which had no additional therapy, consisted of 20 patients. The main clinical variables assessed were duration of morning stiffness, grip strength, activities of daily living, subjective patient assessment of disease severity, number of active joints, number of effluent joints. Ritchie index, psoriasis area and severity index score, cervical, thoracic, and lumbar spine pain and limitations of movement. Statistically significant improvement was found in most variables in both groups. However, better results were observed in the study group. In 2 variables, reduction of spinal pain and range of movement in the lumbar spine, significant improvement (p balneotherapy can have additional beneficial effects on patients with PsA. Other controlled studies with longer followup periods are needed to verify our results.

  9. Uncovering Cinematic Adaptations of James Joyce’s The Dead

    Directory of Open Access Journals (Sweden)

    Pegah Marandi


    Full Text Available The relationship between literature and film is the subject of plentiful analyses and reflections within the general framework of Comparative Literature. A comparison between a literary work and its adaptations shows how filmmakers adhere to the principles of intertextuality. Exploring various adaptations of James Joyce’s The Dead (1914 and comparing them against each other are the main objectives of this research. This study examines how John Huston (1987, Travis Mills and William Ivey Long (2013 adapted James Joyce’s The Dead (1914 culturally, geopolitically, and sociologically. This study demonstrated that Huston’s adaptation was faithful to Joyce’s text in terms of character, costume, culture, and language, whereas Mills and Long’s adaptation was not fully loyal to Joyce especially in terms of character and culture. However, Mills and Long have attempted to create a language similar to Joyce’s. Further, consciousness and interior thoughts as subtle issues precisely shown in the novel were not illustrated wholly in both adaptations. Huston’s creativity was maintained in the last scene, picturing Gabriel’s monologue, whereas Mills and Long’s creativity was shown in creating new postmodern characters and culture.

  10. Daily Living Movement Recognition for Pedestrian Dead Reckoning Applications

    Directory of Open Access Journals (Sweden)

    Alessio Martinelli


    Full Text Available Nowadays, activity recognition is a central topic in numerous applications such as patient and sport activity monitoring, surveillance, and navigation. By focusing on the latter, in particular Pedestrian Dead Reckoning navigation systems, activity recognition is generally exploited to get landmarks on the map of the buildings in order to permit the calibration of the navigation routines. The present work aims to provide a contribution to the definition of a more effective movement recognition for Pedestrian Dead Reckoning applications. The signal acquired by a belt-mounted triaxial accelerometer is considered as the input to the movement segmentation procedure which exploits Continuous Wavelet Transform to detect and segment cyclic movements such as walking. Furthermore, the segmented movements are provided to a supervised learning classifier in order to distinguish between activities such as walking and walking downstairs and upstairs. In particular, four supervised learning classification families are tested: decision tree, Support Vector Machine, k-nearest neighbour, and Ensemble Learner. Finally, the accuracy of the considered classification models is evaluated and the relative confusion matrices are presented.

  11. Using and respecting the dead human body: an anatomist's perspective. (United States)

    Jones, D Gareth


    In his stimulating article enquiring into what the living owe the dead, Wilkinson (2013, Clin. Anat. DOI: 10.1002/ca.22263) sought to unpack a range of ethical questions of considerable interest to anatomists. In this, he looked closely at the extent to which we are or are not to respect all the prior wishes of the deceased, and the implications of this for the role of the family in providing consent, the use of unclaimed bodies, and the public display of bodies. Some of his conclusions challenge widely encountered views by anatomists. In this response I have re-visited these topics in an attempt to ground his arguments in the experience of anatomists, by emphasizing the many intimate connections that exist between each of these areas. The following emerge as issues for further debate. I accept that the wishes of the deceased are preeminent, so that authorities should make every effort to abide by these. This reiterates the importance of body bequests over against unclaimed bodies, and provides a context for assessing the role of family consent. This has repercussions for all activities employing dead bodies, from the dissecting room to public plastination exhibitions. In determining the extent to which the wishes of the deceased are followed the input of other interested parties is a relevant consideration. An ethical assessment of the public display of bodies needs to take into account the nature of the plastination process. © 2014 Wiley Periodicals, Inc.

