Sample records for brain-dead organ donor

  1. [Japanese ethos and organ transplantation from brain-dead donors]. (United States)

    Akiba, Etsuko


    A trend observed since the 1980s in the Japanese academic scene is the overturning of Hippocratic ethics by American individualistic bioethics. However, the Japanese ethos is more sympathetic to personalistic bioethics rooted in Hippocratic ethics, which assumes the universal view of the 'interdependent self' clearly marked off from the 'independent self' specific to American culture. In Japan, organ transplantation from brain-dead donors is promoted despite the lack of consensus on whether brain death signifies death of the individual. From the viewpoint of personalistic bioethics, this situation is problematic because it violates the dictum primum non nocere of the Hippocratic Oath. We should therefore first establish consensus on brain death and then promote a 'culture of donation' based on human dignity.

  2. [Could the number of brain-dead organ donors be increased in France]. (United States)

    Tuppin, Philippe; Moysan, Véronique; Tenaillon, Alain; Kessler, Michèle


    While brain-dead organ donor rates per million populations are useful to follow and to compare organ donation activities, they cannot be used to estimate the potential of brain-dead organ donors. The comparison of available data from national vital statistics system, specific studies on potential of organ donation, and the hospital diagnosis related group (DRG) based information system allow to estimate the potential of brain-dead organ donors between 3500 and 4500. In 2007, 3147 potential donors were identified and 9691 patients still registered at the beginning of 2007 or registered during 2007 for a kidney transplant. Spain has the highest rate of effective organ donors used as a goal to reach. Comparing national vital statistics, Spain and France had a similar potential of donors but Spanish opposition rate is lowest than France (15% versus 30%). Nevertheless, the rate of kidneys extracted but not grafted is higher in Spain (28% versus 13%), which may reflect the limits of the Spanish model and decrease the benefit of the weak opposition rate. In France, the decline of the opposition rate and the increase of donation activities in some region with low rates should be promoted; their impact on transplant volume is low. Promotion of living donors and non-heart-beating donors activities should be considered in front of organ shortage in France in 2007: 3.7 patients registered for a kidney extracted from a brain-dead donor grafted and 3.3 for kidneys extracted from all types of donors.

  3. Complement-mediated inflammation and injury in brain dead organ donors

    NARCIS (Netherlands)

    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

  4. 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

  5. Corticosteroids in the management of brain-dead potential organ donors: a systematic review. (United States)

    Dupuis, S; Amiel, J-A; Desgroseilliers, M; Williamson, D R; Thiboutot, Z; Serri, K; Perreault, M M; Marsolais, P; Frenette, A J


    Summary Current guidelines recommend the administration of hormonal combination therapy including immunosuppressive doses of corticosteroids to donors with low left ventricular ejection fractions and to consider hormonal therapy administration to all donors. However, these recommendations are largely based on observational data. The aim of this systematic review (SR) was to assess the clinical efficacy and safety of corticosteroids in brain-dead potential organ donors. MEDLINE and EMBASE were searched from the earliest accessible date up to March 2013 with a qualified librarian. Studies comparing the effects of any corticosteroid with those of placebo, standard treatment, or another active comparator were sought. Two independent reviewers evaluated each citation retrieved and selected studies independently and in duplicate. A third independent reviewer resolved any disagreement. Outcomes included donor haemodynamics and oxygenation, organ procurement, recipient survival, and graft survival. This review included 11 randomized controlled trials (RCTs) and 14 observational studies. The majority used methylprednisolone and often combined it with other hormonal therapies. Ten out of the 11 RCTs yielded neutral results. However, in observational studies, use of corticosteroids generally resulted in improved donor haemodynamics and oxygenation status, increased organ procurement, and improved recipient and graft survival. Overall quality of included studies was poor, as most of them presented high risks of confounding. This SR highlights the low quality and conflicting evidence supporting the routine use of corticosteroids in the management of organ donors. A large trial evaluating the effect of corticosteroids on outcomes such as organ recovery and graft survival is warranted. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email:

  6. Evaluation of acid-base status in brain dead donors and the impact of metabolic acidosis on organ retrieval. (United States)

    Lee, J H; Kim, M S; Na, S; Koh, S O; Sim, J; Choi, Y S


    Pathophysiologic changes after brain death can lead to acid-base disturbances. The primary aim of this study was to clarify the acid-base state and its source in brain dead donors using Stewart's approach. Additionally, we investigated whether the presence of metabolic acidosis affected the number of organs retrieved from donors. A retrospective review of electronic medical records was performed for brain dead donors who had undergone organ harvesting during the past 5 years in a tertiary medical center. The parameters related to acid-base disturbance and the number of organs retrieved from the donors was assessed. Sixty one brain dead donors were evaluated in this study. Twenty three (37.7%) of these patients had metabolic acidosis at the initial diagnosis of brain death. Metabolic acidosis resulted from hyperchloremia and a large strong ion gap. The severity of metabolic acidosis was masked by hypernatremia and hypoalbuminemia. In addition, donors without metabolic acidosis also showed mixed acid-base disturbances in which metabolic acidosis induced by significant hyperchloremia was combined with metabolic alkalosis caused by hypoalbuminemia and hypernatremia. Although more organs were retrieved from the donors without metabolic acidosis than those with metabolic acidosis (P=0.012), serum albumin level (P=0.010) and donor age (Pmetabolic acid-base disturbances, significantly correlated with the number of organs retrieved in multivariate regression analysis. Most brain dead donors exhibited metabolic acid-base disturbances. However, rather than metabolic acidosis, serum albumin level and donor age were well correlated with the number of organs retrieved.

  7. Influence of hypernatremia and polyuria of brain-dead donors before organ procurement on kidney allograft function. (United States)

    Kazemeyni, Seyed Mohammad; Esfahani, Fatemah


    Polyuria and hypernatremia are common problems during the pretransplant care of brain-dead donors. They have not only important role in hemodynamic stability, but also may influence organ transplantation outcomes. The influence of donor hypernatremia in liver transplantation was reported. This study aimed to determine these effects on kidney allograft. We retrospectively studied on 57 transplanted kidney allografts from cadaveric donors. The effects of the urine output volume and serum level of sodium of the donors were on the recipients' serum creatinine levels 1 week after transplantation and at the last follow-up visit were assessed. Of the donors, 58% had polyuria and 45% had hypernatremia. The median pretransplant urine output of the donors was 130 mL/h (range, 35 mL/h to 450 mL/h), and their mean serum sodium level was 152.0 +/- 13.0 mEq/L. Serum creatinine concentrations in the recipients at the 1st posttransplant week correlated significantly with the recipients' age (r = 0.355, P = .02) and the donors' urine output volume (r = 0.329, P = .04). The serum creatinine measured in the last follow-up visit significantly correlated only with the donors' serum sodium levels (r = 0.316, P = .02) and the donors' age (r = 0.306, P = .02). Multivariate regression analysis showed that the donors' serum levels of sodium and potassium were the predictors of the last measured serum creatinine level. Polyuria and hypernatremia in brain-dead donors are frequent. Elevated serum level of sodium and polyuria in the donor can have adverse effects on kidney allograft function.

  8. Hypoalbuminaemia in brain-dead donors for liver transplantation

    African Journals Online (AJOL)


    We retrospectively reviewed the charts of the 37 brain-dead patients referred to the organ transplant unit at Groote. Schuur Hospital in 2001 and 2002 as potential donors for liver transplantation. All potential donors were assessed, investigated and man- aged according to standard protocols. The assessment con- sisted of ...

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

    Westphal, Glauco Adrieno; Garcia, Valter Duro; Souza, Rafael Lisboa de; Franke, Cristiano Augusto; Vieira, Kalinca Daberkow; Birckholz, Viviane Renata Zaclikevis; Machado, Miriam Cristine; Almeida, Eliana Régia Barbosa de; 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; Albuquerque, André Gustavo Neves de; Abdala, Edson


    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.

  10. 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.

  11. 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.

  12. 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.

  13. Proactive Complex Hormone Therapy in the Clinical Guideline for the Managing the Potential Donor Organs in BrainDead Donors

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    T. I. Konareva


    Full Text Available Goal of study: to improve hemodynamics, respiratory exchange and metabolism of potential donor organs by using combination of Lthyroxin, triiodothyronine, methylprednisolone, desmopressin acetate and insulin.Material and Methods: The clinical study included 98 potential donors (PD with confirmed diagnosis of brain death. Braindead PD were divided into two groups: the 1st group included 43 PD with traumatic brain injury; the 2nd group included 55 PD with a stroke. PD from the 1st and 2nd groups were divided into two subgroups: main subgroup (n=18 and n=30 included those who received Lthyroxine, triiodothyronine and dessom pressin orally; control subgroup (n=25 and n=25 included those who did not receive these drugs. Hemodynamics, electrolytes, biochemical parameters, respiratory exchange and free triiodothyronine and thyroxine in blood were determined during the study. Results and discussion: In the course of the intensive therapy in control subgroups of both groups of PD the doses of noradrenalin and dopamine were not changed. However, the doses of noradrenalin and dopamine were decreased significantly in main subgroups of both groups during the course of the hormone therapy. There were no significant changes in hemodynamics in PD from both control subgroups, whereas in main groups hemodynamics parameters were decreased due to hormone therapy. Significant changes of blood pressure were observed in the main subgroups. Despite exogenous administration, in the main subgroups T3 remained at the lower limit of norm, whereas T4 increased. Improved hemodynamics and gas exchange were revealed in PD following hormone therapy that was important for the blood flow in organs. Following transplantation, in recipients of organs from control subgroup of PD the rejections of the transplants were significantly more frequent than rejections of organs from PD which comprized the main subgroup receiving hormones.Conclusion. Hormone administration to

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

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    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.

  15. 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).

  16. Which Donor for Uterus Transplants: Brain-Dead Donor or Living Donor? A Systematic Review. (United States)

    Lavoué, Vincent; Vigneau, Cécile; Duros, Solène; Boudjema, Karim; Levêque, Jean; Piver, Pascal; Aubard, Yves; Gauthier, Tristan


    The aim of this systematic review was to evaluate and compare the pros and cons of using living donors or brain-dead donors in uterus transplantation programs, 2 years after the first worldwide live birth after uterus transplantation. The Medline database and the Central Cochrane Library were used to locate uterine transplantation studies carried out in human or nonhuman primates. All types of articles (case reports, original studies, meta-analyses, reviews) in English or French were considered for inclusion. Overall, 92 articles were screened and 44 were retained for review. Proof of concept for human uterine transplantation was demonstrated in 2014 with a living donor. Compared with a brain-dead donor strategy, a living donor strategy offers greater possibilities for planning surgery and also decreases cold ischemia time, potentially translating into a higher success rate. However, this approach poses ethical problems, given that the donor is exposed to surgery risks but does not derive any direct benefit. A brain-dead donor strategy is more acceptable from an ethical viewpoint, but its feasibility is currently unproven, potentially owing to a lack of compatible donors, and is associated with a longer cold ischemia time and a potentially higher rejection rate. The systematic review demonstrates that uterine transplantation is a major surgical innovation for the treatment of absolute uterine factor infertility. Living and brain-dead donor strategies are not mutually exclusive and, in view of the current scarcity of uterine grafts and the anticipated future rise in demand, both will probably be necessary.

  17. 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.

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

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    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

  19. 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.

  20. Outcomes of organ donation in brain-dead patient's families: Ethical perspective. (United States)

    Ahmadian, Shamsi; Rahimi, Abolfazl; Khaleghi, Ebrahim


    The families of brain-dead patients have a significant role in the process of decision making for organ donation. Organ donation is a traumatic experience. The ethical responsibility of healthcare systems respecting organ donation is far beyond the phase of decision making for donation. The principles of donation-related ethics require healthcare providers and organ procurement organizations to respect donor families and protect them against any probable harm. Given the difficult and traumatic nature of donation-related experience, understanding the outcomes of donation appears crucial. The aim of this study was to explore the outcomes of organ donation for the families of brain-dead patients. This was a qualitative descriptive study to which a purposeful sample of 19 donor family members were recruited. Data were collected through holding in-depth semi-structured interviews with the participants. Data analysis was performed by following the qualitative content analysis approach developed by Elo and Kyngäs. The main category of the data was "Decision to organ donation: a challenge from conflict to transcendence." This main category consisted of 10 subcategories and 3 general categories. The general categories were "challenging outcomes," "reassuring outcomes," and "transcending outcomes." Ethical considerations: The study was approved by the regional ethical review board. The ethical principles of informed consent, confidentiality, and non-identification were used. Donor families experience different challenges which range from conflict and doubtfulness to confidence, satisfaction, and transcendence. Healthcare providers and organ procurers should not discontinue care and support provision to donor families after obtaining their consent to donate because the post-decision phase is also associated with different complexities and difficulties with which donor families may not be able to cope effectively. In order to help donor families achieve positive outcomes from

  1. Surgical illustration of en-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.

  2. 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

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

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    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.

  4. Exogenous biliverdin improves the function of lung grafts from brain dead donors in rats. (United States)

    Wang, J; Zhou, H-C; Pan, P; Zhang, N; Li, W-Z


    Biliverdin, a product of heme oxygenase-1 (HO-1), ameliorates the posttransplant functions of heart, kidney, and liver. In this study, we investigated the effects of biliverdin on lung grafts from brain dead (BD) rat donors. Male Wistar rats were randomly divided into 3 groups. The sham group (n = 7), did not undergo BD. Both donor and recipient rats in the BD biliverdin group (n = 8) were injected with biliverdin (35 mg/kg in 1 mL) intraperitoneally after confirmed BD and transplantation. In the BD group (n = 8), both donor and recipient rats received the same volume of saline (35 mg/kg in 1 mL) as the BD biliverdin group. All donor rats were observed for 1.5 hours before undergoing lung transplantation. Two hours after transplantation, we obtained blood and lung graft samples. Biliverdin reversed the aggravation of Pa(O(2)) in recipients, reduced the grafts wet/dry ratio, decreased the severity of lung injury measured by histologic examination, reduced serum tumor necrosis factor-alpha and interleukin-8 levels and inhibited myeloperoxidase activity (MPO) in the grafts. Furthermore, it significantly decreased malonaldehyde levels and increased superoxide dismutase levels. Biliverdin reduced cell apoptosis, activated protein expression of biliverdin reductase, and inhibited expression of HO-1 and nuclear factor (NF)-kappaB in lung grafts. Biliverdin exerts protective effects on lung grafts from BD donors through anti-inflammatory, antioxidant, and anti-apoptotic mechanisms.

  5. Prerecovery liver biopsy in the brain-dead donor: a case-control study of logistics, safety, precision, and utility. (United States)

    Oliver, Joseph Benton; Peters, Stephen; Bongu, Advaith; Beidas, Abdel-Kareem; Dikdan, George; Brown, Lloyd; Koneru, Baburao


    Prerecovery liver biopsy (PLB) can potentially to decrease futile recovery and increase utilization of marginal brain-dead donor (BDD) livers. A case-control study was conducted to examine the logistics, safety, histological precision, and liver utilization associated with PLB in BDDs. Twenty-three cases between January 2008 and January 2013 were compared to 2 groups: 48 sequential and 69 clinically matched controls. Compared to the sequential controls, the cases were older (53 versus 46 years), heavier (30.2 versus 25.8 kg/m2), had higher prevalences of hypertension (78.3% versus 44.7%) and alcohol use (56.5% versus 23.4%), and a lower United Network for Organ Sharing expected organ yield (0.73 versus 0.81 livers/donor; P logistically feasible with only a minimal delay and is safe, its interpretation at donor hospitals is reproducible, and it appears to decrease futile liver recovery. © 2013 American Association for the Study of Liver Diseases.

  6. Protection against lung graft injury from brain-dead donors with carbon monoxide, biliverdin, or both. (United States)

    Zhou, Huacheng; Qian, Hua; Liu, Jinfeng; Zhu, Daling; Ding, Wengang; Pan, Peng; Jin, Di; Wang, Juan; Li, Wenzhi


    The process of brain death can induce acute lung injury in donors and aggravate ischemia-reperfusion injury in grafts. Carbon monoxide (CO) and biliverdin (BV) have been shown to attenuate ischemia-reperfusion injury. We therefore examined if the administration of both CO and BV provide enhanced cytoprotection against lung graft injury from brain-dead (BD) rat donors. Brain death was induced in all donors, after which they were observed for 1.5 hours and then underwent lung transplantation. The recipients were ventilated with 40% oxygen (control group), ventilated with 250 ppm CO in 40% oxygen (CO group), treated with BV (35 mg/kg) intraperitoneally (BV group), or treated with CO and BV conjointly (COBV group) before transplantation (n = 8 each group). The recipients were sacrificed 2 hours after lung transplantation by exsanguination. Serum levels of interleukin (IL)-8 and tumor necrosis factor (TNF)-α were measured by enzyme-linked immunosorbent assay. CO and/or BV treatment attenuated partial pressure of arterial oxygen (Pao(2))/fraction of inspired oxygen (Fio(2)) aggravation in the recipients after reperfusion, reduced the wet weight/dry weight ratio, decreased the lung injury score, inhibited the activity of myeloperoxidase in grafts, and decreased serum levels of IL-8 and TNF-α compared with the control group (p < 0.05). The COBV group had significantly decreased malonaldehyde levels and increased superoxide dismutase levels in lung grafts compared with the CO group (p < 0.05). The static pressure-volume curve of the lungs was ameliorated in the CO group, BV group, and COBV group compared with the control group (p < 0.05). CO and BV exert protective effects through anti-inflammatory and anti-oxidant mechanisms, and dual treatment provided enhanced cytoprotection against lung graft injury from BD rat donors. Copyright © 2011 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  7. 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.

  8. Potential brain dead organ donation in neurocritical care mortality. (United States)

    Spatenkova, Vera; Bradac, Ondrej; Suchomel, Petr


    Mortality is a marker of quality in neurocritical care, but it also provides potential for donors after brain death (DBD) following irreversible acute brain damage. The aim of this study was to analyse the neurointensive care unit (NICU) mortality rate and recovery of potential DBD. We performed a 10-year prospective observational cohort computer database analysis of 6138 acute neurological and neurosurgical patients (pts, 58.2% male, mean: age 55.9±14.7 years, body weight 78.3±15.6 kg, body mass index 26.9±4.7, NICU stay 3.8±5.3 days): 3462 (56.4%) pts with brain disease (mostly stroke 43.2%, tumour 31.1%, trauma 13.6%); 10.3% pts with internal carotid artery (ICA) stenosis; 32.6% pts with spine diseases, and others. Mean Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission was 10.63±5.2 and Glasgow Coma Scale on admission was 13.79±2.51. There were 159 (2.6%) cases of mortality with a significantly higher mortality rate in pts with brain diseases (95.6% of deceased pts, p<0.001) than in ICA stenosis (0.6%), spine (1.9%) and from others (1.9%). There were 23 (14.5%) pts with clinical signs of brain death, of whom 13 (56.5%) became donors. The main reasons for non-recovery of potential donors were hemodynamic instability (16.7%) and family reluctance (12.5%). The study showed that our NICU mortality was 2.6%. There were relatively few clinical signs of brain death and not all potential donors were recovered.

  9. Normothermic Ex Vivo Lung Perfusion in Brain-dead Donors Reduces Inflammatory Cytokines and Toll-like Receptor Expression. (United States)

    Shafaghi, Shadi; Mortaz, Esmaeil; Abbasi Dezfuli, Azizollah; Godarzi, Hoda; Sheikhy, Kambiz; Ansari Aval, Zahra; Farzanegan, Behrooz; Emami, Habib; Hosseini-Baharanchi, Fatemeh Sadat; Najafizadeh, Katayoun


    Inflammatory responses and innate immunologic reactions play an important role in the respiratory system. Ex vivo lung perfusion (EVLP) is considered a novel method in the evaluation and reconditioning of donor lungs prior to transplantation. However, EVLP's effect on inflammatory and metabolic markers of human lung tissue is unknown.  This study investigated how the performance of EVLP on brain-dead (BD) donor lungs affects the production and release of inflammatory cytokines (IL-6, IL-8, and TNF-a), inflammatory cells and toll-like receptors (TLR) -2, 4. This study was conducted with an animal subject for qualification of EVLP team and then EVLP was performed on 4 human cases referred to Masih Daneshvari Hospital (Tehran,Iran), from May 2013 to July 2015. Two of these cases, who had acceptable lung function parameters, were enrolled in this study for immunologic investigations. Bronchoalveolar lavages (BAL) were taken before and after EVLP. Cytokines were quantitatively measured before lung retrieval, at the end of the lung removal, at the start of EVLP, and at the end of the each hour of EVLP. TLR expression was measured on the cells obtained by flow cytometry. TNF-a, IL-6 and IL-8 decreased in each stage of washing perfusate in both cases, and the level of cytokines in serum was in the normal range. Flow cytometry analysis revealed a decreasing expression of CD3, CD4/8, CD19, and CD16+56, as well as TLR-2 and TLR-4 in both cases. Intra-capillary pools of pro-inflammatory cytokines (IL-6, IL-8, and TNF-a) were determined to contribute to the lung injury during prolonged lung perfusion. This raises the possibility that EVLP donor lungs could be less immunogenic than standard lungs. However, to assess EVLP's effects on lung grafts and optimize recipient outcomes, further studies with a sufficient number of lungs are required.

  10. 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.

  11. 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.


    Directory of Open Access Journals (Sweden)

    A. E. Shcherba


    Full Text Available Aim. The purpose of our work was to estimate the impact of preconditioning with acetylcysteine and sevoflurane on ischemia-reperfusion injury of cadaveric donor liver with marginal features. Methods and results. In this prospective randomized controlled trial we recruited 21 heart beating donors with brain death. We assigned 11 donors to the study group, and 10 donors to the control group. Morphological characteristics of ischemia- reperfusion injury in both groups were analyzed. Conclusion. Use of pharmacological preconditioning with acetylcysteine and sevoflurane resulted in necrosis and hepatocyte apoptosis reduction as compared to the control group, thereby had a protective effect against ischemia-reperfusion injury. 

  13. 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

  14. 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.

  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


    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. 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. 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. 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. 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.

  16. 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

  17. Do the 'brain dead' merely appear to be alive? (United States)

    Nair-Collins, Michael; Miller, Franklin G


    The established view regarding 'brain death' in medicine and medical ethics is that patients determined to be dead by neurological criteria are dead in terms of a biological conception of death, not a philosophical conception of personhood, a social construction or a legal fiction. Although such individuals show apparent signs of being alive, in reality they are (biologically) dead, though this reality is masked by the intervention of medical technology. In this article, we argue that an appeal to the distinction between appearance and reality fails in defending the view that the 'brain dead' are dead. Specifically, this view relies on an inaccurate and overly simplistic account of the role of medical technology in the physiology of a 'brain dead' patient. We conclude by offering an explanation of why the conventional view on 'brain death', though mistaken, continues to be endorsed in light of its connection to organ transplantation and the dead donor rule. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. 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

  19. Anti-Apoptotic Effects of 3,3',5-Triiodo-L-Thyronine in the Liver of Brain-Dead Rats. (United States)

    Rebolledo, Rolando A; Van Erp, Anne C; Ottens, Petra J; Wiersema-Buist, Janneke; Leuvenink, Henri G D; Romanque, Pamela


    Thyroid hormone treatment in brain-dead organ donors has been extensively studied and applied in the clinical setting. However, its clinical applicability remains controversial due to a varying degree of success and a lack of mechanistic understanding about the therapeutic effects of 3,3',5-Triiodo-L-thyronine (T3). T3 pre-conditioning leads to anti-apoptotic and pro-mitotic effects in liver tissue following ischemia/reperfusion injury. Therefore, we aimed to study the effects of T3 pre-conditioning in the liver of brain-dead rats. Brain death (BD) was induced in mechanically ventilated rats by inflation of a Fogarty catheter in the epidural space. T3 (0.1 mg/kg) or vehicle was administered intraperitoneally 2 h prior to BD induction. After 4 h of BD, serum and liver tissue were collected. RT-qPCR, routine biochemistry, and immunohistochemistry were performed. Brain-dead animals treated with T3 had lower plasma levels of AST and ALT, reduced Bax gene expression, and less hepatic cleaved Caspase-3 activation compared to brain-dead animals treated with vehicle. Interestingly, no differences in the expression of inflammatory genes (IL-6, MCP-1, IL-1β) or the presence of pro-mitotic markers (Cyclin-D and Ki-67) were found in brain-dead animals treated with T3 compared to vehicle-treated animals. T3 pre-conditioning leads to beneficial effects in the liver of brain-dead rats as seen by lower cellular injury and reduced apoptosis, and supports the suggested role of T3 hormone therapy in the management of brain-dead donors.

  20. Pathology Results at Autopsy in Brain-Dead Patients with Brain Tumors. (United States)

    Sadegh Beigee, Farahnaz; Shahryari, Shagin; Mojtabaee, Meysam; Pourabdollah Toutkaboni, Mihan


    Brain tumors are the most challenging causes of brain deaths due to the lack of pathology results in many cases. It is not uncommon to find a brain tumor in a brain-dead patient with no pathology results or neuroradiology reports available; this would exclude the deceased from organ donation. The mortality that occurs while patients are on transplant wait lists motivated us to find a solution to prevent losing brain-dead patients as potential donors. We present our experiences in autopsy examinations of brain tumors and the results of frozen-section pathology. We performed autopsy examinations of 8 brain-dead patients who were suspected of having highly malignant brain tumors and in whom there were no pathology or radiology reports available. The autopsy process began at the conclusion of organ retrieval. First, we performed a complete brain dissection; the tumor was then removed with its adjacent brain tissue and sent for examination by an expert pathologist. Organ transplant was deferred until the pathology examination was completed. Organ transplant was cancelled if the frozen sections revealed a high-grade tumor. For all other results, the transplant was performed. If a medulloblastoma was confirmed, only the heart was transplanted. The duration of the delay for pathologic examination was 30 to 45 minutes. A total of 21 organs were donated that would otherwise have been rejected. It is worth performing an autopsy and frozen-section pathology examination to prevent losing potential organs from donors with brain tumors who are suspected of having a high-grade neoplasm but have no pathology or neuroradiology reports. This process is simple and has the potential to save lives.

  1. Attitudes towards organ donor advocacy among Swedish intensive care nurses. (United States)

    Forsberg, Anna; Lennerling, Annette; Fridh, Isabell; Rizell, Magnus; Lovén, Charlotte; Flodén, Anne


    To explore the attitudes of Swedish intensive care nurses towards organ donor advocacy. The concept of organ donor advocacy is critical to nurses who care for potential donors in order to facilitate organ donation (OD). A retrospective cross-sectional study was employed. Inclusion criteria in this survey were to be a registered nurse and to work in a Swedish intensive care unit (ICU). Participants were identified by the Swedish association of health professionals. A number of 502 Swedish ICU nurses answered the 32-item questionnaire Attitudes Towards Organ Donor Advocacy Scale (ATODAS), covering the five dimensions of organ donor advocacy: attitudes towards championing organ donation at a structural hospital level, or at a political and research level, attitudes towards actively and personally safeguarding the will and wishes of the potential organ donor, or by using a more professional approach and finally to safeguard the will and wishes of the relatives. Data were analysed with the SPSS version 18·0 and the results were assessed by using Student's t-test and post hoc test, analysis of variance (ANOVA), χ(2) , Pearson's correlation and regression analysis. The most favoured advocacy action was safeguarding the POD's will and wishes by a professional approach, closely followed by actively and personally safeguarding the POD's will and wishes. Nurses at local hospitals reported a more positive attitude towards organ donor advocacy overall compared with nurses at larger regional or university hospitals. Important factors leading to positive attitudes were seniority, working experience, participating in conversations with relatives, caring for brain-dead persons and private experiences from OD or organ transplantation. Intensive and critical care nurses with short working experience in university hospitals showed the least positive attitude towards organ donor advocacy. This is problematic because many ODs and all transplantations are performed in university

  2. Factors Affecting the Occurrence of Spinal Reflexes in Brain Dead Cases. (United States)

    Hosseini, Mahsa Sadat; Ghorbani, Fariba; Ghobadi, Omid; Najafizadeh, Katayoun


    Brain death is defined as the permanent absence of all cortical and brain stem reflexes. A wide range of spontaneous or reflex movements that are considered medullary reflexes are observed in heart beating cases that appear brain dead, which may create uncertainty about the diagnosis of brain death and cause delays in deceased-donor organ donation process. We determined the frequency and type of medullary reflexes and factors affecting their occurrence in brain dead cases. During 1 year, 122 cases who fulfilled the criteria for brain death were admitted to the special intensive care unit for organ procurement of Masih Daneshvari Hospital. Presence of spinal reflexes was evaluated by trained coordinators and was recorded in a form in addition to other information including demographic characteristics, cause of brain death, time from detection of brain death, history of craniotomy, vital signs, serum electrolyte levels, and parameters of arterial blood gas determination. Most cases (63%) included in this study were male, and mean age was 33 ± 15 y. There was > 1 spinal reflex observed in 40 cases (33%). The most frequent reflex was plantar response (17%) following by myoclonus (10%), triple flexion reflex (9%), pronator extension reflex (8%), and undulating toe reflex (7%). Mean systolic blood pressure was significantly higher in cases who exhibited medullary reflexes than other cases (126 ± 19 mm Hg vs 116 ± 17 mm Hg; P = .007). Spinal reflexes occur frequently in brain dead cases, especially when they become hemodynamically stable after treatment in the organ procurement unit. Observing these movements by caregivers and family members has a negative effect on obtaining family consent and organ donation. Increasing awareness about spinal reflexes is necessary to avoid suspicion about the brain death diagnosis and delays in organ donation.

  3. Clinical motivation for P-31 MRS studies on the myocardial energy metabolism of brain dead cats

    NARCIS (Netherlands)

    Bruinsma, GJBB; van Echteld, CJA


    Hemodynamic instability of the brain dead potential heart donor is an exclusion criterion for heart donation for transplantation. Based on the results of myocardial biopsies it has been reported that brain death-related catecholamine induced damage of the heart causes depletion of high-energy

  4. Inadequate Antioxidative Responses in Kidneys of Brain-Dead Rats. (United States)

    Hoeksma, Dane; Rebolledo, Rolando A; Hottenrott, Maximilia; Bodar, Yves S; Wiersema-Buist, Janneke J; Van Goor, Harry; Leuvenink, Henri G D


    Brain death (BD)-related lipid peroxidation, measured as serum malondialdehyde (MDA) levels, correlates with delayed graft function in renal transplant recipients. How BD affects lipid peroxidation is not known. The extent of BD-induced organ damage is influenced by the speed at which intracranial pressure increases. To determine possible underlying causes of lipid peroxidation, we investigated the renal redox balance by assessing oxidative and antioxidative processes in kidneys of brain-dead rats after fast and slow BD induction. Brain death was induced in 64 ventilated male Fisher rats by inflating a 4.0F Fogarty catheter in the epidural space. Fast and slow inductions were achieved by an inflation speed of 0.45 and 0.015 mL/min, respectively, until BD confirmation. Healthy non-brain-dead rats served as reference values. Brain-dead rats were monitored for 0.5, 1, 2, or 4 hours, after which organs and blood were collected. Increased MDA levels became evident at 2 hours of slow BD induction at which increased superoxide levels, decreased glutathione peroxidase (GPx) activity, decreased glutathione levels, increased inducible nitric oxide synthase and heme-oxygenase 1 expression, and increased plasma creatinine levels were evident. At 4 hours after slow BD induction, superoxide, MDA, and plasma creatinine levels increased further, whereas GPx activity remained decreased. Increased MDA and plasma creatinine levels also became evident after 4 hours fast BD induction. Brain death leads to increased superoxide production, decreased GPx activity, decreased glutathione levels, increased inducible nitric oxide synthase and heme-oxygenase 1 expression, and increased MDA and plasma creatinine levels. These effects were more pronounced after slow BD induction. Modulation of these processes could lead to decreased incidence of delayed graft function.

  5. Cancer in the organ donor


    DETRY, Olivier


    Organ Donation and Cancer Pr Olivier Detry, Dpt of Abdominal Surgery and Transplantation, University of Liege The risk of transmission of cancer with the transplanted organ has been known since the pioneering years of solid organ transplantation, and is enhanced by immunosuppression and particularly the calcineurin inhibitors. Therefore, classically, potential organ donors with past history of cancer are excluded from donation, with the exception of low-grade malignant tumours of the...

  6. 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.

  7. Ventilatory and hemodynamic management of potential organ donors: an observational survey. (United States)

    Mascia, Luciana; Bosma, Karen; Pasero, Daniela; Galli, Tamara; Cortese, Gerardo; Donadio, Pierpaolo; Bosco, Riccardo


    To determine the current standard ventilatory and cardiovascular management in potential organ donors. Prospective, multiple-center, observational survey. A total of 15 intensive care units in 13 hospitals in Piedmont, Italy. A total of 34 brain-dead patients enrolled in 6 months. Demographics and reasons for lung transplant exclusion were recorded. Ventilatory and hemodynamic variables were compared before and after confirmation of brain death. A total of 23 potential donors were ineligible for lung donation based on pulmonary status and age. Of the 11 eligible lung donors, only two donated the lungs because five had Pao2/Fio2 ratios of tests were performed with apneic oxygenation after disconnection from the ventilator in all cases; tracheal suction was performed with an open circuit in eight cases, and no recruitment maneuvers were performed. Crystalloid infusion was increased after diagnosis of brain death from 187 +/- 151 to 275 +/- 158 mL/hr (p < .05), and central venous pressure increased from 6 +/- 3 to 7 +/- 3 mm Hg (p < .05). Inotropic support was used in 24 donors (70%). Five of 11 potential lung donors (45%) had a Pao2/Fio2 ratio of <300, making them ineligible for lung donation. After the diagnosis of brain death, ventilatory management remained the same, no maneuvers for prevention of derecruitment of the lung were performed, and cardiovascular management was modified to optimize peripheral organ perfusion. These data represent the current standard of care for ventilatory management of potential organ donors and may be suboptimal in preserving lung function.

  8. 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:

  9. [Communication with the relatives of a patient presumed brain dead]. (United States)

    Kompanje, Erwin J O; de Groot, Yorick J; Ijzermans, Jan N M; Visser, Gerhard H; Bakker, Jan; van der Jagt, Mathieu


    The choice of wording in cases of suspected brain death is important. If brain death has not been proven by electrocerebral silence and by absence of spontaneous breathing in an apnoea test in a patient in intensive care, then words like 'brain dead', 'has died' and 'clinical brain death' should be avoided in conversations with the relatives of the patient. This is illustrated by three cases. The first patient was a 46-year-old woman, with thrombosis of the basilar artery; the second was a 26-year-old man who was resuscitated after a bilateral pneumothorax, but developed severe postanoxic encephalopathy; and the third patient was a 64-year-old man with a large intracerebral haemorrhage. The relatives were informed that the patient was 'brain dead' or 'deceased' based on loss of consciousness (Glasgow Coma score of 3) and absence of brain stem reflexes, but prior to the completion of the brain death protocol by electroencephalography and apnoea testing. In the first and third cases, brain death could not be proven, and the pronouncement that the patient was deceased had to be reversed. The emotional relatives refused organ donation. In the second case, death was pronounced upon loss of consciousness and absence of brain stem reflexes. The relatives refused organ donation, after which mechanical ventilation was withdrawn and the patient was declared dead for a second time based on circulatory arrest. A patient is dead after complete brain death determination or after circulatory arrest. Loss of consciousness (Glasgow Coma score of 3) and absence of brain stem reflexes lead to a state of catastrophic cerebral damage, but not to brain death. In such a situation, wording such as 'brain death', 'deceased' and 'clinical brain death' should be avoided in conversations with the relatives.

  10. Ethical issues in the use of anencephalic infants as organ donors. (United States)

    Shinnar, S; Arras, J


    For many, the ethical issues raised in the previous sections are sufficient to justify opposition to tampering with either the dead-donor rule or the definition of death in general and the use of anencephalic infants as organ donors in particular regardless of how many organs could be procured. Others will see it as a question of balancing the relative costs and benefits of the proposal. Given, the likely bad consequences and meager benefits, these protocols are difficult to justify on those grounds as well. The proposals of waiting until brain death has occurred also pose some serious, though not necessarily insurmountable, ethical problems. With supportive care, however, anencephalic infants do not become brain dead in the first week of life. Given the declining incidence of anencephaly, the issue regarding anencephalic infants will probably become moot in the next few years. As the need for organ donors continues to grow, we will undoubtedly be faced with future proposals to harvest vital organs from other "unique" categories of dying or severely impaired patients. We believe that the current dead donor rule and the strict "whole-brain" definition of death are sound public policy and good ethics and should remain the cornerstone of future decisions in this field.

  11. Perceived support among families deciding about organ donation for their loved ones: donor vs nondonor next of kin. (United States)

    Jacoby, Liva; Jaccard, James


    Families' experiences in the hospital influence their decisions about donating organs of brain-dead relatives. Meeting families' support needs during this traumatic time is an obligation and a challenge for critical care staff. (1) To elicit family members' accounts of various types of support received and perceived quality of care for themselves and their loved ones when they made the donation decision, and (2) to examine the relationship between these factors and the families' donation decision. Retrospective telephone interviews of 199 families from different regions of the country were completed. Aside from demographic data, the survey addressed perceptions of informational, emotional, and instrumental support and quality of care. One hundred fifty-four study participants consented to donation; 45 declined. White next of kin were significantly more likely than African Americans to consent. Specific elements of reported support were significantly associated with consent to donate. Donor and nondonor families had differing perceptions of quality care for themselves and their loved ones. Receiving understandable information about organ donation was the strongest predictor of consent. Specific supportive behaviors by staff as recounted by family members of potential donors were significantly associated with consent to donation. These behaviors lend themselves to creative training and educational programs for staff. Such interventions are essential not only for next of kin of brain-dead patients, but also for staff and ultimately for the public as a whole.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. Prednisolone has a positive effect on the kidney but not on the liver of brain dead rats : a potencial role in complement activation

    NARCIS (Netherlands)

    Rebolledo Acevedo, Rolando; Liu, Bo; Akhtar, Mohammed Z.; Ottens, Petra J.; Zhang, Jian-ning; Ploeg, Rutger J.; Leuvenink, Henri G. D.


    Background: Contradictory evidence has been published on the effects of steroid treatments on the outcomes of kidney and liver transplantation from brain dead (BD) donors. Our study aimed to evaluate this disparity by investigating the effect of prednisolone administration on BD rats. Methods: BD

  17. 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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  18. Seropositive abdominal and thoracic donor organs are largely underutilized. (United States)

    Taylor, R M; Pietroski, R E; Hagan, M; Eisenbrey, A B; Fontana, R J


    The aim of this study was to describe the epidemiology and utilization of anti-hepatitis B core protein(+) and anti-hepatitis C virus(+) organ donor referrals in a large organ procurement organization. Between 1995 and 2006, 3,134 deceased organ donor referrals were tested for anti-HBc and anti-HCV using commercial assays. The prevalence of anti-HCV(+) organ donor referrals significantly increased from 3.4% in 1994-1996 to 8.1% in 2003-2005 (P < .001), whereas the prevalence of anti-HBc(+) organ donor referrals remained unchanged at 3%-4% (P = .20). The 112 anti-HBc(+) (3.5%) and 173 anti-HCV(+) (5.5%) organ donor referrals were significantly older and more likely to be noncaucasian than seronegative organ donor referrals (P < .02). The procurement and utilization rates of seropositive thoracic and abdominal donor organs were significantly lower compared with seronegative organ donors (P < .0001). However, liver utilization rates significantly increased from anti-HBc(+) donors over time (21% vs 46%; P = .026), whereas utilization of anti-HCV(+) liver donors remained unchanged over time (5% vs 18%; P = .303). In summary, the proportion of anti-HCV(+) organ donor referrals has significantly increased and the proportion of anti-HBc(+) organ donor referrals has remained stable. Both thoracic and abdominal organs from seropositive donors are largely underutilized. Copyright © 2010 Elsevier Inc. All rights reserved.


    NARCIS (Netherlands)

    van Goor, Harry; Rosman, C; Kooi, K; Wubbels, GH; Bleichrodt, RP


    Objective: To determine if bacterial translocation and endotoxin absorption occur in organ donors with an anatomically intact gastrointestinal tract. Design: Case series. Setting: Intensive care units in general and university hospitals. Patients: Twenty-one (multiple) organ donors. Intervention:

  20. Lung donor selection criteria. (United States)

    Chaney, John; Suzuki, Yoshikazu; Cantu, Edward; van Berkel, Victor


    The criteria that define acceptable physiologic and social parameters for lung donation have remained constant since their empiric determination in the 1980s. These criteria include a donor age between 25-40, a arterial partial pressure of oxygen (PaO2)/FiO2 ratio greater than 350, no smoking history, a clear chest X-ray, clean bronchoscopy, and a minimal ischemic time. Due to the paucity of organ donors, and the increasing number of patients requiring lung transplant, finding a donor that meets all of these criteria is quite rare. As such, many transplants have been performed where the donor does not meet these stringent criteria. Over the last decade, numerous reports have been published examining the effects of individual acceptance criteria on lung transplant survival and graft function. These studies suggest that there is little impact of the historical criteria on either short or long term outcomes. For age, donors should be within 18 to 64 years old. Gender may relay benefit to all female recipients especially in male to female transplants, although results are mixed in these studies. Race matched donor/recipients have improved outcomes and African American donors convey worse prognosis. Smoking donors may decrease recipient survival post transplant, but provide a life saving opportunity for recipients that may otherwise remain on the transplant waiting list. No specific gram stain or bronchoscopic findings are reflected in recipient outcomes. Chest radiographs are a poor indicator of lung donor function and should not adversely affect organ usage aside for concerns over malignancy. Ischemic time greater than six hours has no documented adverse effects on recipient mortality and should not limit donor retrieval distances. Brain dead donors and deceased donors have equivalent prognosis. Initial PaO2/FiO2 ratios less than 300 should not dissuade donor organ usage, although recruitment techniques should be implemented with intent to transplant.

  1. 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

  2. Organic Donor-Acceptor Complexes as Novel Organic Semiconductors. (United States)

    Zhang, Jing; Xu, Wei; Sheng, Peng; Zhao, Guangyao; Zhu, Daoben


    Organic donor-acceptor (DA) complexes have attracted wide attention in recent decades, resulting in the rapid development of organic binary system electronics. The design and synthesis of organic DA complexes with a variety of component structures have mainly focused on metallicity (or even superconductivity), emission, or ferroelectricity studies. Further efforts have been made in high-performance electronic investigations. The chemical versatility of organic semiconductors provides DA complexes with a great number of possibilities for semiconducting applications. Organic DA complexes extend the semiconductor family and promote charge separation and transport in organic field-effect transistors (OFETs) and organic photovoltaics (OPVs). In OFETs, the organic complex serves as an active layer across extraordinary charge pathways, ensuring the efficient transport of induced charges. Although an increasing number of organic semiconductors have been reported to exhibit good p- or n-type properties (mobilities higher than 1 or even 10 cm2 V-1 s-1), critical scientific challenges remain in utilizing the advantages of existing semiconductor materials for more and wider applications while maintaining less complicated synthetic or device fabrication processes. DA complex materials have revealed new insight: their unique molecular packing and structure-property relationships. The combination of donors and acceptors could offer practical advantages compared with their unimolecular materials. First, growing crystals of DA complexes with densely packed structures will reduce impurities and traps from the self-assembly process. Second, complexes based on the original structural components could form superior mixture stacking, which can facilitate charge transport depending on the driving force in the coassembly process. Third, the effective use of organic semiconductors can lead to tunable band structures, allowing the operation mode (p- or n-type) of the transistor to be

  3. Liver transplantation in children using organs from young paediatric donors. (United States)

    Herden, Uta; Ganschow, Rainer; Briem-Richter, Andrea; Helmke, Knut; Nashan, Bjoern; Fischer, Lutz


    Nowadays, most paediatric liver transplant recipients receive a split or other technical variant graft from adult deceased or live donors, because of a lack of available age- and size matched paediatric donors. Few data are available, especially for liver grafts obtained from very young children (transplantations between 1989 and 2009. Recipients were divided into five groups (1-5) depending on donor age (transplantations from deceased donors were performed; 1- and 5-year graft survival rates were 75%, 80%, 78%, 81%, 74% and 75%, 64%, 70%, 67%, 46%, and 1- and 5-year patient survival rates were 88%, 91%, 90%, 89%, 78% and 88%, 84%, 84%, 83%, 63% for groups 1-5, respectively, without significant difference. Eight children received organs from donors younger than 1 year and 45 children received organs from donors between 1 and 6 years of age. Overall, vascular complications occurred in 13.2% of patients receiving organs from donors younger than 6 years. Analysis of our data revealed that the usage of liver grafts from donors younger than 6 years is a safe procedure. The outcome was comparable with grafts from older donors with excellent graft and patient survival, even for donors younger than 1 year. © 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation.

  4. The most altruistic living organ donor: a best friend. (United States)

    Hoffmann, Paul J


    Living organ donors are growing in number and account for a substantial proportion of organs transplanted. Types of living organ donors include family members, anonymous donors, and friends. Although familial donation is the most common form of living organ donation, anonymous donation and donation among friends are gaining popularity. Society has placed living organ donors at the top of the altruistic ladder. However, one's altruistic motives for living organ donation may be affected by the type of relationship he or she has with the organ recipient. Although family relationships are close, pressure and coercion from family members may make informed consent difficult. Anonymous donors do not have the pressure associated with a familial donation, but psychological and self-worth issues may influence their choice to donate. Friendship incorporates the close relationships associated with familial donation and the freedom associated with anonymous donation. Using Aristotle's definition of true friendship, the author argues that best friends are the only true altruistic living organ donors and therefore may be preferable to family donors or anonymous donors.

  5. Organ transplantation from deceased donors with cancer: is it safe?

    Directory of Open Access Journals (Sweden)

    Nalesnik MA


    Full Text Available Michael A Nalesnik1, Michael G Ison21Division of Transplantation and Hepatic Pathology, Department of Pathology, University of Pittsburgh Medical Center, Pittsburg, PA, USA; 2Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Chicago, IL, USAAbstract: The availability of donor organs continues to be insufficient to meet the needs of patients actively waiting for transplant. Consequently, there is continuing pressure to increase the donor organ pool while simultaneously assuring safety for the recipient population. The complication of donor malignancy transmission has been documented almost from the beginning of transplantation, and continues to be a concern today. The anecdotal nature of case reports and compiled series ensures that clinical decisions related to organ use from donors with malignancy will of necessity continue to be made on the basis of low-level evidence. Despite this limitation, the literature indicates that not all donor neoplasms have the same risk for transmission to the recipient, and it is necessary to consider the specific malignancy affecting the donor, as well as the condition of the recipient, before a decision is made to transplant or discard a given organ. Published cases suggest that certain forms of neoplasia, such as melanoma, choriocarcinoma, sarcoma, small cell carcinoma, or metastatic carcinomas serve as strong contraindications to organ donation. In contrast, considerable experience exists to suggest that certain tumors of the central nervous system, small subclinical prostate carcinomas, or small renal cell carcinomas resected prior to transplant, among other tumors, should not in themselves disqualify an individual from donating organs in the appropriate circumstance. This review presents the case for considering organ transplantation in the setting of certain donor malignancies and discusses factors to be weighed in such decisions. Additionally

  6. Tissue banking: relationship with blood donor and organ donor card status. (United States)

    McKenzie, Kenneth D; Fitzpatrick, Patricia E; Sheehan, John D


    Understanding the relationships among altruistic health acts may serve to aid therapeutic research advances. In this paper, we report on the links between two such behaviours-donating blood and carrying an organ donor card-and willingness to donate urological tissue to a tissue bank. Reasons for the differential willingness to do so are examined in this paper. A systematic sample of 259 new and returning attendees at a tertiary urology referral clinic in Ireland completed a self-report questionnaire in an outpatient setting. In addition to demographic details, details of known diagnosis of malignancy and family history of cancer; attitudes to tissue donation for research purposes were gauged using a 5-point Likert scale. Both blood donors and organ donor card carriers were more likely to be willing to donate tissue for research purposes. Blood donors were more likely want to know their overall results in comparison to nonblood donors and want their samples to be used for nonprofit research. Our hypothesis that being a blood donor would be a better predictor to donate urological tissue than being an organ donor card carrier borne out by the trends reported above.

  7. Contact between deceased donors' families and organ recipients. (United States)

    Azuri, Pazit; Tabak, Nili; Kreitler, Shulamit


    The benefits and disadvantages of posttransplant contact between a donor family and the organ recipient are disputed. In this study far more contacters reported benefits rather than disadvantages and noncontacters reported the opposite. The dissatisfaction of noncontacters with no contact was high: no less than 60% wanted some form of contact in the future. The authors conclude that contact has more benefits for the donor family than disadvantages, evidenced by families' desire to maintain contact with the organ recipient. Both donor families and organ recipients need the transplant coordinator's initiative and guidance on this issue.

  8. Organ utilization from increased infectious risk donors: An observational study. (United States)

    L'Huillier, Arnaud G; Humar, Atul; Payne, Clare; Kumar, Deepali


    Donors with an increased risk of transmitting human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV) (increased risk donors [IRDs]) are a potential source of organs for transplant. Organs from IRDs can be utilized with appropriate recipient consent and post-transplant follow-up. We reviewed the characteristics and utilization of IRDs in our Organ Procurement Organization (OPO) over a 2-year period. Donor information from April 1, 2013 to March 31, 2015 was obtained through the OPO database. Only consented donors were included. Donors were categorized as IRDs according to Health Canada/Canadian Standards Association (CSA) criteria. A total of 494 potential donors were identified, of which 92 (18.6%) were IRDs. Of these, at least one organ was transplanted from 76 (82.6%). Risk factors for IRDs included injection drug user (IDU) (12%), men having sex with men (MSM) (7%), commercial sex worker (CSW) (4%), and incarceration (24%). Fifty-nine percent (253/429) of IRD organs were utilized. The most frequently used organ was kidney, followed by liver. Median number of organs recovered per IRD was 3 (interquartile range: 2-5). Nucleic acid testing (NAT) was performed in 18.5% (17/92) of IRDs. Reasons for NAT were IDU (n = 2), MSM (n = 2), CSW (n = 2), and previous incarceration (n = 7). Organ utilization from donors that had NAT was similar to donors who did not (94% vs 80%, P = .29). Follow-up NAT was done in infectious risk from such organs. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Xenotransplantation: A Potential Solution to the Critical Organ Donor Shortage

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    K Howe Sim


    Full Text Available The success of allotransplantation as a treatment for end-stage organ failure has resulted in the need for an increasing number of organ donors. Attempts to meet this need include the use of organs from living related and unrelated donors, financial or other incentives for the donor family, and even the reuse of transplanted organs. Despite these initiatives, the supply of organs for transplantation still falls far short of the demand, as evidenced by longer waiting times for transplantation and decreasing transplantation rates. Even if Canada were able to increase its organ donor rate to that of Spain (40 to 50/million, where organ donation is governed by ‘presumed consent’ legislation, this would not alleviate the problem of donor shortage. Interest in xenotransplantation stems from the need to overcome this increasingly severe shortage of human organs. Indeed, some argue that xenotransplantation is the only potential way of addressing this shortage. As immunological barriers to xenotransplantation are better understood, those hurdles are being addressed through genetic engineering of donor animals and the development of new drug therapies. However, before xenotransplantation can be fully implemented, both the scientific/medical communities and the general public must seriously consider and attempt to resolve the many complex ethical, social and economic issues that it presents.

  10. Increasing Organ Donor Registration in a Primary Care Clinic. (United States)

    Natt, Navneet; Klar, Erin; Cheung, Ingrid; Matharu, Pavan; Bordman, Risa


    Only 30% of Ontarians are registered organ donors in spite of the vast unmet need for organ donations in Ontario, Canada. The purpose of this quality improvement (QI) initiative was to increase the number of registered organ donors in a primary care practice by providing an educational fact sheet and registration form to patients in the clinic's waiting room. Three Plan-Do-Study-Act (PDSA) cycles were conducted. In the first PDSA cycle, we created an information sheet to explain the need for organ donors and the registration process. Nine patients were surveyed regarding the clarity of the information sheet, which resulted in subsequent modification of the information sheet prior to the second PDSA cycle. For the second cycle, the revised information sheet was attached to a donor registration form and distributed to 30 patients in the primary care practice over a two-week period. 23 forms were returned, in which 4 patients were already registered organ donors and 5 patients completed registration forms. In the third PDSA cycle, a more compelling graphic was used on the pamphlet. Similarly, 30 forms were distributed; 23 forms were returned, with 6 newly completed registration forms. Overall, the project increased the donor registration rate from 10.0% to 28.3%. The process allowed patients to become more knowledgeable about organ donation need and aware of the Trillium Gift of Life website. We believe that providing patients with an information pamphlet and registration form in the clinic waiting room enhanced their awareness of organ donation and facilitated registration without delay. This QI initiative represents an effective and practical study to increase donor knowledge and provide opportunities for interested individuals to become registered organ donors.

  11. Donor safety in living donor liver transplantation: The Korean organ transplantation registry study. (United States)

    Lee, Jae Geun; Lee, Kwang-Woong; Kwon, Choon Hyuck David; Chu, Chong Woo; Kim, Bong-Wan; Choi, Dong Lak; You, Young Kyoung; Kim, Dong-Sik; Nah, Yang Won; Kang, Koo Jeong; Choi, In Soek; Yu, Hee Chul; Hong, Geun; Han, Ho-Seong; Hwang, Shin; Kim, Myoung Soo


    Major concerns about donor safety cause controversy and limit the use of living donor liver transplantation to overcome organ shortages. The Korean Organ Transplantation Registry established a nationwide organ transplantation registration system in 2014. We reviewed the prospectively collected data of all 832 living liver donors who underwent procedures between April 2014 and December 2015. We allocated the donors to a left lobe group (n = 59) and a right lobe group (n = 773) and analyzed the relations between graft types and remaining liver volumes and complications (graded using the Clavien 5-tier grading system). The median follow-up was 19 months (range, 10-31 months). During the study period, 553 men and 279 women donated livers, and there were no deaths after living liver donation. The overall, biliary, and major complication (grade ≥ III) rates were 9.3%, 1.7%, and 1.9%, respectively. The graft types and remaining liver volume were associated with significantly different overall, biliary, and major complication rates. Of the 16 patients with major complications, 9 (56.3%) involved biliary complications (2 biliary strictures [12.5%] and 7 bile leakages [43.8%]). Among the 832 donors, the mean aspartate transaminase, alanine aminotransferase, and total bilirubin levels were 23.9 ± 8.1 IU/L, 20.9 ± 11.3 IU/L, and 0.8 ± 0.4 mg/dL, respectively, 6 months after liver donation. In conclusion, biliary complications were the most common types of major morbidity in living liver donors. Donor hepatectomy can be performed successfully with minimal and easily controlled complications. Our study shows that prospective, nationwide cohort data provide an important means of investigating the safety in living liver donation. Liver Transplantation 23 999-1006 2017 AASLD. © 2017 by the American Association for the Study of Liver Diseases.

  12. The donor advocacy team: a risk management program for living organ, tissue, and cell transplant donors. (United States)

    Eguchi, Susumu; Soyama, Akihiko; Nagai, Kazuhiro; Miyazaki, Yasushi; Kurihara, Shintaro; Hidaka, Masaaki; Ono, Shinichiro; Adachi, Tomohiko; Natsuda, Koji; Hara, Takanobu; Fujita, Fumihiko; Kanetaka, Kengo; Takatsuki, Mistuhisa


    Although the incidence of living donor death is low in Japan, statistics show one living liver donor death in more than 7000 living liver transplants. Thus, medical transplant personnel must recognize that the death of a living organ or tissue transplant donor can occur and develop an appropriate risk management program. We describe how Nagasaki University Hospital established and implemented a Donor Advocacy Team (DAT) program: a risk management program for initiation in the event of serious, persistent, or fatal impairment of an organ, tissue, or cell transplantation from a living donor. The purposes of the DAT program are as follows: 1. To disclose official information without delay. 2. To provide physical and psychological care to the patient experiencing impairment and their family. 3. To provide psychological care to the medical staff in charge of the transplant. 4. To standardize the responses of the diagnosis and treatment department staff and other hospital staff. 5. To minimize the damage that the whole medical transplantation system may suffer and leverage the occurrence for improvement. To address (1) and (5), actions, such as reporting and responses to the government, mass media, transplant-related societies, and organ transplant networks, have been established to ensure implementation.

  13. The influence of donor factors on corneal organ culture contamination. (United States)

    Gruenert, Anja K; Rosenbaum, Katja; Geerling, Gerd; Fuchsluger, Thomas A


    To evaluate the contamination rate and the corresponding spectrum of microbes and to identify donor risk factors for corneal organ culture contaminations. A total of 3306 organ-cultured donor corneas were included in the study. We performed a retrospective database analysis to evaluate donor factors such as gender, age, death-to-explantation interval (DEI), procurement site and cause of death and to determine their influence on donor cornea contaminations. Odds ratios (ORs) were calculated for each factor. The overall contamination rate was 7.8% (n = 259). Younger donor age (OR: 2.2, p = 0.003, chi-squared test), a DEI of more than 24 hr (OR: 1.6, p cultured cornea based on specific donor factors. However, donors with risk factors should not be generally excluded from cornea donation. Further studies including antibiograms might clarify whether a change in the antibiotic composition of the culture medium would be useful to deal with the increasing number of multi-resistant microbes. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  14. 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.

  15. Improving Organ Donor Registration Using Kiosks in Primary Care Clinics (United States)

    Salim, Ali; Berry, Cherisse; Ley, Eric J.; Schulman, Danielle; Anderson, Jacqueline; Navarro, Sonia; Zheng, Ling; Chan, Linda S.


    Objective: In the USA, organ donor shortage is especially pronounced among minority ethnic populations such as Hispanics, who are 60% less likely to donate compared to non-Hispanic Whites. Recent evidence suggests that US Hispanics may consent to organ donation via a registry within a doctor's office. The objective of this study was to investigate…

  16. 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.

  17. The live donor assessment tool: a psychosocial assessment tool for live organ donors. (United States)

    Iacoviello, Brian M; Shenoy, Akhil; Braoude, Jenna; Jennings, Tiane; Vaidya, Swapna; Brouwer, Julianna; Haydel, Brandy; Arroyo, Hansel; Thakur, Devendra; Leinwand, Joseph; Rudow, Dianne LaPointe


    Psychosocial evaluation is an important part of the live organ donor evaluation process, yet it is not standardized across institutions, and although tools exist for the psychosocial evaluation of organ recipients, none exist to assess donors. We set out to develop a semistructured psychosocial evaluation tool (the Live Donor Assessment Tool, LDAT) to assess potential live organ donors and to conduct preliminary analyses of the tool's reliability and validity. Review of the literature on the psychosocial variables associated with treatment adherence, quality of life, live organ donation outcome, and resilience, as well as review of the procedures for psychosocial evaluation at our center and other centers around the country, identified 9 domains to address; these domains were distilled into several items each, in collaboration with colleagues at transplant centers across the country, for a total of 29 items. Four raters were trained to use the LDAT, and they retrospectively scored 99 psychosocial evaluations conducted on live organ donor candidates. Reliability of the LDAT was assessed by calculating the internal consistency of the items in the scale and interrater reliability between raters; validity was estimated by comparing LDAT scores between those with a "positive" evaluation outcome and "negative" outcome. The LDAT was found to have good internal consistency, inter-rater reliability, and showed signs of validity: LDAT scores differentiated the positive vs. negative outcome groups. The LDAT demonstrated good reliability and validity, but future research on the LDAT and the ability to implement the LDAT prospectively is warranted. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

  18. Extracorporeal membrane oxygenation support of donor abdominal organs in non-heart-beating donors. (United States)

    Ko, W J; Chen, Y S; Tsai, P R; Lee, P H


    Both family consent and legal consent were required for organ/tissue donation from non-heart-beating donors (NHBD) in Taiwan. A district attorney had to come to the bedside to confirm the donor's asystole, confirm the family consent, and complete some legal documents before a legal consent was issued for organ donation. The resultant warm ischemic time would be unpredictably long and in fact precluded the organ donation from NHBD in Taiwan. We developed a method of using extracorporeal membrane oxygenation (ECMO) to maintain NHBD for a longer time and prevent warm ischemic injury of the donor abdominal organs. After ventilator disconnection in NHBD, phentolamine and heparin were injected and mannitol infusion was given. After the donor's asystole was confirmed by the electrocardiogram (EKG) strip recording, the ECMO support was set up through the right femoral veno-arterial route, an occlusion balloon catheter was inserted through the left femoral artery to occlude the thoracic aorta, and bilateral femoral arteries were ligated. Usually, the ECMO could begin within 10 min after the donor's asystole. The ECMO, combined with a cooler, provided cold oxygenated blood to the abdominal visceral organs, and prevented their warm ischemic injuries. Under the ECMO support (range: 45-70 min), eight renal grafts were procured from 4 NHBD. With the exception of the first two renal grafts with delayed function, all others had immediate function postoperatively and dialysis was no longer needed. In conclusion, by our ECMO technique, NHBD could be maintained for a longer time and the renal grafts had better immediate postoperative function than those reported by other methods.

  19. Dithienosilolothiophene: A New Polyfused Donor for Organic Electronics

    KAUST Repository

    Schroeder, Bob C.


    We report the synthesis of a novel pentacyclic donor moiety, dithienosilolothiophene, and its incorporation into low bandgap semiconducting polymers. The unique geometry of this new donor allowed attaching four solubilizing side chains on the same side of the fused ring system, thus ensuring sufficient solubility when incorporated into conjugated polymers while simultaneously reducing the steric hindrance between adjacent polymer chains. The optoelectronic properties of three new polymers comprising the novel pentacyclic donor were investigated and compared to structurally similar thieno[3,2-b]thienobis(silolothiophene) polymers. Organic solar cells were fabricated in order to evaluate the new materials’ potential as donor polymers in bulk heterojunction solar cells and gain further insight into how the single-sided side-chain arrangement affects the active layer blend morphology.

  20. Blood-borne viral infections among blood, organ and tissue donors

    Directory of Open Access Journals (Sweden)

    M. Sh. Khubutiya


    Full Text Available The article presents an actual information on the detection rate of blood-borne viral infections (BBVI among blood donors, potential organ and tissue donors in Russia and other countries. The causes of differences in BBVI prevalence between blood donors and potential organ and tissue donors have been analyzed. The BBVI prevalence among potential organ donors was proved to be much higher than among blood donors due to their medical-and-social characteristics.

  1. Higher refusal rates for organ donation among older potential donors in the Netherlands: impact of the donor register and relatives.

    NARCIS (Netherlands)

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


    BACKGROUND: The availability of donor organs is considerably reduced by relatives refusing donation after death. There is no previous large-scale evaluation of the influence of the Donor Register (DR) consultation and the potential donor's age on this refusal in The Netherlands. METHODS: This study

  2. Combat organ trafficking – reward the donor or regulate sales

    Directory of Open Access Journals (Sweden)

    M. Slabbert


    Full Text Available There is an acute shortage of transplantable human organs worldwide. The current systems of organ procurement cannot supply in the demand. A new approach is imperative. While countries struggle to find ways of motivating more people to become organ donors, the international illegal black market is thriving. A possible solution to the problem in South Africa might be to change current legislation by confirming human organ trafficking a specific crime as is the case in the United Kingdom. However, more available organs for transplantation in the current recognised system are also essential. To achieve this, it is proposed that donors should be rewarded more effectively, or a regulated market in human organs should be allowed.

  3. 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 ...

  4. CHAPTER 3. High-performance Organic Photovoltaic Donor Polymers

    KAUST Repository

    Wadsworth, Andrew


    The field of organic photovoltaics has advanced a great deal over the last decade, with device efficiencies now exceeding 11%. A large part of this success can be attributed to the development of donor polymer materials, from their humble beginnings as homopolymers to the highly tuned push-pull copolymer and terpolymer materials that are now being reported on a regular basis. Through the careful use of chemical modification, it has been possible to design and synthesize a wide variety of donor polymers, allowing optimization of both the optoelectronic and structural properties of the materials. In doing so, more favourable active layer blends have been achieved and therefore significant improvements in device performance have been observed. Herein we discuss how the chemical design of donor polymers for organic photovoltaics has led to the emergence of high-performance materials.

  5. Assessment Methods of Quality of Life of Living Organ Donors

    Directory of Open Access Journals (Sweden)

    S. V. Gautier


    Full Text Available The study of quality of life of living organ donors in transplantation by questionnaires has increasingly become the subject of clinical studies. However, there are no unified criteria and standard norms of quality of life. Each questionnaire has its own criteria and evaluation scale. This review presents the main general questionnaires that have been applied worldwide for the quality of life assessment of living kidney and liver donors. Special questionnaires used to refine the parameters of quality of life and their coordination with common questionnaires are considered. Optimal questionnaire to detect quality of life in modern research for living organ donors is identified.

  6. The first non-heart-beating organ donor in Hawaii--medical and ethical considerations. (United States)

    Cheung, A H; Kailani, H K; Limm, W M


    The shortage of organ donors remains a major obstacle in transplantation in Hawaii. Some patients die while waiting for a life-saving organ. Across the nation, "marginal" donors, including non-heart-beating donors are used. The authors describe the first successful non-heart-beating organ donor transplant in Hawaii, and include medical and ethical considerations.

  7. Tissue Banking: Relationship with Blood Donor and Organ Donor Card Status


    McKenzie, Kenneth D.; Fitzpatrick, Patricia E.; Sheehan, John D.


    Understanding the relationships among altruistic health acts may serve to aid therapeutic research advances. In this paper, we report on the links between two such behaviours—donating blood and carrying an organ donor card—and willingness to donate urological tissue to a tissue bank. Reasons for the differential willingness to do so are examined in this paper. A systematic sample of 259 new and returning attendees at a tertiary urology referral clinic in Ireland completed a self-report questi...

  8. [Computed tomography as a tool to detect potential brain-dead donors]. (United States)

    Revuelto-Rey, Jaume; Aldabó-Pallás, Teresa; Egea-Guerrero, Juan José; Vilches-Arenas, Ángel; Lara, Enrique Javier; Gordillo-Escobar, Elena


    To assess the ability of urgent head computed tomography (CT) scan screening to detect patients who can evolve to brain death (BD). Patients who underwent urgent head CT scan and meet the following criteria: midline shift greater than 5mm and/or decrease or absence of basal cisterns. A follow-up for 28 days of each patient was made. Epidemiological data (sex, age, cause of brain injury), clinical data (level of consciousness, severity index in the CT) and patient outcomes (death, BD, discharge or transfer) were recorded. This was a prospective observational study. One hundred and sixty-six patients were selected for study, with mean age 60.08 (SD 21.8) years. A percentage of 49.4 were men and the rest women. In the follow-up, 20,5% (n=34) had BD. In univariate analysis, intracerebral hemorrhage, Glasgow Coma Scale score less than 8 and alteration of basal cisterns were statistically significant in predicting BD (P<.05). Multivariate analysis showed that patients with compression of basal cisterns were 20 (95% confidence interval [95% CI] 2.61 to 153.78; P=.004] times more likely to progress to brain death, while the absence there of 62.6 (95% CI 13.1 to 738.8; P<.001] times more. Our work shows that data as easy to interpret as compression/absence of basal cisterns can be a powerful tool for screening patients at risk for progression to BD. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  9. Priority to organ donors: Personal responsibility, equal access and the priority rule in organ procurement

    DEFF Research Database (Denmark)

    Albertsen, Andreas


    In the effort to address the persistent organ shortage it is sometimes suggested that we should incentivize people to sign up as organ donors. One way of doing so is to give priority in the allocation of organs to those who are themselves registered as donors. Israel introduced such a scheme...... recently and the preliminary reports indicate increased donation rates. How should we evaluate such initiatives from an ethical perspective? Luck egalitarianism, a responsibility-sensitive approach to distributive justice, provides one possible justification: Those who decide against being organ donors...

  10. Higher refusal rates for organ donation among older potential donors in the Netherlands: impact of the donor register and relatives. (United States)

    van Leiden, Hendrik A; Jansen, Nichon E; Haase-Kromwijk, Bernadette J J M; Hoitsma, Andries J


    The availability of donor organs is considerably reduced by relatives refusing donation after death. There is no previous large-scale evaluation of the influence of the Donor Register (DR) consultation and the potential donor's age on this refusal in The Netherlands. This study examines 2101 potential organ donors identified in intensive care units between 2005 and 2008 and analyzes the association of DR consultation and subsequent refusal by relatives and the relationship with the potential donor's age. Of the 1864 potential donor cases where the DR was consulted, the DR revealed no registration in 56%, 20% registration of consent, and 18% objection. In the other 6.5% of cases, where the DR indicated that relatives had to decide, the relatives' refusal rate was significantly lower than in the absence of a DR registration (46% vs. 63%). In 6% of the cases where the DR recorded donation consent, relatives still refused donation. DR registration, objection in the DR, and the relatives' refusal rate if the DR was not decisive increased with donor age. Despite the introduction of a DR, relatives still play an equally important role in the final decision for organ donation. The general public should be encouraged to register their donation preferences in the DR and also to discuss their preferences with their families. The higher refusal rate of older potential donors means that this group should receive more information about organ donation, especially because the cohort of available donors is ageing.

  11. Are Brain Dead Individuals Dead? Grounds for Reasonable Doubt


    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 organizat...

  12. Do incentives matter? Providing benefits to families of organ donors. (United States)

    Bryce, C L; Siminoff, L A; Ubel, P A; Nathan, H; Caplan, A; Arnold, R M


    Whether the number of organs available for transplant would be positively or negatively affected by providing benefits to families of organ donors has been debated by policymakers, ethicists and the transplant community at large. We designed a telephone survey to measure public opinion regarding the use of benefits in general and of five types in particular: funeral benefits, charitable contributions, travel/lodging expenses, direct payments and medical expenses. Of the 971 adults who completed the survey (response rate = 69%), all were from Pennsylvania households, 45.6% were registered organ donors, and 51.7% were nonwhite. Although 59% of respondents favored the general idea of incentives, support for specific incentives ranged from 53% (direct payment) to 84% (medical expenses). Among those registered as donors, more nonwhites than whites supported funeral benefits (88% vs. 81%; p = 0.038), direct payment (63% vs. 41%; p donation but would influence the behavior of others. While benefits appear to be favored, their true impact can only be assessed through pilot programs.

  13. Factors relating to consent for organ donation: prospective data on potential organ donors. (United States)

    Marck, C H; Neate, S L; Skinner, M R; Dwyer, B M; Hickey, B B; D'Costa, R; Weiland, T J; Jelinek, G A


    Obtaining family consent to organ donation is a significant obstacle to improving further Australian deceased organ donation rates. Currently, neither the consent rates for donors eligible to donate after circulatory death, nor factors that influence decision to decline or consent to donation in general are known in Australia. This study at four university teaching hospitals in Melbourne, Victoria, examined consecutive patients where organ donation was discussed with the family A total of 123 cases were identified; the family consent rate was 52.8%, and 34.1% proceeded to donation. Consent to donation was related to potential donor factors such as country of birth, cultural background in Australia, a non-religious or Christian background and registration on the Australian Organ Donor Register. Family-related factors included being English speaking and having knowledge of the deceased's wishes about organ donation. Family of donation after circulatory death-eligible donors were less likely to consent to donation than the family of donation after brain death-eligible donors, although not reaching statistical significance. Among consented potential donors, those eligible for donation after brain death and with a shorter length of stay were more likely to proceed to donating organs for transplantation. Despite a small sample size, these findings describe current consent and donation rates and associated factors and may assist in improving conversations about organ donation. © 2014 Royal Australasian College of Physicians.

  14. Liver transplantation utilizing old donor organs: a German single-center experience. (United States)

    Rauchfuss, F; Voigt, R; Dittmar, Y; Heise, M; Settmacher, U


    Due to the current profound lack of suitable donor organs, transplant centers are increasingly forced to accept so-called marginal organs. One criterion for marginal donors is the donor age >65 years. We have presented herein the impact of higher donor age on graft and patient survival. Since 2004, 230 liver transplantations have been performed at our center, including 54 donor organs (23.5%) from individuals >65 years of age. We performed a retrospective analysis of recipient and graft survivals. The overall 1-year mortality was 22.2% (12/54) among recipients of organs from older donors versus 19.5% among recipients whose donors were organs were grouped according to age, the 1-year mortality in patients receiving organs from donors aged 65-69 years was 30% (6/20); 70-74 years, 29.4% (5/17); and donors >75 years, 5.9% (1/17). There was no significant correlation between mortality rate and the number of additional criteria of a marginal donor organ. The current lack of donor organs forces transplant centers to accept organs from older individuals; increasingly older patients are being recruited for the donor pool. Our results showed that older organs may be transplanted with acceptable outcomes. This observation was consistent with data from the current literature. It should be emphasized, however, that caution is advised when considering the acceptance of older organs for patients with hepatitis C-related cirrhosis.

  15. Organ donor shortage in the Netherlands : definition of the potential donor pool and the role of family refusal

    NARCIS (Netherlands)

    Frazer-Jansen, N.E.


    The shortage of post-mortem organ donors in the Netherlands is a prominent problem for patients on the waiting list for organ transplantation. As long as there is a shortage of suitable organs for transplantation, the need to identify bottlenecks in the organ donation process is crucial to further

  16. A pilot program to evaluate deceased donor disease transmission risk: the New York Organ Donor Network Infectious Disease Working Group. (United States)

    Pellett Madan, Rebecca; Delli Carpini, Kristin; Huprikar, Shirish; Lerner, Harvey; Patel, Gopi; Ratner, Lloyd E; Goldstein, Michael J; Herold, Betsy C


    Recent cases of donor-derived infections raise the question of how best to screen donors without excessive restriction of the donor pool. The New York Organ Donor Network (NYODN) established an Infectious Diseases Working Group (IDWG) in 2008, which established an on-call schedule of voluntary transplant infectious disease physicians to provide remote evaluations for donors at increased risk for disease transmission. Data were reviewed from 40 available IDWG evaluations from 2008 to 2011. Eighteen cases (45%) were considered to be at unacceptable risk for infection transmission. Sixteen of these cases were excluded from donation secondary to IDWG recommendation; there was limited recipient center interest in the remaining two cases. Approximately 22 (55%) cases were categorized by the IDWG as acceptable, with 14 proceeding to recovery of 49 organs. IDWG physician recommendations were conveyed to recipient centers, and screening guidelines for donors were revised based on the IDWG experiences. Establishment of a donation service area disease transmission evaluation service is a valuable program for donor screening and may promote dissemination of more detailed donor information to recipient centers.

  17. Effect of Organ Scandal on Corneal Donation Rate and Organ Donors at a German University Hospital. (United States)

    Röck, Daniel; Petersen, Peter; Yoeruek, Efdal; Thaler, Sebastian; Bartz-Schmidt, Karl Ulrich; Röck, Tobias


    BACKGROUND The purpose of this study was to assess the effect of an organ transplantation scandal on the rate of corneal donations and organ donors at the University Hospital Tübingen. MATERIAL AND METHODS Data from all hospital deaths from January 2012 to December 2013 were analyzed retrospectively. Each deceased patient was considered as a potential corneal donor. The corneal donor procurement was handled by an ophthalmic resident on a full-time basis with standard used unchanged set of procedures. Each patient who died due to cerebral complications was considered as a potential organ donor. During the two-year period, a German transplantation scandal occurred at the end of 2012 and received worldwide attention. The rates of corneal donation and organ donation in 2012 and 2013 were examined and evaluated. RESULTS Among the 1685 deceased patients, approval for corneal donation was received in 220 cases (13.1%): 124 cases (15.0%) in 2012 and 96 cases (11.2%) in 2013. This corresponds to a decline of 23%. The leading causes of nonfulfillment of corneal donations were refusal to donation: 401 cases (48.4%) in 2012 and 445 cases (52.0%) in 2013; and medical contraindications: 201 cases (24.2%) in 2012 and 212 cases (24.8%) in 2013. During the two-year period, consent for organ donation was obtained in 25 cases (1.5%): 15 cases (1.8%) in 2012 and 10 cases (1.2%) in 2013. The number of realized organ donors was 20 cases (1.2%): 12 cases (1.4%) in 2012 and 8 cases (0.9%) in 2013. This corresponds to a decline of 33%. CONCLUSIONS After a transplantation scandal, the number of realized corneal donors and realized organ donors decreased significantly. It seems that increasing professional performance is very important to gaining trust inside and outside the hospital and improving corneal and organ donation rate.


    Directory of Open Access Journals (Sweden)

    S. V. Gautier


    Full Text Available The paper analyzes the nature of psychological adaptation and rehabilitation of patients, recipients of solid organs. The results of the clinical and psychological work with patients, recipients of donor organs, carried out in theSverdlovskRegionalClinicalHospital№ 1 are shown. Special attention has been paid to the study of motivation as the main psychological factor in the process of adaptation and rehabilitation. We have also shown the infl uence of body image and self-evaluation on the emotional state of patients after the operation. Special stress is laid on the significance of psychological factors which improve the quality of the patient’s life. The main principles and the system of psychological rehabilitation are presented. 

  19. HIV+ deceased donor referrals: A national survey of organ procurement organizations. (United States)

    Cash, Ayla; Luo, Xun; Chow, Eric K H; Bowring, Mary Grace; Shaffer, Ashton A; Doby, Brianna; Wickliffe, Corey E; Alexander, Charles; McRann, Deborah; Tobian, Aaron A R; Segev, Dorry L; Durand, Christine M


    HIV-infected (HIV+) donor organs can be transplanted into HIV+ recipients under the HIV Organ Policy Equity (HOPE) Act. Quantifying HIV+ donor referrals received by organ procurement organizations (OPOs) is critical for HOPE Act implementation. We surveyed the 58 USA OPOs regarding HIV+ referral records and newly discovered HIV+ donors. Using data from OPOs that provided exact records and CDC HIV prevalence data, we projected a national estimate of HIV+ referrals. Fifty-five (95%) OPOs reported HIV+ referrals ranging from 0 to 276 and newly discovered HIV+ cases ranging from 0 to 10 annually. Six OPOs in areas of high HIV prevalence reported more than 100 HIV+ donor referrals. Twenty-seven (47%) OPOs provided exact HIV+ referral records and 28 (51%) OPOs provided exact records of discovered HIV+ cases, totaling 1450 HIV+ referrals and 39 discovered HIV+ donors in the prior year. These OPOs represented 67% and 59% of prevalent HIV cases in the USA; thus, we estimated 2164 HIV+ referrals and 66 discovered HIV+ cases nationally per year. OPOs reported a high volume of HIV+ referrals annually, of which a subset will be medically eligible for donation. Particularly in areas of high HIV prevalence, OPOs require ongoing support to implement the HOPE Act. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. The dead donor rule: can it withstand critical scrutiny? (United States)

    Miller, Franklin G; Truog, Robert D; Brock, Dan W


    Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)-the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured.

  1. Click to "like" organ donation: the use of online media to promote organ donor registration. (United States)

    Stefanone, Michael; Anker, Ashley E; Evans, Melanie; Feeley, Thomas Hugh


    Efforts to promote organ donation have traditionally relied on mass-mediated or interpersonal communication to promote donor registration. Despite its popularity, the use of online media has yet to be carefully evaluated as a platform to promote organ donation. To describe results of an intervention to promote donor registration that relies solely on online media to communicate to target audiences. For 3 years, 6 campaigns were implemented in 3 different online media formats. Online media formats included (1) traditional online advertising, (2) student seeders' social networking sites campaigns, and (3) challenge campaigns. Online media campaigns primarily targeted college-aged individuals.Intervention-Each campaign directed individuals to the dedicated project website, where they could access educational material about donation and request a donor registration card. Unique website visitors, webpages viewed per site visit, time spent on site, and organ donor cards requested/received were tracked in relation to each online media format. Traditional online advertising offered greater message exposure but failed to result in a higher proportion of website visitors who registered their donation intentions. Use of student seeders (ie, motivated students who promote donation by using social networking sites) and challenge campaigns resulted in greater attention to the project website, donor card requests, and subsequent returns. Additional research is recommended to reveal the effect of combining 2 or more varying online media formats within a single campaign.

  2. 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.