  12. Open ocean dead zones in the tropical North Atlantic Ocean (United States)

    Karstensen, J.; Fiedler, B.; Schütte, F.; Brandt, P.; Körtzinger, A.; Fischer, G.; Zantopp, R.; Hahn, J.; Visbeck, M.; Wallace, D.


    Here we present first observations, from instrumentation installed on moorings and a float, of unexpectedly low (zones are created at shallow depth, just below the mixed layer, in the euphotic zone of cyclonic eddies and anticyclonic-modewater eddies. Both types of eddies are prone to high surface productivity. Net respiration rates for the eddies are found to be 3 to 5 times higher when compared with surrounding waters. Oxygen is lowest in the centre of the eddies, in a depth range where the swirl velocity, defining the transition between eddy and surroundings, has its maximum. It is assumed that the strong velocity at the outer rim of the eddies hampers the transport of properties across the eddies boundary and as such isolates their cores. This is supported by a remarkably stable hydrographic structure of the eddies core over periods of several months. The eddies propagate westward, at about 4 to 5 km day-1, from their generation region off the West African coast into the open ocean. High productivity and accompanying respiration, paired with sluggish exchange across the eddy boundary, create the "dead zone" inside the eddies, so far only reported for coastal areas or lakes. We observe a direct impact of the open ocean dead zones on the marine ecosystem as such that the diurnal vertical migration of zooplankton is suppressed inside the eddies.

  13. Dead zones in colloidal quantum dot photovoltaics: evidence and implications

    KAUST Repository

    Barkhouse, D. Aaron R.


    In order to fabricate photovoltaic (PV) cells incorporating light-trapping electrodes, flexible foil substrates, or more than one junction, illumination through the top-contact (i.e.: non-substrate) side of a photovoltaic device is desirable. We investigate the relative collection efficiency for illumination through the top vs. bottom of PbS colloidal quantum dot (CQD) PV devices. The external quantum efficiency spectra of FTO/TiO2/PbS CQD/ITO PV devices with various PbS layer thicknesses were measured for illumination through either the top (ITO) or bottom (FTO) contacts. By comparing the relative shapes and intensities of these spectra with those calculated from an estimation of the carrier generation profile and the internal quantum efficiency as a function of distance from the TiO2 interface in the devices, a substantial dead zone, where carrier extraction is dramatically reduced, is identified near the ITO top contact. The implications for device design, and possible means of avoiding the formation of such a dead zone, are discussed.

  14. Management of the dead in Tacloban City after Typhoon Haiyan

    Directory of Open Access Journals (Sweden)

    Julius Erving Ballera


    Full Text Available Introduction: The post-disaster management of the dead involves a series of steps including on-site identification, transfer, storage and examination of bodies and delivery to families for burial. Two weeks after Typhoon Haiyan, a team from the Department of Health (DOH was tasked with identifying the dead in Tacloban City. Methods: A suitable site for the collection of bodies was identified and an algorithm and standard data collection form developed. The retrieval of bodies was coordinated with the Bureau of Fire Protection personnel. Upon receipt of a body, two team members conducted a systematic external examination. Findings were documented, photos were taken and each body was assigned a unique number. Results: The DOH team examined 128 bodies. Of these, the majority (86% were complete bodies; 95% were decomposed and two were skeletonized. Two thirds (66% were adults, sex was identifiable for 92%, and the male to female ratio was 1:1.4. The majority of adults were females. Only 11% were presumptively identified from documents in clothing; 89% remained unidentified. Conclusion: From the limited setting of this study, we describe the process of rapid body processing post-Haiyan. We prioritized rapid processing over more technically complicated means of identification, including DNA testing. Our protocol showed a dignified and efficient way of identifying corpses. As local and regional laboratory capacity increases in the Philippines, the collection of DNA specimens may become part of the identification algorithm.