  3. Using a standardized donor ratio to assess the performance of organ procurement organizations. (United States)

    Stogis, Sheryl; Hirth, Richard A; Strawderman, Robert L; Banaszak-Holl, Jane; Smith, Dean G


    To develop a Standardized Donor Ratio (SDR) as an outcome measure for evaluating the effectiveness of organ procurement organizations (OPOs). All deaths by cause in the United States during 1993-1994 as reported in the Vital Mortality Statistics, Multiple Cause of Death files. The OPO-specific data were provided by the United Network for Organ Sharing (UNOS). Each OPO's expected number of donors was calculated by applying national donation rates to deaths with potential for donation in 24 age, sex, and race cells. The SDR was calculated by dividing the observed number of donors by the expected number. The chi2 tests of the hypothesis that the OPO's performance differed from the national norm of 1.0 were performed. The SDR was compared to the existing performance standard based on the unadjusted number of donors per million live population in the OPO's service area. An ordinary least squares (OLS) regression assessed predictors of the SDR. The SDRs ranged from 0.41 to 1.99. Twenty-nine of 64 OPOs had SDRs significantly different than 1.0. The SDRs were positively associated with the percent of white living population and the number of organ types transplanted per transplant center served by the OPO. The SDRs can be used by Centers for Medicare and Medicaid Services (CMS), UNOS, and OPOs to target quality improvement initiatives, present more accurate comparisons of OPO performance, and develop public policy on the evaluation of the effectiveness of organ procurement efforts.

  4. The role of affect in attitudes toward organ donation and donor-relevant decisions

    NARCIS (Netherlands)

    Berg, H. van de; Manstead, A.S.R.; Pligt, J. van der; Wigboldus, D.H.J.


    We argue that affect plays a vital role in attitudes toward organ donation and that reluctance to become an organ donor is likely to be related to the experience of affective ambivalence. Assessing the affect associated with organ donation could help to predict donor-relevant decisions. Results of a

  5. Organ Donation Registration and Decision-Making Among Current Blood Donors in the Netherlands

    NARCIS (Netherlands)

    Merz, Eva-Maria; van den Hurk, Katja; de Kort, Wim L. A. M.


    Introduction: In the Netherlands, there is a constant shortage in donor organs, resulting in long waiting lists. The decision to register as organ donor is associated with several demographic, cultural, and personal factors. Previous research on attitudes and motivations toward blood and organ

  6. Organ donation registration among current blood donors in The Netherlands. Personal, cultural and network determinants

    NARCIS (Netherlands)

    Merz, E.M.; van den Hurk, Katja; De Kort, Wim L.A.M.


    Introduction: In the Netherlands, there is a constant shortage in donor organs, resulting in long waiting lists. The decision to register as organ donor is associated with several demographic, cultural, and personal factors. Previous research on attitudes and motivations toward blood and organ

  7. Organ donation after circulatory death in a university teaching hospital. (United States)

    Sidiropoulos, S; Treasure, E; Silvester, W; Opdam, H; Warrillow, S J; Jones, D


    Although organ transplantation is well established for end-stage organ failure, many patients die on waiting lists due to insufficient donor numbers. Recently, there has been renewed interest in donation after circulatory death (DCD). In a retrospective observational study we reviewed the screening of patients considered for DCD between March 2007 and December 2012 in our hospital. Overall, 148 patients were screened, 17 of whom were transferred from other hospitals. Ninety-three patients were excluded (53 immediately and 40 after review by donation staff). The 55 DCD patients were younger than those excluded (P=0.007) and they died from hypoxic brain injury (43.6%), intraparenchymal haemorrhage (21.8%) and subarachnoid haemorrhage (14.5%). Antemortem heparin administration and bronchoscopy occurred in 50/53 (94.3%) and 22/55 (40%) of cases, respectively. Forty-eight patients died within 90 minutes and proceeded to donation surgery. Associations with not dying in 90 minutes included spontaneous ventilation mode (P=0.022), absence of noradrenaline infusion (P=0.051) and higher PaO2:FiO2 ratio (P=0.052). The number of brain dead donors did not decrease over the study period. The time interval between admission and death was longer for DCD than for the 45 brain dead donors (5 [3-11] versus 2 [2-3] days; Porgan transplants due to DCD. Introducing a DCD program can increase potential organ donors without reducing brain dead donors. Antemortem investigations appear to be acceptable to relatives when included in the consent process.

  8. Transplantation of organs from deceased donors with meningitis and encephalitis: a UK registry analysis. (United States)

    Trotter, Patrick B; Robb, Matthew; Hulme, William; Summers, Dominic M; Watson, Christopher J E; Bradley, J Andrew; Neuberger, James


    Deceased organ donors, where the cause of death is meningitis or encephalitis, are a potential concern because of the risks of transmission of a potentially fatal infection to recipients. Using the UK Transplant Registry, a retrospective cohort analysis of deceased organ donors in the UK was undertaken to better understand the extent to which organs from deceased donors with meningitis and/or encephalitis (M/E) (of both known and unknown cause) have been used for transplantation, and to determine the associated recipient outcomes. Between 2003 and 2015, 258 deceased donors with M/E were identified and the causative agent was known in 188 (72.9%). These donors provided 899 solid organs for transplantation (455 kidneys and 444 other organs). The only recorded case of disease transmission was from a donor with encephalitis of unknown cause at time of transplantation who transmitted a fatal nematode infection to 2 kidney transplant recipients. A further 3 patients (2 liver and 1 heart recipient) died within 30 days of transplantation from a neurological cause (cerebrovascular accident) with no suggestion of disease transmission. Overall, patient and graft survival in recipients of organs from donors with M/E were similar to those for all other types of deceased organ donor. Donors dying with M/E represent a valuable source of organs for transplantation. The risk of disease transmission is low but, where the causative agent is unknown, caution is required. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. [Factors associated with organ and tissue donation refusal. Prospective study in the West of France]. (United States)

    Noury, Didier; Tuppin, Philippe; Lesant, Jean-Noël; Jourdain, Sylvie; Favière, Elisabeth; Auger, Eric; Pihan, Claude; Boulvard, Armelle


    The refusal to permit organ sampling is of around 30% and is one of the principle causes for the lack of sampling. This study was aimed at establishing the frequency of decisions taken with regard to donations and the factors associated with refusal. A prospective study was conducted between April 2, 2000 and March 31, 2001 in hospitals authorised to perform organ sampling in the Western area of France. For each potential donor identified, a questionnaire was filled in after each interview. A logistical model was used in order to identify the independent and statistical factors associated with the refusal to allow sampling of an organ or tissue. Among the potentials donors, 265 brain dead donors, and 868 donors with ceased heart beats for tissue sampling, were included. The refusal rate was of respectively 32.8 and 45 %. Only 2.4% of potential donors carried cards identifying them as such. While living, the rate of refusal expressed by the two types of potential donors was similar (9%). The brain dead potential donors had more frequently expressed their consent for donation (20.7 vs. 9%). In the organ donors, the interviews were conducted by two persons in only 37.9% of cases, and in 2.4% of cases of potential tissue donors. In the potential organ donors, only those with a card identifying them as such and the hesitations of the family at the start of the interview were significantly associated with a lesser frequency of refusal. In potential tissue donors, the hesitations of the family reduced the refusal rate but age, religious beliefs, death etiology and the person conducting the interview increased it. The encouraging efforts made for the awareness of donation during a person's lifetime must continue and the use of a donor card extended. The development of co-ordination posters in the hospitals would enhance the development of binomial interviews with the families.

  10. Dual kidney transplantation with organs from extended criteria cadaveric donors. (United States)

    D'Arcy, Frank T; O'Connor, Kevin M; Shields, William; Zimmerman, Jose A; Mohan, Ponnusamy; Eng, Molly; Little, Dilly M; Power, Richard; Dorman, Anthony; Hickey, David P


    The critical shortage of kidneys available for transplantation has led to alternate strategies to expand the pool. Transplantation of the 2 kidneys into a single recipient using organs suboptimal for single kidney transplantation was suggested. We assessed results in 24 grafts allocated for dual kidney transplantation vs those in a control group of 44 designated for single kidney transplantation. Each group underwent pretransplant biopsy and recipients were age matched. Dual kidney transplantation was done in 24 of 1,091 transplants (2.1%) from 2001 to 2008. In patients with dual kidney transplant vs single kidney transplant mean recipient age was 60.6 vs 60.8 years, mean HLA-A, B and DR mismatches were 3.3 vs 2.9, and average patient waiting time was 15.6 vs 13.9 months. All grafts were perfused with University of Wisconsin solution with a mean cold ischemia time of 17.9 hours. On donor dual kidney biopsy in the dual kidney transplant vs single kidney transplant group the average fibrosis rate was 30% (range 25% to 45%) vs 25% (range 3% to 40%) and the glomerulosclerosis rate was 17.9% (range 3.2% to 40.7%) vs 7.1% (range 0% to 50%). Good postoperative renal function was noted in 14 dual kidney transplantation cases. Acute tubular necrosis requiring dialysis developed in 5 patients as well as acute rejection in 1. Two dual kidney recipients (8%) died in the postoperative period with no single kidney deaths. One patient underwent bilateral transplantectomy. Mean anesthesia time was longer in the dual group (371 vs 212 minutes). Patient and graft survival was equivalent to that in the control group at 36 months. Careful selection of marginal kidneys based on clinical and histological criteria allows the use of organs that would not ordinarily be sufficient for transplantation with acceptable outcomes. This is a valid strategy to address the organ shortage.

  11. Sex differences in deceased donor organ transplantation rates in the United States. (United States)

    Murugan, Raghavan; Sileanu, Florentina; Wahed, Abdus S; Al-Khafaji, Ali; Singbartl, Kai; Kellum, John A


    Greater numbers of organs transplanted from deceased male donors have been attributed to sex differences in the causes of death. Understanding sex differences in transplantation will help to design interventions to mitigate disparities in transplantation. Using 62,643 deceased donors from the United Network for Organ Sharing data from 1994 through 2005, we estimated sex-specific prevalence of donors, age- and sex-specific transplantation rate, and transplantation by organ type, accounting for donor demographic, clinical, and processes of care variables. There was greater male donor prevalence (58.8%). Age-specific transplantation rates from men were greater for those younger than 35 years (men vs. women, 3.89 vs. 3.56 organs transplanted per donor; Porgans per donor; Ptransplantation was lower from men (2.78 vs. 2.85 organs per donor; Porgans were transplanted from men (adjusted rate ratio, 0.97; 95% confidence interval: 0.96-0.98). Of individual organs, there was a lower rate of lung (20%), liver (1%), and kidney (1%) transplantation from men, whereas there was a lower rate of heart (16%) and pancreas (7%) transplantation from women. Overall, lower transplantation rate from men may be due to unmeasured factors or it could be secondary to biologic differences in organ function. Further research is required to understand sex differences in organ transplantation rates.

  12. Attitudes about organ and tissue donation among the general public and blood donors in Hong Kong. (United States)

    Li, P K; Lin, C K; Lam, P K; Szeto, C C; Lau, J T; Cheung, L; Wong, M; Chan, A Y; Ko, W M


    The cadaveric organ and tissue donation rate in Hong Kong is not satisfactory; 1 million blood donors are registered and more than 300,000 are active. However, the current attitudes toward organ and tissue donation in the general public and blood donors of Hong Kong are unknown. Random general public (n = 1018) and blood donors (n = 1227) of Chinese origin, with age ranging from 16 to 60 years, were interviewed using a standard verified questionnaire that examines attitudes and knowledge of organ and tissue donation. The mean age of the general public and blood donors were 32.6 and 28.9 years, respectively. Of the general public, 44.4% were men and among blood donors, 60% were men. About 56% of both groups thought that organ donation is an obligation of citizens. Blood donors were more aware than the general public about the types of organs that can be donated. When compared with the general public, a significantly higher percentage of blood donors were willing to donate their organs (81% vs 53%), had heard about organ donation cards (98.3% vs 89.5%), and had signed the cards (49.9% vs 22.6%). About 70% of both groups who had signed a card were carrying it. Thirty-nine percent of the general public and 17% of blood donors had not decided whether they would donate. For blood donors, 49.7% were willing to donate their relatives' organs, compared with 41.8% of the general public. Most individuals in both groups would not object to their relatives' decision to donate. About two thirds of individuals in both groups disagreed with the concept of an opt-out law, though only 20% of the general public and 14.4% of blood donors would refuse donation if an opt-out law were in practice. This study shows that blood donors have better knowledge of organ donation and are more willing to donate their organs and sign an organ donation card than the general public. However, a substantial proportion of blood donors have not signed a donor card. It would be useful to design promotion

  13. The utilization of solid organs for transplantation in the setting of infection with multidrug-resistant organisms: an expert opinion. (United States)

    Bishara, Jihad; Goldberg, Elad; Lev, Shaul; Singer, Pierre; Ashkenazi, Tamar; Cohen, Jonathan


    Organ transplantation remains the optimal treatment for many patients suffering from end-stage organ disease. Increasing numbers of patients admitted to intensive care units, among them potential heart-beating, brain-dead organ donors, are exposed to infections with multidrug-resistant organisms, in particular carbapenem-resistant Klebsiella pneumoniae (CR-KP). An extensive literature search failed to reveal any information regarding the eligibility for transplantation of organs from such donors. For this reason, in 2009, the Israel Transplant Center, together with the Israeli Society for Infectious Diseases, established a working group with the intention of developing a national-specific approach to the use of these organs. In this viewpoint article, we present an algorithm based on expert opinion and our clinical experience with a donor who was found to be an asymptomatic carrier of CR-KP. © 2012 John Wiley & Sons A/S.

  14. HIV screening practices for living organ donors, New York State, 2010: need for standard policies. (United States)

    Kwan, Candice K; Al-Samarrai, Teeb; Smith, Lou C; Sabharwal, Charulata J; Valente, Kim A; Torian, Lucia V; McMurdo, Lisa M; Shepard, Colin W; Brooks, John T; Kuehnert, Matthew J


    Our survey of kidney and liver transplant centers in New York State found a wide variation among transplant centers in evaluation and screening for HIV risk and infection among prospective living donors. Survey results underscore the need to standardize practices. A recent transmission of human immunodeficiency virus (HIV) from a living donor to a kidney recipient revealed a possible limitation in existing screening protocols for HIV infection in living donors. We surveyed kidney and liver transplant centers (N = 18) in New York State to assess HIV screening protocols for living donors. Although most transplant centers evaluated HIV risk behaviors in living donors, evaluation practices varied widely, as did the extent of HIV testing and prevention counseling. All centers screened living donors for serologic evidence of HIV infection, either during initial evaluation or ≥1 month before surgery; however, only 50% of transplant centers repeated HIV testing within 14 days before surgery for all donors or donors with specific risk behaviors. Forty-four percent of transplant centers used HIV nucleic acid testing (NAT) to screen either all donors or donors with recognized risk behaviors, and 55% never performed HIV NAT. Results suggest the need to standardize evaluation of HIV risk behaviors and prevention counseling in New York State to prevent acquisition of HIV by prospective living organ donors, and to conduct HIV antibody testing and NAT as close to the time of donation as possible to prevent HIV transmission to recipients.

  15. Being Sherlock Holmes: the Internet as a tool for assessing live organ donors. (United States)

    Bramstedt, Katrina A; Katznelson, Steven


    Donor advocacy is a critical feature of live donor transplantation. Donor Advocates and Donor Advocate Teams (DAT) are now routine to the practice of live donor evaluation in the USA. Multidisciplinary in nature, DATs gather both medical and psychosocial information about potential live organ donors and then render a decision as to whether or not these individuals are suitable to participate. Because of the critical ethical and psychosocial concerns about live donation, thorough donor evaluations are essential. Additionally, the information gathered must be accurate, and this requires honest disclosure by the donor candidate. In this paper, we describe how DATs can use various forms of free, public content available on the Internet to aid live donor assessments. In this way, the DAT assumes somewhat of an investigative role; however, this is ethically justified in light of the DAT duty to protect the donor. The protective effect can also spread to the transplant program, in general, when inappropriate donors are excluded from the donation process.

  16. Expanding the donor pool: regional variation in pediatric organ donation rates. (United States)

    Godown, Justin; McKane, Meghann; Wujcik, Kari; Mettler, Bret A; Dodd, Debra A


    There are limited published data on pediatric organ donation rates. The aim of this study was to describe the trends in pediatric organ donation over time and to assess the regional variation in pediatric deceased organ donation. OPTN data were utilized to assess the trends in pediatric organ donation over time. The number of deceased pediatric organ donors was indexed using regional mortality data obtained from the National Center for Health Statistics and compared across UNOS regions and two different eras. The number of pediatric deceased organ donors has declined in the recent era, largely driven by fewer adolescent donors. For all age groups, there is significant regional variation in organ donation rates, with identifiable high- and low-performing regions. Expansion of the donor pool may be possible by optimizing organ donation in regions demonstrating lower recruitment of pediatric donors. Using the region with the highest donation rate for each age group as the gold standard, we estimate a potential 24% increase in the number of donors if all regions performed comparably, equating to 215 new pediatric donors annually. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Are health professionals responsible for the shortage of organs from deceased donors in Malaysia? (United States)

    Abidin, Zada L Zainal; Ming, Wee Tong; Loch, Alexander; Hilmi, Ida; Hautmann, Oliver


    The rate of organ donations from deceased donors in Malaysia is among the lowest in the world. This may be because of the passivity among health professionals in approaching families of potential donors. A questionnaire-based study was conducted amongst health professionals in two tertiary hospitals in Kuala Lumpur, Malaysia. Four hundred and sixty-two questionnaires were completed. 93.3% of health professionals acknowledged a need for organ transplantation in Malaysia. 47.8% were willing to donate their organs (with ethnic and religious differences). Factors which may be influencing the shortage of organs from deceased donors include: nonrecognition of brainstem death (38.5%), no knowledge on how to contact the Organ Transplant Coordinator (82.3%), and never approaching families of a potential donor (63.9%). There was a general attitude of passivity in approaching families of potential donors and activating transplant teams among many of the health professionals. A misunderstanding of brainstem death and its definition hinder identification of a potential donor. Continuing medical education and highlighting the role of the Organ Transplant Coordinator, as well as increasing awareness of the public through religion and the media were identified as essential in improving the rate of organ donations from deceased donors in Malaysia. © 2012 The Authors Transplant International © 2012 European Society for Organ Transplantation. Published by Blackwell Publishing Ltd.

  18. Donors with a prior history of cardiac surgery are a viable source of lung allografts. (United States)

    Costa, Joseph; Sreekanth, Sowmyashree; Kossar, Alex; Raza, Kashif; Robbins, Hilary; Shah, Lori; Sonett, Joshua R; Arcasoy, Selim; D'Ovidio, Frank


    End-stage lung disease continues to rise despite the lack of suitable lung donors, limiting the numbers of lung transplants performed each year. Expanded donor criteria, use of donation after cardiac death donors and the advent of ex vivo lung perfusion have resulted only in a slight increase in donor lung utilization. Organ donors with prior cardiac surgery (DPCS) present risks and technical challenges; however, they may be a potential source of suitable lung allografts with an experienced procurement surgeon. We present our experience having evaluated potential lung donors with a prior history of cardiac surgery, resulting in successful transplant outcomes. This is a single-institution retrospective review of brain-dead organ donors that were evaluated for lung donation in the period 2012-15. Donor and recipient characteristics were collected. Post-lung transplant survival was recorded. From 2012 to 2015, 259 donors were evaluated, 12 with a prior history of cardiac surgery of which 4 had coronary artery bypass, 3 had aortic root replacement, 2 had aortic valve replacement, 1 pulmonary embolectomy, 1 two-time reoperative valve replacement and 1 paediatric congenital ventricular septal defect repair. DPCS, 6/12 (50% dry run) provided suitable allografts generating six single-lung transplants (three right and three left, 1 donor provided twin single-lung transplants) and one double-lung transplant. Interval between cardiac surgery and procurement for those rejected was median 5840 (IQR 2350-8640) days and interval for the donors that provided allografts was median 438 (IQR 336-1095) days (Mann-Whitney, P = 0.07). Recipient 1-year survival from DPCS is 100%. Recipient 1-year survival was 92% in allografts explanted from donors with no prior cardiac surgery (2012-13). To date, this is the largest single-centre experience using lung allografts from brain-dead DPCS. Our experience shows despite predicted technical difficulties, with good communication between thoracic

  19. Organ Donation From Deceased Donors: A Proactive Detection Program in Saudi Arabia. (United States)

    Shaheen, Faissal A M; Souqiyyeh, Muhammad Ziad; Attar, Besher; Ibrahim, Amal; Alsayyari, Abdulla


    Several challenging obstacles remain to increasing the number of organ donations from deceased patients in a hospital setting. These include medical, administrative, and ethical issues. Possible medical obstacles include the failure of early recognition of possible donors and inadequate care of potential and actual donors. To maximize the use of donated organs, proper care of the donors and expedited donor consent cannot be overemphasized. The care rendered to patients should ensure appropriate perfusion and nutrition of the organs, with meticulous follow-up until organ recovery. For example, patients involved in accidents are presumed to be healthy, but many have no available medical history on file. At the time of organ recovery, unexpected infections or malignancies can be minimized by raising the index of suspicion of the presence of serious conditions in donors, especially in donors with unknown medical history. A careful physical examination and an appropriate and aggressive laboratory investigation may disclose the cause of suspected clinical conditions in these potential donors. Individuals who work in intensive care units are the main group of health care providers directly involved in the process of organ donation. Appointing a donor coordinator in each intensive care unit could improve all aspects of organ donation. Such coordination could harmonize efforts toward the goals mentioned above and surmount the obstacles encountered during deceased-donor organ donation. Here, we describe the preliminary results of the Proactive Detection Program, a collaboration between the Saudi Center for Organ Transplantation (the national organ donation and transplant supervising center) and intensive care units of donating hospitals. With its success in Saudi Arabia, it is hoped that it will be widely adopted in other regions.

  20. Donor-derived Coccidioides immitis fungemia in solid organ transplant recipients. (United States)

    Blodget, E; Geiseler, P Jan; Larsen, R A; Stapfer, M; Qazi, Y; Petrovic, L M


    We report disseminated coccidioidomycosis in 3 transplant recipients from a donor in an endemic area found to have unrecognized meningeal coccidioidomycosis. All 3 transplant recipients presented within 3 weeks of receipt of their organ. Only 1 organ recipient survived the acute presentation of coccidioidomycosis. Serologic testing for Coccidioides immitis infection should be considered for organ donors residing in endemic areas. © 2011 John Wiley & Sons A/S.

  1. A plea for uniform European definitions for organ donor potential and family refusal rates.

    NARCIS (Netherlands)

    Jansen, N.E.; Haase-Kromwijk, B.J.; Leiden, H.A. van; Weimar, W.; Hoitsma, A.J.


    Conversion of potential organ donors to actual donors is negatively influenced by family refusals. Refusal rates differ strongly among countries. Is it possible to compare refusal rates in order to be able to learn from countries with the best practices? We searched in the literature for reviews of

  2. Is Signature Size Associated With Organ Donor Designation on Driver's Licenses? (United States)

    Sehgal, N K R; Sullivan, C; Scallan, C; Figueroa, M; Pencak, J A; Kirkland, J; Scott, K; Thornton, J D


    Previous studies suggest that large signature size is associated with narcissistic characteristics. By contrast, organ donation is an indicator of altruism. Because altruism and narcissism may be viewed as opposites, we sought to determine if smaller signature size is associated with willingness to be an organ donor. Using a cross-sectional study design, we reviewed the health records of 571 randomly selected primary care patients at a large urban safety-net medical system to obtain their demographic and medical characteristics. We also examined driver's licenses that were scanned into electronic health records as part of the patient registration process. We measured signature sizes and obtained the organ donor designation from these driver's licenses. Overall, 256 (45%) patients were designated as donors on their driver's licenses. Signature size averaged 113.3 mm(2) but varied greatly across patients (10th percentile 49.1 mm(2), 90th percentile 226.1 mm(2)). On multivariate analysis, donor designation was positively associated with age 18-34 years, non-black race, having private insurance, and not having any comorbid conditions. However, signature size was not associated with organ donor designation. Signature size is not associated with verified organ donor designation. Further work is needed to understand the relationship between personality types and willingness to be an organ donor. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Live or Let Die?: Fine Margins Between Life and Death in a Brain-Dead Pregnancy. (United States)

    Heywood, Rob


    In PP v Health Service Executive, the Irish High Court was recently asked to decide on the lawfulness of maintaining somatic treatment that was being provided to a brain-dead woman who was 15-weeks pregnant. In delivering judgment, Kearns P held that the treatment should not be maintained and that the artificial support being provided to the woman could lawfully be withdrawn. The legal basis for this ruling, however, is not free from criticism. The focus of this discussion is to consider how an English court would deal with a case similar to this should the need ever arise. There are crucial differences between English and Irish law which could impact upon the reasoning and, quite possibly, the outcome. Given that it is not beyond the realms of possibility that a similar case could occur in England at some point in the future, it is important that a number of legal questions are explored and their implications illuminated. © The Author 2017. Published by Oxford University Press; all rights reserved. For Permissions, please email:

  4. Hospital Characteristics Affect Consent and Conversion Rates for Potential Organ Donors. (United States)

    Ali, Jawad T; Ebadat, Aileen; Martins, Danilo; Ali, Sadia; Horton, Shannon; Coopwood, Thomas B; Brown, Carlos V R


    Consent and conversion rates of potential organ donors in the United States need to be maximized to match the number of individuals awaiting organ donation. Studies to date have not focused on characteristics of centers with better outcomes. We performed an 8-year (2006-2014) retrospective study of our local organ procurement organization database. We categorized hospitals in our region as academic centers versus nonacademic centers, trauma centers versus nontrauma centers, and large (≥400 beds) centers versus small (organ donors. There were 22,732 referrals to our organ procurement organization that resulted in 1,057 eligible deaths. When comparing academic to nonacademic hospitals, academic hospitals had higher consent (71% vs 59%, P organ donors. Small (types of hospitals.

  5. Donor-Derived Coccidioides immitis Endocarditis and Disseminated Infection in the Setting of Solid Organ Transplantation. (United States)

    Nelson, Joanna K; Giraldeau, Genevieve; Montoya, Jose G; Deresinski, Stan; Ho, Dora Y; Pham, Michael


    Background.  Endocarditis is a rare manifestation of infection with Coccidioides. This is the first reported case of donor-derived Coccidioides endocarditis obtained from a heart transplant. Methods.  We present a unique case of donor-derived Coccidioides immitis endocarditis and disseminated infection in a heart transplant patient. We also conducted a review of the literature to identify other cases of donor-derived coccidioidomycosis in solid organ transplant recipients and reviewed their clinical characteristics. Results.  Fifteen prior cases of donor-derived coccidioidomycosis were identified. A majority of these cases were diagnosed by positive culture (83%). Mortality was high at 58%. Conclusions.  Clinicians should maintain a high index of suspicion for disseminated coccidioidomycosis in patients who received transplants with organs from donors with a history of residing in endemic regions.

  6. Challenges to research and innovation to optimize deceased donor organ quality and quantity. (United States)

    Abt, P L; Marsh, C L; Dunn, T B; Hewitt, W R; Rodrigue, J R; Ham, J M; Feng, S


    Solid organ transplantation is encumbered by an increasing number of waitlisted patients unrequited by the current organ supply. Preclinical models suggest that advances in deceased donor management and treatment can increase the quantity and quality of organs available for transplantation. However, the science of donor intervention and the execution of high quality, prospective, multi-center, randomized-controlled trials are restricted by a myriad of logistical challenges mired in regulatory and ethical ambiguity. By highlighting the obstacles to conducting research in deceased donors, this report endeavors to stimulate the creation of a multi-disciplinary framework to facilitate the design, implementation and supervision of innovative trials that increase the quantity and/or quality of deceased donor organs. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

  7. Impact of a Full-Time Donor Management Protocol on Donors' Liver Biopsy Findings: Progress to Date. (United States)

    Mojtabaee, Meysam; Shamsaeefar, Alireza; Gholami, Siavash; Mohsenzadeh, Mojtaba; Sadegh Beigee, Farahnaz


    This study investigated a fixed coordinator-directed donor management strategy's impact on donated liver quality, as determined by definitive biopsy results. We collected donated liver biopsy results from donations both before and after implementing a fixed coordinator-directed donor management strategy. This strategy involved full-time attendance by a donor coordinator and continued resuscitation of brain-dead donors. All donations took place in a single organ procurement unit. We also followed up results of biopsies from the Liver Transplantation Center database of Namazi Hospital in Shiraz, Iran. We compared biopsy findings of 192 livers donated from 2012 to 2013 (group A) with 276 livers donated from 2015 until August 2016 (group B). Data analysis showed that 67 livers (34.9%) in group A were rejected for transplant owing to severe steatosis in 17 (8.9%), moderate/severe fibrosis in 9 (4.7%), moderate/severe necrosis in 28 (14.6%), and 13 (6.8%) rejected for other pathologies. Among group B livers, 59 (21.4%) were not deemed suitable for transplant owing to severe steatosis in 37 (13.5%), moderate/severe fibrosis in 6 (2.1%), and moderate/ severe necrosis in 16 (5.7%). Overall, steatosis was found in 94 livers (49.2%) in group A versus 175 livers (63.3%) in group B (P = .007). Donor age in group A averaged 36.5 years versus 47.9 years in group B (P = .02). Necrosis was found in 33 livers (17.2%) in group A and 22 livers (7.9%) in group B (P = .008). One-month survival rates were 95.3% and 96.3% for groups A and B (P = .08). Donated liver disqualification before transplant noticeably decreased despite the shift in demographic patterns from 2012 to 2016. In group A, brain-dead liver donors were younger and more often died from trauma, whereas group B donors had more cerebrovascular accident-induced deaths. This achievement took place alongside increased rates of steatosis and decreased rates of necrosis.

  8. Donor corneoscleral rim contamination by gentamicin-resistant organisms

    Directory of Open Access Journals (Sweden)

    Gopinathan Usha


    Full Text Available Gentamicin is the most widely used antibiotic in the decontamination of donor cornea for penetrating keratoplasty. However, the incidence of resistance to gentamicin is on the rise. Bacterial isolates from 178 donor corneal rims were studied for gentamicin sensitivity. The overall rate of gentamicin resistance was 63.4%. At 86.2% the Pseudomonas. species had the highest rate of resistance, followed by Streptococci at 84.6%. The high rate of gentamicin resistance encountered by us and others suggest that either addition of a second antibiotic to corneal storage media or replacement of gentamicin by an antibiotic with a broader spectrum of activity may help reduce the risk of endophthalmitis following penetrating keratoplasty

  9. Should living kidney donors with hypertension be considered for organ donation? (United States)

    Townsend, Raymond R; Reese, Peter P; Lim, Mary Ann


    The large number of end-stage kidney disease patients waiting for a kidney transplant often means years of delay before a suitable organ becomes available. Living kidney donors are one way to circumvent such long waiting times, and the desire to increase the pool of living kidney donors has allowed the selection of donors with hypertension. Hypertensive kidney donors, despite having larger glomeruli, and fewer glomeruli, particularly when over the age of 50 years, do well in follow-up. The data are mainly in white living kidney donors whose preexisting hypertension has been well controlled [blood pressure (BP) donation do as well as nonhypertensive donors as long they are older (age >50 years), nonobese (BMI 26-30 kg/m), and have no evidence of end-organ damage prior to donation. Although the data supporting long-term safety of nephrectomy in hypertensive donors are modest, small studies with short-term follow-up suggest no increase in the incidence of kidney disease or worsening of the control of hypertension in donors with a history of high BP.

  10. Organic Metals. Systematic Molecular Modifications of Hexamethylenetetraheterofulvalene Donors

    DEFF Research Database (Denmark)

    Engler, E. M.; Patel, V. V.; Andersen, Jan Rud


    Two synthetic approaches for modifying hexamethylenetetraheterofulvalene donors are described for the purpose of perturbing in a systematic way the interesting solid state properties of the TCNQ salts of the parent systems. The first approach consists of a steric modification in which a methyl gr...... group is introduced into the outer five-membered rings of the parent molecules. The second type of modification involves an electronic perturbation in which the outer five-membered alkyl rings are replaced with fused thiophene derivatives...

  11. 75 FR 58400 - Donor Management Research: Improvements in Clinical Management of Deceased Organ Donors (United States)


    ... criteria for determination of death are pronounced in a timely manner so that organ donation intentions may... parties within the organ donation and transplant community regarding guidance for a possible grant or... pathway: Either donation after neurologic determination of death or donation after cardiac determination...

  12. When Operating on Dead People Saves Lives: Benefits of Surgical Organ Donor Intensivists. (United States)

    Long, Kristin; Talley, Cynthia; Yarrison, Rebecca B; Bernard, Andrew


    Solid organ transplantation has emerged as a life-saving treatment for many patients suffering from end-stage organ failure. Organs have been successfully recovered after a variety of aggressive interventions. We propose that decompressive laparotomy, when clinically indicated, should be considered in the aggressive resuscitation of potential organ donors. A thorough literature review examining aggressive interventions on potential organ donors was conducted after experience with a unique case at this institution. Articles were reviewed for the types of interventions performed as well as the time frame in relation to organ donation. In our case, several ethical issues were raised when considering decompressive laparotomy in a patient pronounced dead by neurologic criteria. We propose that having a surgical intensivist involved in the management of potential donors will further increase the salvage rate, as more invasive resuscitation options are possible.

  13. When Operating on Dead People Saves Lives: Benefits of Surgical Organ Donor Intensivists

    Directory of Open Access Journals (Sweden)

    Kristin Long


    Full Text Available Solid organ transplantation has emerged as a life-saving treatment for many patients suffering from end-stage organ failure. Organs have been successfully recovered after a variety of aggressive interventions. We propose that decompressive laparotomy, when clinically indicated, should be considered in the aggressive resuscitation of potential organ donors. A thorough literature review examining aggressive interventions on potential organ donors was conducted after experience with a unique case at this institution. Articles were reviewed for the types of interventions performed as well as the time frame in relation to organ donation. In our case, several ethical issues were raised when considering decompressive laparotomy in a patient pronounced dead by neurologic criteria. We propose that having a surgical intensivist involved in the management of potential donors will further increase the salvage rate, as more invasive resuscitation options are possible.

  14. Projections in donor organs available for liver transplantation in the United States: 2014-2025. (United States)

    Parikh, Neehar D; Hutton, David; Marrero, Wesley; Sanghani, Kunal; Xu, Yongcai; Lavieri, Mariel


    With the aging US population, demographic shifts, and obesity epidemic, there is potential for further exacerbation of the current liver donor shortage. We aimed to project the availability of liver grafts in the United States. We performed a secondary analysis of the Organ Procurement and Transplantation Network database of all adult donors from 2000 to 2012 and calculated the total number of donors available and transplanted donor livers stratified by age, race, and body mass index (BMI) group per year. We used National Health and Nutrition Examination Survey and Centers for Disease Control and Prevention historical data to stratify the general population by age, sex, race, and BMI. We then used US population age and race projections provided by the US Census Bureau and the Weldon Cooper Center for Public Service and made national and regional projections of available donors and donor liver utilization from 2014 to 2025. We performed sensitivity analyses and varied the rate of the rise in obesity, proportion of Hispanics, population growth, liver utilization rate, and donation after cardiac death (DCD) utilization. The projected adult population growth in the United States from 2014 to 2025 will be 7.1%. However, we project that there will be a 6.1% increase in the number of used liver grafts. There is marked regional heterogeneity in liver donor growth. Projections were significantly affected by changes in BMI, DCD utilization, and liver utilization rates but not by changes in the Hispanic proportion of the US population or changes in the overall population growth. Overall population growth will outpace the growth of available donor organs and thus potentially exacerbate the existing liver graft shortage. The projected growth in organs is highly heterogeneous across different United Network for Organ Sharing regions. Focused strategies to increase the liver donor pool are warranted. © 2015 American Association for the Study of Liver Diseases.

  15. Perylene-Diimide Based Donor-Acceptor-Donor Type Small-Molecule Acceptors for Solution-Processable Organic Solar Cells (United States)

    Ganesamoorthy, Ramasamy; Vijayaraghavan, Rajagopalan; Sakthivel, Pachagounder


    Development of nonfullerene acceptors plays an important role in the commercial availability of plastic solar cells. We report herein synthesis of bay-substituted donor-acceptor-donor (D-A-D)-type perylene diimide (PDI)-based small molecules (SM-1 to SM-4) by Suzuki coupling method and their use as acceptors in bulk heterojunction organic solar cells (BHJ-OSCs) with poly(3-hexylthiophene) (P3HT) polymer donor. We varied the number of electron-rich thiophene units and the solubilizing side chains and also evaluated the optical and electrochemical properties of the small molecules. The synthesized small molecules were confirmed by Fourier-transform infrared (FT-IR) spectroscopy, nuclear magnetic resonance (NMR) spectroscopy, and high-resolution mass spectroscopy (HR-MS). The small molecules showed extensive and strong absorption in the ultraviolet-visible (UV-Vis) region up to 750 nm, with bandgap (E_{{g}}^{{opt}} ) reduced below polymer donor showed maximum power conversion efficiency (PCE) of 0.19% with V oc of 0.30 V, J sc of 1.72 mA cm-2, and fill factor (FF) of 37%. The PCE decreased with the number of thiophene units. The PCE of SM-2 was lower than that of SM-1. This difference in PCE can be explained by the higher aggregation tendency of the bithiophene compared with the thiophene unit. Introduction of the solubilizing group in the bay position increased the aggregation property, leading to much lower PCE than for the small molecules without solubilizing group.

  16. Perylene-Diimide Based Donor-Acceptor-Donor Type Small-Molecule Acceptors for Solution-Processable Organic Solar Cells (United States)

    Ganesamoorthy, Ramasamy; Vijayaraghavan, Rajagopalan; Sakthivel, Pachagounder


    Development of nonfullerene acceptors plays an important role in the commercial availability of plastic solar cells. We report herein synthesis of bay-substituted donor-acceptor-donor (D-A-D)-type perylene diimide (PDI)-based small molecules (SM-1 to SM-4) by Suzuki coupling method and their use as acceptors in bulk heterojunction organic solar cells (BHJ-OSCs) with poly(3-hexylthiophene) (P3HT) polymer donor. We varied the number of electron-rich thiophene units and the solubilizing side chains and also evaluated the optical and electrochemical properties of the small molecules. The synthesized small molecules were confirmed by Fourier-transform infrared (FT-IR) spectroscopy, nuclear magnetic resonance (NMR) spectroscopy, and high-resolution mass spectroscopy (HR-MS). The small molecules showed extensive and strong absorption in the ultraviolet-visible (UV-Vis) region up to 750 nm, with bandgap (E_{{g}}^{{opt}} ) reduced below energy levels of small molecules SM-1 to SM-4 were suitable for use as electron-accepting materials. The small molecules showed good thermal stability up to 300°C. BHJ-OSCs with SM-1 and P3HT polymer donor showed maximum power conversion efficiency (PCE) of 0.19% with V oc of 0.30 V, J sc of 1.72 mA cm-2, and fill factor (FF) of 37%. The PCE decreased with the number of thiophene units. The PCE of SM-2 was lower than that of SM-1. This difference in PCE can be explained by the higher aggregation tendency of the bithiophene compared with the thiophene unit. Introduction of the solubilizing group in the bay position increased the aggregation property, leading to much lower PCE than for the small molecules without solubilizing group.

  17. Intensive care nurses' perceptions of their professional competence in the organ donor process: a national survey. (United States)

    Meyer, Käthe; Bjørk, Ida Torunn; Eide, Hilde


    This paper is a report of a study that explored Norwegian intensive care nurses' perceptions of their professional competence to identify educational needs in the organ donor process. Intensive care professionals are requested to consider organ donation each time they care for patients with severe cerebral lesion to ensure donor organs for transplantation. The donor process challenges intensive care nurses' professional competence. Nurses' knowledge and experience may influence their professional competence in caring for organ donors and their relatives. METHODS.: A cross-sectional survey was conducted in all 28 Norwegian donor hospitals between October 2008 and January 2009. Intensive care nurses (N = 801) were invited to participate and the response rate was 71·4%. Dimensions of professional competence, learning needs and contextual and demographic variables were explored. Data were analysed using descriptive and inferential statistics. Few intensive care nurses had extensive experience of or competence and training in organ donation. Nurses working at university hospitals had more experience, but lesser training than nurses in local hospitals. Experience of donor acquisition had an impact on intensive care nurses' perceptions of their professional competence in the donor process. Discussions on the ward and educational input were seen as important for the further development of professional competence. Training provided by experienced colleagues and a culture that encourages discussion about aspects of the donor process can develop nurses' professional competence and communally defined professional practice. Educational input that cultivates various types of knowledge can be beneficial in organ donation. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  18. Effect of a specialized pediatric institutional setting on organ recovery from potential donors. (United States)

    Donkin, Marcella; Kolovos, Nikoleta; Checchia, Paul A


    The relationship between accessibility to the full range of subspecialty care available at freestanding pediatric hospitals and organ donor management and recovery rates has not been studied. To examine current rates of recovery of organs from children for transplantation at free-standing pediatric hospitals versus all other hospitals. Data from the hospitals served by Mid-America Transplant Services from January 2000 to July 2003 were reviewed. Organ recovery rates from freestanding children's hospitals were compared with the rates from other types of institutions. Patients were included if their organs were considered medically suitable at the time of referral for donation. Overall, 66% (210/318) of the potential organs were recovered. The type of institution in which the potential donor was managed did not influence the proportion of organs recovered: 67% (96/144) at freestanding children's hospitals versus 66% (114/174) at all other hospitals. A greater proportion of livers were recovered at other donor institutions than at children's hospitals (100% vs 85%, Porgan recovery rate from potential pediatric donors is low. In general, this rate does not appear to be affected by the type of managing pediatric institution except for liver recovery, which favors institutions that are not freestanding children's hospitals. The low rate of recovery suggests that although suitable donors are identified, appropriate referrals are made, and families provide consent for donation, major obstacles remain to the successful recovery of organs.

  19. Time trends in organ donation after neurologic determination of death: a cohort study (United States)

    Kramer, Andreas H.; Baht, Ryan; Doig, Christopher J.


    Background: The cause of brain injury may influence the number of organs that can be procured and transplanted with donation following neurologic determination of death. We investigated whether the distribution of causes responsible for neurologic death has changed over time and, if so, whether this has had an impact on organ quality, transplantation rates and recipient outcomes. Methods: We performed a cohort study involving consecutive brain-dead organ donors in southern Alberta between 2003 and 2014. For each donor, we determined last available measures of organ injury and number of organs transplanted, and compared these variables for various causes of neurologic death. We compared trends to national Canadian data for 2000-2013 (2000-2011 for Quebec). Results: There were 226 brain-dead organ donors over the study period, of whom 100 (44.2%) had anoxic brain injury, 63 (27.9%) had stroke, and 51 (22.6%) had traumatic brain injury. The relative proportion of donors with traumatic brain injury decreased over time (> 30% in 2003-2005 v. 6%-23% in 2012-2014) (p = 0.004), whereas that with anoxic brain injury increased (14%-37% v. 46%-80%, respectively) (p organs transplanted per donor was 3.6 with anoxic brain injury versus 4.5 with traumatic brain injury or stroke (p = 0.002). Interpretation: Anoxic brain injury has become a leading cause of organ donation after neurologic determination of death in Canada. Organs from donors with anoxic brain injury have a greater degree of injury, and fewer are transplanted. These findings have implications for availability of organs for transplantation in patients with end-stage organ failure. PMID:28401114

  20. Time trends in organ donation after neurologic determination of death: a cohort study. (United States)

    Kramer, Andreas H; Baht, Ryan; Doig, Christopher J


    The cause of brain injury may influence the number of organs that can be procured and transplanted with donation following neurologic determination of death. We investigated whether the distribution of causes responsible for neurologic death has changed over time and, if so, whether this has had an impact on organ quality, transplantation rates and recipient outcomes. We performed a cohort study involving consecutive brain-dead organ donors in southern Alberta between 2003 and 2014. For each donor, we determined last available measures of organ injury and number of organs transplanted, and compared these variables for various causes of neurologic death. We compared trends to national Canadian data for 2000-2013 (2000-2011 for Quebec). There were 226 brain-dead organ donors over the study period, of whom 100 (44.2%) had anoxic brain injury, 63 (27.9%) had stroke, and 51 (22.6%) had traumatic brain injury. The relative proportion of donors with traumatic brain injury decreased over time (> 30% in 2003-2005 v. 6%-23% in 2012-2014) ( p = 0.004), whereas that with anoxic brain injury increased (14%-37% v. 46%-80%, respectively) ( p organs transplanted per donor was 3.6 with anoxic brain injury versus 4.5 with traumatic brain injury or stroke ( p = 0.002). Anoxic brain injury has become a leading cause of organ donation after neurologic determination of death in Canada. Organs from donors with anoxic brain injury have a greater degree of injury, and fewer are transplanted. These findings have implications for availability of organs for transplantation in patients with end-stage organ failure.

  1. Care With The Potential Organ Donor In The Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Francisca Patrícia Barreto de Carvalho


    Full Text Available Introduction: Organ transplants have expanded throughout the country, being extremely significant for the population. Objective: To know the reality of organ harvesting and describe the care with the potential organ donor in an Intensive Care Unit (ICU and compare it with the pertinent literature. Method: It is a research of exploratory and descriptive nature, with a qualitative approach. The data were analyzed through the content analysis idealized by Bardin. Results: The findings indicate that the resolution of care and procedures with the potential donor is essential to the success of transplants in our country. Conclusions: Several difficulties have been encountered, as the lack of human and material resources generating impasses in the specific care of the potential organ donor and the lack of provision of continuing education. Keywords: Organ donation; Intensive Care Unit; Nursing.

  2. The role of message frame, perceived risk, and ambivalence in individuals' decisions to become organ donors. (United States)

    Cohen, Elizabeth L


    The decision to become an organ donor involves considering both self-relevant risks and the needs of others. This study applied prospect theory to examine how news exemplar message frames that focus on the possible survival or death of a potential organ transplant recipient affect participants' willingness to become organ donors. Perceived personal risk and ambivalence were examined as moderating variables. Results indicate that risk, rather than ambivalence, played an instrumental role in participants' decisions to donate. Although no main effects or interactions related to message frame emerged in initial analyses, a supplemental analysis revealed an interaction such that there was a modest persuasive advantage for the loss-framed message among low-risk participants. Findings suggest that vivid exemplar message frames, compared to other types of more explicit organ donor appeals, may be associated with unique decisions about organ donation.

  3. Extracorporeal support for organ donation after cardiac death effectively expands the donor pool. (United States)

    Magliocca, Joseph F; Magee, John C; Rowe, Stephen A; Gravel, Mark T; Chenault, Richard H; Merion, Robert M; Punch, Jeffrey D; Bartlett, Robert H; Hemmila, Mark R


    We sought to evaluate the effect on short-term outcomes of normothermic, extracorporeal perfusion (ECMO) for donation of abdominal organs for transplantation after cardiac death (DCD). Study parameters included increase in number of donors and organs, types of organs procured, and viability of kidneys transplanted. We retrospectively reviewed medical record data for all patients enrolled in our ECMO-supported DCD donor protocol between 10/1/2000 to 2/01/2004. We also reviewed the records for all patients undergoing organ donation after brain-death (DBD) during the study period at our institution. Recipient data were obtained and analyzed for all kidneys procured from both groups. Twenty patients were enrolled in our DCD protocol and underwent attempted organ donation. Fifteen patients completed the protocol; 3 maintained cardiac function throughout the prescribed 60 minutes after withdrawal of life support, and two patients' organs were deemed unsuitable for transplantation. Fourteen (70%) of the DCD donor patients originated on the trauma service and six (30%) were from other clinical services. The DCD program increased the potential donor pool by 33% (61 versus 81 patients) and the number of kidneys transplanted by 24% (100 versus 124). A total of 24 kidney, 5 liver, and 1 pancreas transplants were performed with these organs. Two of 24 (8.3%) DCD kidneys had delayed graft function. There were no perioperative rejection episodes or deaths. The implementation of a DCD protocol using extracorporeal perfusion increased the potential organ donor pool at our institution by 33%. This was accomplished without short term adverse effect on organ function compared with kidneys transplanted from DBD donors.

  4. 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

  5. Cytomegalovirus seroprevalence in organ donors and kidney transplant recipients, Colombia, 2010-2014. (United States)

    Arias-Murillo, Yazmín Rocío; Osorio-Arango, Karime; Cortés, Jorge Alberto; Beltrán, Mauricio


    Cytomegalovirus infections have gained high importance for individuals that have received organ transplants given the clinical implications this may have in immunocompromised patients.  To describe the seroprevalence of cytomegalovirus in organ donors and recipients of kidney transplants nationwide from the six regions established by the Red Nacional de Donación y Trasplante.  We conducted a descriptive retrospective study that included 1,813 organ donors and 3,313 recipients of kidney transplants, and we calculated IgM and IgG seroprevalence for cytomegalovirus. IgG prevalence was stratified according to sex, age group, and region, and the results were analyzed in each donor-recipient pair and classified according to the risk. Statistical packages IBM SPSS®, Statistics 22, and Epi Info 7 were utilized.  IgG prevalence for cytomegalivirus was 86.8% in donors and 91.0% in kidney transplant recipients with statistical significance observed for age, geographical location, and between donors and recipients. We analyzed 1,764 pairs of donors and recipients, of which 91.4% were categorized as having intermediate risk.  The results of this study showed high cytomegalovirus infection rates in Colombia. Given the risk, categorization of patients undergoing transplants, measures should be adopted by medical teams to minimize risks.

  6. Liver transplantation using donor organs with markedly elevated liver enzymes: how far can we go? (United States)

    Radunz, Sonia; Paul, Andreas; Nowak, Knut; Treckmann, Jürgen W; Saner, Fuat H; Mathé, Zoltan


    The disparity between the demand for solid organs and the current supply is a growing problem for patients with end-stage liver disease. To overcome organ shortage, extended criteria donor organs are also accepted for liver transplantation. We here unprecedentedly report the clinical course of patients receiving livers with markedly elevated liver enzymes. Between November 2007 and December 2010, 15 donor livers with markedly elevated liver enzymes [median aspartate aminotransferase (AST) 1400 (500-7538) U/l, median alanine aminotransferase (ALT) 1026 (308-9179) U/l] were offered to our transplant centre. Based on elaborate judgment, seven of these donor livers were rejected and eight donor livers were transplanted. All eight transplanted patients showed a liver enzyme peak on the day of surgery (AST 2076 ± 1808 U/l, ALT 1087 ± 833 U/l) and a statistically significant decrease from day 0 to day 7 post-liver transplantation. INR decreased and platelet count increased statistically significantly within 1 week after liver transplantation. The patients were discharged from the hospital 28 ± 11 days after liver transplantation in good clinical condition. These data demonstrate that using donor livers with markedly elevated liver enzymes may be an acceptable option to expand the donor pool. Universal objective parameters for acceptance should be defined in future studies. © 2011 John Wiley & Sons A/S.

  7. Islamic Sunni Mainstream Opinions on Compensation to Unrelated Live Organ Donors

    Directory of Open Access Journals (Sweden)

    Ahmad Natour


    Full Text Available This article focuses on contemporary Islamic attitudes towards the question of compensation to a non-relative live organ donor. This article presents the history of the debate on organ transplantation in Islam since the 1950s and the key ethical questions. It continues by presenting the opinions of the mainstream ulema such as Tantawi and Qaradawi. The article ends with a conclusion that there must be no compensation made to a non-related live organ donor, not even a symbolic gift of honor (ikramiyya.

  8. A plea for uniform European definitions for organ donor potential and family refusal rates. (United States)

    Jansen, Nichon E; Haase-Kromwijk, Bernadette J J M; van Leiden, Hendrik A; Weimar, Willem; Hoitsma, Andries J


    Conversion of potential organ donors to actual donors is negatively influenced by family refusals. Refusal rates differ strongly among countries. Is it possible to compare refusal rates in order to be able to learn from countries with the best practices? We searched in the literature for reviews of donor potential and refusal rates for organ donation in intensive care units. We found 14 articles pertinent to this study. There is an enormous diversity among the performed studies. The definitions of potential organ donors and family refusal differed substantially. We tried to re-calculate the refusal rates. This method failed because of the influence caused by the registered will on donation in the Donor Register. We therefore calculated the total refusal rate. This strategy was also less satisfactory considering possible influence of the legal consent system on the approach of family. Because of lack of uniform definitions, we can conclude that the refusal rates for organ donation can not be used for a sound comparison among countries. To be able to learn from well-performing countries, it is necessary to establish uniform definitions regarding organ donation and registration of all intensive care deaths.

  9. Organic Materials in the Undergraduate Laboratory: Microscale Synthesis and Investigation of a Donor-Acceptor Molecule (United States)

    Pappenfus, Ted M.; Schliep, Karl B.; Dissanayake, Anudaththa; Ludden, Trevor; Nieto-Ortega, Belen; Lopez Navarrete, Juan T.; Ruiz Delgado, M. Carmen; Casado, Juan


    A series of experiments for undergraduate courses (e.g., organic, physical) have been developed in the area of small molecule organic materials. These experiments focus on understanding the electronic and redox properties of a donor-acceptor molecule that is prepared in a convenient one-step microscale reaction. The resulting intensely colored…

  10. 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.

  11. Impact of donor-acceptor morphology on the charge carrier generation in organic photovoltaic devices (United States)

    Inche Ibrahim, M. L.


    We investigate the impact of donor-acceptor morphology on the generation of charge carriers in organic photovoltaic cells and photodiodes based on a recently proposed model. It is found that for devices with typical values of permittivity and actual charge carrier mobilities, the donor-acceptor morphology plays an important role in the charge carrier generation, practically at all operating electric fields. Higher permittivity and actual mobilities increase the charge carrier generation, and also decrease the effect of donor-acceptor morphology on the charge carrier generation. Although the donor-acceptor morphology is important for charge carrier generation in general, but having permittivity and/or actual mobilities that are significantly higher than the typical values are more desirable in order to maximize the charge carrier generation.

  12. An Algorithm Measuring Donor Cell-Free DNA in Plasma of Cellular and Solid Organ Transplant Recipients That Does Not Require Donor or Recipient Genotyping

    Directory of Open Access Journals (Sweden)

    Paul MK Gordon


    Full Text Available Cell-free DNA (cfDNA has significant potential in the diagnosis and monitoring of clinical conditions but accurately and easily distinguishing the relative proportion of DNA molecules in a mixture derived from two different sources (i.e. donor and recipient tissues after transplantation is challenging. In human cellular transplantation there is currently no useable method to detect in vivo engraftment and blood-based non-invasive tests for allograft rejection in solid organ transplantation are either non-specific (e.g. creatinine in kidney transplantation, liver enzymes in hepatic transplantation or absent (i.e. heart transplantation. Elevated levels of donor cfDNA have been shown to correlate with solid organ rejection but complex methodology limits implementation of this promising biomarker. We describe a cost-effective method to quantify donor cfDNA in recipient plasma using a panel of high-frequency single nucleotide polymorphisms, next-generation (semiconductor sequencing and a novel mixture model algorithm. In vitro, our method accurately and rapidly determined donor/recipient DNA admixture. For in vivo testing, donor cfDNA was serially quantified in an infant with a urea cycle disorder after receiving six daily infusions of donor liver cells. Donor cfDNA isolated from 1-2 ml of recipient plasma was detected as late as 24 weeks after infusion suggesting engraftment. The percentage of circulating donor cfDNA was also assessed in pediatric and adult heart transplant recipients undergoing routine endomyocardial biopsy with levels observed to be stable over time and generally measuring <1% in cases without moderate or severe cellular rejection. Unlike existing non-invasive methods used to define the proportion of donor cfDNA in solid organ transplant patients, our assay does not require sex mismatch, donor genotyping or whole-genome sequencing and potentially has broad application to detect cellular engraftment or allograft injury after

  13. Does the Presence of a Measurable Blood Alcohol Level in a Potential Organ Donor Affect the Outcome of Liver Transplantation? (United States)

    Hassanein, Tarek I.; Gavaler, Judith S.; Fishkin, David; Gordon, Robert; Starzl, Thomas E.; Van Thiel, David H.


    The widespread application of hepatic transplantation has created a tremendous demand for donor organs. An assessment of donor parameters is thought to be important in selecting good donors; however, the criteria utilized have not been standardized. This study was performed to determine the effect of a measurable donor blood alcohol level on graft survival. Fifty-two patients who underwent orthotopic liver transplantation at the University of Pittsburgh were included in the study. Twenty-five patients received liver grafts from donors having a blood alcohol level between 0.04 and 0.4 g/l with a mean of 0.17 g/l. Twenty-seven patients received a liver graft from a donor who had no measurable blood alcohol. There were no differences between these two groups of donors regarding the time of initial hospitalization until the time of donation. Graft failure within the first 30 days was 24% for those receiving an organ from an alcohol-positive donor as compared with 22.2% in those receiving an organ from an alcohol negative donor. The recipient mortality rate was 16% and 11%, respectively. No relationships between the donor blood alcohol level and organ performance, frequency of primary graft nonfunction, or number of episodes of acute cellular rejection were evident. Based upon these data, the presence of a measurable blood alcohol level in a donor should not mitigate against organ donation. PMID:2058808

  14. A quasi-experimental investigation of message appeal variations on organ donor registration rates. (United States)

    Siegel, Jason T; Alvaro, Eusebio M; Crano, William D; Lac, Andrew; Ting, Sarah; Jones, Sara Pace


    Approximately 6,000 Americans die every year awaiting an organ transplant. Health promotion interventions may alleviate the shortage of viable organs by increasing the number of registered organ donors. This study is the first to evaluate the differential effectiveness of various organ donor messages in naturalistic settings. A 4 (Appeal)x4 (Exemplar)x4 (Location) counterbalanced quasi-experimental design was implemented. The behavioral outcome measure was the number of individuals who registered to be organ donors at computer kiosks. A number of significant main effects and interactions emerged. Most notably, of the 4 different appeals (counterargument, emotional, motivating action, dissonance), counterargument was by far the most efficacious, especially in academic-type settings (library, university, community college); the emotional appeal was most successful in hospitals. The findings from this study have implications for both organ donor investigations and health campaign research in general. Statistical interactions highlight the importance of evaluating multiple exemplars in multiple locations for each type of appeal when conducting health campaign research. Copyright (c) 2008 APA, all rights reserved.

  15. 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.

  16. 42 CFR 486.344 - Condition: Evaluation and management of potential donors and organ placement and recovery. (United States)


    ... recovery, and organ placement, including donation after cardiac death, if the OPO has implemented a... and blood type. (f) Donation after cardiac death. If an OPO recovers organs from donors after cardiac... potential donors are thoroughly assessed for medical suitability for organ donation and clinically managed...

  17. Care With The Potential Organ Donor In The Intensive Care Unit


    Francisca Patrícia Barreto de Carvalho; Kênnia Stephanie Morais Oliveira; Glauber Weder dos Santos Silva; Geórgia Nóbrega Melo; Thiago Enggle de Araújo Alves; Ana Cristina Arrais; Ilana Deyse Rocha Leite; Amélia Carolina Lopes Fernandes; Lucidio Clebeson Oliveira; Francisco Rafael Ribeiro Soares


    Introduction: Organ transplants have expanded throughout the country, being extremely significant for the population. Objective: To know the reality of organ harvesting and describe the care with the potential organ donor in an Intensive Care Unit (ICU) and compare it with the pertinent literature. Method: It is a research of exploratory and descriptive nature, with a qualitative approach. The data were analyzed through the content analysis idealized by Bardin. Results: The fin...

  18. Azomethine-based Donor Materials for Organic Solar Cells

    NARCIS (Netherlands)

    Dingemans, T.J.; Petrus, M.L.

    Solution processable organic photovoltaics (OPVs) are attracting much attention because of their anticipated advantages such as low cost, flexibility, lightweight, and the potential to be produced on a large scale. The photoactive layer of OPVs consists of a blend of an electron donating and an

  19. [Refractory cardiac arrest patients in prehospital care, potential organ donors]. (United States)

    Le Jan, Arnaud; Dupin, Aurélie; Garrigue, Bruno; Sapir, David


    Under the authority of the French Biomedicine Agency, a new care pathway integrates refractory cardiac arrest patients into a process of organ donation. It is a medical, logistical and ethical challenge for the staff of the mobile emergency services. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Determining optimal threshold for glucose control in organ donors after neurologic determination of death: a United Network for Organ Sharing Region 5 Donor Management Goals Workgroup prospective analysis. (United States)

    Sally, Mitchell B; Ewing, Tyler; Crutchfield, Megan; Patel, Madhukar S; Raza, Shariq; De La Cruz, Salvador; Zatarain, John; Malinoski, Darren Jay


    The appropriate level of glucose control in organ donors after neurologic determination of death (DNDD) remains uncertain. We hypothesized that a glucose target of 180 mg/dL would be appropriate for optimizing organ transplantation rates and outcomes. Demographic, critical care, organ transplantation, and graft outcome data were prospectively collected on all DNDDs in United Network for Organ Sharing (UNOS) Region 5 from 2010 to 2012. Glucose levels were assessed at four time points in the organ donation process. The primary outcome measure was having four or more organs transplanted per donor (OTPD). Univariate analyses were conducted to determine the relationship between glucose levels and OTPD, organ transplantation rates, and graft function. Multivariate analyses were performed to determine independent predictors of four or more OTPDs. Glucose levels were analyzed at the following cutoff points: 150 or less, 180, and 200 mg/dL. Results with a p Glucose levels of 150 mg/dL or less were not associated with differences in organ use. Levels of 180 mg/dL or less were associated with more OTPDs (3.5 vs. 3.2), a higher rate of four or more OTPDs (42% vs. 34%), and more heart (34% vs. 28%), pancreas (18% vs. 11%), and kidney (85% vs. 81%) use. Levels of 200 mg/dL or less revealed similar results. However, only a level of 180 mg/dL or less was an independent predictor of four or more OTPDs (odds ratio, 1.4). All three levels were associated with higher kidney graft survival after a mean (SD) of 10 (6.0) months of follow-up (97% vs. 95%). Hyperglycemia is common in DNDDs and is associated with lower organ transplantation rates and worse graft outcomes. Targeting a glucose level of 180 mg/dL or less seems to preserve outcomes and is consistent with general critical care guidelines. Therapeutic study, level II.

  1. Dual kidney transplantation with organs from extended criteria cadaveric donors.

    LENUS (Irish Health Repository)

    D'Arcy, Frank T


    The critical shortage of kidneys available for transplantation has led to alternate strategies to expand the pool. Transplantation of the 2 kidneys into a single recipient using organs suboptimal for single kidney transplantation was suggested. We assessed results in 24 grafts allocated for dual kidney transplantation vs those in a control group of 44 designated for single kidney transplantation. Each group underwent pretransplant biopsy and recipients were age matched.

  2. Transplantation of solid organs procured from influenza A H1N1 infected donors. (United States)

    Cockbain, Andrew J; Jacob, Matthew; Ecuyer, Clare; Hostert, Lutz; Ahmad, Niaz


    Following the influenza A H1N1 (swine flu) pandemic, there remains little evidence informing the safety of transplanting organs from donors suspected or diagnosed with H1N1. Limited guidelines from the major transplant societies leave the use of such organs at the discretion of individual transplant centres, and practice varies considerably both nationally and internationally. We present the largest published series of outcome following transplantation of organs from H1N1 positive donors and demonstrate that these organs can be transplanted safely and with good short-term outcome. We discuss our local policy for treatment of recipients with Oseltamivir. © 2011 The Authors. Transplant International © 2011 European Society for Organ Transplantation.

  3. Donor-Derived Strongyloides stercoralis Infection in Solid Organ Transplant Recipients in the United States, 2009–2013 (United States)

    Abanyie, F. A.; Gray, E. B.; Delli Carpini, K. W.; Yanofsky, A.; McAuliffe, I.; Rana, M.; Chin-Hong, P. V.; Barone, C. N.; Davis, J. L.; Montgomery, S. P.; Huprikar, S.


    Infection with Strongyloides stercoralis is typically asymptomatic in immunocompetent hosts, despite chronic infection. In contrast, immunocompromised hosts such as solid organ transplant recipients are at risk for hyperinfection syndrome and/or disseminated disease, frequently resulting in fatal outcomes. Infection in these recipients may result from reactivation of latent infection or infection through transmission from an infected donor. We describe the Centers for Disease Control and Prevention's experience with seven clusters of donor-derived infection from 2009 to 2013. Six of the seven (86%) donors were born in Latin America; donor screening was not performed prior to organ transplantation in any of these investigations. Eleven of the 20 (55%) organ recipients were symptomatic, two of whom died from complications of strongyloidiasis. We also describe the New York Organ Donor Network (NYODN) experience with targeted donor screening from 2010 to 2013. Of the 233 consented potential donors tested, 10 tested positive for Strongyloides antibody; and 18 organs were transplanted. The majority (86%) of the donors were born in Central or South America. Fourteen recipients received prophylaxis after transplantation; no recipients developed strongyloidiasis. The NYODN experience provides evidence that when targeted donor screening is performed prior to transplantation, donor-derived infection can be averted in recipients. PMID:25703251

  4. Promoting democracy in Ghana: exploring the democratic roles of donor-sponsored non-governmental organizations

    NARCIS (Netherlands)

    Kamstra, J.; Knippenberg, L.W.J.


    This article examines the democratic roles performed by Ghanaian non-governmental organizations (NGOs). Drawing on a comparative case study approach, it explores how the organizational characteristics of five donor-sponsored NGOs relate to their ability to perform different democratic roles. Our

  5. 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

  6. Tetrathiafulvalene S-oxide: a Potential Donor Impurity in the Organic Metal TTF-TCNQ

    DEFF Research Database (Denmark)

    Carlsen, Lars; Bechgaard, Klaus; Jacobsen, Claus Schelde


    Tetrathiafulvalene S-oxide, which because of its size similarity with tetrathiafulvalene is a potential ‘donor impurity’ in the organic metal TTF–TCNQ, was prepared and characterized spectroscopically. Experiments in which tetrathiafulvalene S-oxide was purposely doped into TTF–TCNQ indicate, how...

  7. West Nile Virus RNA in Tissues from Donor Associated with Transmission to Organ Transplant Recipients

    Centers for Disease Control (CDC) Podcasts


    William Hale reads an abridged version of the Emerging Infectious Diseases’ dispatch, West Nile Virus RNA in Tissues from Donor Associated with Transmission to Organ Transplant Recipients.  Created: 11/19/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/21/2013.

  8. Utilization of Organs From Donors According to Hepatitis C Antibody and Nucleic Acid Testing Status: Time for Change. (United States)

    Kling, C E; Perkins, J D; Landis, C S; Limaye, A P; Sibulesky, L


    Previous studies have grouped all donors positive for hepatitis C virus (HCV) antibody (Ab). Only recently has donor HCV nucleic acid testing (NAT) become routine, and the impact of Ab and NAT status on organ utilization is unknown. Using the United Network for Organ Sharing database, we identified 9290 donors from 2015 to 2016 for whom both HCV Ab and NAT data were available and compared organ utilization by HCV status. Overall, 93.8% of donors were Ab negative and NAT negative (Ab-NAT-), 0.15% were Ab negative and NAT positive, 1.8% were Ab positive and NAT negative (Ab+NAT-), and 4.2% were both Ab and NAT positive (Ab+NAT+). Ab-NAT- donors donated at the highest rate for all organs except livers, of which Ab+NAT- donors donated at a higher rate (81.2% vs 73.2%, p = 0.03). Livers were discarded for reasons related to abnormal biopsies in Ab+NAT+ donors, whereas kidneys from Ab- or NAT-positive donors were discarded for reasons related to HCV status. Using a propensity score-matched model, we estimated that using Ab+NAT- donors at the same rate as Ab-NAT- donors could result in 48 more kidney donors, 37 more heart donors, and 15 more lung donors annually. We urge the use of HCV Ab+NAT- donors for appropriately selected and consenting recipients. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  9. Development of Graft-Site Candidiasis in 3 Solid Organ Transplant Recipients from the Same Donor. (United States)

    El-Bandar, Nasrin; Kroy, Daniela C; Fuller, Tom Florian; Kramer, Jürgen; Liefeldt, Lutz; Budde, Klemens; Blobel, Conrad; Miller, Kurt; Friedersdorff, Frank


    BACKGROUND Graft-site candidiasis rarely develops in solid organ transplant recipients; however, severe life-threatening complications can occur. We report the course of 3 solid organ transplant recipients developing graft-site candidiasis. CASE REPORT All grafts, consisting of 2 kidneys and 1 liver, were procured from a single donor. Patient data were collected from our database. Candida albicans was isolated from a swab taken during multiple-organ recovery. Complications associated with candidiasis occurred in all 3 recipients with preservation of the liver transplant. Both renal transplant recipients had vascular complications, eventually resulting in graft nephrectomy and subsequent return to dialysis. The patients recovered completely without residual effects of their prior fungal infection. CONCLUSIONS Fungal infections in solid organ transplant recipients are rare. Since the sequelae of these infections are serious and usually pertain to more than 1 recipient at a time, antifungal prophylaxis may be warranted in select donors.

  10. Successful heart transplantation after prolonged cardiac arrest and extracorporeal life support in organ donor-a case report. (United States)

    Arroyo, Diego; Gasche, Yvan; Banfi, Carlo; Stiasny, Brian; Bendjelid, Karim; Giraud, Raphaël


    Although heart transplantation is a successful therapy for patients suffering from end-stage heart failure, the therapeutic is limited by the lack of organs. Donor cardiac arrest is a classic hindrance to heart retrieval as it raises issues on post-transplant outcomes. The present case reports a successful heart transplantation after prolonged donor cardiac arrest (total lowflow time of 95 minutes) due to anaphylactic shock necessitating extracorporeal life support. We further provide an overview of the current evidence and outcomes of heart transplantation in cases of donor cardiac arrest. Providing that donor and recipient criteria are respected, donor cardiac arrest does not seem to be an adverse predictor in heart transplantation.

  11. Synthesis and Characterization of Organic Dyes Containing Various Donors and Acceptors (United States)

    Wu, Tzi-Yi; Tsao, Ming-Hsiu; Chen, Fu-Lin; Su, Shyh-Gang; Chang, Cheng-Wen; Wang, Hong-Paul; Lin, Yuan-Chung; Ou-Yang, Wen-Chung; Sun, I-Wen


    New organic dyes comprising carbazole, iminodibenzyl, or phenothiazine moieties, respectively, as the electron donors, and cyanoacetic acid or acrylic acid moieties as the electron acceptors/anchoring groups were synthesized and characterized. The influence of heteroatoms on carbazole, iminodibenzyl and phenothiazine donors, and cyano-substitution on the acid acceptor is evidenced by spectral, electrochemical, photovoltaic experiments, and density functional theory calculations. The phenothiazine dyes show solar-energy-to-electricity conversion efficiency (η) of 3.46–5.53%, whereas carbazole and iminodibenzyl dyes show η of 2.43% and 3.49%, respectively. PMID:20162019

  12. Synthesis and Characterization of Organic Dyes Containing Various Donors and Acceptors

    Directory of Open Access Journals (Sweden)

    Wen-Chung Ou-Yang


    Full Text Available New organic dyes comprising carbazole, iminodibenzyl, or phenothiazine moieties, respectively, as the electron donors, and cyanoacetic acid or acrylic acid moieties as the electron acceptors/anchoring groups were synthesized and characterized. The influence of heteroatoms on carbazole, iminodibenzyl and phenothiazine donors, and cyano-substitution on the acid acceptor is evidenced by spectral, electrochemical, photovoltaic experiments, and density functional theory calculations. The phenothiazine dyes show solar-energy-to-electricity conversion efficiency (η of 3.46–5.53%, whereas carbazole andiminodibenzyl dyesshow η of 2.43% and 3.49%, respectively.

  13. Factors affecting the deceased organ donation rate in the Chinese community: an audit of hospital medical records in Hong Kong. (United States)

    Cheung, C Y; Pong, M L; Au Yeung, S F; Chau, K F


    The number of actual donors per million population is the most commonly used metric to measure organ donation rates worldwide. It is deemed inadequate, however, because it does not take into account the potential donor pool. The aim of this study was to determine the true potential for solid organ donation from deceased brain-dead donors and the reasons for non-donation from potential donors in the Chinese community. Medical records of all hospital deaths between 1 January and 31 December 2014 at a large regional hospital in Hong Kong were reviewed. Those who were on mechanical ventilation with documented brain injury and aged ≤75 years were classified as possible organ donors. The reasons why some potential organ donors did not become utilised organ donors were recorded and evaluated. Among 3659 patient deaths, 121 were classified as possible organ donors. The mean age of the possible organ donors was 59.4 years and 72.7% of them were male. The majority (88%) were from non-intensive care units. Of the 121 possible organ donors, 108 were classified as potential organ donors after excluding 13 unlikely to fulfil brain death criteria. Finally 11 patients became actual organ donors with an overall conversion rate of 10%. Reasons for non-donation included medical contra-indication (46%), failure to identify and inform organ donation coordinators (14%), failure of donor maintenance (11%), brain death diagnosis not established (18%), and refusal by relatives (11%). It is possible to increase the organ donation rate considerably by action at different stages of the donation process. Ongoing accurate audit of current practice is necessary.

  14. Impact of Thermal Annealing on Organic Photovoltaic Cells Using Regioisomeric Donor-Acceptor-Acceptor Molecules. (United States)

    Zhang, Tao; Han, Han; Zou, Yunlong; Lee, Ying-Chi; Oshima, Hiroya; Wong, Ken-Tsung; Holmes, Russell J


    We report a promising set of donor-acceptor-acceptor (D-A-A) electron-donor materials based on coplanar thieno[3,2-b]/[2,3-b]indole, benzo[c][1,2,5]thiadiazole, and dicyanovinylene, which are found to show broadband absorption with high extinction coefficients. The role of the regioisomeric electron-donating thienoindole moiety on the physical and structural properties is examined. Bulk heterojunction (BHJ) organic photovoltaic cells (OPVs) based on the thieno[2,3-b]indole-based electron donor NTU-2, using C70 as an electron acceptor, show a champion power conversion efficiency of 5.2% under AM 1.5G solar simulated illumination. This efficiency is limited by a low fill factor (FF), as has previously been the case in D-A-A systems. In order to identify the origin of the limited FF, further insight into donor layer charge-transport behavior is realized by examining planar heterojunction OPVs, with emphasis on the evolution of film morphology with thermal annealing. Compared to as-deposited OPVs that exhibit insufficient donor crystallinity, crystalline OPVs based on annealed thin films show an increase in the short-circuit current density, FF, and power conversion efficiency. These results suggest that that the crystallization of D-A-A molecules might not be realized spontaneously at room temperature and that further processing is needed to realize efficient charge transport in these materials.

  15. Organ procurement and the body donor-family binomial: instruments to subsidize nursing approach

    Directory of Open Access Journals (Sweden)

    Gisele da Cruz Ferreira


    Full Text Available We aimed to describe the design of instruments to subsidize the care for the body donor-family binomial in the perspective of the process of organ procurement. The Activities of Living Model grounded the instruments for data collection. We identified 33 possible diagnoses, 14 associated to the body preservation and 19 to responses from family members facing grieving and the decision on whether to authorize the donation. We selected 31 interventions to preserve the body for organs/tissues procurement, and 25 to meet the needs for information, coping and support for the family decision. The nursing diagnoses, interventions, and outcomes were registered according to the North American Nursing Diagnosis Association, Nursing Intervention Classification, and Nursing Outcome Classification, respectively. The instruments follow the legislation of the Board of Nursing and the donor/organ procurement, needing to be validated by field experts.

  16. Laboratorial evaluation of potential donors of organs and tissues for transplantation

    Directory of Open Access Journals (Sweden)

    Quinidia Lúcia Duarte de Almeida Quithé de Vasconcelos


    Full Text Available The objective of this study was to describe the laboratorial complementary evaluation in potential donors of organs and tissues for transplantation. It is a descriptive, quantitative study made in six hospitals in Natal/ Rio Grande do Norte, Brazil, between August/2010 to February/2011. The sample consisted of 65 potential donors and a checklist type instrument was used. Information was collected and analyzed using descriptive statistics. From a total number of donors, 89.2% had blood typing, 80.0% hematological tests and verification of the electrolytes. As for the functions, 70.8% had tests for verification of pulmonary function and 80.0% for renal function. From the alterations detected, 69.2% presented hyperoxia, 66.2% leukocytosis, 47.7% hypernatremia, 43.1% increase in the creatine kinase, 10.0% with positive serology. Relevant tests were not made. It is essential to assess potential donors to detect and treat alterations, ensuring the quality of the organs and the quality of the transplantation.

  17. Fullerene C{sub 70} as a p-type donor in organic photovoltaic cells

    Energy Technology Data Exchange (ETDEWEB)

    Zhuang, Taojun; Wang, Xiao-Feng, E-mail:, E-mail:, E-mail:; Sano, Takeshi; Kido, Junji, E-mail:, E-mail:, E-mail: [Department of Organic Device Engineering, Graduate School of Science and Engineering, and Research Center for Organic Electronics (ROEL), Yamagata University, Yonezawa 992-8510 (Japan); Hong, Ziruo, E-mail:, E-mail:, E-mail: [Department of Organic Device Engineering, Graduate School of Science and Engineering, and Research Center for Organic Electronics (ROEL), Yamagata University, Yonezawa 992-8510 (Japan); Department of Materials Science and Engineering, University of California-Los Angeles, California 90095 (United States); Li, Gang; Yang, Yang [Department of Materials Science and Engineering, University of California-Los Angeles, California 90095 (United States)


    Fullerenes and their derivatives have been widely used as n-type materials in organic transistor and photovoltaic devices. Though it is believed that they shall be ambipolar in nature, there have been few direct experimental proofs for that. In this work, fullerene C{sub 70}, known as an efficient acceptor, has been employed as a p-type electron donor in conjunction with 1,4,5,8,9,11-hexaazatriphenylene hexacarbonitrile as an electron acceptor in planar-heterojunction (PHJ) organic photovoltaic (OPV) cells. High fill factors (FFs) of more than 0.70 were reliably achieved with the C{sub 70} layer even up to 100 nm thick in PHJ cells, suggesting the superior potential of fullerene C{sub 70} as the p-type donor in comparison to other conventional donor materials. The optimal efficiency of these unconventional PHJ cells was 2.83% with a short-circuit current of 5.33 mA/cm{sup 2}, an open circuit voltage of 0.72 V, and a FF of 0.74. The results in this work unveil the potential of fullerene materials as donors in OPV devices, and provide alternative approaches towards future OPV applications.

  18. Optimising expanded donor organs through dual kidney transplantation: a case-control study. (United States)

    Frutos, Miguel Á; Mansilla, Juan J; Cabello, Mercedes; Soler, Jorge; Ruiz, Pilar; Lebron, Miguel; Baena, Víctor; Hernández, Domingo


    In order to take full advantage of ECD kidneys, which may not provide sufficient renal mass if used individually, it has been suggested that such organs be used in dual or bilateral kidney transplantation (DTx). We analysed the experience in a single hospital between May 2007 and March 2011 in a case-control study. Criteria for determining whether to perform single or dual Tx were defined in a protocol in which the biopsy score was important, but not the only factor. Donor's age, medical history, kidney size and creatinine clearance were also considered. During this time period, 80 kidneys from donors over age 65 were transplanted. Single transplants (STx) accounted for 40 of the organs, and another 40 were used in DTx. Mean donor age for STx was 68.7 ± 3.0 years; for DTx, it was 74.2 ± 4.3 years (Porgans having characteristics that probably make them unsuitable for STx. The decision to perform DTx makes using ECD kidneys easier, and it should be based on a combination of pre-transplant histological criteria and the donor's clinical characteristics.

  19. Transplanting Diseases from Organ Donors in Western Europe: Fault Liability or Strict Liability? (United States)

    Broeckx, Nils; Verhoeven, Dimitri


    This article will examine the problem of disease transmission through organ transplantation from a civil liability perspective. Both fault liability and strict product liability might be possible. These two types of liability will be compared, while applying them to the actions of the central parties involved in organ donation and transplantation, namely the physician/hospital, the donor and the organ exchange organisation. While product liability is generally an easier way to obtain compensation than fault liability, it might nevertheless place too heavy a burden on the transplant professionals.

  20. Experiences of donor families after consenting to organ donation: a qualitative study. (United States)

    Berntzen, Helene; Bjørk, Ida Torunn


    The aim of this study was to investigate the experience of Norwegian donor families during organ donation after brain death. This was a qualitative study using personal interviews. Twenty donor-family members from thirteen different situations were interviewed about their experience of being a close relative in an organ donation situation. The principles of qualitative content analysis were used. An experience of strain caused by the organ donation situation was identified. Lack of comprehension and awareness of the process of organ donation contributed to this, and continuing information after the consent was given appeared to be necessary. Reconciliation with the decision of organ donation and the subsequent situation was gained through understanding the organ donation process, through recognition of the increased strain and through satisfaction resulting from the contribution made by organ donation. Healthcare personnel were key persons in contributing to such understanding and recognition. When attending to families in an organ donation situation, the focus must be on ensuring comprehension of the situation both through information provided in the hospital and during follow-up. It seems essential to arrange for a period of parting that can contribute to reconciliation, and to offer follow-up according to individual needs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. 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.