  15. May we practise endotracheal intubation on the newly dead? (United States)

    Ardagh, M


    Endotracheal intubation (ETI) is a valuable procedure which must be learnt and practised, and performing ETI on cadavers is probably the best way to do this, although lesser alternatives do exist. Performing ETI on a cadaver is viewed with a real and reasonable repugnance and if it is done without proper authorisation it might be illegal. Some form of consent is required. Presumed consent would preferably be governed by statute and should only occur if the community is well informed and therefore in a position of being able to decline. Currently neither statute nor adequate informing exists. Endotracheal intubation on the newly dead may be justifiable according to a Guttman scale if the patient has already consented to organ donation and if further research supports the relevance of the Guttman scale to this question. A "mandated choice" with prior individual consent as a matter of public policy is the best of these solutions, however until such a solution is in place we may not practise endotracheal intubation on the newly dead.

  16. Compliance with donor age recommendations in oocyte donor recruitment advertisements in the USA. (United States)

    Alberta, Hillary B; Berry, Roberta M; Levine, Aaron D


    IVF using donated oocytes offers benefits to many infertile patients, yet the technique also raises a number of ethical concerns, including worries about potential physical and psychological risks to oocyte donors. In the USA, oversight of oocyte donation consists of a combination of federal and state regulations and self-regulatory guidelines promulgated by the American Society for Reproductive Medicine. This study assesses compliance with one of these self-regulatory guidelines - specifically, ASRM's preferred minimum age for donors of 21. To assess compliance, 539 oocyte donor recruitment advertisements from two recruitment channels (Craigslist and college newspapers) were collected and evaluated. Of these, 61% in the Craigslist dataset and 43% in the college newspaper dataset listed minimum ages between 18 and 20, which is inconsistent with ASRM's preferred minimum age recommendation of 21. Advertisements placed by oocyte donor recruitment agencies were more likely than advertisements placed by clinics to specify minimum ages between 18 and 20. These results indicate that ASRM should evaluate and consider revising its donor age guidelines. IVF using donated human eggs can help many patients who have difficulty having children. However, the technique also raises ethical concerns, including concerns about potential physical and psychological harms to egg donors. In the USA, oversight of egg donation relies on a combination of federal and state regulation and professional self-regulation. Governmental regulations address only limited aspects of egg donation, such as the potential spread of infectious diseases and the reporting of success rates, leaving voluntary guidelines developed by an association of medical professionals to address most issues, including ethical concerns raised by the practice. One of these voluntary guidelines recommends that egg donors should be at least 21 years of age. In this article, we analysed 539 egg donor recruitment advertisements

  17. Electrostatically defined silicon quantum dots with counted antimony donor implants

    Energy Technology Data Exchange (ETDEWEB)

    Singh, M., E-mail:; Luhman, D. R.; Lilly, M. P. [Sandia National Laboratories, Albuquerque, New Mexico 87185 (United States); Center for Integrated Nanotechnologies, Sandia National Laboratories, Albuquerque, New Mexico 87175 (United States); Pacheco, J. L.; Perry, D.; Garratt, E.; Ten Eyck, G.; Bishop, N. C.; Wendt, J. R.; Manginell, R. P.; Dominguez, J.; Pluym, T.; Bielejec, E.; Carroll, M. S. [Sandia National Laboratories, Albuquerque, New Mexico 87185 (United States)


    Deterministic control over the location and number of donors is crucial to donor spin quantum bits (qubits) in semiconductor based quantum computing. In this work, a focused ion beam is used to implant antimony donors in 100 nm × 150 nm windows straddling quantum dots. Ion detectors are integrated next to the quantum dots to sense the implants. The numbers of donors implanted can be counted to a precision of a single ion. In low-temperature transport measurements, regular Coulomb blockade is observed from the quantum dots. Charge offsets indicative of donor ionization are also observed in devices with counted donor implants.