  2. Uncontrolled organ donation after circulatory death: potential donors in the emergency department. (United States)

    Reed, Matthew James; Lua, Stephanie Boon Hui


    The continuing shortfall of organs for transplantation has led to interest in Maastricht Category II (uncontrolled) Donation after Circulatory Death (DCD) organ donation. As preparation for a proposed pilot, this study aimed to explore the potential of uncontrolled DCD organ donation from patients presenting in cardiac arrest to the emergency department (ED) who are unsuccessfully resuscitated. We identified all patients who died in our ED following unsuccessful resuscitation after cardiac arrest who were aged between 16 years and 60 years, whose collapse was witnessed, in whom the paramedics arrived within 15 min, whose death in the ED was less than 2 h after their collapse, who were on the organ donation register and who arrived in the ED during the working week (Monday to Friday between 9:00 and 17:00). During a 14-month period from 1 August 2008 to 30 September 2009, 564 patients had a cardiac arrest in the Lothian region. Four patients may have been eligible to participate in an uncontrolled DCD organ donation programme. Identifying potential organ donors in the ED who are unsuccessfully resuscitated from cardiac arrest may contribute to reducing the shortfall of organs for transplantation, although numbers are likely to be small. If such a programme was to be introduced during weekday working hours, there may be around four donors a year. However, even one additional donor per year from hospitals across the UK with an ED and a transplantation service would add considerably to the overall organ donation rate. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  3. Community participation in international health: practical recommendations for donor and recipient organizations

    Directory of Open Access Journals (Sweden)

    Akukwe Chinua


    Full Text Available This article discusses the need for donor agencies and recipient organizations to involve target communities in the conceptualization, development, monitoring, and implementation of health services and programs in international health. This paper assumes that most donor organizations are based in industrialized countries. Given that resources are finite in both developing and developed countries, the article briefly reviews the current trend of declining public funds for health systems and an increasing role for privately funded health services worldwide. The article calls for community-based international health services that reflect the priorities of target populations, and it also discusses practi cal steps to involve local populations in community-based health planning and management in international health.

  4. Non-therapeutic (elective) ventilation of potential organ donors: the ethical basis for changing the law.


    Shaw, A B


    Non-therapeutic ventilation of potential organ donors would increase the supply of kidneys for transplantation. There are no major ethical objections to it. The means of permitting it are forbidden by laws with an ethical basis. A law permitting it would need an ethical basis. Introducing a third legal method of diagnosing death would be unethical. Expanding the power of the advance directive to permit procedures involving minimal harm would be ethical but not helpful. Extending the power of ...

  5. Viral nucleic acid testing (NAT) and OPO-level disposition of high-risk donor organs. (United States)

    Kucirka, L M; Alexander, C; Namuyinga, R; Hanrahan, C; Montgomery, R A; Segev, D L


    The use of Public Health Service/Centers for Disease Control and Prevention (PHS/CDC) high-risk donor (HRD) organs remains controversial, especially in light of a recent high-profile case of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission. Nucleic acid testing (NAT), while more expensive and time consuming, reduces infectious risk by shortening the period between infection and detectability. The purpose of this study was to characterize HRDs and disposition of their organs by organ procurement organization (OPO), to measure NAT practices by OPO and to examine associations between NAT practices and use of HRD organs. We analyzed 29 950 deceased donors (2574 HRDs) reported to UNOS since July 1, 2004 and May 8, 2008. We then surveyed all OPO clinical directors about their use of NAT, average time to receive NAT results, locations where NAT is performed and percentage of the time NAT results are available for allocation decisions. In total, 51.7% of OPOs always perform HIV NAT, while 24.1% never do. A similar pattern is seen for HCV NAT performance, while the majority (65.6%) never perform HBV NAT. AIDS prevalence in an OPO service area is not associated with NAT practice. OPOs that perform HIV NAT are less likely to export organs outside of their region. The wide variation of current practice and the possibility that NAT would improve organ utilization support consideration for a national policy.

  6. The effect of psychological support for the relatives of intensive care unit patients on cadaveric organ donation rate. (United States)

    Adanir, T; Erdogan, I; Hunerli, G; Unveren, G; Dasci, H; Cetin, H Y; Ozsan, I; Aydin, U


    We searched to see whether psychological support for relatives of intensive care unit patients helps them to donate organs of their brain-dead relatives. After receiving ethics committee permission, first-degree relatives of 200 general intensive care unit patients were enrolled in the study. The participants were divided into 2 groups randomly: an interview group (n = 100) and a control group (n = 100). Participants were asked to complete a questionnaire. Interviews with the psychologist and patients' relatives in the interview group were therapeutic in nature and were conducted according to the relatives' psychosocial needs in an unstructured format. In the control group, the psychologist and patients' relatives were not interviewed. The study utilized demographic data, the questionnaire for relatives of patients to mention their attitude on organ donation and the reasons for this choice, and the Participant Information Form to record demographic data and relatives' degree of relationship with the patient. There was no statistically significant difference between the 2 groups when compared according to sex ratio, patient age, and duration of patients' hospital stay. Whereas in the interview group, 75% agreed to allow their relatives to be organ donors, only 32% in the control group agreed (P psychological support for the relatives of the potential brain-dead donor to cope with the psychological problems to be faced can improve the rate of organ donation. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Successful Recovery and Transplantation of 11 Organs Including Face, Bilateral Upper Extremities, and Thoracic and Abdominal Organs From a Single Deceased Organ Donor. (United States)

    Tullius, Stefan G; Pomahac, Bohdan; Kim, Heung Bae; Carty, Matthew J; Talbot, Simon G; Nelson, Helen M; Delmonico, Francis L


    We report on the to date largest recovery of 11 organs from a single deceased donor with the transplantation of face, bilateral upper extremities, heart, 1 lung, liver (split for 2 recipients), kidneys, pancreas, and intestine. Although logistically challenging, this case demonstrates the feasibility and safety of the recovery of multiple thoracic and abdominal organs with multiple vascular composite allotransplants and tissues. Our experience of 8 additional successful multiple vascular composite allotransplants, thoracic, and abdominal organ recoveries suggests that such procedures are readily accomplishable from the same deceased donor.


    National Research Council Canada - National Science Library

    S. V. Gautier; S. M. Khomyakov


    Aim. To estimate the requirement of the population of the Russian Federation for an organ transplantation and donor resource, to offer approach to planning of an effective network of the medical organizations...

  9. Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria. (United States)

    Mularoni, A; Bertani, A; Vizzini, G; Gona, F; Campanella, M; Spada, M; Gruttadauria, S; Vitulo, P; Conaldi, P; Luca, A; Gridelli, B; Grossi, P


    Donor-derived infections due to multidrug-resistant bacteria are a growing problem in solid organ transplantation, and optimal management options are not clear. In a 2-year period, 30/214 (14%) recipients received an organ from 18/170 (10.5%) deceased donors with infection or colonization caused by a carbapenem-resistant gram-negative bacteria that was unknown at the time of transplantation. Among them, 14/30 recipients (47%) received a transplant from a donor with bacteremia or with infection/colonization of the transplanted organ and were considered at high risk of donor-derived infection transmission. The remaining 16/30 (53%) recipients received an organ from a nonbacteremic donor with colonization of a nontransplanted organ and were considered at low risk of infection transmission. Proven transmission occurred in 4 of the 14 high-risk recipients because donor infection was either not recognized, underestimated, or not communicated. These recipients received late, short or inappropriate posttransplant antibiotic therapy. Transmission did not occur in high-risk recipients who received appropriate and prompt antibiotic therapy for at least 7 days. The safe use of organs from donors with multidrug-resistant bacteria requires intra- and inter-institutional communication to allow appropriate management and prompt treatment of recipients in order to avoid transmission of infection. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

  10. Why and how to compensate living organ donors: ethical implications of the new Australian scheme. (United States)

    Giubilini, Alberto


    The Australian Federal Government has announced a two-year trial scheme to compensate living organ donors. The compensation will be the equivalent of six weeks paid leave at the rate of the national minimum wage. In this article I analyse the ethics of compensating living organ donors taking the Australian scheme as a reference point. Considering the long waiting lists for organ transplantations and the related costs on the healthcare system of treating patients waiting for an organ, the 1.3 million AUD the Australian Government has committed might represent a very worthwhile investment. I argue that a scheme like the Australian one is sufficiently well designed to avoid all the ethical problems traditionally associated with attaching a monetary value to the human body or to parts of it, namely commodification, inducement, exploitation, and equality issues. Therefore, I suggest that the Australian scheme, if cost-effective, should represent a model for other countries to follow. Nonetheless, although I endorse this scheme, I will also argue that this kind of scheme raises issues of justice in regard to the distribution of organs. Thus, I propose that other policies would be needed to supplement the scheme in order to guarantee not only a higher number of organs available, but also a fair distribution. © 2014 John Wiley & Sons Ltd.

  11. CVD graphene as interfacial layer to engineer the organic donor-acceptor heterojunction interface properties. (United States)

    Zhong, Shu; Zhong, Jian Qiang; Mao, Hong Ying; Wang, Rui; Wang, Yu; Qi, Dong Chen; Loh, Kian Ping; Wee, Andrew Thye Shen; Chen, Zhi Kuan; Chen, Wei


    We demonstrate the use of chemical-vapor-deposited (CVD) graphene as an effective indium-tin-oxide (ITO) electrode surface modifier to engineer the organic donor-acceptor heterojunction interface properties in an inverted organic solar cell device configuration. As revealed by in situ near-edge X-ray adsorption fine structure measurement, the organic donor-acceptor heterojunction, comprising copper-hexadecafluoro-phthalocyanine (F16CuPc) and copper phthalocyanine (CuPc), undergoes an obvious orientation transition from a standing configuration (molecular π-plane nearly perpendicular to the substrate surface) on the bare ITO electrode to a less standing configuration with the molecular π-plane stacking adopting a large projection along the direction perpendicular to the electrode surface on the CVD graphene-modified ITO electrode. Such templated less-standing configuration of the organic heterojunction could significantly enhance the efficiency of charge transport along the direction perpendicular to the electrode surface in the planar heterojunction-based devices. Compared with the typical standing organic-organic heterojunction on the bare ITO electrode, our in situ ultraviolet photoelectron spectroscopy experiments reveal that the heterojunction on the CVD graphene modified ITO electrode possesses better aligned energy levels with respective electrodes, hence facilitating effective charge collection.

  12. High Center Volume Does Not Mitigate Risk Associated with Using High Donor Risk Organs in Liver Transplantation. (United States)

    Beal, Eliza W; Black, Sylvester M; Mumtaz, Khalid; Hayes, Don; El-Hinnawi, Ashraf; Washburn, Kenneth; Tumin, Dmitry


    High-risk donor allografts increase access to liver transplant, but potentially reduce patient and graft survival. It is unclear whether the risk associated with using marginal donor livers is mitigated by increasing center experience. The United Network for Organ Sharing registry was queried for adult first-time liver transplant recipients between 2/2002 and 12/2015. High donor risk was defined as donor risk index >1.9, and 1-year patient and graft survival were compared according to donor risk index in small and large centers. Multivariable Cox regression estimated the hazard ratio (HR) associated with using high-risk donor organs, according to a continuous measure of annual center volume. The analysis included 51,770 patients. In 67 small and 67 large centers, high donor risk index predicted increased mortality (p = 0.001). In multivariable analysis, high-donor risk index allografts predicted greater mortality hazard at centers performing 20 liver transplants per year (HR 1.35; 95% CI 1.22, 1.49; p transplant. Specific strategies to mitigate the risk of liver transplant involving high-risk donors are needed, in addition to accumulation of center expertise.

  13. Importance of the Donor:Fullerene intermolecular arrangement for high-efficiency organic photovoltaics

    KAUST Repository

    Graham, Kenneth


    The performance of organic photovoltaic (OPV) material systems are hypothesized to depend strongly on the intermolecular arrangements at the donor:fullerene interfaces. A review of some of the most efficient polymers utilized in polymer:fullerene PV devices, combined with an analysis of reported polymer donor materials wherein the same conjugated backbone was used with varying alkyl substituents, supports this hypothesis. Specifically, the literature shows that higher-performing donor-acceptor type polymers generally have acceptor moieties that are sterically accessible for interactions with the fullerene derivative, whereas the corresponding donor moieties tend to have branched alkyl substituents that sterically hinder interactions with the fullerene. To further explore the idea that the most beneficial polymer:fullerene arrangement involves the fullerene docking with the acceptor moiety, a family of benzo[1,2-b:4,5-b]dithiophene-thieno[3,4-c]pyrrole-4,6-dione polymers (PBDTTPD derivatives) was synthesized and tested in a variety of PV device types with vastly different aggregation states of the polymer. In agreement with our hypothesis, the PBDTTPD derivative with a more sterically accessible acceptor moiety and a more sterically hindered donor moiety shows the highest performance in bulk-heterojunction, bilayer, and low-polymer concentration PV devices where fullerene derivatives serve as the electron-accepting materials. Furthermore, external quantum efficiency measurements of the charge-transfer state and solid-state two-dimensional (2D) 13C{1H} heteronuclear correlation (HETCOR) NMR analyses support that a specific polymer:fullerene arrangement is present for the highest performing PBDTTPD derivative, in which the fullerene is in closer proximity to the acceptor moiety of the polymer. This work demonstrates that the polymer:fullerene arrangement and resulting intermolecular interactions may be key factors in determining the performance of OPV material systems

  14. Donor-acceptor complex formation in evaporated small molecular organic photovoltaic cells

    Energy Technology Data Exchange (ETDEWEB)

    Susarova, Diana K.; Troshin, Pavel A.; Lyubovskaya, Rimma N.; Razumov, Vladimir F. [Institute of Problems of Chemical Physics of Russian Academy of Sciences, Semenov Prospect 1, Chernogolovka, Moscow 142432 (Russian Federation); Hoeglinger, Doris; Koeppe, Robert; Serdar Sariciftci, N. [Linz Institute for Organic Solar Cells (LIOS), Johannes Kepler University Linz, Altenbergerstrasse 69, A-4040 Linz (Austria); Babenko, Sergey D. [Institute for Energy Problems of Chemical Physics, Russian Academy of Sciences (Branch), Semenov Prospect 1/10, Chernogolovka, Moscow 142432 (Russian Federation)


    Novel perylene diimide Py-PDI and naphthalene diimide Py-NDI possessing chelating pyridyl groups have been synthesized. The materials are comparatively investigated as electron acceptors in small molecular photovoltaic cells comprising zinc phthalocyanine ZnPc as an electron donor component. It was shown that these compounds form self-assembled coordination complexes with ZnPc in solution and co-evaporated solid blends. Py-PDI and Py-NDI used as electron acceptor materials in photovoltaic cells with donor ZnPc significantly outperform the reference materials, i.e. perylene and naphthalene diimides that possess no chelating pyridyl groups. Superior photovoltaic performance of Py-PDI and Py-NDI is explained by a complex formation between these compounds and ZnPc. Such interactions of donor and acceptor materials strongly improve photoinduced charge carrier generation. This gives great advantages not just for the construction of organic solar cells but also for organic photodetectors. The devices fabricated in this study are also useful as fast and highly sensitive photodetectors with response times of less than 10 microseconds as well as a strong photoconductive behavior under forward bias. (author)

  15. Organ donor management: Eight common recommendations and actions that deserve reflection. (United States)

    Chamorro-Jambrina, C; Muñoz-Ramírez, M R; Martínez-Melgar, J L; Pérez-Cornejo, M S


    Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis. Aspects such as catecholamine storm management, use of vasoactive drugs, hemodynamic objectives and monitoring, assessment of the heart for donation, and general care of the donor in BD are reviewed. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  16. Screening recipients of increased-risk donor organs: a survey of transplant infectious diseases physician practices. (United States)

    Theodoropoulos, N; Ladner, D P; Ison, M G


    In 1994, the Public Health Service published guidelines to minimize the risk of human immunodeficiency virus (HIV) transmission and to monitor recipients following the transplantation of organs from increased-risk donors. A 2007 survey revealed the post-transplant surveillance of recipients of organs from increased-risk donors (ROIRD) is variable. An electronic survey was sent to transplant infectious diseases physicians at US solid organ transplant centers. A total of 126 surveys were sent to infectious diseases physicians, and we received 51 (40%) responses. We found that 22% of respondents obtain only verbal, 69% verbal and written, and 8% do not obtain any special consent from ROIRD, despite an Organ Procurement and Transplantation Network policy requiring such consent. Post-solid organ transplantation serologies for HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) are performed by 6-8% of respondents in all recipients, by 69% of respondents in ROIRD only, and 25% of respondents do not perform them at all. Post-transplant nucleic acid testing is carried out by 55-64% of respondents in ROIRD, by 0-2% in all recipients, and not performed by 35-43% of respondents. Screening RIORD for HIV, HBV, and HCV has increased since 2007, but remains less than optimal and is incomplete when screening for disease transmission at many centers. © 2013 John Wiley & Sons A/S.

  17. Deceased donor liver transplantation in infants and small children: are partial grafts riskier than whole organs? (United States)

    Cauley, Ryan P; Vakili, Khashayar; Potanos, Kristina; Fullington, Nora; Graham, Dionne A; Finkelstein, Jonathan A; Kim, Heung Bae


    Infants have the highest wait-list mortality of all liver transplant candidates. Although previous studies have demonstrated that young children may be at increased risk when they receive partial grafts from adult and adolescent deceased donors (DDs), with few size-matched organs available, these grafts have increasingly been used to expand the pediatric donor pool. We aimed to determine the current adjusted risks of graft failure and mortality in young pediatric recipients of partial DD livers and to determine whether these risks have changed over time. We analyzed 2683 first-time recipients of DD livers alone under the age of 24 months in the United Network for Organ Sharing database (1995-2010), which included 1118 partial DD livers and 1565 whole DD organs. Transplant factors associated with graft loss in bivariate analyses (P organs in 2006-2010 [hazard ratio (HR) for graft failure = 0.81, 95% CI = 0.56-1.18; HR for mortality = 1.02, 95% CI = 0.66-1.71]. In conclusion, partial DD liver transplantation has become less risky over time and now has outcomes comparable to those of whole liver transplantation for infants and young children. This study supports the use of partial DD liver grafts in young children in an attempt to significantly increase the pediatric organ pool. © 2013 American Association for the Study of Liver Diseases.

  18. Tuning Optoelectronic Properties of Organic Semiconductors Via Donor-Acceptor Cocrystals and Interfacial Composites (United States)

    Wang, Chen

    Organic donor-acceptor (D-A) interaction has attracted intensive research interest because of the promising applications in electronic devices and renewable energy. Depending on the interaction process, the optoelectronic properties of organic semiconductors may change dramatically. To improve their performance and expand the applications, we have investigated the structure-property relationship in D-A cocrystals and nanofibril composites. These materials provide unique D-A interface structures, thus allowing tunable charge transfer across the interface, which can be modified and controlled by exquisite molecule design and supramolecular assembly. In Chapter 2, we studied the fabrication, conductivity, and chemiresistive sensor performance of tetrathiafulvalene (TTF) - 7,7,8,8-tetracyanoquinodimethane (TCNQ) charge transfer cocrystal microfibers. Compared to TCNQ and TTF, TTF-TCNQ cocrystal has much higher conductivity under ambient conditions, due to the high yield of charge separation, which also induces high polarization at the interface, resulting in different binding intensity towards alkyl and aromatic amines. Based on this investment, we developed a TTF-TCNQ chemiresistive sensor to efficiently discriminate alkyl and aromatic amine vapors. In Chapter 3, we further designed a new series of D-A cocrystals, and studied the coassembly and optical properties. The cocrystal is composed of coronene and perylene diimide at 1:1 molar ratio and belongs to the triclinic system, as confirmed by X-ray analysis. The donor and acceptor molecules perform an alternate pi-pi stacking along the (100) direction, leading to the strong one-dimensional growth tendency of macroscopic cocrystal. Additionally, due to the charge transfer interaction, the cocrystal shows a new and largely red-shifted photoluminescence band, compared to the crystals of the components. In Chapter 4, we alternatively developed a series of donor-acceptor nanofibril composites, in which the donor and

  19. Nursing strategies for coping with the care of a potential organ donor

    Directory of Open Access Journals (Sweden)

    Silvia Silva Souza


    Full Text Available This work aimed to understand strategies that the nursing staff from an Intensive Care Unit applies to situations involving the care of a person with brain death as a potential donor. The study was conducted through qualitative, descriptive and exploratory research, carried out by 14 members of the nursing staff who work with the potential organ donor. Data were collected through semi-structured interviews, and a thematic context analysis was applied. The strategies of coping focused on emotion were: escape from reality, and reframe the event. And the strategies focused on the problem were: provide competent care, and search for other support. It is concluded that caring for a person with brain death is constituted as a very stressful event to the nursing professionals. These professionals need institutional support to better cope with these situations, because depending on how they manage their task, it may directly influence the assistance provided to patients.

  20. Molecular Understanding of Fullerene - Electron Donor Interactions in Organic Solar Cells

    KAUST Repository

    Ryno, Sean


    Organic solar cells hold promise of providing low-cost, renewable power generation, with current devices providing up to 13% power conversion efficiency. The rational design of more performant systems requires an in-depth understanding of the interactions between the electron donating and electron accepting materials within the active layers of these devices. Here, we explore works that give insight into the intermolecular interactions between electron donors and electron acceptors, and the impact of molecular orientations and environment on these interactions. We highlight, from a theoretical standpoint, the effects of intermolecular interactions on the stability of charge carriers at the donor/acceptor interface and in the bulk and how these interactions influence the nature of the charge transfer states as wells as the charge separation and charge transport processes. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Opinions of Dutch liver transplant recipients on anonymity of organ donation and direct contact with the donors family. (United States)

    Annema, Coby; Op den Dries, Sanna; van den Berg, Aad P; Ranchor, Adelita V; Porte, Robert J


    In the Netherlands, anonymity of organ donation, which is currently protected by legislation, has come under discussion. In the Dutch society, a tendency to allow direct contact between transplant recipients and their donor's family is noticeable. As little is known about the opinion of Dutch liver transplant recipients on anonymity of organ donation and direct contact with the donor's family, this study examines their opinions. A cross-sectional study was conducted in 244 liver transplant recipients. Their opinions were examined in relation to demographic, transplant-related and emotional variables. Data were collected by questionnaire. Transplant-related variables were retrieved from the hospital's liver transplant database. Fifty-three percent of the respondents (n = 177) agreed with anonymity of organ donation, mainly out of respect for the donor. Living situation, age, and level of positive affect influenced this opinion. The majority of the respondents (65%) indicated that they would like to receive some information about their donor, like age, sex, and health status. Only 19% of the respondents favored direct contact with the donor's family, mainly to express their gratitude personally. Respondents transplanted for alcoholic cirrhosis were less in favor of direct contact. Respondents with feelings of guilt doubted more about direct contact. There is no need to change the current legislation on anonymity of organ donation. However, most liver transplant recipients would like to receive some general information about their donor. Therefore, clear guidelines on the sharing of donor data with recipients need to be established.

  2. Oligomeric Dithienopyrrole-Thienopyrrolodione (DTP-TPD) Donor-Acceptor Copolymer for Organic Photovoltaics: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Hammond, S. R.; Braunecker, W.; Garcia, A.; Larsen, R.; Owczarczyk, Z.; Olson, D.; Ginley, D.


    A new donor-acceptor copolymer system based upon a dithienopyrrole (DTP) donor moiety and a thienopyrrolodione (TPD) accepting moiety has been designed and synthesized for organic photovoltaic (OPV) applications. The TPD accepting moiety has recently gained significant attention in the OPV community and is being incorporated into a number of different polymer systems. In contrast, the DTP donor moiety has received only limited attention, likely due in part to synthetic difficulties relating to the monomer. In our hands, the bis(trimethyltin)-DTP monomer was indelibly contaminated with ~5% of the mono-destannylated DTP, which limited the Stille polymerization with the dibromo-TPD monomer (>99% pure) to produce material with Mn ~ 4130 g/mol (PDI = 1.10), corresponding to around eight repeat units. Despite this limitation, UV-visible absorption spectroscopy demonstrates strong absorption for this material with a band gap of ~1.6 eV. Cyclic voltammetry indicates a highest occupied molecular orbital (HOMO) energy level of -5.3 eV, which is much lower than calculations predicted. Initial bulk heterojunction OPV devices fabricated with the fullerene acceptor phenyl C61 butyric acid methyl ester (PCBM) exhibit Voc ~ 700 mV, which supports the deep HOMO value obtained from CV. These results suggest the promise of this copolymer system.

  3. Donor-specific tolerance induction in organ transplantation via mixed splenocytes chimerism (United States)

    Yamazaki, S; Kanamoto, A; Takayama, T


    We have shown previously that donor-derived splenocytes can replace recipients' bone marrow and induce donor-specific tolerance (DST). We have also shown the usefulness of the chimeric state for the induction of DST. Further analysis of mixed splenocytes chimera, especially the role of each T cells in mixed splenocytes chimera, is indispensable issue for its clinical use. A chimeric state has been shown to achieve long-term survival in major histocompatibility complex (MHC)-mismatched grafts. The donor-derived splenocytes can replace recipients' bone marrow and induce DST. The long-term survival of allogeneic skin grafts was achieved without immunosuppressants. In this study we show the role of each T cell type in a splenocyte mixed chimera. This review provides a short summary of our original work, adding some supplemental interpretations. Mixed chimerism is thus considered an attractive approach for the induction of DST without the use of immunosuppressants. In this paper, we summarize some of the findings on mixed splenocyte chimeras and review mixed chimerism in recent organ transplantation. PMID:23656242

  4. Non-therapeutic (elective) ventilation of potential organ donors: the ethical basis for changing the law. (United States)

    Shaw, A B


    Non-therapeutic ventilation of potential organ donors would increase the supply of kidneys for transplantation. There are no major ethical objections to it. The means of permitting it are forbidden by laws with an ethical basis. A law permitting it would need an ethical basis. Introducing a third legal method of diagnosing death would be unethical. Expanding the power of the advance directive to permit procedures involving minimal harm would be ethical but not helpful. Extending the power of proxies to permit specific non-therapeutic procedures which caused or risked minimal harm to incompetent patients is the best way forward.

  5. On harm thresholds and living organ donation: must the living donor benefit, on balance, from his donation? (United States)

    Williams, Nicola Jane


    For the majority of scholars concerned with the ethics of living organ donation, inflicting moderate harms on competent volunteers in order to save the lives or increase the life chances of others is held to be justifiable provided certain conditions are met. These conditions tend to include one, or more commonly, some combination of the following: (1) The living donor provides valid consent to donation. (2) Living donation produces an overall positive balance of harm-benefit for donors and recipients which cannot be obtained in a less harmful manner. (3) Donation is not liable to cause significant and long-term morbidity to, or the death of, the donor. This paper critically examines the suggestion that these criteria are not sufficient to offer a general account of justified living organ donation in the context of competent volunteers and that key to justified living organ donation is that donors receive sufficient benefits from their donation that these outweigh the harms they suffer. However, although this view-termed here 'The Donor Benefit Standard'-directs welcome attention to the many and complex motives which may underlie living organ donation, this paper ultimately concludes that given the threats this position poses to individual autonomy and the lives of those in need of organ transplants 'The Donor Benefit Standard' should ultimately be rejected.

  6. Unpacking Donor Retention: Individual Monetary Giving to U.S.-Based Christian Faith-Related, International Nongovernmental Organizations

    Directory of Open Access Journals (Sweden)

    Ramya Ramanath


    Full Text Available This article examines an important but relatively overlooked aspect in the field of international giving in the U.S.—individual monetary donations to Christian faith-related international nongovernmental organizations (INGOs—and outlines the cognitive process influencing donors who choose to keep up their financial support to Christian faith-related INGOs. The propositions forwarded in this article draw on existing literature on Christian giving to international causes, INGO management, donor retention and finally, the logic of self-perception to highlight how existing donors might evaluate their repeat giving decision. The more existing donors of Christian faith-related INGOs can identify themselves with the INGO’s identity—comprising its beliefs and values, its claims to legitimacy, and performance—the more likely it is for donors to be satisfied and decide to maintain a stable relationship with the specific INGO.

  7. Deceased Organ Donors With a History of Increased Risk Behavior for the Transmission of Blood-Borne Viral Infection: The UK Experience. (United States)

    Trotter, Patrick B; Summers, Dominic M; Robb, Matthew; Hulme, William; Ushiro-Lumb, Ines; Watson, Christopher J E; Neuberger, James; Bradley, J Andrew


    Deceased organ donors are routinely screened for behaviors that increase the risk of transmissible blood-borne viral (BBV) infection, but the impact of this information on organ donation and transplant outcome is not well documented. Our aim was to establish the impact of such behavior on organ donation and utilization, as well transplant recipient outcomes. We identified all UK deceased organ donors from 2003 to 2015 with a disclosed history of increased risk behavior (IRB) including intravenous drug use (IVDU), imprisonment and increased risk sexual behavior. Of 17 262 potential donors, 659 (3.8%) had IRB for BBV and 285 (1.7%) were seropositive for BBV, of whom half had a history of IRB (mostly IVDU [78.5%]). Of actual donors with IRB, 393 were seronegative for viral markers at time of donation. A history of recent IVDU was associated with fewer potential donors proceeding to become actual organ donors (64% vs 75%, P = 0.007). Donors with IRB provided 1091 organs for transplantation (624 kidneys and 467 other organs). Transplant outcome was similar in recipients of organs from donors with and without IRB. There were 3 cases of unexpected hepatitis C virus transmission, all from an active IVDU donor who was hepatitis C virus seronegative at time of donation, but was found to be viremic on retrospective testing. Donors with a history of IRB provide a valuable source of organs for transplantation with good transplant outcomes and there is scope for increasing the use of organs from such donors.

  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. Graft reepithelialization after penetrating keratoplasty using organ-cultured donor tissue. (United States)

    Borderie, Vincent M; Touzeau, Olivier; Bourcier, Tristan; Allouch, Cécile; Laroche, Laurent


    To analyze graft reepithelialization after penetrating keratoplasty using organ-cultured donor tissue. Retrospective observational cohort study. One thousand one hundred thirty-eight consecutive penetrating keratoplasties (1003 patients) performed between 1992 and 2004 were analyzed, and 1003 were included (1 graft per patient was included). Slit-lamp examination after fluorescein staining. Graft reepithelialization time was recorded. The average graft reepithelialization time was 4.6+/-13.2 days (range, 1-210 days; median, 2.5 days). Complete corneal epithelial healing was obtained in 1 day in 28.5% of patients, in 3 days in 65.8%, in 7 days in 93.6%, and in 14 days in 97.0%. Postoperative chronic epithelial defects occurred in 3.0% of patients. In univariate analysis, death-to-storage time, storage time, deswelling time, rejection risk, trephination size, suture method, use of dexamethasone ointment during surgery, use of sodium hyaluronate during surgery, and use of high postoperative steroid regimen significantly influenced the graft reepithelialization time (Ptime. The use of sodium hyaluronate at the end of surgery to coat the ocular surface shortened graft reepithelialization time after penetrating keratoplasty using organ-cultured donor tissue. Graft reepithelialization time was longer in high-risk recipients, and it increased with high dexamethasone eyedrops regimen.

  10. Successful Renal Transplantation of Deceased Donor Kidneys With 100% Glomerular Fibrin Thrombi and Acute Renal Failure Due to Disseminated Intravascular Coagulation. (United States)

    Soares, Kevin C; Arend, Lois J; Lonze, Bonnie E; Desai, Niraj M; Alachkar, Nada; Naqvi, Fizza; Montgomery, Robert A


    Disseminated intravascular coagulation (DIC)-positive kidneys have historically been turned down for fear of poor outcomes. Higher severity injuries, which are prone to DIC, are typically seen in younger, otherwise healthy potential donors. The continued kidney allograft shortage has generated interest in the use of these DIC-positive grafts. There have been some reports of acceptable outcomes of renal transplantation using kidneys from donors with DIC. There are multiple clinical series demonstrating good outcomes from DIC-positive kidneys when the extent of glomeruli containing fibrin thrombi is less than 50% and donor renal function is preserved. These grafts are frequently associated with a period of delayed graft function. We report 2 transplants with kidneys from brain dead donors with known DIC. Both donors had renal failure and pretransplant renal biopsies showing 100% of the glomeruli containing fibrin thrombi. The recipients experienced delayed graft function requiring hemodialysis which was discontinued on postoperative days 18 and 39 for cases 1 and 2, respectively. Both patients are now over 14 months posttransplant with stable allograft function. Until clearer organ selection criteria are established, caution should be exercised when considering the use of kidneys with a similar phenotype and allocation decisions made by a multidisciplinary transplant team on a case-by-case basis.

  11. 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.

  12. Organ donation education initiatives: A report of the Donor Management Task Force. (United States)

    Michetti, Christopher P; Nakagawa, Thomas A; Malinoski, Darren; Wright, Charles; Swanson, LeAnn


    It is essential that hospitals and health professionals establish systems to facilitate patients' organ donation wishes. Donation education has been neither standardized nor systematic, and resources related to donation processes have not been widely accessible. This report describes 2 free, publicly available educational resources about the organ donation process created to advance the mission of basic education and improve donation processes within hospitals and health care systems. Members of the Donor Management Task Force of the Organ Donation and Transplantation Alliance (the Alliance) and the Health Resources and Services Administration of the US Department of Health and Human Services convened annually in person and by teleconferencing during the year to develop 2 educational vehicles on organ donation. Two educational products were developed: the Organ Donation Toolbox, an online repository of documents and resources covering all aspects of the donation process, and the Educational Training Video that reviews the basic foundations of a successful hospital donation system. There is a need for more research and education about the process of organ donation as it relates to the medical and psychosocial care of patients and families before the end of life. The educational products described can help fill this critical need. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Untapped potential in Australian hospitals for organ donation after circulatory death. (United States)

    Rakhra, Sandeep S; Opdam, Helen I; Gladkis, Laura; Arcia, Byron; Fink, Michael A; Kanellis, John; Macdonald, Peter S; Snell, Gregory I; Pilcher, David V


    To determine the potential for organ donation after circulatory death (DCD) in Australia by applying ideal and expanded organ suitability criteria, and to compare this potential with actual DCD rates. Retrospective cohort study. Setting, methods: We analysed DonateLife audit data for patients aged 28 days to 80 years who died between July 2012 and December 2014 in an intensive care unit or emergency department, or who died within 24 hours of discharge from either, in the 75 Australian hospitals contributing data to DonateLife. Ideal and expanded organ donation criteria were derived from international and national guidelines, and from expert opinion. Potential DCD organ donors were identified by applying these criteria to patients who had been intubated and were neither confirmed as being brain-dead nor likely to have met brain death criteria at the official time of death. 8780 eligible patients were identified, of whom 202 were actual DCD donors. For 193 potential ideal (61%) and 313 potential expanded criteria DCD donors (72%), organ donation had not been discussed with their families; most were potential donors of kidneys (416 potential donors) or lungs (117 potential donors). Potential donors were typically older, dying of non-neurological causes, and more frequently had chronic organ disease than actual donors. Identifying all these potential donors, assuming a consent rate of 60%, would have increased Australia's donation rate from 16.1 to 21.3 per million population in 2014. The untapped potential for DCD in Australia, particularly of kidneys and lungs, is significant. Systematic review of all patients undergoing end-of-life care in critical care environments for donor suitability could result in significant increases in organ donation rates.

  14. Study of the Contributions of Donor and Acceptor Photoexcitations to Open Circuit Voltage in Bulk Heterojunction Organic Solar Cells

    Directory of Open Access Journals (Sweden)

    Douglas Yeboah


    Full Text Available One of the key parameters in determining the power conversion efficiency (PCE of bulk heterojunction (BHJ organic solar cells (OSCs is the open circuit voltage . The processes of exciting the donor and acceptor materials individually in a BHJ OSC are investigated and are found to produce two different expressions for . Using the contributions of electron and hole quasi-Fermi levels and charge carrier concentrations, the two different expressions are derived as functions of the energetics of the donor and acceptor materials and the photo-generated charge carrier concentrations, and calculated for a set of donor-acceptor blends. The simultaneous excitation of both the donor and acceptor materials is also considered and the corresponding , which is different from the above two, is derived. The calculated from the photoexcitation of the donor is found to be somewhat comparable with that obtained from the photoexcitation of the acceptor in most combinations of the donor and acceptor materials considered here. It is also found that the calculated from the simultaneous excitations of donor and acceptor in BHJ OSCs is also comparable with the other two . All three thus derived produce similar results and agree reasonably well with the measured values. All three depend linearly on the concentration of the photoexcited charge carriers and hence incident light intensity, which agrees with experimental results. The outcomes of this study are expected to help in finding materials that may produce higher and hence enhanced PCE in BHJ OSCs.

  15. Early renal failure after domino liver transplantation using organs from donors with primary hyperoxaluria type 1. (United States)

    Saner, Fuat H; Treckmann, Juergen; Pratschke, Johann; Arbogast, Helmut; Rahmel, Axel; Vester, Udo; Paul, Andreas


    Organ shortage is responsible for high mortality rates of patients awaiting liver transplantation (LT). Domino transplantation has had reported success in patients with metabolic disorders. Primary hyperoxaluria type 1 (PH1) is a rare metabolic disorder. There are a few case reports that suggest that PH1 livers originating from donors that have undergone combined liver-kidney transplantation can be successfully used for domino transplantation. In the last decade, five patients received a domino liver transplant from patients with PH1 in the EUROTRANSPLANT region. In this study, we report the clinical course and outcome of these five patients who were received a domino graft transplant. All patients, with the exception of one, suffered from multifocal hepatocellular carcinoma and underwent domino LT from patients undergoing combined liver-kidney transplantation for PH1. Within the first 4 weeks, all the domino recipients developed dialysis-dependent kidney failure despite good liver function. Four of the five patients died. The only survivor underwent retransplantation due to hepatic artery thrombosis. Twenty months after transplantation, this patient is doing well and has had no recurrence of hepatocellular carcinoma. Domino LT using donors with PH1 results in early renal failure and cannot be recommended for transplantation unless preventive strategies have been identified.

  16. Effect of organ donation after circulatory determination of death on number of organ transplants from donors with neurologic determination of death. (United States)

    Rao, Vivek; Dhanani, Sonny; MacLean, Janet; Payne, Clare; Paltser, Elizabeth; Humar, Atul; Zaltzman, Jeffrey


    To increase the available pool of organ donors, Ontario introduced donation after circulatory determination of death (DCD) in 2006. Other jurisdictions have reported a decrease in donations involving neurologic determination of death (NDD) after implementation of DCD, with a drop in organ yield and quality. In this study, we examined the effect of DCD on overall transplant activity in Ontario. We examined deceased donor and organ transplant activity during 3 distinct 4-year eras: pre-DCD (2002/03 to 2005/06), early DCD (2006/07 to 2009/10) and recent DCD (2010/11 to 2013/14). We compared these donor groups by categorical characteristics. Donation increased by 57%, from 578 donors in the pre-DCD era to 905 donors in the recent DCD era, with a 21% proportion (190/905) of DCD donors in the recent DCD era. However, overall NDD donation also increased. The mean length of hospital stay before declaration for NDD was 2.7 days versus 6.0 days before withdrawal of life support and subsequent asystole in cases of DCD. The average organ yield was 3.73 with NDD donation versus 2.58 with DCD ( p organs from DCD donors were successfully transplanted. From the pre-DCD era to the recent DCD era, transplant activity in each era increased for all solid-organ recipients, including heart (from 158 to 216), kidney (from 821 to 1321), liver (from 477 to 657) and lung (from 160 to 305). Implementation of DCD in Ontario led to increased transplant activity for all solid-organ recipients. There was no evidence that the use of DCD was pre-empting potential NDD donation. In contrast to groups receiving other organs, heart transplant candidates have not yet benefited from DCD. © 2017 Canadian Medical Association or its licensors.

  17. Reimbursing live organ donors for incurred non-medical expenses: a global perspective on policies and programs. (United States)

    Sickand, M; Cuerden, M S; Klarenbach, S W; Ojo, A O; Parikh, C R; Boudville, N; Garg, A X


    Methods to reimburse living organ donors for the non-medical expenses they incur have been implemented in some jurisdictions and are being considered in others. A global understanding of existing legislation and programs would help decision makers implement and optimize policies and programs. We searched for and collected data from countries that practice living organ donation. We examined legislation and programs that facilitate reimbursement, focusing on policy mechanisms, eligibility criteria, program duration and types of expenses reimbursed. Of 40 countries, reimbursement is expressly legal in 16, unclear in 18, unspecified in 6 and expressly prohibited in 1. Donor reimbursement programs exist in 21 countries; 6 have been enacted in the last 5 years. Lost income is reimbursed in 17 countries, while travel, accommodation, meal and childcare costs are reimbursed in 12 to 19 countries. Ten countries have comprehensive programs, where all major cost categories are reimbursed to some extent. Out-of-country donors are reimbursed in 10 jurisdictions. Reimbursement is conditional on donor income in 7 countries, and recipient income in 2 countries. Many nations have programs that help living donors with their financial costs. These programs differ in operation and scope. Donors in other regions of the world are without support.