  18. Internal bioerosion in dead and live hard corals in intertidal zone of Hormuz Island (Persian Gulf). (United States)

    Jafari, Mohammad Ali; Seyfabadi, Jafar; Shokri, Mohammad Reza


    Internal macrobioeroders and their erosion rate in three live and dead coral genera (Favia, Platygyra and Porites) from the intertidal zone of the Hormuz Island were studied by collecting five live and five dead colonies from each genus, from which 4 mm cross-sections were cut and photographed. Photos were analyzed using the Coral Point Count with Excel extensions. Totally, 9 taxa were identified: four bivalve species, one sponge, three polychaetes, and one barnacle. Bioerosion rate did not significantly differ among the three live corals, but among the dead ones only Porites was significantly more eroded than Favia. Sponge had the highest role in the erosion of the dead Platygyra, while barnacles were the most effective eroding organism in the live Platygyra. Polychaetes, followed by bivalves, were the most destructive bioeroders on the dead and live Porites. Further, none of the bioeroding organisms had selectively chosen either the dead or live Favia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Syntheses of donor-acceptor-functionalized dihydroazulenes

    DEFF Research Database (Denmark)

    Broman, Søren Lindbæk; Jevric, Martyn; Bond, Andrew


    The dihydroazulene (DHA)/vinylheptafulvene (VHF) photo/thermoswitch has been of interest for use in molecular electronics and advanced materials. The switching between the two isomers has previously been found to depend strongly on the presence of donor and acceptor groups. The fine-tuning of opt...

  20. Hyperpolarizability studies of some nonconjugated twin donor ...

    Indian Academy of Sciences (India)


    Nonlinear optics; oscillator strength; optical gap; polarizability. 1. Introduction. The design of materials with large ... strength and optical gaps of the twin donor acceptor sys- tems by varying the number of alkyl groups .... The microscopic first hyperpolarizability, β is a 3rd rank tensor, which has 27 tensor components.


    African Journals Online (AJOL)



    Mar 3, 2005 ... Objectives: To determine the status of blood donor haematology in two regional sites in Kenya and to assess the potential role of automated haematology in National blood bank process control. Design: A cross sectional descriptive study. Setting: Two regional blood banks - Nairobi and its environs (Blood ...

  2. The Dutch Living Donor Kidney Exchange Program

    NARCIS (Netherlands)

    M. de Klerk (Marry)


    textabstractKidney transplantation is the optimal option for patients with an end-stage renal disease. The first successful transplantation with a living genetically related donor has been performed since 26 October 1954, when an identical twin transplant was performed in Boston. In the years that

  3. FORUM Paediatric living donor liver transplantation

    African Journals Online (AJOL)

    biliary anatomy. In general, children are well served by receiving a left lateral segment graft. Donor safety is the over-riding concern and has been excellent after left lateral segmentectomy, with a usually quoted .... Langnas AN, Marujo WC, Inagaki M, Stratta RJ, Wood RP, Shaw BW Jr. The results of reduced-size.

  4. Cancellous bone autografts: Donor sites, indications, techniques ...

    African Journals Online (AJOL)

    A prospective study of patients who had cancellous bone-graft was conducted to identify the indications and complications related to the techniques used in harvesting such grafts from the ilium, distal femur and proximal tibia. The commonest indication for cancellous bone graft was non-union. Donor site pain was the most ...

  5. Electron Donor Acceptor Interactions. Final Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ana L. [Arizona State Univ., Tempe, AZ (United States)


    The Gordon Research Conference (GRC) on Electron Donor Acceptor Interactions was held at Salve Regina University, Newport, Rhode Island, 8/11-16/02. Emphasis was placed on current unpublished research and discussion of the future target areas in this field.

  6. Choosing the order of deceased donor and living donor kidney transplantation in pediatric recipients: a Markov decision process model. (United States)

    Van Arendonk, Kyle J; Chow, Eric K H; James, Nathan T; Orandi, Babak J; Ellison, Trevor A; Smith, Jodi M; Colombani, Paul M; Segev, And Dorry L


    Most pediatric kidney transplant recipients eventually require retransplantation, and the most advantageous timing strategy regarding deceased and living donor transplantation in candidates with only 1 living donor remains unclear. A patient-oriented Markov decision process model was designed to compare, for a given patient with 1 living donor, living-donor-first followed if necessary by deceased donor retransplantation versus deceased-donor-first followed if necessary by living donor (if still able to donate) or deceased donor (if not) retransplantation. Based on Scientific Registry of Transplant Recipients data, the model was designed to account for waitlist, graft, and patient survival, sensitization, increased risk of graft failure seen during late adolescence, and differential deceased donor waiting times based on pediatric priority allocation policies. Based on national cohort data, the model was also designed to account for aging or disease development, leading to ineligibility of the living donor over time. Given a set of candidate and living donor characteristics, the Markov model provides the expected patient survival over a time horizon of 20 years. For the most highly sensitized patients (panel reactive antibody > 80%), a deceased-donor-first strategy was advantageous, but for all other patients (panel reactive antibody Markov model illustrates how patients, families, and providers can be provided information and predictions regarding the most advantageous use of deceased donor versus living donor transplantation for pediatric recipients.

  7. Brain Basics

    Medline Plus

    Full Text Available ... time in healthy people and are working to compare that with brain development in people mental disorders. Genes and environmental ... the brain than ever before. Brain Imaging Using brain imaging technologies such as magnetic resonance imaging (MRI), which uses magnetic fields to take pictures ...

  8. Adaptive NN Control for Multisteering Plane Aircraft with Dead Zone or Backlash Input Nonlinearity


    Meng, Xiang-fei; Wang, Ying; Lv, Mao-long


    Considering that many factors such as actuator input dead zone, backlash, and external disturbance could affect the exactness of trajectory tracking, therewith a robust adaptive neural network control scheme on the basis of control allocation is proposed for the sake of tracking control of multisteering plane aircraft with actuator input dead zone or backlash nonlinearity. First of all, an actuator input dead zone or backlash nonlinearity control assignment model is established and the contro...

  9. Butyltin residues in southern sea otters (Enhydra lutris nereis) found dead along California coastal waters (United States)

    Kannan, K.; Guruge, K.S.; Thomas, N.J.; Tanabe, S.; Giesy, J.P.


    Tributyltin (TBT) and its degradation products, mono- (MBT) and dibutyltin (DBT), were determined in liver, kidney, and brain tissues of adult southern sea otters (Enhydra lutris nereis) found dead along the coast of California during 1992a??1996. Hepatic concentrations of butyltin compounds (BTs = MBT + DBT + TBT) ranged from 40 to 9200 ng/g wet wt, which varied depending on the sampling location and gender. Concentrations of BTs in sea otters were comparable to those reported in stranded bottlenose dolphins from the U.S. Atlantic Coast during 1989a??1994. Greater accumulation of butyltins in sea otters was explained by their bottom-feeding habit and the diet that consists exclusively of invertebrates such as mollusks and gastropods. Livers of female sea otters contained approximately 2-fold greater concentrations of BTs than did those of males. The composition of butyltin compounds in sea otter tissues was predominated by TBT in most cases and suggestive of recent exposure. Large harbors such as Monterey Harbor that handle ships legally painted with TBT-containing antifouling paints continued to experience ecotoxicologically significant butyltin contamination. Sea otters, which were affected by infectious diseases, contained greater concentrations of BTs in their tissues than those that died from trauma and other unknown causes.

  10. Living donor hepatectomy in female donors with ongoing menstruation: Safety and ethical issues

    Directory of Open Access Journals (Sweden)

    Horng-Ren Yang


    Conclusions: Our study shows safety of right lobe living donation in female donors with ongoing menstruation with no increased risk of intraoperative excessive bleeding and postoperative physiological impact on their general health.