  18. Donor-acceptor alternating copolymer nanowires for highly efficient organic solar cells. (United States)

    Lee, Jaewon; Jo, Sae Byeok; Kim, Min; Kim, Heung Gyu; Shin, Jisoo; Kim, Haena; Cho, Kilwon


    A donor-acceptor conjugated copolymer enables the formation of nanowire systems that can be successfully introduced into bulk-heterojunction organic solar cells. A simple binary solvent mixture that makes polarity control possible allows kinetic control over the self-assembly of the crystalline polymer into a nanowire structure during the film-forming process. The enhanced photoconductivity of the nanowire-embedded photoactive layer efficiently facilitates photon harvesting in the solar cells. The resultant maximum power conversion efficiency is 8.2% in a conventional single-cell structure, revealing a 60% higher performance than in devices without nanowires. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Functional evaluation of human donation after cardiac death donor hearts using a continuous isolated myocardial perfusion technique: Potential for expansion of the cardiac donor population. (United States)

    Osaki, Satoru; Locher, Matthew R; Lushaj, Entela B; Akhter, Shahab A; Kohmoto, Takushi


    To investigate the resuscitation potential and contractile function in adult human donation after cardiac death (DCD) hearts by ex vivo perfusion. With institutional review board approval and under the DCD protocol at the University of Wisconsin (UW) Organ Procurement Organization, 5 brain dead (BD) and 5 DCD donor hearts were evaluated. All BD hearts were declined for clinical transplantation because of coronary artery disease, advanced age, or social history. All hearts were preserved by flushing and cold storage with UW solution. By using our ex vivo perfusion system, the left ventricular end systolic pressure-volume relationship (LV-ESPVR) was assessed for 2 hours of oxygenated blood reperfusion. All BD (n = 5) and 4 DCD hearts were successfully resuscitated. One DCD heart was unable to be resuscitated due to prolonged warm ischemic time (WIT; 174 minutes). Mean WIT for resuscitated DCD hearts (from extubation to flushing with cold UW solution) was 34 ± 3 minutes (range, 26 to 40 minutes); mean cold ischemic time for BD donors was 211 ± 31 minutes compared with 177 ± 64 minutes for DCD donors. The calculated LV-ESPVRs for BD hearts after 1 and 2 hours of reperfusion were 6.9 ± 0.7 and 5.7 ± 1.0 mm Hg/mL, respectively; LV-ESPVRs for DCD hearts after 1 and 2 hours of reperfusion were 5.6 ± 1.5 (P = .45) and 3.0 ± 0.7 mm Hg/mL (P = .07), respectively. We successfully resuscitated and measured ex vivo cardiac function in human DCD and BD donor hearts. Resuscitation potential in DCD hearts was achieved when the WIT was less than 40 minutes. Contractile performance in DCD hearts tended to be lower compared with BD hearts. Further investigation with longer reperfusion periods seems warranted. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  20. π-conjugated donor-acceptor porphyrin copolymers for organic photovoltaics (United States)

    Peng, Xiaobin; Huang, Yuying; Li, Lisheng; Cao, Yong


    Conjugated donor-acceptor (D-A) molecular structures play a very important role in the significant progress of organic photovotaics. However, the reports on conjugated D-A porphyrin polymers for organic solar cells are very limited. In this work, five conjugated D-A porphyrin copolymers PEZPEBTA(C12), PEZPEBT, PEZPEBTff, PEZPETPD(O), and PEZPETDPPT(O) were synthesized by Sonagashira coupling of a porphyrin donor unit with five typical acceptor units 2-dodecyl-2H-benzotriazole, benzo[1,2,5]thiadiazole, 5,6-difluoro-benzo[1,2,5]thiadiazole, 5-octyl-thieno[3,4-c]pyrrole-4,6-dione, and 3,6-bis-(thiophen-2-yl)-2,5-dioctyl-2,5-dihydro-pyrrolo[3,4-c]pyrrole-1,4-dione linked by ethynylene linkages, respectively. They possess excellent thermal stability with a decomposition temperature of around 400°C. All absorption spectra of the copolymers were significantly red shifted with enhanced Q bands at the near-infrared region both in solutions and in films due to the simultaneous introduction of ethynylene linkages and acceptor units, which make the polymer main chains coplanar and π-conjugated and enhance the intramolecular charge transfer. PEZPEBT and PEZPEBTff are electrochemically active in both the oxidation and reduction regions, while PEZPEBTA(C12), PEZPETPD(O), and PEZPETDPPT(O) show only oxidation peaks. Power conversion efficiencies of 0.12%, 0.41%, 0.26%, 0.19%, and 0.41% were achieved for the polymer solar cells based on PEZPEBTA(C12), PEZPEBT, PEZPEBTff, PEZPETPD(O), and PEZPETDPPT(O), respectively, under AM 1.5, 100 mW/cm2 with methanofullerene [6,6]-phenyl C61-butyric acid methyl ester (PC61BM) (1:2, w/w) as the active layer in the presence of 3% pyridine.

  1. Community preferences for the allocation of donor organs for transplantation: a discrete choice study. (United States)

    Howard, Kirsten; Jan, Stephen; Rose, John M; Wong, Germaine; Irving, Michelle; Tong, Allison; Craig, Jonathan C; Chadban, Steven; Allen, Richard D; Cass, Alan


    Demand for organs for transplant exceeds supply. There is an ongoing debate about the relative weighting that should be given to different allocation criteria. Little is known about the relative weight the community places on various allocation criteria. This study aims to determine community preferences for organ allocation. Community respondents recruited from a web-based panel chose which patient received a transplant in 30 scenarios presenting two hypothetical patients. Patients were described in age, sex, previous transplants, whether they or family were registered donors, had caring responsibilities, adherence, time on waiting list, estimated survival and quality of life (QOL) with and without transplant, comorbidities, and lifestyle factors, such as smoking. Analyses were conducted in NLOGIT 5.0, using a mixed-logit model. Two thousand fifty-one respondents aged 18 to 83 years completed the survey. All attributes significantly influenced recipient choice except sex and having diabetes. Younger patients were preferred over older patients. Family member donor registration, having caring responsibilities, and longer time on waiting list increased priority. Pretransplant life expectancy was valued more highly than posttransplant life expectancy; 1 year less of pretransplant life expectancy required an increase of 1.49 years in posttransplant life expectancy to compensate. Posttransplant QOL was valued more highly than pretransplant QOL. Lower pretransplant life expectancy (need) was more important than higher posttransplant life expectancy (utility). Although current allocation algorithms are consistent with community preferences for prioritizing children and time on the waiting list, favoring patients with high predicted posttransplant survival as potential recipients may not be aligned with community preferences.


    Directory of Open Access Journals (Sweden)

    S. V. Gautier


    Full Text Available Aim. To estimate the requirement of the population of the Russian Federation for an organ transplantation and donor resource, to offer approach to planning of an effective network of the medical organizations (the centers of transplantation. Materials and methods. The analysis and comparison of statistical data on population, number of the patients receiving a dialysis, data about medical care on an organ transplantation in Russia and foreign countries is made. Results. On the basis of what the assessment of requirement of the population of the Russian Federation in an organ transplantation and donor resource is carried out, approach to planning of an effective network of the medical organizations (the centers of transplantation and scenarios of development of organ do- nation and transplantation in Russia is offered. Conclusion. To provide the population of the Russian Federation with medical care on an organ transplantation according to real requirement and donor resource, in each region of the Russian Federation have to be organized deceased organ donation and transplantation of a cadaveric kidney. But the transplantation of extrarenal organs is better to develop in the federal centers of hi-tech medical care with donor providing from territories of adjacent regions. 

  3. State of deceased donor transplantation in India: A model for developing countries around the world. (United States)

    Abraham, Georgi; Vijayan, Madhusudan; Gopalakrishnan, Natarajan; Shroff, Sunil; Amalorpavanathan, Joseph; Yuvaraj, Anand; Nair, Sanjeev; Sundarrajan, Saravanan


    Renal replacement therapy (RRT) resources are scarce in India, with wide urban-rural and interstate disparities. The burden of end-stage renal disease is expected to increase further due to increasing prevalence of risk factors like diabetes mellitus. Renal transplantation, the best RRT modality, is increasing in popularity, due to improvements made in public education, the deceased donor transplantation (DDT) programme and the availability of free and affordable transplant services in government hospitals and certain non-governmental philanthropic organizations. There are about 120000 haemodialysis patients and 10000 chronic peritoneal dialysis patients in India, the majority of them waiting for a donor kidney. Shortage of organs, lack of transplant facilities and high cost of transplant in private facilities are major barriers for renal transplantation in India. The DDT rate in India is now 0.34 per million population, among the lowest in the world. Infrastructural development in its infancy and road traffic rules not being strictly implemented by the authorities, have led to road traffic accidents being very common in urban and rural India. Many patients are declared brain dead on arrival and can serve as potential organ donors. The DDT programme in the state of Tamil Nadu has met with considerable success and has brought down the incidence of organ trade. Government hospitals in Tamil Nadu, with a population of 72 million, provide free transplantation facilities for the underprivileged. Public private partnership has played an important role in improving organ procurement rates, with the help of trained transplant coordinators in government hospitals. The DDT programmes in the southern states of India (Tamil Nadu, Kerala, Pondicherry) are advancing rapidly with mutual sharing due to public private partnership providing vital organs to needy patients. Various health insurance programmes rolled out by the governments in the southern states are effective in

  4. Utilization of increased risk for transmission of infectious disease donor organs in solid organ transplantation: Retrospective analysis of disease transmission and safety. (United States)

    Irwin, Linda; Kotton, Camille N; Elias, Nahel; Palafox, Julie; Basler, Debra; Shao, Sarah H; Lester, William; Zhang, Xiaofeng; Kimball, Brendan; Trencher, Carrie; Fishman, Jay A


    The inadequate supply of transplantable organs necessitates new approaches to organ availability. Serologies and nucleic acid testing (NAT) for hepatitis C virus (HCV), hepatitis B virus (HBV), and human immunodeficiency virus (HIV) are used in microbiologic screening of potential organ donors. Organs from donors considered at "high risk" (Centers for Disease Control and Prevention, CDC 1994) or "increased risk" (U.S. Public Health Service, PHS 2013) for transmission of viral infection to recipients may provide an expanded source of organs for transplantation. We review a single-center experience with 257 adult organ recipients of organs from donors meeting either CDC 1994 or PHS 2013 risk criteria between 2011 and 2016. Tracking these transplants required modification of the Transplant Center electronic database to identify all recipients of increased-risk donor (IRD) organs, documentation of informed consent, and microbiologic testing data. No transmissions of HIV, HBV, or HCV were identified by NAT or clinically. Nine patients developed positive serologic assays for one of the tested viruses; all recipients were retested and remain negative by NAT. Notably, post-transplant HBV core serologies reverted to negative on re-testing; these positive serologies are likely false positives caused by receipt of blood products. Use of IRD organs can be performed safely with appropriate informed consent and rigorous pre- and post-transplant microbiological testing. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Organ transplantation from "increased infectious risk donors": the experience of the Nord Italia Transplant program - A retrospective study. (United States)

    Grossi, Paolo Antonio; Dalla Gasperina, Daniela; Lombardi, Domenico; Ricci, Andrea; Piccolo, Giuseppe; Nanni Costa, Alessandro


    The purpose of this study was to assess the safety and the clinical outcome associated with organ transplantation from increased infectious risk donors (IRD). We retrospectively identified all adult deceased IRD referred to the Nord Italia Transplant program coordinating center from November 2006 to November 2011. All potential donors were screened for social risk factors that may increase the risk of donor-derived infection with human immunodeficiency (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV). All recipients were followed monthly for the first 6 months post-transplant. A total of 86 potential IRD were identified during the study period. Three hundred and seventy-nine organs from IRD were offered to the transplant centers, but only 185 (48.8%) were used for transplantation. Organs from IRD were transplanted into 174 recipients. The complete follow-up data were available for 152 of 174 (87.3%) recipients. During a mean follow-up of 11.7 months (median 12; range 2.4-12), no transmission of HIV, HBV, or syphilis was documented by serology and nucleic acid testing (NAT) testing. Two patients transplanted with organs from HCV-RNA-positive donors, as expected, developed post-transplant HCV infection. In conclusion, the use of organs from IRD was associated with a safe increase in the transplant procedures in our country. © 2017 Steunstichting ESOT.

  6. Application of solution processable squaraine dyes as electron donors for organic bulk-heterojunction solar cells. (United States)

    Rao, B Ananda; Yesudas, K; Kumar, G Siva; Bhanuprakash, K; Rao, V Jayathirtha; Sharma, G D; Singh, S P


    New low bandgap small molecules based on a squaraine (SQ) chromophore, bis[4-(2,6-di-tert-butyl)vinylpyrylium]squaraine (TBU-SQ), bis[2,6-di-tert-butyl-4-(prop-1-en-2-yl)pyrylium]squaraine (MeTBU-SQ) and bis[4-(but-1-en-2-yl)-2,6-di-tert-butylpyrylium]squaraine (EtTBU-SQ), were synthesized and used as electron donors along with PC70BM for their application in solution processed organic bulk-heterojunction (OBHJ) solar cell (SC). The long wavelength of these SQ dyes are located in between 650-750 nm in thin films and the optical bandgaps are about 1.64, 1.52 and 1.48 eV, respectively. The electrochemical properties of these SQ dyes indicate that they are well suited for the fabrication of OBHJSCs as electron donors along with fullerene derivatives as electron acceptors. The OBHJ photovoltaic (PV) devices fabricated with the blend of TBU-SQ:PC70BM, MeTBU-SQ:PC70BM and EtTBU-SQ:PC70BM cast from chloroform (CF) solvent exhibited a power conversion efficiency (PCE) of 1.71%, 2.15%, and 1.89%, respectively. The PCE of the OBHJSCs based on MeTBU-SQ:PC70BM blends cast from DIO-THF (DIO = 1,8-diiodooctane) additive solvent and cast from DIO-THF with subsequent thermal annealing have been further improved up to 2.73% and 3.14%, respectively. This enhancement in the PCE is attributed to the improvement in the crystalline nature of the blend and more balanced charge transport resulting from the higher hole mobility. All these results have been supported by the quantum chemical calculations.

  7. Giving Your Last Gift: A Study of the Knowledge, Attitude and Information of Greek Students Regarding Organ Donation. (United States)

    Katsari, Vasiliki; Domeyer, Philip J; Sarafis, Pavlos; Souliotis, Kyriakos


    Organ donation rates in Greece are the lowest in the European Union. Studying and improving young students' awareness may increase organ donation rates. This study aimed to investigate young students' knowledge, attitude and information regarding organ donation and whether they are modified by putative predictors. A 62-item electronic questionnaire was sent to 1451 eligible students aged 18-30 years in 16 Greek public technical schools. Two composite scales (knowledge and attitude) were created. The multivariate statistical analysis included ordinal logistic and linear regression, as appropriate. Only 37.9% of the students knew the correct definition of organ donation, 40.3% knew which organs can be donated, 27.4% were informed about the new Greek legislation, and 83.1% acknowledged the need for better information. Although 60.5% would donate an organ after death, only 16.1% would become living donors. Although 83.1% of the students declared knowing what brain death means, 18.6% believe that a brain-dead person could fully recover and 32.3% are unsure about it. Being a health professional or a blood donor, the parent's educational level, the wish to donate all organs after death, the information from announcements or posters, the fear of organ removal after death without prior consent, the consent for autopsy, the wish for better information, and the misbelief that a brain-dead person could fully recover emerged as important predictors of the knowledge and attitude, regarding organ donation. An important lack of knowledge and misperceptions were noted regarding organ donation. Significant predictors were identified.

  8. Outcomes of transplantation using organs from a donor infected with Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae. (United States)

    Ariza-Heredia, E J; Patel, R; Blumberg, E A; Walker, R C; Lewis, R; Evans, J; Sankar, A; Willliams, M D; Rogers, J; Milano, C; Razonable, R R


    Transmission of pathogens from donor to recipient is a potential complication of organ transplantation. Herein, we describe the clinical course and outcomes of 4 transplant recipients who received tissues from a donor with multi-organ infection with Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae. Recipient 1 underwent simultaneous liver and kidney transplantation for alpha-1 antitrypsin deficiency and alcohol-related cirrhosis, and acute tubular necrosis, respectively. Soon after transplantation, he developed an infected hematoma and peritonitis due to KPC-producing K. pneumoniae despite receiving tigecycline prophylaxis. He was treated with a prolonged course of tigecycline, amikacin, and meropenem, in conjunction with surgical evacuation and percutaneous drainage of the infected fluid collections. Recipient 2 underwent living-donor liver transplantation for cholangiocarcinoma and primary sclerosing cholangitis using vein graft from the donor infected with KPC-producing K. pneumoniae. Culture of the preservation fluid containing the vein graft was positive for KPC-producing K. pneumoniae. The patient received preemptive amikacin and tigecycline, and he did not develop any infection (as evidenced by negative surveillance blood cultures). The isolates from the donor and Recipients 1 and 2 were indistinguishable by pulsed-field gel electrophoresis. Recipients 3 and 4 underwent kidney and heart transplantation, respectively; both patients received perioperative tigecycline prophylaxis and did not develop infections due to KPC-producing K. pneumoniae. All transplant recipients had good short-term outcomes. These cases highlight the importance of inter-institutional communication and collaboration to ensure the successful management of recipients of organs from donors infected with multidrug-resistant organisms. © 2012 John Wiley & Sons A/S.

  9. Role of the charge transfer state in organic donor-acceptor solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Deibel, Carsten; Strobel, Thomas [Experimental Physics VI, Julius-Maximilians-University of Wuerzburg (Germany); Dyakonov, Vladimir [Experimental Physics VI, Julius-Maximilians-University of Wuerzburg (Germany); Bavarian Centre for Applied, Energy Research (ZAE Bayern), Wuerzburg (Germany)


    Charge transfer complexes are interfacial charge pairs residing at the donor-acceptor heterointerface in organic solar cell. Experimental evidence shows that it is crucial for the photovoltaic performance, as both photocurrent and open circuit voltage directly depend on it. For charge photogeneration, charge transfer complexes represent the intermediate but essential step between exciton dissociation and charge extraction. Recombination of free charges to the ground state is via the bound charge transfer state before being lost to the ground state. In terms of the open circuit voltage, its maximum achievable value is determined by the energy of the charge transfer state. An important question is whether or not maximum photocurrent and maximum open circuit voltage can be achieved simultaneously. The impact of increasing the CT energy - in order to raise the open circuit voltage, but lowering the kinetic excess energy of the CT complexes at the same time - on the charge photogeneration will accordingly be discussed. Clearly, the fundamental understanding of the processes involving the charge transfer state is essential for an optimisation of the performance of organic solar cells. (Abstract Copyright [2010], Wiley Periodicals, Inc.)

  10. Organic donor-acceptor thin film systems. Towards optimized growth conditions

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Kerstin Andrea


    In this work the preparation of organic donor-acceptor thin films was studied. A chamber for organic molecular beam deposition was designed and integrated into an existing deposition system for metallic thin films. Furthermore, the deposition system was extended by a load-lock with integrated bake-out function, a chamber for the deposition of metallic contacts via stencil mask technique and a sputtering chamber. For the sublimation of the organic compounds several effusion cells were designed. The evaporation characteristic and the temperature profile within the cells was studied. Additionally, a simulation program was developed, which calculates the evaporation characteristics of different cell types. The following processes were integrated: evaporation of particles, migration on the cell walls and collisions in the gas phase. It is also possible to consider a temperature gradient within the cell. All processes can be studied separately and their relative strength can be varied. To verify the simulation results several evaporation experiments with different cell types were employed. The thickness profile of the prepared thin films was measured position-dependently. The results are in good agreement with the simulation. Furthermore, the simulation program was extended to the field of electron beam induced deposition (EBID). The second part of this work deals with the preparation and characterization of organic thin films. The focus hereby lies on the charge transfer salt (BEDT-TTF)(TCNQ), which has three known structure variants. Thin films were prepared by different methods of co-evaporation and were studied with optical microscopy, X-ray diffraction and energy dispersive X-ray spectroscopy (EDX).The formation of the monoclinic phase of (BEDT-TTF)(TCNQ) could be shown. As a last part tunnel structures were prepared as first thin film devices and measured in a He{sub 4} cryostat. (orig.)

  11. Long-term results after lung transplantation using organs from circulatory death donors: a propensity score-matched analysis†. (United States)

    Sabashnikov, Anton; Patil, Nikhil P; Popov, Aron-Frederik; Soresi, Simona; Zych, Bartlomiej; Weymann, Alexander; Mohite, Prashant N; García Sáez, Diana; Zeriouh, Mohamed; Wahlers, Thorsten; Choi, Yeong-Hoon; Wippermann, Jens; Wittwer, Thorsten; De Robertis, Fabio; Bahrami, Toufan; Amrani, Mohamed; Simon, André R


    Due to organ shortage in lung transplantation (LTx), donation after circulatory death (DCD) has been implemented in several countries, contributing to an increasing number of organs transplanted. We sought to assess long-term outcomes after LTx with organs procured following circulatory death in comparison with those obtained from donors after brain death (DBD). Between January 2007 and November 2013, 302 LTxs were performed in our institution, whereby 60 (19.9%) organs were retrieved from DCD donors. We performed propensity score matching (DCD:DBD = 1:2) based on preoperative donor and recipient factors that were significantly different in univariate analysis. After propensity matching, there were no statistically significant differences between the groups in terms of demographics and preoperative donor and recipient characteristics. There were no significant differences regarding intraoperative variables and total ischaemic time. Patients from the DCD group had significantly higher incidence of primary graft dysfunction grade 3 at the end of the procedure (P = 0.014), and significantly lower pO2/FiO2 ratio during the first 24 h after the procedure (P = 0.018). There was a trend towards higher incidence of the need for postoperative extracorporeal life support in the DCD group. Other postoperative characteristics were comparable. While the overall cumulative survival was not significantly different, the DCD group had significantly poorer results in terms of bronchiolitis obliterans syndrome (BOS)-free survival in the long-term follow-up. Long-term results after LTx with organs procured following DCD are in general comparable with those obtained after DBD LTx. However, patients transplanted using organs from DCD donors have a predisposition for development of BOS in the longer follow-up. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  12. Opinions of Dutch Liver Transplant Recipients on Anonymity of Organ Donation and Direct Contact With the Donors Family

    NARCIS (Netherlands)

    Annema-de Jong, Coby; op den Dries, Sanna; van den Berg, Aad P.; Ranchor, Adelita V.; Porte, Robert J.

    Background. In the Netherlands, anonymity of organ donation, which is currently protected by legislation, has come under discussion. In the Dutch society, a tendency to allow direct contact between transplant recipients and their donor's family is noticeable. As little is known about the opinion of

  13. Control of electric field strength and orientation at the donor-acceptor interface in organic solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Liu, A.; Zhao, S.; Wu, J. [Materials Science and Engineering Department, Stanford University, Stanford, CA (United States); Rim, S.B. [Electrical Engineering Department, Stanford University, Stanford, CA (United States); Koenemann, M.; Erk, P. [BASF GmbH, Ludwigshafen (Germany); Peumans, P.


    Electrical doping is essential to achieve efficient photocurrent extraction in small-molecular-weight organic solar cells. It is shown that such doping creates strong electric fields at the donor-acceptor interface that prevent geminate electron-hole recombination. (Abstract Copyright [2008], Wiley Periodicals, Inc.)

  14. Design of Donor Polymers with Strong Temperature-Dependent Aggregation Property for Efficient Organic Photovoltaics. (United States)

    Hu, Huawei; Chow, Philip C Y; Zhang, Guangye; Ma, Tingxuan; Liu, Jing; Yang, Guofang; Yan, He


    Bulk heterojunction (BHJ) organic solar cells (OSCs) have attracted intensive research attention over the past two decades owing to their unique advantages including mechanical flexibility, light weight, large area, and low-cost fabrications. To date, OSC devices have achieved power conversion efficiencies (PCEs) exceeding 12%. Much of the progress was enabled by the development of high-performance donor polymers with favorable morphological, electronic, and optical properties. A key problem in morphology control of OSCs is the trade-off between achieving small domain size and high polymer crystallinity, which is especially important for the realization of efficient thick-film devices with high fill factors. For example, the thickness of OSC blends containing state-of-the-art PTB7 family donor polymers are restricted to ∼100 nm due to their relatively low hole mobility and impure polymer domains. To further improve the device performance and promote commercialization of OSCs, there is a strong demand for the design of new donor polymers that can achieve an optimal blend morphology containing highly crystalline yet reasonably small domains. In this Account, we highlight recent progress on a new family of conjugated polymers with strong temperature-dependent aggregation (TDA) property. These polymers are mostly disaggregated and can be easily dissolved in solution at high temperatures, yet they can strongly aggregate when the solution is cooled to room temperature. This unique aggregation property allows us to control the disorder-order transition of the polymer during solution processing. By preheating the solution to high temperature (∼100 °C), the polymer chains are mostly disaggregated before spin coating; as the temperature of the solution drops during the spin coating process, the polymer can strongly aggregate and form crystalline domains yet that are not excessivelylarge. The overall blend morphology can be optimized by various processing conditions (e

  15. Association between education about organ transplantation aimed at medical students and the acquisition of the organ donor card. A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Xiomara Benavides-López


    Full Text Available Background. The transplantation group of the National University of Colombia considers that education about transplants is important to raise the donation rate in this country. Objective. To find a statistical association between education about transplantation aimed at medical students and the number of students and their families bearing the organ donor card. Materials and methods. Cross-sectional analytical study. Two surveys were designed and sent to two different student populations. The first group had taken the course "Human Organ and Tissue Transplantation", and the second group was composed of students from the fifth semester of medical education. The statistical test used was difference of proportions, sample size of 50 people, statistical power of 80%, difference in proportions 20%, alpha 0.05, p <0.05. Results. The surveys were answered by 29 students from first group and 74 students from second group. First question: "Do you carry the organ donor card?", p-value of 0.03 found. Second question: "Do your family members carry the organ donor card?", p-value of 0.732 found. Affirmative answer to the first question, p=0.10 and answer to second question, p=0.0005. Conclusion. An association was found between education about transplantation focused on medical students and bearing the organ donor card and communicating their wishes to their families. Likewise, an association between education and a positive attitude toward donation was found in the families of students that participated on the course "Human Organ and Tissue Transplantation".

  16. Results from a horizon scan on risks associated with transplantation of human organs, tissues and cells: from donor to patient. (United States)

    Herberts, C A; Park, M V D Z; Pot, J W G A; de Vries, C G J C A


    The successful transplantation of human materials such as organs, tissues and cells into patients does not only depend on the benefits, but also on the mitigation of risks. To gain insight into recent publications on risks associated with the process of transferring human materials from donor to recipient we performed a horizon scan by reviewing scientific literature and news websites of 2011 on this subject. We found there is ample information on how extended donor criteria, such as donor age, affect the survival rates of organs or patients. Interestingly, gender mismatch does not appear to be a major risk factor in organ rejection. Data on risks of donor tumor transmission was very scarce; however, risk categories for various tumor types have been suggested. In order to avoid rejection, a lot of research is directed towards engineering tissues from a patient's own tissues and cells. Some but not all of these developments have reached the clinic. Developments in the field of stem cell therapy are rapid. However, many hurdles are yet to be overcome before these cells can be applied on a large scale in the clinic. The processes leading to genetic abnormalities in cells differentiated from stem cells need to be identified in order to avoid transplantation of aberrant cells. New insights have been obtained on storage and preservation of human materials, a critical step for success of their clinical use. Likewise, quality management systems have been shown to improve the quality and safety of human materials used for transplantation.

  17. Improved access to histopathology using a digital system could increase the organ donor pool and improve allocation. (United States)

    Neil, Desley A H; Roberts, Ian S D; Bellamy, Christopher O C; Wigmore, Stephen J; Neuberger, James M


    Improvements in digital slide scanners have reached a stage that digital whole slide images (WSIs) can be used for diagnostic purposes. A digital system for histopathology, analogous to the systems used in radiology, would allow the establishment of networks of subspecialist histopathologists to provide a regional, national or even international rota to support out of hours histopathology for emergency frozen sections, urgent paraffin sections and to generally improve efficiencies with the provision of histopathology services. Such a system would promote appropriate organ utilization by allowing rapid characterization of unexpected lesions in the donor to determine whether donation should occur and further characterization of the organ, such as the degree of fibrosis in the kidney or steatosis in the liver, to determine whether the organ should be used. If introduced across Europe, this would promote safe and effective exchange of organs and support a cost efficient use of pathologist expertise. This review article outlines current issues with the provision of an urgent out of hours histopathology service and focuses on how such a service has the potential to increase organ donors, improve allocation, sharing and the use of available donor organs. © 2014 Steunstichting ESOT.

  18. Ex vivo lung perfusion to improve donor lung function and increase the number of organs available for transplantation. (United States)

    Valenza, Franco; Rosso, Lorenzo; Coppola, Silvia; Froio, Sara; Palleschi, Alessandro; Tosi, Davide; Mendogni, Paolo; Salice, Valentina; Ruggeri, Giulia M; Fumagalli, Jacopo; Villa, Alessandro; Nosotti, Mario; Santambrogio, Luigi; Gattinoni, Luciano


    This paper describes the initial clinical experience of ex vivo lung perfusion (EVLP) at the Fondazione Ca' Granda in Milan between January 2011 and May 2013. EVLP was considered if donor PaO2 /FiO2 was below 300 mmHg or if lung function was doubtful. Donors with massive lung contusion, aspiration, purulent secretions, pneumonia, or sepsis were excluded. EVLP was run with a low-flow, open atrium and low hematocrit technique. Thirty-five lung transplants from brain death donors were performed, seven of which after EVLP. EVLP donors were older (54 ± 9 years vs. 40 ± 15 years, EVLP versus Standard, P transplantation was higher (79 [40-84] vs. 39 [36-46], P transplantation, primary graft dysfunction (PGD72 grade 3, 32% vs. 28%, EVLP versus Standard, P = 1), mortality at 30 days (0% vs. 0%, P = 1), and overall survival (71% vs. 86%, EVLP versus Standard P = 0.27) were not different between groups. EVLP enabled a 20% increase in available donor organs and resulted in successful transplants with lungs that would have otherwise been rejected ( number: NCT01967953). © 2014 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.

  19. Identifying the most suitable endogenous control for determining gene expression in hearts from organ donors

    Directory of Open Access Journals (Sweden)

    Gómez Enrique


    Full Text Available Abstract Background Quantitative real-time reverse transcription PCR (qRT-PCR is a useful tool for assessing gene expression in different tissues, but the choice of adequate controls is critical to normalise the results, thereby avoiding differences and maximizing sensitivity and accuracy. So far, many genes have been used as a single reference gene, without having previously verified their value as controls. This practice can lead to incorrect conclusions and recent evidence indicates a need to use the geometric mean of data from several control genes. Here, we identified an appropriate set of genes to be used as an endogenous reference for quantifying gene expression in human heart tissue. Results Our findings indicate that out of ten commonly used reference genes (GADPH, PPIA, ACTB, YWHAZ, RRN18S, B2M, UBC, TBP, RPLP and HPRT, PPIA, RPLP and GADPH show the most stable gene transcription levels in left ventricle specimens obtained from organ donors, as assessed using geNorm and Normfinder software. The expression of TBP was found to be highly regulated. Conclusion We propose the use of PPIA, RPLP and GADPH as reference genes for the accurate normalisation of qRT-PCR performed on heart tissue. TBP should not be used as a control in this type of tissue.

  20. Dissociation of charge-transfer states at donor-acceptor interfaces of organic heterojunctions (United States)

    Inche Ibrahim, M. L.


    The dissociation of charge-transfer (CT) states into free charge carriers at donor-acceptor (DA) interfaces is an important step in the operation of organic solar cells and related devices. In this paper, we show that the effect of DA morphology and architecture means that the directions of CT states (where a CT state’s direction is defined as the direction from the electron to the hole of the CT state) may deviate from the direction of the applied electric field. The deviation means that the electric field is not fully utilized to assist, and could even hinder the dissociation process. Furthermore, we show that the correct charge carrier mobilities that should be used to describe CT state dissociation are the actual mobilites at DA interfaces. The actual mobilities are defined in this paper, and in general are not the same as the mobilities that are used to calculate electric currents which are the mobilites along the direction of the electric field. Then, to correctly describe CT state dissociation, we modify the widely used Onsager-Braun (OB) model by including the effect of DA morphology and architecture, and by employing the correct mobilities. We verify that when the modified OB model is used to describe CT state dissociation, the fundamental issues that concern the original OB model are resolved. This study demonstrates that DA morphology and architecture play an important role by strongly influencing the CT state dissociation as well as the mobilites along the direction of the electric field.

  1. Solution-processable functionalized graphene in donor/acceptor-type organic photovoltaic cells

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Zhiyong; He, Dawei; Wang, Yongsheng; Wu, Hongpeng; Wang, Jigang [Key Laboratory of Luminescence and Optical Information, Ministry of Education, Institute of Optoelectronic Technology, Beijing Jiaotong University, Beijing 100044 (China)


    An organic photovoltaic device based on an acceptor of solution-processable functionalized graphene (SPFGraphene) was designed. The devices were based on heterostructure polymer-graphene composite layers. The structural configuration of devices is ITO/PEDOT:PSS/P3HT:SPFGraphene/LiF/Al. Due to the functional groups of the graphene, a homogeneous blend of graphene-polymer composite could be obtained. In the graphene-polymer composite, the graphene acted as exciton dissociation sites and provided the transport pathway of LUMO-graphene-Al. Doping of graphene into P3HT resulted in appropriate energetic distance between HOMO and LUMO of the donor/acceptor for a high open circuit voltage and provided higher exciton dissociation volume mobility of carrier transport for a large short-circuit current density. The device containing only 10 wt% of graphene shows the best performance with a power conversion efficiency of 0.88%, an open-circuit voltage of 0.77 V, and a short-circuit current density of 3.72 mA/cm{sup 2}. (author)

  2. Theoretical study on the application of double-donor branched organic dyes in dye-sensitized solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Lu, Yan-Hong; Liu, Rui-Rui [Gansu Key Laboratory of Polymer Materials, College of Chemistry and Chemical Engineering, Key Laboratory of Eco-environment-related Polymer Materials, Ministry of Education, Northwest Normal University, Lanzhou, 730070, Gansu (China); Zhu, Kai-Li [College of Chemistry and Life Science, Gansu Normal University for Nationalities, Hezuo, 747000, Gansu (China); Song, Yan-Lin [Gansu Key Laboratory of Polymer Materials, College of Chemistry and Chemical Engineering, Key Laboratory of Eco-environment-related Polymer Materials, Ministry of Education, Northwest Normal University, Lanzhou, 730070, Gansu (China); Geng, Zhi-Yuan, E-mail: [Gansu Key Laboratory of Polymer Materials, College of Chemistry and Chemical Engineering, Key Laboratory of Eco-environment-related Polymer Materials, Ministry of Education, Northwest Normal University, Lanzhou, 730070, Gansu (China)


    A novel organic dye with 2D-A structure has been designed and calculated whereby density functional theory (DFT) and time-dependent density functional theory (TD-DFT) for dye-sensitized solar cells. The double-donor branched dye which was consisted of two separated light-harvesting moieties was beneficial to photocurrent generation. First, we discussed the effects of different donor chains on photoelectric performance in the dye molecule, using the DTP-B8 which was a previously reported structure as the reference. Only to conclude that the suitable length can achieve the satisfactory efficiency. Secondly, to modify and sift potential sensitizers further, three series of dyes (BC-series, CB-series and CC-series) were designed and characterized. The increased molar extinction coefficient and the red-shifted λ{sub max} was attributed to an increasing in electron conjunction. This work presented a new route to design sensitizers that provide two channels for donating more electrons and improve the final efficiency. It is expected to provide some theoretical guidance on designing and synthetizing high efficiency photosensitive dye in the future experiments. - Highlights: • A novel organic dye with 2D-A structure was designed and characterized. • The double-donor branched dye was consisted of two separated light-harvesting paths. • The double-donor branched dye was beneficial to photocurrent generation. • The molar extinction coefficient was greatly improved in this novel structure. • Four promising candidates have been screened out.


    Khodeli, N; Chkhaidze, Z; Partsakhashvili, D; Pilishvili, O; Kordzaia, D


    The number of patients who are in the "Transplant Waiting List" is increasing each year. At the same time, as a result of the significant shortage of donor organs, part of the patients dies without waiting till surgery. According to the Maastricht classification for non-heart beating donors, the patients, who had cardiac arrest outside the hospital (in the uncontrolled by medical staff conditions) should be considered as a potential donors of category II. For these patients, the most effective resuscitation is recommended. The extracorporeal life support (ECLS) considers the connection to a special artificial perfusion system for the restoration of blood circulation out-of-hospital with further transportation to the hospital. If restoration of independent cardiac activity does not occur, in spite of the full range of resuscitative measures, these patients may be regarded as potential donors. The final decision should be received in the hospital, by the council of physicians, lawyers and patient's family members. Until the final decision, the prolongation of ECLS and maintaining adequate systemic and organic circulation is recommended.

  4. Deceased Organ Donors With a History of Increased Risk Behavior for the Transmission of Blood-Borne Viral Infection: The UK Experience.


    Trotter, PB; Summers, DM; Robb, M; Hulme, W; Ushiro-Lumb, I.; Watson, CJE; Neuberger, J; Bradley, AJ


    $\\textbf{BACKGROUND}$: Deceased organ donors are routinely screened for behaviors that increase the risk of transmissible blood borne viral (BBV) infection, but the impact of this information on organ donation and transplant outcome is not well documented. Our aim was to establish the impact of such behavior on organ donation and utilization, as well transplant recipient outcomes. $\\textbf{METHODS}$: We identified all UK deceased organ donors from 2003-2015 with a disclosed hist...

  5. Amiodarone pretreatment of organ donors exerts anti-oxidative protection but induces excretory dysfunction in liver preservation and reperfusion. (United States)

    Moussavian, Mohammed Reza; Kollmar, Otto; Schmidt, Michael; Scheuer, Claudia; Wagner, Matthias; Slotta, Jan Erik; Gronow, Gernot; Justinger, Christoph; Menger, Michael Dieter; Schilling, Martin Karl


    The continuous shortage of organs necessitates the use of marginal organs from donors with various diseases, including arrhythmia-associated cardiac failure. One of the most frequently used anti-arrhythmic drugs is amiodarone (AM), which is given in particular in emergency situations. Apart from its anti-arrhythmic actions, AM provides anti-oxidative properties in cardiomyocytes. Thus, we were interested in whether AM donor pretreatment affects the organ quality and function of livers procured for preservation and transplantation. Donor rats were pretreated with AM (5 mg/kg of body weight) 10 minutes before flush-out of the liver with a cold (4 degrees C) histidine-tryptophan-ketoglutarate solution (n = 8). Livers were then stored for 24 hours at 4 degrees C before ex situ reperfusion with a 37 degrees C Krebs-Henseleit solution for 60 minutes in a nonrecirculating system. At the end of reperfusion, tissue samples were taken for histology and Western blot analysis. Animals with vehicle only (0.9% NaCl) served as ischemia/reperfusion controls (n = 8). Additionally, livers of untreated animals (n = 8) not subjected to 24 hours of cold ischemia served as sham controls. AM pretreatment effectively attenuated lipid peroxidation, stress protein expression, and apoptotic cell death. This was indicated by an AM-mediated reduction of malondialdehyde, heme oxygenase-1, and caspase-3 activation. However, AM treatment also induced mitochondrial damage and hepatocellular excretory dysfunction, as indicated by a significantly increased glutamate dehydrogenase concentration in the effluate and decreased bile production. In conclusion, AM donor pretreatment exerts anti-oxidative actions in liver preservation and reperfusion. However, these protective AM actions are counteracted by an induction of mitochondrial damage and hepatocellular dysfunction. Accordingly, AM pretreatment of donors for anti-arrhythmic therapy should be performed with caution.