  11. The Role of Dead Wood in Maintaining Arthropod Diversity on the Forest Floor

    Energy Technology Data Exchange (ETDEWEB)

    Hanula, James L. [Dept. of Agriculture Forest Service, Athens, GA (United States). Southern Research Station; Horn, Scott [Dept. of Agriculture Forest Service, Athens, GA (United States). Southern Research Station; Wade, Dale D. [Dept. of Agriculture Forest Service, Athens, GA (United States). Southern Research Station


    Dead wood is a major component of forests and contributes to overall diversity, primarily by supporting insects that feed directly on or in it. Further, a variety of organisms benefit by feeding on those insects. What is not well known is how or whether dead wood influences the composition of the arthropod community that is not solely dependent on it as a food resource, or whether woody debris influences prey available to generalist predators. One group likely to be affected by dead wood is ground-dwelling arthropods. We studied the effect of adding large dead wood to unburned and frequently burned pine stands to determine if dead wood was used more when the litter and understory plant community are removed. We also studied the effect of annual removal of dead wood from large (10-ha) plots over a 5-year period on ground-dwelling arthropods. In related studies, we examined the relationships among an endangered woodpecker that forages for prey on live trees, its prey, and dead wood in the forest. Finally, the results of these and other studies show that dead wood can influence the abundance and diversity of the ground-dwelling arthropod community and of prey available to generalist predators not foraging directly on dead trees.

  12. The effect of ketoconazole on pulmonary pathology associated with dead Dirofilaria immitis. (United States)

    Tarish, J; Atwell, R


    The involvement of thromboxane and lipoxygenase in the regulation of pulmonary lesions and immune responses was investigated in dogs given ketoconazole and exposed to dead adult Dirofiliara immitis. Immunopathological reactions to the dead filariae were monitored by light and transmission electron microscopy and serology. When compared with control tissues, ketoconazole administration enhanced the level of pulmonary haemorrhage and early parenchymal fibrosis associated with dead adult filariae. Ultrastructurally, alveolar capillaries were filled with erythrocyte aggregations and proteinaceous material. These results suggested that an intact thromboxane and lipoxygenase pathway within the arachidonic acid system is necessary to minimize the effect of dead D. immitis in this pulmonary artery model.

  13. Comparison between morphological and staining characteristics of live and dead eggs of Schistosoma mansoni

    Directory of Open Access Journals (Sweden)

    AK Sarvel


    Full Text Available Schistosoma mansoni eggs are classified, according to morphological characteristics, as follows: viable mature and immature eggs; dead mature and immature eggs, shells and granulomas. The scope of this study was to compare the staining characteristics of different morphological types of eggs in the presence of fluorescent labels and vital dyes, aiming at differentiating live and dead eggs. The eggs were obtained from the intestines of infected mice, and put into saline 0.85%. The fluorescent labels were Hoechst 33258 and Acridine Orange + Ethidium Bromide and vital dyes (Trypan Blue 0.4% and Neutral Red 1%. When labelled with the probe Hoechst 33258, some immature eggs, morphologically considered viable, presented fluorescence (a staining characteristic detected only in dead eggs; mature eggs did not present fluorescence, and the other types of dead eggs, morphologically defined, showed fluorescence. As far as Acridine Orange + Ethidium Bromide are concerned, either the eggs considered to be live, or the dead ones, presented staining with green color, and only the hatched and motionless miracidium was stained with an orange color. Trypan Blue was not able to stain the eggs, considered to be dead but only dead miracidia which had emerged out of the shell. Neutral Red stained both live and dead eggs. Only the fluorescent Hoechst 33258 can be considered a useful tool for differentiation between dead and live eggs.

  14. "Dead in bed": a tragic complication of type 1 diabetes mellitus.

    LENUS (Irish Health Repository)

    O'Reilly, M


    "Dead in bed" is a tragic description of a particular type of sudden death in type 1 diabetes mellitus (DM). Patients are typically found dead in the early morning, lying in an undisturbed bed, having been well the previous evening. The incidence of "dead in bed" syndrome is not known but studies suggest figures of between 4.7 and 27.3% of all unexplained deaths in type 1 DM. The pathogenesis is unclear but patients typically have a preceding history of recurrent severe hypoglycaemia. We describe two cases of "dead in bed" syndrome which occurred at our institution within a 12-month period.

  15. Steady-state analysis of dead-time effect on bidirectional buck converters

    DEFF Research Database (Denmark)

    Bidoggia, Benoit; Maheshwari, Ram Krishan; Nielsen, Rasmus Ørndrup


    analyzed. It has been shown that in a region around zero there is no dead-time effect. The analytical expression of the borders between the areas where the dead-time effect is positive, zero or negative has been given. Moreover it has been shown that between these three areas, there are four other...... between output voltage, input voltage and duty cycle as a function of the output current. In the literature, the dead-time effect has been studied in relation with inverters, active filters, voltage regulated modules and high-precision power amplifiers, and dead-time compensation techniques have been...