  6. The effect of parasocial interaction on intention to register as organ donors through entertainment-education programs in Korea. (United States)

    Jeong, Hyeonju; Park, Hyun Soon


    This study is based on the theory of reasoned action and self-efficacy, and it examines the mediating role of attitude, subjective norm, and self-efficacy between parasocial interaction and the intention to donate organs. Judgment sampling was used and 329 respondents were participated in the survey. Participants consisted of 102 males (30.9%) and 227 females (69.1%), and their ages ranged from 13 to 77 years. The Cronbach's α for each scale was .81 for parasocial interaction scale (M = 3.01, SD = 0.55), .89 for attitude scale (M = 4.28, SD = 0.55), .89 for subjective norm (M = 4.28, SD = 0.55), and .76 for self-efficacy (M = 3.31, SD = 0.89). The level of parasocial interaction was found to be significantly associated with attitude and subjective norms that predicted intention to register as organ donors. Although the mediating effect of self-efficacy between parasocial interaction and intention has been proven, self-efficacy showed a conflicting result in the process of model testing in that the level of parasocial interaction affected the degree of subjective norms, which in turn influenced intention by enhancing self-efficacy. The results indicate that parasocial interaction has an indirect effect on intention to register as organ donors through attitude and subjective norms. It is expected that this finding contributes to developing a number of strategies to encourage people's intention to register as organ donors. © 2013 APJPH.

  7. Photo-switchable Donor-Acceptor (D-A) Dyad Interfacial Self-Assembled Monolayers for Organic Photovoltaic Cells (United States)


    S) AND ADDRESS(ES) UNIVERSITY OF TEXAS AT EL PASO 500 UNIV ST ADMIN BLDG 209 EL PASO, TX 79968-0001 US 8.  PERFORMING ORGANIZATION      REPORT NUMBER...Number Contact phone number if there is a problem with the report 915-747-7573 Organization / Institution name Univ . of Texas - El Paso Grant/Contract...AFRL-AFOSR-VA-TR-2015-0396 (HBCU) Photo-switchable Donor-Acceptor for Organic Photovoltaic Cells Luis Echegoyen UNIVERSITY OF TEXAS AT EL PASO Final

  8. Utilization of organs from donors after circulatory death for vascularized pancreas and islet of Langerhans transplantation: recommendations from an expert group. (United States)

    Berney, Thierry; Boffa, Catherine; Augustine, Titus; Badet, Lionel; de Koning, Eelco; Pratschke, Johann; Socci, Carlo; Friend, Peter


    Donation after circulatory death (DCD) donors are increasingly being used as a source of pancreas allografts for vascularized organ and islet transplantation. We provide practice guidelines aiming to increase DCD pancreas utilization. We review risk assessment and donor selection criteria. We report suggested factors in donor and recipient clinical management and provide an overview of the activities and outcomes of vascularized pancreas and islet transplantation. © 2015 Steunstichting ESOT.

  9. Organ culture storage of pre-prepared corneal donor material for Descemet's membrane endothelial keratoplasty. (United States)

    Bhogal, Maninder; Matter, Karl; Balda, Maria S; Allan, Bruce D


    To evaluate the effect of media composition and storage method on pre-prepared Descemet's membrane endothelial keratoplasty (DMEK) grafts. 50 corneas were used. Endothelial wound healing and proliferation in different media were assessed using a standard injury model. DMEK grafts were stored using three methods: peeling with free scroll storage; partial peeling with storage on the stroma and fluid bubble separation with storage on the stroma. Endothelial cell (EC) phenotype and the extent of endothelial overgrowth were examined. Global cell viability was assessed for storage methods that maintained a normal cell phenotype. 1 mm wounds healed within 4 days. Enhanced media did not increase EC proliferation but may have increased EC migration into the wounded area. Grafts that had been trephined showed evidence of EC overgrowth, whereas preservation of a physical barrier in the bubble group prevented this. In grafts stored in enhanced media or reapposed to the stroma after trephination, endothelial migration occurred sooner and cells underwent endothelial-mesenchymal transformation. Ongoing cell loss, with new patterns of cell death, was observed after returning grafts to storage. Grafts stored as free scrolls retained more viable ECs than grafts prepared with the fluid bubble method (74.2± 3% vs 60.3±6%, p=0.04 (n=8). Free scroll storage is superior to liquid bubble and partial peeling techniques. Free scrolls only showed overgrowth of ECs after 4 days in organ culture, indicating a viable time window for the clinical use of pre-prepared DMEK donor material using this method. Methods for tissue preparation and storage media developed for whole corneas should not be used in pre-prepared DMEK grafts without prior evaluation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  10. Unpacking Donor Retention: Individual Monetary Giving to U.S.-Based Christian Faith-Related, International Nongovernmental Organizations


    Ramya Ramanath


    This article examines an important but relatively overlooked aspect in the field of international giving in the U.S.—individual monetary donations to Christian faith-related international nongovernmental organizations (INGOs)—and outlines the cognitive process influencing donors who choose to keep up their financial support to Christian faith-related INGOs. The propositions forwarded in this article draw on existing literature on Christian giving to international causes, INGO management, dono...

  11. Prototype of a computerized scale for the active search for potential organ donors. (United States)

    Ludwig, Érika Fernanda Dos Santos Bezerra; Pereira, Marta Cristiane Alves; Martinez, Yolanda Dora Évora; Mendes, Karina Dal Sasso; Rossaneis, Mariana Angela


    to develop a prototype of a computerized scale for the active search for potential organ and tissue donors. methodological study, with the analysis of 377 electronic medical records of patients who died due to encephalic death or cardiorespiratory arrest in the intensive care units of a tertiary hospital. Among the deaths due to cardiorespiratory arrest, the study aimed to identify factors indicating underreported encephalic death cases. The Acute Physiology and Chronic Health Evaluation II and Sepsis Related Organ Failure Assessment severity indexes were applied in the protocols. Based on this, a scale was built and sent to five experts for assessment of the scale content, and subsequently, it was computerized by using a prototyping model. 34 underreported encephalic death cases were identified in the medical records of patients with cardiorespiratory arrest. Statistically significant differences were found in the Wilcoxon test between the scores of hospital admissions in the intensive care unit and the opening of the encephalic death protocol for both severity indexes. the prototype was effective for identifying potential organ donors, as well as for the identification of the degree of organ dysfunction in patients with encephalic death. desenvolver protótipo de escala informatizada para busca ativa de potenciais doadores de órgãos e tecidos. pesquisa metodológica, com análise de 377 prontuários eletrônicos de pacientes que evoluíram a óbito, por morte encefálica, ou parada cardiorrespiratória, nas unidades de terapia intensiva de hospital terciário. Nos óbitos por parada cardiorrespiratória, buscou-se identificar fatores que indicassem subnotificação de morte encefálica. Nos protocolos, foram aplicados os índices de gravidade Acute Physiology and Chronic Health Evaluation II e Sepsis Related Organ Failure Assessment. A partir disso, construiu-se a escala que foi encaminhada a cinco especialistas, para avaliação de conteúdo, e, posteriormente

  12. The current status and future perspectives of organ donation in Japan: learning from the systems in other countries. (United States)

    Soyama, Akihiko; Eguchi, Susumu


    The revised Organ Transplant Law came into effect in Japan in July 2010. The law allows for organ procurement from brain-dead individuals, including children, with family consent from subjects who had not previously rejected organ donation. Nevertheless, the number of cadaveric organ donations has not increased as expected. The Spanish Model is widely known as the most successful system in the field of organ donation. The system includes an earlier referral of possible donors to the transplant coordination teams, a new family-based approach and care methods, and the development of additional training courses aimed at specific groups of professionals, which are supported by their corresponding societies. South Korea, a country which neighbors Japan, has recently succeeded in increasing the rates of organ donation by introducing several systems, such as incentive programs, an organ procurement organization, a donor registry, and a system to facilitate potential donor referral. In this review, we present the current status of organ donation in Japan and also explore various factors that may help to improve the country's low donation rate based on the experiences of other developed countries.

  13. Organ quality metrics are a poor predictor of costs and resource utilization in deceased donor kidney transplantation. (United States)

    Stahl, Christopher C; Wima, Koffi; Hanseman, Dennis J; Hoehn, Richard S; Ertel, Audrey; Midura, Emily F; Hohmann, Samuel F; Paquette, Ian M; Shah, Shimul A; Abbott, Daniel E


    The desire to provide cost-effective care has lead to an investigation of the costs of therapy for end-stage renal disease. Organ quality metrics are one way to attempt to stratify kidney transplants, although the ability of these metrics to predict costs and resource use is undetermined. The Scientific Registry of Transplant Recipients database was linked to the University HealthSystem Consortium Database to identify adult deceased donor kidney transplant recipients from 2009 to 2012. Patients were divided into cohorts by kidney criteria (standard vs expanded) or kidney donor profile index (KDPI) score (Cost was defined as reimbursement based on Medicare cost/charge ratios and included the costs of readmission when applicable. More than 19,500 patients populated the final dataset. Lower-quality kidneys (expanded criteria donor or KDPI 85+) were more likely to be transplanted in older (both P costs compared with standard criteria donor transplants (risk ratio [RR] 0.97, 95% confidence interval [CI] 0.93-1.00, P = .07). KDPI 85+ was associated with slightly lower costs than KDPI quality metrics are less influential predictors of short-term costs than recipient factors. Future studies should focus on recipient characteristics as a way to discern high versus low cost transplantation procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. 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.

  15. Early molecular diagnosis of acute Chagas disease after transplantation with organs from Trypanosoma cruzi-infected donors. (United States)

    Cura, C I; Lattes, R; Nagel, C; Gimenez, M J; Blanes, M; Calabuig, E; Iranzo, A; Barcan, L A; Anders, M; Schijman, A G


    Organ transplantation (TX) is a novel transmission modality of Chagas disease. The results of molecular diagnosis and characterization of Trypanosoma cruzi acute infection in naïve TX recipients transplanted with organs from infected deceased donors are reported. Peripheral blood and cerebrospinal fluid samples from the TX recipients of organs from infected donors were prospectively and sequentially studied for detection of T. cruzi by means of kinetoplastid DNA polymerase chain reaction (kDNA-PCR). In positive blood samples, a PCR algorithm for identification of T. cruzi Discrete Typing Units (DTUs) and quantitative real-time PCR (qPCR) to quantify parasitic loads were performed. Minicircle signatures of T. cruzi infecting populations were also analyzed using restriction fragment length polymorphism (RFLP)-PCR. Eight seronegative TX recipients from four infected donors were studied. In five, the infection was detected at 68.4 days post-TX (36-98 days). In one case, it was transmitted to two of three TX recipients. The comparison of the minicircle signatures revealed nearly identical RFLP-PCR profiles, confirming a common source of infection. The five cases were infected by DTU TcV. This report reveals the relevance of systematic monitoring of TX recipients using PCR strategies in order to provide an early diagnosis allowing timely anti-trypanosomal treatment. © Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.

  16. Utilization of organs from donors after circulatory death for vascularized pancreas and islet of Langerhans transplantation : recommendations from an expert group

    NARCIS (Netherlands)

    Berney, Thierry; Boffa, Catherine; Augustine, Titus; Badet, Lionel; de Koning, Eelco; Pratschke, Johann; Socci, Carlo; Friend, Peter


    Donation after circulatory death (DCD) donors are increasingly being used as a source of pancreas allografts for vascularized organ and islet transplantation. We provide practice guidelines aiming to increase DCD pancreas utilization. We review risk assessment and donor selection criteria. We report

  17. Donor-acceptor conjugated polymers based on multifused ladder-type arenes for organic solar cells. (United States)

    Wu, Jhong-Sian; Cheng, Sheng-Wen; Cheng, Yen-Ju; Hsu, Chain-Shu


    Harvesting solar energy from sunlight to generate electricity is considered as one of the most important technologies to address the future sustainability of humans. Polymer solar cells (PSCs) have attracted tremendous interest and attention over the past two decades due to their potential advantage to be fabricated onto large area and light-weight flexible substrates by solution processing at a lower cost. PSCs based on the concept of bulk heterojunction (BHJ) configuration where an active layer comprises a composite of a p-type (donor) and an n-type (acceptor) material represents the most useful strategy to maximize the internal donor-acceptor interfacial area allowing for efficient charge separation. Fullerene derivatives such as [6,6]-phenyl-C61 or 71-butyric acid methyl ester (PCBM) are the ideal n-type materials ubiquitously used for BHJ solar cells. The major effort to develop photoactive materials is numerously focused on the p-type conjugated polymers which are generally synthesized by polymerization of electron-rich donor and electron-deficient acceptor monomers. Compared to the development of electron-deficient comonomers (acceptor segments), the development of electron-rich donor materials is considerably flourishing. Forced planarization by covalently fastening adjacent aromatic and heteroaromatic subunits leads to the formation of ladder-type conjugated structures which are capable of elongating effective conjugation, reducing the optical bandgap, promoting intermolecular π-π interactions and enhancing intrinsic charge mobility. In this review, we will summarize the recent progress on the development of various well-defined new ladder-type conjugated materials. These materials serve as the superb donor monomers to prepare a range of donor-acceptor semi-ladder copolymers with sufficient solution-processability for solar cell applications.

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

    Machado, Calixto; Kerein, 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.

  19. [Insulation characteristics of transport containers for organ cultured donor corneas under different ambient temperatures]. (United States)

    Schroeter, J; Meltendorf, C


    The aim of this study was to evaluate the ability of different transport containers to maintain an inside temperature between +10 and +40 degrees C, which is supposed to be safe for organ cultured donor corneas in dextran containing culture media, for a period of 24 hours at ambient temperatures of -10, 0, +10 and +50 degrees C. 3 containers were tested: 1. Styrofoam box with 2.5 cm thick walls (Graft-tec, AL.CHI.MI.A., Padova, Italy). 2. Thermos jug 0.5 litre (Primus, Solna, Sweden), a double walled metal jug. 3. ThempShell-22 degrees (VWR International, Darmstadt, Germany), a box of gel filled plastic elements. The containers were exposed to -10, 0, +10 and +50 degrees C for 24 hours each. A continuous temperature recording of the ambient and internal environments was performed using electronic thermometers (Mini Intelligent Logger, Escort). The inside temperature of the styrofoam box reached the outside temperature level after 80 - 230 min for all tested settings. The Thermos jug reached the outside temperature approximately after 5 hours. In contrast, the inside temperature of the TempShell-22 degrees CC was at -10 degrees C outside temperature 21 degrees C after 6 hours, 19 degrees C after 12 hours and 12 degrees C after 24 hours. At an ambient temperature of 0 and +10 degrees C the inside temperature of the TempShell-22 degrees C was 19.2 and 17.8 degrees C respectively after 24 hours. An ambient temperature of + 50 degrees C led to an inside temperature of the TempShell-22 degrees C of 30.5 degrees C after 6, 38.3 degrees C after 12 hours and 47.0 degrees C after 24 hours. A standard Styrofoam box with 2.5 cm thick walls and the tested thermos jug are not suitable to assure a safe temperature range. The TempShell-22 degrees C assures a safe temperature range for low ambient temperatures (-10 to +10 degrees C) for at least 24 hours and for an ambient temperature of +50 degrees C for at least 10 hours. Georg Thieme Verlag KG Stuttgart.New York.

  20. Estimation of stability constants for metal-ligand complexes containing neutral nitrogen donor atoms with applications to natural organic matter (United States)

    Atalay, Yasemin B.; Di Toro, Dominic M.; Carbonaro, Richard F.


    Linear free energy relationships (LFERs) were developed for estimating 1:1 metal-ligand stability constants (log KML) for small organic molecules containing neutral nitrogen donor atoms. A data set of 44 monodentate and 112 bidentate ligands for six metal ions: Mn2+, Co2+, Ni2+, Cu2+, Zn2+ and Cd2+ was employed to parameterize the LFER equations. Monodentate and bidentate log KML values were adequately described using Irving-Rossotti LFERs previously developed for ligands containing negatively-charged oxygen functional groups. Modifications to the LFER equations were necessary to account for steric hindrances to metal complexation by primary, secondary, and tertiary amines. The resulting LFER equations can be used to estimate log KML values for monodentate and bidentate ligands with neutral nitrogen donor groups where such values do not currently exist in the literature. Comparison of these results to our previous work with negatively-charged oxygen donor atoms reveals that neutral nitrogen functional groups are weaker than their oxygen counterparts for metal ions classified as “hard” on the basis of Hard-Soft Acid-Base (HSAB) theory. For “soft” metals, the opposite is true. These LFERs can be used to incorporate nitrogen functional groups in models for metal ion binding to natural organic matter (NOM).

  1. Molecular Engineering of Near Infrared Absorbing Thienopyrazine Double Donor Double Acceptor Organic Dyes for Dye-Sensitized Solar Cells. (United States)

    Cheema, Hammad; Peddapuram, Adithya; Adams, Rebecca E; McNamara, Louis; Hunt, Leigh Anna; Le, Ngoc; Watkins, Davita L; Hammer, Nathan I; Schmehl, Russell H; Delcamp, Jared H


    The thienopyrazine (TPz) building block allows for NIR photon absorption in dye-sensitized solar cells (DSCs) when used as a π-bridge. We synthesized and characterized 7 organic sensitizers employing thienopyrazine (TPz) as a π-bridge in a double donor, double acceptor organic dye design. Donor groups are varied based on electron donating strength and sterics at the donor-π bridge bond with the acceptor groups varied as either carboxylic acids or benzoic acids on the π-bridge. This dye design was found to be remarkably tunable with solution absorption onsets ranging from 750 to near 1000 nm. Interestingly, the solution absorption measurements do not accurately approximate the dye absorption on TiO2 films with up to a 250 nm blue-shift of the dye absorption onset on TiO2. This shift in absorption and the effect on electron transfer properties is investigated via computational analysis, time-correlated single photon counting studies, and transient absorption spectroscopy. Structure-performance relationships were analyzed for the dyes in DSC devices with the highest performance observed at 17.6 mA/cm2 of photocurrent and 7.5% PCE for a cosensitized device with a panchromatic IPCE onset of 800 nm.

  2. Organic donor/acceptor photovoltaics : The role of C-60/metal interfaces

    NARCIS (Netherlands)

    Melzer, C; Krasnikov, VV; Hadziioannou, G


    The photovoltaic properties of thin films based on donor/acceptor heterojunctions, prepared by means of either consecutive evaporation or co-evaporation, and sandwiched between asymmetric contacts are investigated. (E,E,E,E)-1,4-bis[(4-styryl)styryl]-2-methoxy-5-(2'-ethylhexoxy)benzene (MEH-OPV5)

  3. Request for organ donation without donor registration: a qualitative study of the perspectives of bereaved relatives

    NARCIS (Netherlands)

    Groot, J.J.A.M. de; Hoek, M. van; Hoedemaekers, C.W.; Hoitsma, A.J.; Schilderman, H.; Smeets, W.; Vernooij-Dassen, M.; Leeuwen, E. van


    BACKGROUND: 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. METHODS: A content analysis of narratives of 24 bereaved relatives (14

  4. Improving the use of donor organs in pancreas and islet of Langerhans transplantation

    NARCIS (Netherlands)

    Hilling, Denise Eline


    Pancreas transplantation and islet of Langerhans transplantation are potential solutions to treat patients with type 1 diabetes. However, pancreas grafts are scarce and there is a shortage of donor pancreata relative to the number of patients needing a transplant. The aim of this thesis was to

  5. Universal Efficiency Improvement in Organic Solar Cells Based on a Poly(3-hexylthiophene) Donor and an Indene-C60 Bisadduct Acceptor with Additional Donor Nanowires. (United States)

    Joe, Sung-yoon; Yim, Jong Hyuk; Ryu, Shin Young; Ha, Na Young; Ahn, Yeong Hwan; Park, Ji-Yong; Lee, Soonil


    With poly(3-hexylthiophene) (P3HT) nanowire (NW) inclusion in active layers (ALs), organic solar cells (OSCs) based on P3HT donor and indene-C60 bisadduct (ICBA) acceptor showed power conversion efficiency (PCE) improvements for both bulk heterojunction (BHJ)- and bilayer (BL)-structure AL devices. The PCE increase was approximately 14 % for both types of P3HT:ICBA OSCs. However, improvements in short-circuit current density (Jsc ) were about 4.4 and 6.4 % for BHJ- and BL-type AL devices, respectively. A systematic study showed that the addition of P3HT NWs did not result in enhanced internal quantum efficiencies for either type of device. However, the difference in light-harvesting efficiency was important in accounting for Jsc variations. Interestingly, there was no correlation between Jsc and PCE variations, whereas the open-circuit voltage (Voc ) and fill factor (FF) showed correlations with the PCE. The variation in FF is discussed in terms of Voc and equivalent-circuit parameters based on a nonideal diode model. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Organ donation in adults: a critical care perspective. (United States)

    Citerio, Giuseppe; Cypel, Marcelo; Dobb, Geoff J; Dominguez-Gil, Beatriz; Frontera, Jennifer A; Greer, David M; Manara, Alex R; Shemie, Sam D; Smith, Martin; Valenza, Franco; Wijdicks, Eelco F M


    The shortage of organs for transplantation is an important medical and societal problem because transplantation is often the best therapeutic option for end-stage organ failure. We review the potential deceased organ donation pathways in adult ICU practice, i.e. donation after brain death (DBD) and controlled donation after circulatory death (cDCD), which follows the planned withdrawal of life-sustaining treatments (WLST) and subsequent confirmation of death using cardiorespiratory criteria. Strategies in the ICU to increase the number of organs available for transplantation are discussed. These include timely identification of the potential organ donor, optimization of the brain-dead donor by aggressive management of the physiological consequence of brain death, implementation of cDCD protocols, and the potential for ex vivo perfusion techniques. Organ donation should be offered as a routine component of the end-of-life care plan of every patient dying in the ICU where appropriate, and intensivists are the key professional in this process.

  7. Manuseio do potencial doador de múltiplos órgãos Care of the potential organ donor

    Directory of Open Access Journals (Sweden)

    Tatiana H. Rech


    Full Text Available JUSTIFICATIVA E OBJETIVOS: O transplante de órgãos sólidos vem sendo considerado o tratamento de eleição para várias doenças terminais que afetam rim, pâncreas, fígado, coração e pulmão. Atualmente, o maior limitante às cirurgias dos transplantes é a escassez de órgãos. O objetivo deste estudo foi revisar aspectos fisiopatológicos da morte encefálica e resumir estratégias terapêuticas atuais, para o cuidado otimizado do doador, do que depende o sucesso dos transplantes. CONTEÚDO: A morte encefálica é uma síndrome inflamatória que pode rapidamente produzir alterações deletérias nos órgãos dos potenciais doadores. Esse contexto de instabilidade hemodinâmica, metabólica e eletrolítica, exige do intensivista cuidados especiais com o doador de múltiplos órgãos. CONCLUSÔES: O adequado conhecimento da complexa fisiopatologia envolvendo a morte encefálica é de fundamental importância para que se implemente de forma racional um protocolo de manuseio agressivo do potencial doador, o que certamente resultará num aumento de órgãos captados e do número de órgãos captados por doador, além da redução das taxas de disfunção primária dos enxertos transplantados.BACKGROUND AND OBJECTIVES: Organ transplantation has long been considered the treatment of choice for many end-stage organ diseases. As soon as transplantation turned to be a viable therapy, organ shortage became the major limitation for the procedures. Nowadays, there is an increasing imbalance between organ supply and demand. Apparently, the most promising way to increase organ supply is optimizing the care for the brain death organ donor. The objective of this manuscript was to review the pathophysiological aspects and therapeutic strategies for the optimized care of the potential organ donor. CONTENTS: Brain death causes a massive catecholamine release, inducing a variety of deleterious effects that can threat organ perfusion. Studies have documented

  8. Influence of the highest occupied molecular orbital energy level of the donor material on the effectiveness of the anode buffer layer in organic solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Bernede, J.C.; Leriche, P.; Roncali, J. [UNAM, Moltech Anjou, CNRS, UMR 6200, Groupe Systemes Conjugues Lineaires, Angers (France); Cattin, L. [UNAM, Institut Jean Rouxel (IMN), UMR 6502, Nantes (France); Djobo, S. Ouro; Morsli, M. [Universite de Nantes, LAMP, EA 3825, Faculte des Sciences et des Techniques, Nantes (France); Kanth, S.R.B.; Patil, S. [Solid State and Structural Chemistry Unit, Indian Institute of Science, Bangalore (India); Godoy, A. [University San Sebastian, Prog. Bachiller, Cs. Biolog. Qcas, Bellavista (Chile); Diaz, F.R.; Del Valle, M.A. [University Catolica Chile, Fac. Quimica, Santiago (Chile)


    Efficiency of organic photovoltaic cells based on organic electron donor/organic electron acceptor junctions can be strongly improved when the transparent conductive Anode is coated with a Buffer Layer (ABL). Here, the effects of a metal (gold) or oxide (molybdenum oxide) ABL are reported, as a function of the Highest Occupied Molecular Orbital (HOMO) of different electron donors. The results indicate that a good matching between the work function of the anode and the highest occupied molecular orbital of the donor material is the major factor limiting the hole transfer efficiency. Indeed, gold is efficient as ABL only when the HOMO of the organic donor is close to its work function {phi}{sub Au}. Therefore we show that the MoO{sub 3} oxide has a wider field of application as ABL than gold. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  9. The suitability of corneas stored by organ culture for penetrating keratoplasty and influence of donor and recipient factors on 5-year graft survival. (United States)

    Armitage, W John; Jones, Mark N A; Zambrano, Isaac; Carley, Fiona; Tole, Derek M


    To determine the impact of donor factors on the suitability of corneas stored by organ culture for penetrating keratoplasty (PK) and the influence of donor and recipient factors on 5-year survival of first PK. Logistic regression analyses were carried out to determine the influence of donor factors on, respectively, the risk of microbial contamination during organ culture, the suitability of corneas for PK (endothelial cell density ≥ 2200 cells/mm(2)), and the quality of corneas (endothelial cell density ≥ 2500 cells/mm(2)). Only one cornea, randomly selected, from each donor was included in these analyses. A Cox regression analysis was used to determine the influence of donor and recipient factors on 5-year PK survival. Risk of contamination (n = 8317): Causes of donor death including infection, respiratory disease, and cancer all increased the risk of contamination during organ culture (P culture (P influence. Corneas from organ donors were more likely to be suitable for PK (P = 0.0003). Five-year graft survival (n = 3014): Graft survival was dominated by the indication for PK (P influenced the suitability of corneas for PK. The indication for PK and other recipient factors were the main predictors of graft failure.

  10. The ELPAT living organ donor Psychosocial Assessment Tool (EPAT): from 'what' to 'how' of psychosocial screening - a pilot study. (United States)

    Massey, Emma K; Timmerman, Lotte; Ismail, Sohal Y; Duerinckx, Nathalie; Lopes, Alice; Maple, Hannah; Mega, Inês; Papachristou, Christina; Dobbels, Fabienne


    Thorough psychosocial screening of donor candidates is required in order to minimize potential negative consequences and to strive for optimal safety within living donation programmes. We aimed to develop an evidence-based tool to standardize the psychosocial screening process. Key concepts of psychosocial screening were used to structure our tool: motivation and decision-making, personal resources, psychopathology, social resources, ethical and legal factors and information and risk processing. We (i) discussed how each item per concept could be measured, (ii) reviewed and rated available validated tools, (iii) where necessary developed new items, (iv) assessed content validity and (v) pilot-tested the new items. The resulting ELPAT living organ donor Psychosocial Assessment Tool (EPAT) consists of a selection of validated questionnaires (28 items in total), a semi-structured interview (43 questions) and a Red Flag Checklist. We outline optimal procedures and conditions for implementing this tool. The EPAT and user manual are available from the authors. Use of this tool will standardize the psychosocial screening procedure ensuring that no psychosocial issues are overlooked and ensure that comparable selection criteria are used and facilitate generation of comparable psychosocial data on living donor candidates. © 2017 Steunstichting ESOT.

  11. Donor-acceptor conjugates-functionalized zinc phthalocyanine: Towards broad absorption and application in organic solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Liang, Fushun; Shi, Fan; Wang, Lifen; Su, Zhongmin [Department of Chemistry, Northeast Normal University, Changchun 130024 (China); Fu, Yingying; Xie, Zhiyuan [State Key Laboratory of Polymer Physics and Chemistry, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022 (China); Zhang, Xintong [Key Laboratory for UV-Emitting Materials and Technology of Ministry of Education, Northeast Normal University, Changchun 130024 (China)


    New zinc phthalocyanine (ZnPc-TDA), peripherally functionalized with donor-acceptor conjugates was synthesized, and its optical, thermal, electrochemical, and photovoltaic properties were studied. The black ZnPc-TDA exhibited both excellent solubility in common organic solvents, and broad absorption covering the range 300-900 nm. The photovoltaic devices with the configuration of ITO/PEDOT-PSS/ZnPc-TDA:PCBM/LiF/Al produced short circuit current densities of 2.26 mA/cm{sup 2}, the open circuit voltage of 0.68 V and power conversion efficiency of 0.4% under AM1.5G illumination. (author)

  12. The development of a narrative describing the bereavement of families of potential organ donors: A systematic review (United States)

    Dicks, Sean Glenton; Ranse, Kristen; Northam, Holly; Boer, Douglas P; van Haren, Frank MP


    Families of potential post-mortem organ donors face various challenges in the unfamiliar hospital context and after returning home. This review of sources published between 1968 and 2017 seeks to understand their journey as a bereavement experience with a number of unique features. Grief theory was used to identify ways that staff can assist family members to tolerate ambiguities and vulnerabilities while contributing to an environment characterised by compassion and social inclusion. Staff can guide families and create opportunities for meaningful participation, building resilience and developing bereavement-related skills that could assist them in the months that follow. PMID:29379629

  13. 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 ... for blood transfusions Medication side effects Abdominal hernia Death Potential long-term organ specific donor complications blank - ...

  14. The transplantation of solid organs from HIV-positive donors to HIV-negative recipients: ethical implications. (United States)

    Wispelwey, Bram P; Zivotofsky, Ari Z; Jotkowitz, Alan B


    HIV-positive individuals have traditionally been barred from donating organs due to transmission concerns, but this barrier may soon be lifted in the USA in limited settings when recipients are also infected with HIV. Recipients of livers and kidneys with well-controlled HIV infection have been shown to have similar outcomes to those without HIV, erasing ethical concerns about poorly chosen beneficiaries of precious organs. But the question of whether HIV-negative patients should be disallowed from receiving an organ from an HIV-positive donor has not been adequately explored. In this essay, we will discuss the background to this scenario and the ethical implications of its adoption from the perspectives of autonomy, beneficence/non-maleficence and justice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  15. Structure and reactivity in neutral organic electron donors derived from 4-dimethylaminopyridine

    Directory of Open Access Journals (Sweden)

    Jean Garnier


    Full Text Available The effects on the redox properties of modifying the molecular skeleton of neutral bis-2-(4-dimethylaminopyridinylidene electron donors, derived from 4-dimethylaminopyridine (4-DMAP, have been explored, by varying two parameters: (i the length of a polymethylene chain linking the two pyridine-derived rings and (ii the nature of the nitrogen substituents on the 4 and 4′ positions of the precursor pyridines. Restricting the bridge length to two methylene units significantly altered the redox profile, while changes in the nitrogen-substituents at the 4 and 4′ positions led to only slight changes in the redox potentials.

  16. Strategies for an Expanded Use of Kidneys From Elderly Donors. (United States)

    Pérez-Sáez, María José; Montero, Núria; Redondo-Pachón, Dolores; Crespo, Marta; Pascual, Julio


    The old-for-old allocation policy used for kidney transplantation (KT) has confirmed the survival benefit compared to remaining listed on dialysis. Shortage of standard donors has stimulated the development of strategies aimed to expand acceptance criteria, particularly of kidneys from elderly donors. We have systematically reviewed the literature on those different strategies. In addition to the review of outcomes of expanded criteria donor or advanced age kidneys, we assessed the value of the Kidney Donor Profile Index policy, preimplantation biopsy, dual KT, machine perfusion and special immunosuppressive protocols. Survival and functional outcomes achieved with expanded criteria donor, high Kidney Donor Profile Index or advanced age kidneys are poorer than those with standard ones. Outcomes using advanced age brain-dead or cardiac-dead donor kidneys are similar. Preimplantation biopsies and related scores have been useful to predict function, but their applicability to transplant or refuse a kidney graft has probably been overestimated. Machine perfusion techniques have decreased delayed graft function and could improve graft survival. Investing 2 kidneys in 1 recipient does not make sense when a single KT would be enough, particularly in elderly recipients. Tailored immunosuppression when transplanting an old kidney may be useful, but no formal trials are available.Old donors constitute an enormous source of useful kidneys, but their retrieval in many countries is infrequent. The assumption of limited but precious functional expectancy for an old kidney and substantial reduction of discard rates should be generalized to mitigate these limitations.

  17. Knowledge and attitude toward organ donation among people in Lanja: A rural town in India

    Directory of Open Access Journals (Sweden)

    Vaishaly K Bharambe


    Full Text Available Organ shortage is the greatest challenge facing the field of organ transplantation today. We aimed to study the attitude and knowledge toward body and organ donation among people in rural India. The present study was conducted in a rural town called Lanja, in the Konkan region of Maharashtra in India. A questionnaire covering demographic data, knowledge, and attitude of the participants was distributed to 400 students, middle-aged and senior citizens; 91.5% of the respondents were aware about organ donation. Television (55.2% and newspaper (45.8% were the most popular sources of information. About 56.2% and 32.8% believed that a healthy person and a cardiac dead person can be donors, respectively. Nearly 29.4% believed that a brain-dead person can be a donor and 22.4% clearly stated as to be having no idea regarding the health status of a donor. Highest awareness was observed regarding eye donation (92%. High awareness was also observed regarding heart, kidney, and liver donations, that is, 71.1%, 61.2%, and 54.2%, respectively. Awareness regarding donation of other tissues and organs was poor. Only 46.8% believed that the family of the deceased person can give consent for organ donation if the donor had not signed the donor card. Awareness regarding both body and organ donation in rural India is high. However, there is lack of understanding regarding the concept of brain-death. Awareness regarding body and other organ and tissue donations besides eye, kidney, etc., needs further awareness drives.

  18. The role of synovial fluid markers of catabolism and anabolism in osteoarthritis, rheumatoid arthritis and asymptomatic organ donors. (United States)

    Kokebie, Rediet; Aggarwal, Rohit; Lidder, Sukhwinderjit; Hakimiyan, Arnavaz A; Rueger, David C; Block, Joel A; Chubinskaya, Susan


    The purpose of this study was to correlate the level of anabolic and catabolic biomarkers in synovial fluid (SF) from patients with rheumatoid arthritis (RA), patients with osteoarthritis (OA) and asymptomatic organ donors. SF was collected from the knees of 45 OA, 22 RA patients and 20 asymptomatic organ donors. Eight biomarkers were selected and analyzed by using an enzyme-linked immunosorbent assay: interleukin (IL)-1, IL-6, IL-8 and IL-11; leukemia-inhibitory factor (LIF); cartilage oligomeric protein (COMP); osteocalcin; and osteogenic protein 1 (OP-1). Data are expressed as medians (interquartile ranges). The effects of sex and disease activity were assessed on the basis of the Western Ontario and McMaster Universities index score for patients with OA and on the basis of white blood cell count, erythrocyte sedimentation rate and C-reactive protein level for patients with RA. The mean ages (± SD) of the patients were as follows: 53 ± 9 years for patients with OA, 54 ± 11 years for patients with RA and 52 ± 7 years for asymptomatic organ donors. No effect of participants' sex was identified. In the SF of patients with RA, four of five cytokines were higher than those in the SF of patients with OA and those of asymptomatic organ donors. The most significant differences were found for IL-6 and IL-8, where IL-6 concentration in SF of patients with RA was almost threefold higher than that in patients with OA and fourfold higher than that in asymptomatic donor controls: 354.7 pg/ml (1,851.6) vs. 119.4 pg/ml (193.2) vs. 86.97 pg/ml (82.0) (P < 0.05 and P < 0.05, respectively). IL-8 concentrations were higher in SF of patients with RA than that in patients with OA as well as that in asymptomatic donor controls: 583.6 pg/ml (1,086.4) vs. 429 pg/ml (87.3) vs. 451 pg/ml (170.1) (P < 0.05 and P < 0.05, respectively). No differences were found for IL-11 in the SF of patients with RA and that of patients with OA, while a 1.4-fold difference was detected in the SF of

  19. Organic photovoltaic devices based on graphene as an electron-acceptor material and P3OT as a donor material

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Haiteng; He, Dawei; Wang, Yongsheng; Liu, Zhiyong; Wu, Hongpeng; Wang, Jigang [Key Laboratory of Luminescence and Optical Information, Ministry of Education, Institute of Optoelectronic Technology, Beijing Jiaotong University, Beijing (China)


    We present the fabrication and performance studies of organic photovoltaic (OPV) devices with bulk heterojunction (BHJ) structure that use organic solution-processable functionalized graphene (SPFGraphene) as an electron-acceptor material and poly(3-octylthiophene) (P3OT) as a donor material. The structural configuration of the device is ITO/PEDOT:PSS/P3OT:PCBM-SPFGraphene/LiF/Al. After mixing graphene into the device, the performance enhanced significantly. Given illumination at 100 mW/cm{sup 2} AM1.5 and P3OT/PCBM (1:1) mixture with 9 wt% of SPFGraphene, we recorded the best performances. The open-circuit voltage (V{sub oc}) is 0.67 V. The short-circuit current density (J{sub sc}) is 4.6 mA/cm{sup 2}. The FF is 0.37. And the power conversion efficiency is 1.14%. In the P3OT:PCBM-SPFGraphene composite, the SPFGraphene acts as exciton dissociation sites and provides the transport pathway of LUMO-graphene-Al. Adding SPFGraphene into P3OT produces an appropriate energetic distance between the HOMO and the LUMO of the donor/acceptor, which leads to a high open-circuit voltage. Besides, doping SPFGraphene provides a higher exciton dissociation volume mobility of carrier transport, which leads to a large short-circuit current density. (Copyright copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  20. Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America. (United States)

    Clemente, Wanessa Trindade; Pierrotti, Lígia Camera; Abdala, Edson; Morris, Michele I; Azevedo, Luiz S; López-Vélez, Rogelio; Cuenca-Estrella, Manuel; Torre-Cisneros, Julian; Petersen, Eskild; Camargo, Luis Fernando A; Wright, Alissa Jade; Beeching, Nicholas J; Vilela, Eduardo Garcia; Santoro-Lopes, Guilherme; Len, Oscar; Stucchi, Raquel S B; Manuel, Oriol; Faria, Luciana Costa; Leblebicioglu, Hakan; Huprikar, Shirish; Molina, Israel; Mourão, Paulo Henrique Orlandi; Kotton, Camille N; Aguado, José María


    The Recommendations for Management of Endemic Diseases and Travel Medicine in Solid-Organ Transplant Recipients and Donors: Latin America clinical practice guideline is intended to guide clinicians caring for solid-organ transplant (SOT) donors, candidates and recipients regarding infectious diseases (ID) issues related to this geographical region, mostly located in the tropics. These recommendations are based on both systematic reviews of relevant literature and expert opinion from both transplant ID and travel medicine specialists. The guidelines provide recommendations for risk evaluation and laboratory investigation, as well as management and prevention of infection of the most relevant endemic diseases of Latin America. This summary includes a brief description of the guideline recommendations but does not include the complete rationale and references for each recommendation, which is available in the online version of the article, published in this journal as a supplement. The supplement contains 10 reviews referring to endemic or travel diseases (eg, tuberculosis, Chagas disease [ChD], leishmaniasis, malaria, strongyloidiasis and schistosomiasis, travelers diarrhea, arboviruses, endemic fungal infections, viral hepatitis, and vaccines) and an illustrative section with maps ( Contributors included experts from 13 countries (Brazil, Canada, Chile, Denmark, France, Italy, Peru, Spain, Switzerland, Turkey, United Kingdom, United States, and Uruguay) representing four continents (Asia, the Americas and Europe), along with scientific and medical societies.