  16. The development and current status of Intensive Care Unit management of prospective organ donors (United States)

    Ellis, Margaret Kathleen Menzel; Sally, Mitchell Brett; Malinoski, Darren


    Introduction: Despite continuous advances in transplant medicine, there is a persistent worldwide shortage of organs available for donation. There is a growing body of research that supports that optimal management of deceased organ donors in Intensive Care Unit can substantially increase the availability of organs for transplant and improve outcomes in transplant recipients. Methods: A systematic literature review was performed, comprising a comprehensive search of the PubMed database for relevant terms, as well as individual assessment of references included in large original investigations, and comprehensive society guidelines. Results: In addition to overall adherence to catastrophic brain injury guidelines, optimization of physiologic state in accordance with established donor management goals (DMGs), and establishment of system-wide processes for ensuring early referral to organ procurement organizations (OPOs), several specific critical care management strategies have been associated with improved rates and outcomes of renal transplantation from deceased donors. These include vasoactive medication selection, maintenance of euvolemia, avoidance of hydroxyethyl starch, glycemic control, targeted temperature management, and blood transfusions if indicated. Conclusions: Management of deceased organ donors should focus first on maintaining adequate perfusion to all organ systems through adherence to standard critical care guidelines, early referral to OPOs, and family support. Furthermore, several specific DMGs and strategies have been recently shown to improve both the rates and outcomes of organ transplantation. PMID:27555674

  17. ِAnalysis of donor motivations in living donor liver transplantation

    Directory of Open Access Journals (Sweden)

    Hesham eAbdeldayem


    Full Text Available Objectives: The introduction of the living donor liver transplantation (LDLT in Egypt as in elsewhere, has raised important psychological conflicts and ethical questions. The objective of this study was to get better understanding of the potential donors’ motives towards LDLT.Methods:This study was conducted on consecutive 193 living –liver donors who underwent partial hepatectomy as donors for LDLT during the period between April 2003 and January 2013, at the National Liver Institute Menoufeyia University, Egypt. Potential donors were thoroughly evaluated preoperatively through a screening questionnaire and interviews as regard their demographic data, relationship to the potential recipient and motives towards proceeding to surgery. They were assured that the information shared between them and the transplant centre is confidential. Results.The donors’ mean age was 25.53± 6.39 years with a range of 18-45 years. Males represented 64.7 % and females were 35.3%. The most common donors (32.1%, n_62, were sons and daughters to their parents (sons: n_43, daughters: n_19 while parents to their offsprings represent 15% (mothers: n_21, fathers: n_8. Brothers and sisters represent 16.5 % (brothers: n_22, sisters: n_10. Nephews & nieces giving their uncles or aunts were 14%. The number of wives donating to their husbands was 11 (5.7%. Interestingly, there was no single husband who donated his wife. Among the remaining donors, there were 11 cousins & one uncle. Unrelated donors were 20 (10.4%. Several factors seemed to contribute to motivation for donation: the seriousness of the potential recipient condition, the relationship and personal history of the donor to the potential recipient, the religious beliefs, the trust in the health care system, and family dynamics and obligations.Conclusions. Absolute absence of coercion on the living-liver donor’s motives may not be realistic because of the serious condition of the potential recipient. It is

  18. Lung Transplantation From Donors After Previous Cardiac Surgery: Ideal Graft in Marginal Donor? (United States)

    Palleschi, A; Mendogni, P; Tosi, D; Montoli, M; Carrinola, R; Mariolo, A V; Briganti, F; Nosotti, M


    Lung transplantation is a limited by donor pool shortage. Despite the efforts to extend the graft acceptability with recurrent donor criteria reformulations, previous cardiothoracic surgery is still considered a contraindication. A donor who underwent cardiac surgery could potentially provide an ideal lung but high intraoperative risks and intrinsic technical challenges are expected during the graft harvesting. The purpose of this study is to present our dedicated protocol and four clinical cases of successful lung procurements from donors who had a previous major cardiac surgery. One donor had ascending aortic root (AAR) substitution, another had mitral valve substitution, and two had coronary artery bypass surgery. The others' eligibility criteria for organ allocation, such as ABO compatibility, PaO 2 /FiO 2 ratio, absence of aspiration, or sepsis were respected. In one of the cases with previous coronary bypass grafting, the donor had a veno-arterial extracorporeal membrane oxygenation support. Consequently, the grafts required an ex vivo lung perfusion evaluation. We report the technical details of procurement and postoperative courses of recipients. All procurements were uneventful, without lung damage or waste of abdominal organs related to catastrophic intraoperative events. All recipients had a successful clinical outcome. We believe that successful transplantation is achievable even in a complicated setting, such as cases involving donors with previous cardiac surgery frequently are. Facing lung donor shortage, we strongly support any effort to avoid the loss of possible acceptable lungs. In particular, previous major cardiac surgery does not strictly imply a poor quality of lungs as well as unsustainable graft procurement. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Dynamic CT with brain death

    Energy Technology Data Exchange (ETDEWEB)

    Nakasu, Satoshi; Kodooka, Minoru; Handa, Jyoji (Shiga Univ. of Medical Science, Otsu (Japan))


    Dynamic CT studies were performed on three patients who were diagnosed symptomatically as ''brain-dead'' and on another patient whose EEG was flat due to an overdosage of a barbiturate. Dynamic studies in two of the three patients with presumed brain death revealed no increase in attenuation values, and EEG studies showed no electrical activities of the brain. However, in the one remaining patient whose EEG retained some activity, a dynamic study showed an increase in attenuation values in the circle of Willis. In contrast, the patient whose EEG was flat due to a barbiturate overdosage had a somewhat slowed, but still significant, increase in attenuation values, indicating a decreased but maintained cerebral circulation. Although brain death has been accepted as a concept, no criteria for its diagnosis are widely agreed on, and the necessity for a more refined confirmatory test is increasing. The advantage of this method is that the circulation in the posterior fossa including the brainstem can be evaluated simultaneously if an appropriate slice is selected. Because this method is relatively non-invasive and technically simple, we consider it valuable as an aid in the diagnosis of brain death.

  20. How the Seven Deadly Sins can Lead to Project Failure

    Directory of Open Access Journals (Sweden)

    Harold Kerzner


    Full Text Available For more than forty years, the project management landscape has seen textbooks, journal articles and presented papers discussing the causes of project failures. Unfortunately, many of the failure analyses seem to look at failure superficially rather than in depth. When trying to discover the root cause of a failure, we usually look first in the contractor’s company for someone to blame rather than in our own company. If that doesn’t work, then we begin climbing the organizational hierarchy in our own company by focusing on the project team, followed by the project manager. Once we find someone to blame, the search seems to end and we feel comfortable that we have discovered the cause of the failure. It is human nature to begin finger-pointing at the bottom of the organizational hierarchy first, rather than at the top. Yet, more often than not, the real cause of failure is the result of actions (or inactions and decisions made at the top of the organizational chart than at the bottom. It is also human nature to make decisions based upon how we are affected by the Seven Deadly Sins, namely: envy, anger, pride, greed, sloth, lust and gluttony. Decisions made based upon the Seven Deadly Sins, whether they are made at the top or bottom of the organization, can have dire consequences on projects. Sometimes the sins are hidden and not easily recognized by ourselves or others. We simply do not see or feel that were are committing a sin. The Seven Deadly Sins affect all of us sooner or later, even though we refuse to admit it. Some of us may be impacted by just one or two of the sins, whereas others may succumb to all seven. What is unfortunate is that the greatest damage can occur on projects when the sins influence the way that senior levels of management must interface with projects, whether as a project sponsor or as a member of a governance group. Bad decisions at the top, especially if based upon emotions rather than practicality, can place the