  1. Knowledge and attitude of the Flemish primary care physician toward organ donation and transplantation. (United States)

    Coucke, L; Snoeck, E; De Maeseneer, J; Haentjens, I; Peersman, W; Troisi, R; Rogiers, X


    Primary care physicians (PCP) might play an important role in the acceptance of organ donation (OD) in the population. This would require both a positive attitude and a good basic knowledge about the organ donation and transplantation (ODT) process. Studies on this subject are very limited however. The objectives of this study are to determine the knowledge and attitude of the PCP towards OD in Flanders. Three-hundred twenty-seven Flemish PCPs completed an electronic questionnaire, comprising 6 sections: demographic factors, practical experience, knowledge, education, attitude and potential role in the ODT process. Eighty-seven percent of the Flemish PCP agree with the implementation of heart-beating organ donation. Ninety-four percent would agree to donate the organs of their own child. 80% know that even without explicit consent the prelevation of the organs and tissues of each potential Belgian donor will take place. Although they are aware of the current legislation, their knowledge regarding donor criteria showed significant gaps. A minority of the PCP's know that donors can be little brain-dead children (53%) or elderly above 70 years (45%). Only 61% of PCPs know that brain dead is associated with irreversible damage to the brain and only 28% know that more than one physician is involved in making the diagnosis. A majority (91%) is willing to play a role in the ODT process. But about two-thirds (61%) of them doubt their ability to answer questions of patients on this subject. 82.5% of this group would find it useful to participate in a specific training. When they are offered different choices to play a role in the process, the most accepted (84%) one is informing the transplant centre about the donor's medical history and risk behavior. The Flemish PCP has a positive attitude towards ODT. He is willing to play a role in the ODT process. However, our study clearly documents deficits in the knowledge about brain death and the need for postgraduate training in

  2. Remarkable changes in the choice of timing to discuss organ donation with the relatives of a patient: a study in 228 organ donations in 20 years (United States)


    Introduction We studied whether the choice of timing of discussing organ donation for the first time with the relatives of a patient with catastrophic brain injury in The Netherlands has changed over time and explored its possible consequences. Second, we investigated how thorough the process of brain death determination was over time by studying the number of medical specialists involved. And we studied the possible influence of the Donor Register on the consent rate. Methods We performed a retrospective chart review of all effectuated brain dead organ donors between 1987 and 2009 in one Dutch university hospital with a large neurosurgical serving area. Results A total of 271 medical charts were collected, of which 228 brain dead patients were included. In the first period, organ donation was discussed for the first time after brain death determination (87%). In 13% of the cases, the issue of organ donation was raised before the first EEG. After 1998, we observed a shift in this practice. Discussing organ donation for the first time after brain death determination occurred in only 18% of the cases. In 58% of the cases, the issue of organ donation was discussed before the first EEG but after confirming the absence of all brain stem reflexes, and in 24% of the cases, the issue of organ donation was discussed after the prognosis was deemed catastrophic but before a neurologist or neurosurgeon assessed and determined the absence of all brain stem reflexes as required by the Dutch brain death determination protocol. Conclusions The phases in the process of brain death determination and the time at which organ donation is first discussed with relatives have changed over time. Possible causes of this change are the introduction of the Donor Register, the reintroduction of donation after circulatory death and other logistical factors. It is unclear whether the observed shift contributed to the high refusal rate in The Netherlands and the increase in family refusal in our

  3. [Correlation between microbial growth in conjunctival swabs of corneal donors and contamination of organ culture media]. (United States)

    Li, S; Bischoff, M; Schirra, F; Langenbucher, A; Ong, M; Halfmann, A; Herrmann, M; Seitz, B


    The aim of the study was to determine the rate of contamination in conjunctival swabs from corneal donors by microbiological investigations and to correlate this with microbial contamination of the culture medium. Contamination of conjunctival swabs and culture media was analyzed retrospectively for the years 2009, 2010 and 2011 at the LIONS corneal bank of Saar-Lor-Lux Trier/Westpfalz at the Saarland University Medical Center. The total annual number of conjunctival swabs was 316 in 2009, 341 in 2010 and 381 in 2011. Conjunctival swabs were taken prior to 1.25% povidone-iodine application. After disinfection donor corneas were harvested by in situ corneoscleral disc excision in all cases. The correlation between positive conjunctival swabs and microbial contamination of the culture medium was analyzed. In every year examined the contamination rate of the culture medium was significantly higher in cases of contaminated conjunctival swabs (p culture medium was contaminated in 16.5%, 11.5% and 7.6% of the donated corneas with positive conjunctival swabs and in 7.2%, 1.9% and 0.6% in donated corneas with negative conjunctival swabs, respectively. A positive correlation was found between contamination of the culture medium and microbial colonization of the conjunctival swabs, Nevertheless, microbial colonization of the conjunctiva was high and contamination of the culture medium was relatively low. For the microbial contamination rate of the donated corneas in the medium, conjunctival disinfection time with iodine solution before explantation of the corneoscleral disc and the addition of antibiotics to the culture medium seem to play a protective role.

  4. Community preferences for the allocation of deceased donor organs for transplantation: a focus group study. (United States)

    Irving, Michelle J; Tong, Allison; Jan, Stephen; Wong, Germaine; Cass, Alan; Allen, Richard D; Craig, Jonathan C; Chadban, Steven; Rose, John; Howard, Kirsten


    Solid organ transplantation is the treatment of choice for those with organ failure, but suitable organs are a limited community resource. Little is known about community preferences for the allocation of those organs. We aimed to determine community preferences for organ allocation and reasons for their choices. Participants were recruited from the community in four states in Australia. In focus groups, they identified and discussed attributes that they believed were important for allocating organs to potential recipients. Transcripts were analysed thematically. Thirteen focus groups with 114 participants were conducted. Four major themes emerged: (i) saving and improving the lives; (ii) lowering the risk of lost opportunities; (iii) fairness and (iv) accountability. While happy to discuss general principles, many were not comfortable making organ allocation decisions and were happy to defer to health professionals; this reticence tended to disappear when discussing the use of their own organs. Participants wanted to save as many lives as possible as well as lower the risk of lost opportunities for those on the waiting list by maximizing the chances of success of every donation. A rational utilitarian ethical model of organ allocation, therefore, appeared to be the dominant framework adopted by the community. Key considerations were compatibility, high chance of peri-operative survival and favouring those with positive lifestyle and self-management choices. Communication between the transplant community and general community about organ allocation could be undertaken to create trust and shared understanding, which may ultimately increase organ donation rates in the future.

  5. Effects of the buffer layer inserted between the transparent conductive oxide anode and the organic electron donor

    Energy Technology Data Exchange (ETDEWEB)

    Godoy, A.; Kouskoussa, B.; Benchouk, K.; Khelil, A. [Facultad Ciencias de la Salud, Universidad Diego Portales, Ejercito 141, Santiago de Chile (Chile); Cattin, L.; Soto, G.M. [Universite de Nantes, Nantes Atlantique Universites, Institut des Materiaux Jean Rouxel (IMN)-CNRS, Faculte des Sciences et Techniques, 2 rue de la Houssiniere, BP 92208, Nantes F-44000 (France); Toumi, L. [LPCM2E, Universite d' Oran Es-Senia, LPCM2E (Algeria); Diaz, F.R.; del Valle, M.A. [Laboratorio de Polimeros, Facultad de Quimica, Pontificia Universidad Catolica de Chile, Casilla 306, Correo 22, Santiago (Chile); Morsli, M.; Bernede, J.C. [Universite de Nantes, Nantes Atlantique Universites, LAMP, Faculte des Sciences et Techniques, 2 rue de la Houssiniere, BP 92208, Nantes F-44000 (France)


    In optoelectronic devices, the work function of the transparent conductive oxide, which is used as anode, does not match well the highest occupied molecular orbital of the organic material, which induces the formation of a barrier opposed to hole exchange at this interface. Therefore a thin buffer layer is often used to achieve good matching of the band structure at the interface. From experimental results it can be deduced that the main effects of the buffer layer consist in a better matching of the band structure at the interface anode/organic material and in a more homogeneous organic layer growth. We show that, whatever the nature of the buffer layer-metal, oxide, organic material - the classical Schottky-Mott model allows to anticipate, at least roughly, the behaviour of the contact, even if some dipole effect are often present. A good correlation between the ''metal/buffer layer'' work function and the barrier {phi}{sub b} for hole exchange at anode/organic electron donor interfaces is obtained, as expected by the model. (author)

  6. Narrative responsibility and moral dilemma: A case study of a family's decision about a brain-dead daughter. (United States)

    Kinjo, Takanobu; Morioka, Masahiro


    A brain death case is presented and reinterpreted using the narrative approach. In the case, two Japanese parents face a dilemma about whether to respect their daughter's desire to donate organs even though, for them, it would mean literally killing their daughter. We argue that the ethical dilemma occurred because the parents were confronted with two conflicting narratives to which they felt a "narrative responsibility," namely, the responsibility that drives us to tell, retell, and coauthor the (often unfinished) narratives of loved ones. We suggest that moral dilemmas arise not only from conflicts between moral justifications but also from conflicts between narratives and human relationships.

  7. Brain-dead patients are not cadavers: the need to revise the definition of death in Muslim communities. (United States)

    Rady, Mohamed Y; Verheijde, Joseph L


    The utilitarian construct of two alternative criteria of human death increases the supply of transplantable organs at the end of life. Neither the neurological criterion (heart-beating donation) nor the circulatory criterion (non-heart-beating donation) is grounded in scientific evidence but based on philosophical reasoning. A utilitarian death definition can have unintended consequences for dying Muslim patients: (1) the expedited process of determining death for retrieval of transplantable organs can lead to diagnostic errors, (2) the equivalence of brain death with human death may be incorrect, and (3) end-of-life religious values and traditional rituals may be sacrificed. Therefore, it is imperative to reevaluate the two different types and criteria of death introduced by the Resolution (Fatwa) of the Council of Islamic Jurisprudence on Resuscitation Apparatus in 1986. Although we recognize that this Fatwa was based on best scientific evidence available at that time, more recent evidence shows that it rests on outdated knowledge and understanding of the phenomenon of human death. We recommend redefining death in Islam to reaffirm the singularity of this biological phenomenon as revealed in the Quran 14 centuries ago.

  8. Kinetics of Hydrogen Evolution on Copper Electrode Involving Organic Acids as Proton Donors

    Directory of Open Access Journals (Sweden)

    A. Survila


    Full Text Available Linear potential sweep (LPS voltammetry was applied to study the kinetics of hydrogen evolution in solutions containing glycolic, malic, tartaric, and gluconic acids. The CE mechanism of hydrogen evolution was analyzed invoking the 2nd Fick's law equations supplemented by terms that account for chemical interactions between diffusing particles. Acids are considered as components that are capable of releasing hydrated protons taking part in the charge-transfer step. Current peaks observed on LPS voltammograms are in linear dependence on ν (ν is the potential sweep rate. They obey well-known relationships obtained for simple redox processes, provided that the concentration of oxidant is treated as total concentration of proton donors. Determination of surface concentrations as current density functions makes it possible to transform LPS voltammograms into linear Tafel plots normalized with respect to the surface concentration of hydronium ions. Similar kinetic parameters (α≈0.6 and i0≈ 10 μA cm−2 obtained at pH 3 for all OA solutions indicate that the nature of OA has no noticeable influence on the charge-transfer process.

  9. Solution Processed Organic Photovoltaic Cells Using D-A-D-A-D Type Small Molecular Donor Materials with Benzodithiophene and Diketopyrrolopyrrole Units. (United States)

    Park, Sangman; Nam, So Yeon; Suh, Dong Hack; Lee, Jaemin; Lee, Changjin; Yoon, Sung Cheol


    Organic photovoltaic Cells (OPVs) have been considered to be a next-generation energy source to overcome exhaustion of resources. Currently, OPVs are developed based on two types of donor material with polymer and small molecule. Polymeric donor materials have shown better power conversion efficiency (PCE) than small molecular donor materials, since it's easy to control the morphology of photoactive film. However, the difficulty in synthetic reproducibility and purification of polymeric donor were main drawback to overcome. And then, recently small molecule donor materials have been overcome bad morphology of OPVs film by using appropriate alkyl substituents and relatively long conjugation system. In this study, we designed and synthesized D-A-D-A-D type small molecular donor materials containing alternatively linked benzodithiophene (BDT) and diketopyrrolopyrrole (DPP) units. Also, we studied on the effect of photovoltaic performance of prepared small molecular D-A-D-A-D type donor with variation of thiophene links and with/without hexyl substituent. Our small molecular donors showed HOMO energy levels from -5.26 to -5.34 eV and optical bandgaps from 1.70 to 1.87 eV by CV (cyclic voltammetry) and UV/Vis spectroscopy, respectively. Finally, 3.4% of PCE can be obtained using a mixture of BDT(DPP)2-T2 and PCBM as an active layer with a Voc of 0.78 V, a Jsc of 9.72 mA/cm2, and a fill factor of 0.44 under 100 mW/cm2 AM 1.5G simulated light. We will discuss the performance of D-A-D-A-D type small molecular donor based OPVs with variation of both terminal substituents.

  10. Solution processable diketopyrrolopyrrole (DPP cored small molecules with BODIPY end groups as novel donors for organic solar cells

    Directory of Open Access Journals (Sweden)

    Diego Cortizo-Lacalle


    Full Text Available Two novel triads based on a diketopyrrolopyrrole (DPP central core and two 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene (BODIPY units attached by thiophene rings have been synthesised having high molar extinction coefficients. These triads were characterised and used as donor materials in small molecule, solution processable organic solar cells. Both triads were blended with PC71BM as an acceptor in different ratios by wt % and their photovoltaic properties were studied. For both the triads a modest photovoltaic performance was observed, having an efficiency of 0.65%. Moreover, in order to understand the ground and excited state properties and vertical absorption profile of DPP and BODIPY units within the triads, theoretical DFT and TDDFT calculations were performed.

  11. Solution processable diketopyrrolopyrrole (DPP) cored small molecules with BODIPY end groups as novel donors for organic solar cells. (United States)

    Cortizo-Lacalle, Diego; Howells, Calvyn T; Pandey, Upendra K; Cameron, Joseph; Findlay, Neil J; Inigo, Anto Regis; Tuttle, Tell; Skabara, Peter J; Samuel, Ifor D W


    Two novel triads based on a diketopyrrolopyrrole (DPP) central core and two 4,4-difluoro-4-bora-3a,4a-diaza-s-indacene (BODIPY) units attached by thiophene rings have been synthesised having high molar extinction coefficients. These triads were characterised and used as donor materials in small molecule, solution processable organic solar cells. Both triads were blended with PC71BM as an acceptor in different ratios by wt % and their photovoltaic properties were studied. For both the triads a modest photovoltaic performance was observed, having an efficiency of 0.65%. Moreover, in order to understand the ground and excited state properties and vertical absorption profile of DPP and BODIPY units within the triads, theoretical DFT and TDDFT calculations were performed.

  12. Donor-derived transmission events in 2013: a report of the Organ Procurement Transplant Network Ad Hoc Disease Transmission Advisory Committee. (United States)

    Green, Michael; Covington, Shandie; Taranto, Sarah; Wolfe, Cameron; Bell, Walter; Biggins, Scott W; Conti, David; DeStefano, G David; Dominguez, Edward; Ennis, Donna; Gross, Thomas; Klassen-Fischer, Mary; Kotton, Camille; LaPointe-Rudow, Dianne; Law, Yuk; Ludrosky, Kristen; Menegus, Marilyn; Morris, Michele I; Nalesnik, Michael A; Pavlakis, Martha; Pruett, Timothy; Sifri, Costi; Kaul, Daniel


    The Organ Procurement Transplant Network Disease Transmission Advisory Committee (DTAC), a multidisciplinary committee, evaluates potential donor-derived transmission events (PDDTE), including infections and malignancies, to assess for donor transmitted events. Reports of unexpected PDDTE to Organ Procurement Transplant Network in 2013 were fully reviewed by DTAC. A standardized algorithm was used to assess each PDDTE from a given donor and to classify each individual recipient from that donor. Of 443 total PDDTE submitted, 159 were triaged and not sent out to the full DTAC. Of 284 fully evaluated reports, 32 (11.3%) resulted in a proven/probable (P/P) transmission of infection, malignancy or other conditions to 42 recipients. Of 204 infection events, 24 were classified as P/P affecting 30 recipients, with four deaths. Bacteria were the most frequently reported type of infection, accounting for 99 reports but only 12 recipients from 11 donors experienced P/P transmission. There were 65 donors reported with potential malignancy events and 5 were classified as P/P transmissions with 8 affected recipients and 2 deaths. Additionally, there were 16 noninfection, nonmalignancy reports resulting in 3 P/P transmissions to 4 recipients and 1 death. There was a 43% increase in the number of PDDTE reported and reviewed in 2013 over 2012. However, the percent with P/P transmission remains low, affecting recipients from 32 donors especially when compared with the more than 14,000 donors recovered annually in the United States. The continued use of the new standard algorithm and triaging process will enhance the reproducibility of DTAC assessments and allow more robust analysis of our aggregate DTAC experience.

  13. Beyond the Officially Sacred, Donor and Believer: Religion and Organ Transplantation. (United States)

    Messina, E


    Religious concerns might represent an important issue when donation for transplantation is discussed. Even if no religious tradition formally forbids organ donation and transplantation, members of the same religious group may have differing and often conflicting opinions in their own interpretation of how their religion encourages and/or supports organ donation and transplantation, as discussed in this article. It also should be considered that even if a religion refuses to define concrete rules about organ donation and transplantation, there are a great number of factors that may influence the decision-making process. Examples may include negative perceptions of the cutting and removal of organs or ignorance about the transplantation system, both of which would influence the decision-making process concerning transplantation. Knowledge of these facts may provide useful information, perhaps increasing transplant numbers. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Should we pay donors to increase the supply of organs for transplantation? No

    National Research Council Canada - National Science Library

    Chapman, Jeremy


    Paymentfor livingkidney donation is illegal in most countries. Arthur Matas (doi: 10.1136/bmj.a157) believes that legalisation is needed to shorten waiting times, but Jeremy Chapman argues that it will reduce the supply of all organs

  15. Assessment of Lungs for Transplant Recovered from Uncontrolled Donation after Circulatory Determination of Death Donors. (United States)

    Egan, Thomas; Blackwell, John; Birchard, Katherine; Haithcock, Benjamin; Long, Jason; Gazda, Stephen; Casey, Nissa; Thys, Caitlin


    To address the lung donor shortage, we obtained institutional review board and US Food and Drug Administration approval to transplant lungs recovered from uncontrolled donation after circulatory determination of death donors (uDCDDs). To compare outcomes of recipients of lungs recovered from uDCDDs vs. brain-dead donors. After consent and screening, lungs recovered from uDCDDs were assessed by 4 hours ex vivo lung perfusion (EVLP) and computed tomography (CT) scan. Over the course of 29 months, 502 potential uDCDDs younger than 66 years were identified in a single county, with death declaration by emergency medical services and four emergency departments in this and two other countries. We determined reasons that lungs from these uDCDDs were not able to be transplanted: uDCDDs could not have lungs recovered (224), next-of-kin could not be found or refused to discuss (67), next-of-kin refused (48), medical examiner case (39), logistics/missed (35), and miscellaneous (35). There were 247 medical contraindications: 141 pulmonary and 106 nonpulmonary. Lungs were recovered from 31 uDCDDs. Thirteen lungs did not have EVLP: 5 injured lungs (one pulmonary embolism [PE] with perforated infarct, two motor vehicle crash with severe injuries, one adhesion, and one lightning strike), two large PE, two prolonged ischemic time, two obvious chronic obstructive pulmonary disease, one technical, and one consent withdrawn. Eighteen lungs had EVLP: 10 with immediate edema (three PE, three unknown down time, three long ischemic time, and one ruptured aneurysm into L pleural space, making long cardiopulmonary resuscitation ineffective), and one myocarditis, possible lung involvement. In three lungs, CT showed edema after EVLP: one poor flush and poor EVLP performance, one edema after myocardial infarction (MI) with 10-year history of chronic heart failure, and one edema with MI, resuscitated, arrested again. One concurrent pneumonia was diagnosed by bronchoscopy, CT, and cultures; one

  16. Study of the potential energy conversion efficiency of organic solar cells based on donor/acceptor heterojunctions (United States)

    Geens, Wim


    Organic solar cells can offer an appealing alternative for bulk silicon solar cells due to their attractive properties such as flexibility and possibility to apply low-cost manufacturing techniques. The different types of existing organic solar cells reported in the literature have been critically assessed in terms of performance and processability, based on which it was concluded that the concept of the donor/acceptor bulk heterojunction sandwiched between a transparent and a metal electrode has the most potential. In order to gain more insight into the charge transport properties of spin-cast photovoltaic conjugated polymer/fullerene blends, these films were incorporated into field-effect transistors to derive values for the electron and hole mobilities. Model calculations showed that increasing these mobility values in combination with the use of thicker active layers could significantly enhance the short-circuit current density of the bulk heterojunction solar cells. Optimisation of the charge transport is required and was realised in this study by choosing PPV-oligomers and C60 as well-defined building blocks to construct the donor/acceptor networks. First, these materials were spin-cast in single-layer diodes to allow full electrical characterisation, which was then compared with simulation of the devices in dark as well as under illumination. The photovoltaic performance of blended PPV-oligomer/C60 devices remained rather low due to C60-induced shunting paths and high molecular disorder. In a second part, more morphological order was obtained by using vacuum evaporation to deposit the organic materials. Besides structural characterisation of the evaporated films, the electrical behaviour of single-layer devices was investigated and the influence of interfacial layers was addressed. Photovoltaic devices based on evaporated planar heterojunctions reaching a conversion efficiency of 1.9% and exhibiting an open-circuit voltage of over 1 V were realised

  17. Unsymmetrical donor–acceptor–donor–acceptor type indoline based organic semiconductors with benzothiadiazole cores for solution-processed bulk heterojunction solar cells

    Directory of Open Access Journals (Sweden)

    Wenqin Li


    Full Text Available Bulk heterojunction (BHJ solar cells based on small molecules have attracted potential attention due to their promise of conveniently defined structures, high absorption coefficients, solution process-ability and easy fabrication. Three D–A–D–A type organic semiconductors (WS-31, WS-32 and WS-52 are synthesized, based on the indoline donor and benzotriazole auxiliary acceptor core, along with either bare thiophene or rigid cyclopentadithiophene as π bridge, rhodanine or carbonocyanidate as end-group. Their HOMO orbitals are delocalized throughout the whole molecules. Whereas the LUMOs are mainly localized on the acceptor part of structure, which reach up to benzothiadiazole, but no distribution on indoline donor. The first excitations for WS-31 and WS-32 are mainly originated by electron transition from HOMO to LUMO level, while for WS-52, partly related to transition between HOMO and LUMO+1 level. The small organic molecules are applied as donor components in bulk heterojunction (BHJ organic solar cells, using PC61BM as acceptor material to check their photovoltaic performances. The BHJ solar cells based on blended layer of WS-31:PC61BM and WS-32:PC61BM processed with chloroform show overall photoelectric conversion efficiency (PCE of 0.56% and 1.02%, respectively. WS-32 based BHJ solar cells show a higher current density originated by its relatively larger driving force of photo-induced carrier in photo-active layer to LUMO of PC61BM. Keywords: Indoline donor, Unsymmetrical organic semiconductors, BHJ solar cells, Photovoltaic performances

  18. Validation of a rapid type 1 diabetes autoantibody screening assay for community-based screening of organ donors to identify subjects at increased risk for the disease. (United States)

    Wasserfall, C; Montgomery, E; Yu, L; Michels, A; Gianani, R; Pugliese, A; Nierras, C; Kaddis, J S; Schatz, D A; Bonifacio, E; Atkinson, M A


    The Network for Pancreatic Organ donors with Diabetes (nPOD) programme was developed in response to an unmet research need for human pancreatic tissue obtained from individuals with type 1 diabetes mellitus and people at increased risk [i.e. autoantibody (AAb)-positive] for the disease. This necessitated the establishment of a type 1 diabetes-specific AAb screening platform for organ procurement organizations (OPOs). Assay protocols for commercially available enzyme-linked immunosorbent assays (elisas) determining AAb against glutamic acid decarboxylase (GADA), insulinoma-associated protein-2 (IA-2A) and zinc transporter-8 (ZnT8A) were modified to identify AAb-positive donors within strict time requirements associated with organ donation programmes. These rapid elisas were evaluated by the international islet AAb standardization programme (IASP) and used by OPO laboratories as an adjunct to routine serological tests evaluating donors for organ transplantation. The rapid elisas performed well in three IASPs (2011, 2013, 2015) with 98-100% specificity for all three assays, including sensitivities of 64-82% (GADA), 60-64% (IA-2A) and 62-68% (ZnT8A). Since 2009, nPOD has screened 4442 organ donors by rapid elisa; 250 (5·6%) were identified as positive for one AAb and 14 (0.3%) for multiple AAb with 20 of these cases received by nPOD for follow-up studies (14 GADA+, two IA-2A(+) , four multiple AAb-positive). Rapid screening for type 1 diabetes-associated AAb in organ donors is feasible, allowing for identification of non-diabetic, high-risk individuals and procurement of valuable tissues for natural history studies of this disease. © 2016 British Society for Immunology.

  19. Simulated Donor Family Encounters at Organ Transplantation Coordinators In-Service Training Course: Process and Impact Evaluation. (United States)

    Karabilgin, Ö S; Altuğ, N; Çalışkan, S A; Bozoklar, C A; Durak, H I; Demiral Yılmaz, N


    This study introduced the modified version of the Organ Transplantation Coordinator course including simulated donor family encounters (SDFEs) and communication skills. It also evaluated participants' opinions and achievement levels, and how they implemented what they learned in the course in their work settings. The course used the modified Analysis, Design, Development, Implementation, and Evaluation model and was evaluated in 3 steps. The participants' views were obtained using the course overall evaluation form and communication skills evaluation form, their success was assessed with the posttest and SDFEs evaluation form, and the effects of what they learned during the course on their work settings were assessed through telephone interviews. At this step, the participants were asked to write letters about the targets they intended to achieve in their work settings. The letters were analyzed with the content analysis method, and a questionnaire consisting of 105 targets was developed. A year later the participants were telephoned and asked to what extent they achieved their targets. The participants' satisfaction from the whole course was high (x: 8.65 ± 1.06). In the communication skills evaluation form, the participants stated that they would mainly utilize their communication and empathy skills during donor family encounters. The participants' mean posttest score was high (x: 96.0 ± 3.8). During the SDFEs, 70% of the respondents' performance was considered sufficient. Telephone interviews conducted with the questionnaire revealed that 77.6% of the targets were fulfilled. It can be said that the course affected the participants in terms of implementing their knowledge and communication skills related to family encounters. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Water Based Inkjet Material Deposition Of Donor-Acceptor Nanoparticles For Usage In Organic Photovoltaics (United States)

    Penmetcha, Anirudh Raju

    Significant efficiency increases are being made for bulk heterojunction organic photovoltaic prototype devices with world records at 11%. However the chlorinated solvents most frequently used in prototype manufacture would cause local health and safety concerns or large scale environmental pollution upon expansion of these techniques for commercialization. Moreover, research to bridge prototype and large-scale production of these solar cells is still in its infancy. Most prototype devices are made in inert glove box environments using spin-coating. There is a need to develop a non-toxic ink and incorporate it into a material deposition system that can be used in mass production. In this thesis, P3HT:PCBM organic photovoltaic devices were fabricated with the help of inkjet printing. P3HT:PCBM blends were dissolved in organic solvent systems, and this solution was used as the ink for the printer. The "coffee-ring effect" as well as the effect of inkjet printing parameters on film formation were highlighted - thus the inkjet printing method was validated as a stepping stone between lab-scale production of OPVs and large-scale roll-to-roll manufacturing. To address the need of a non-toxic ink, P3HT:PCBM blends were then dispersed in water, using the miniemulsion method. The nanoparticles were characterized for their size, as well as the blending between the P3HT and PCBM within the nanoparticle. These dispersions were then converted into inks. Finally, these nanoparticle inks were inkjet-printed to fabricate OPV devices. Based on the results obtained here, tentative "next steps" have been outlined in order to improve upon this research work, in the future.


    NARCIS (Netherlands)


    Because of the shortage of cadaveric donors, three techniques of partial liver grafting have been developed. These techniques are placed in perspective in relation to the organ shortage. Reduced size liver transplantation (RSLTx) is widely used and has results comparable to those from whole liver

  2. Steric control of the donor/acceptor interface: Implications in organic photovoltaic charge generation

    KAUST Repository

    Holcombe, Thomas W.


    The performance of organic photovoltaic (OPV) devices is currently limited by modest short-circuit current densities. Approaches toward improving this output parameter may provide new avenues to advance OPV technologies and the basic science of charge transfer in organic semiconductors. This work highlights how steric control of the charge separation interface can be effectively tuned in OPV devices. By introducing an octylphenyl substituent onto the investigated polymer backbones, the thermally relaxed charge-transfer state, and potentially excited charge-transfer states, can be raised in energy. This decreases the barrier to charge separation and results in increased photocurrent generation. This finding is of particular significance for nonfullerene OPVs, which have many potential advantages such as tunable energy levels and spectral breadth, but are prone to poor exciton separation efficiencies. Computational, spectroscopic, and synthetic methods were combined to develop a structure-property relationship that correlates polymer substituents with charge-transfer state energies and, ultimately, device efficiencies. © 2011 American Chemical Society.

  3. Pros and Cons: Usage of organs from donors infected with hepatitis C virus - Revision in the direct-acting antiviral era. (United States)

    Coilly, Audrey; Samuel, Didier


    Should organs from hepatitis C antibody positive donors (HCVD+) be used for transplantation? Organ shortage forces transplant teams to use donors with extended criteria. The decision to transplant a HCVD+ graft is a balance between the risk of transmission of a virus that could lead to end-stage liver diseases and the benefit of access to transplantation, specifically in patients with life-threatening disease. The other issue is the impact of HCV-related liver fibrosis in the donor graft on the long-term outcome in the recipient. Thus, the use of HCVD+ demonstrated a shorter meantime on the waiting list in kidney transplantation. When a HCVD+ graft is transplanted, the risk of HCV transmission depends on; 1) the quality of screening of the donor; 2) the presence of viral replication in the donor at the time of transplantation and the ability to detect it; and 3) the HCV status of the recipient but also the type of transplanted organ. In liver transplantation, the use of HCVD+ graft is usually restricted to recipients with a chronic HCV infection. Several reports showed some competition between HCV donor and recipient strain without deleterious impact on graft and patient survival. Controversies are still pending regarding the quality of the graft and the progression of fibrosis. The recent approval of direct-acting antiviral agents (DAA) dramatically changes the landscape of HCV infection treatment. After transplantation, combinations of DAA show high efficacy and good safety profile. In the near future, extensive use of DAA should reduce the number of HCVD+ with a positive HCV RNA, limiting the risk of transmission but also the number of patients on waiting lists for a disease related to HCV. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  4. Functionalized isothianaphthene monomers that promote quinoidal character in donor-acceptor copolymers for organic photovoltaics

    KAUST Repository

    Douglas, Jessica D.


    A series of low band gap isothianaphthene-based (ITN) polymers with various electron-withdrawing substituents and intrinsic quinoidal character were synthesized, characterized, and tested in organic photovoltaic (OPV) devices. The three investigated ITN cores contained either ester, imide, or nitrile functionalities and were each synthesized in only four linear steps. The relative electron-withdrawing strength of the three substituents on the ITN moiety was evaluated and correlated to the optical and electronic properties of ITN-based copolymers. The ester- and imide-containing p-type polymers reached device efficiencies as high as 3% in bulk heterojunction blends with phenyl C 61-butyric acid methyl ester (PC 61BM), while the significantly electron-deficient nitrile-functionalized polymer behaved as an n-type material with an efficiency of 0.3% in bilayer devices with poly(3-(4-n-octyl)phenylthiophene) (POPT). © 2012 American Chemical Society.

  5. Extracorporeal lung perfusion and ventilation to improve donor lung function and increase the number of organs available for transplantation. (United States)

    Valenza, F; Rosso, L; Gatti, S; Coppola, S; Froio, S; Colombo, J; Dossi, R; Pizzocri, M; Salice, V; Nosotti, M; Reggiani, P; Tosi, D; Palleschi, A; Pappalettera, M; Ferrero, S; Perazzoli, A; Costantini, D; Scalamogna, M; Rossi, G; Colombo, C; Santambrogio, L; Gattinoni, L


    Ex vivo lung perfusion (EVLP) has been validated as a valuable technique to increase the pool of organs available for lung transplantation. After a preclinical experience, we obtained permission from the Ethics Committee of our institution to transplant lungs after EVLP reconditioning. ABO compatibility, size match, and donor arterial oxygen pressure (PaO(2))/fraction of inspired oxygen (FiO(2)) ≤ 300 mm Hg were considered to be inclusion criteria, whereas the presence of chest trauma and lung contusion, evidence of gastric content aspiration, pneumonia, sepsis, or systemic disease were exclusion criteria. We only considered subjects on an extra corporeal membrane oxygenation (ECMO) bridge to transplantation with rapid functional deterioration. Using Steen solution with packed red blood cells oxygenated with 21% O(2), 5% to 7% CO(2) was delivered, targeted with a blood flow of approximately 40% predicted cardiac output. Once normothermic, the lungs were ventilated with a tidal volume of 7 mL/kg a PEEP of 5 cmH(2)O and a respiratory rate of 7 bpm. Lungs were considered to be suitable for transplantation if well oxygenated [P(v-a) O(2) > 350 mm Hg on FiO(2) 100%], in the absence of deterioration of pulmonary vascular resistance and lung mechanics over the perfusion time. From March to September 2011, six lung transplantations were performed, including two with EVLP. The functional outcomes were similar between groups: at T72 posttransplantation, the median PaO(2)/FiO(2) were 306 mm Hg (range, 282 to 331 mm Hg) and 323 mm Hg (range, 270 to 396 mm Hg) (P = 1, EVLP versus conventional). Intensive care unit ICU and hospital length of stay were similar (P = .533 and P = .663, respectively) with no mortality at 60 days in both groups. EVLP donors were older (49 ± 6 y versus 21 ± 7 y, P organs available for transplantation with short-term outcomes comparable to conventional transplantations. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Cardiac Donor Risk Factors Predictive of Short-Term Heart Transplant Recipient Mortality: An Analysis of the United Network for Organ Sharing Database. (United States)

    Sorabella, R A; Guglielmetti, L; Kantor, A; Castillero, E; Takayama, H; Schulze, P C; Mancini, D; Naka, Y; George, I


    To address the shortage of donor hearts for transplantation, there is significant interest in liberalizing donor acceptance criteria. Therefore, the aim of this study was to evaluate cardiac donor characteristics from the United Network for Organ Sharing (UNOS) database to determine their impact on posttransplantation recipient outcomes. Adult (≥18 years) patients undergoing heart transplantation from July 1, 2004, to December 31, 2012, in the UNOS Standard Transplant Analysis and Research (STAR) database were reviewed. Patients were stratified by 1-year posttransplantation status; survivors (group S, n = 13,643) and patients who died or underwent cardiac retransplantation at 1-year follow-up (group NS/R = 1785). Thirty-three specific donor variables were collected for each recipient, and independent donor predictors of recipient death or retransplantation at 1 year were determined using multivariable logistic regression analysis. Overall 1-year survival for the entire cohort was 88.4%. Mean donor age was 31.5 ± 11.9 years, and 72% were male. On multivariable logistic regression analysis, donor age >40 years (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.27 to 1.64), graft ischemic time >3 hours (OR 1.32, 1.16 to 1.51), and the use of cardioplegia (OR 1.17, 1.01 to 1.35) or Celsior (OR 1.21, 1.06 to 1.38) preservative solution were significant predictors of recipient death or retransplantation at 1 year posttransplantation. Male donor sex (OR 0.83, 0.74 to 0.93) and the use of antihypertensive agents (OR 0.88, 0.77 to 1.00) or insulin (OR 0.84, 0.76 to 0.94) were protective from adverse outcomes at 1 year. These data suggest that donors who are older, female, or have a long projected ischemic time pose greater risk to heart transplant recipients in the short term. Additionally, certain components of donor management protocols, including antihypertensive and insulin administration, may be protective to recipients. Copyright © 2015 Elsevier Inc. All rights

  7. An Effort to Increase Organ Donor Registration Through Intergroup Competition and Electronic Word of Mouth. (United States)

    Smith, Sandi W; Hitt, Rose; Park, Hee Sun; Walther, Joseph; Liang, Yuhua Jake; Hsieh, Gary


    The effort to increase Web organ donation registrations in Michigan by enhancing 2 types of university campaigns with social media strategies informed by social identity theory is the focus of this research. The two campaigns focused on either ingroup or rivalry outgroup social identification, and each was enhanced with individually focused social media in the first year of the campaign and with electronic word of mouth in Year 2 of the campaign. Results indicated that individually focused social media such as Facebook ads worked well in rivalry campaigns (in which registrations increased two times over baseline) but not in ingroup identification campaigns (in which registrations decreased significantly over baseline when ads were introduced in the first year of each type of campaign). Electronic word-of-mouth strategies worked well in both ingroup identification campaigns (in which registrations increased two times over baseline) and rivalry campaigns (in which registrations rose almost eight times over baseline, when strategies were introduced in the second year of each type of campaign).

  8. 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 P<0.01. All recipients had similar SGOT (P=0.48), SGPT (P=0.75) and Model for End-Stage Liver Disease scores (P=0.98) before LTx; similar graft cold and warm ischemia 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.

  9. The synthesis, structure, and properties of 5,6,11,12-tetraarylindeno[1,2-b]fluorenes and their applications as donors for organic photovoltaic devices

    KAUST Repository

    Lo, Yuan-Chih


    The synthesis, structure, and properties of three new 5,6,11,12-tetraarylindeno[1,2-b]fluorenes are reported. The highly twisted conformations between an indeno[1,2-b]fluorene core and peripheral aryl substitutions endow these indeno[1,2-b]fluorene derivatives with good photostability for use as electron donors for vacuum-deposited photovoltaic devices. The optimized device based on a TAInF2 donor blended with C70 as an electron acceptor produces a high open-circuit voltage (>0.9 V) and a power conversion efficiency of 2.91%. This work demonstrates the first application of an indenofluorene derivative as an electron donor in organic solar cells.

  10. Dual kidney transplantation involving organs from expanded criteria donors: a review of our series and an update on current indications. (United States)

    Medina-Polo, J; Pamplona-Casamayor, M; Miranda-Utrera, N; González-Monte, E; Passas-Martínez, J B; Andrés Belmonte, A


    Our purpose was to review our kidney transplantation program based on the use of expanded criteria donors, and to determine current indications for dual kidney transplantation (DKT). In 1996, a program was initiated to transplant kidneys from donors of over 60 years performing single or dual transplantation. In 1996, a program was initiated to transplant kidneys from donors of over 60 years performing single or dual transplantation. DKT were performed with donors >75 and donors between 60 and 74 years of age and glomerulosclerosis of >15%. The kidneys of donors between 60 and 74 years of age and with glomerulosclerosis of transplantation (SKT). In 2005, we started to perform SKT despite glomerulosclerosis being >15%, taking into account donor and recipient characteristics. From 1996 to 2004, 222 SKTs and 88 DKTs were performed. Graft survival after 1 and 4 years was, respectively, 91% and 78% for SKT and 95% and 79% for DKT. In 2005, we started to perform SKT despite glomerulosclerosis being >15%, taking into account donor and recipient characteristics. From 2005 to 2011, 328 SKT and 32 DKT were performed. During this period most kidneys used for DKT were from female donors >75 years old, weighing 1 mg/dL and glomerulosclerosis of >15%. The recipients for DKT were mostly male, 75 kg. DKT from expanded criteria donors shows good outcomes. However, in many cases SKT may fulfill the need of the recipient. The archetype for DKT is an older female weighing <65 kg and the most common recipient is an overweight male who is <70 years old. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Why should we compensate organ donors when we can continue to take organs for free? A response to some of my critics. (United States)

    Cherry, Mark J


    In Kidney for Sale by Owner: Human Organs, Transplantation, and the Market, I argued that the market is the most efficient and effective-and morally justified-means of procuring and allocating human organs for transplantation. This special issue of The Journal of Medicine and Philosophy publishes several articles critical of this position and of my arguments mustered in its support. In this essay, I explore the core criticisms these authors raise against my conclusions. I argue that clinging to comfortable, but unfounded, notions that human body parts are not commodities, that the physician-patient relationship transcends commercial practices, and that medicine rises above market-place morality (where "market-place morality" is presented rhetorically as a criticism) leads to a real failure adequately to appreciate the complex reality of modern medicine. Denying the illicit moral intuitions that commodification of body parts is immoral or that it necessarily violates human dignity would benefit donors and recipients alike, while also reinforcing virtuous transplantation practice and policy. Honestly acknowledging the medical marketplace would shed light on what is often a hazy and shrouded policy setting. At stake is not solely the efficiency of procuring human organs for transplantation but also the recognition of the moral authority of persons over themselves.

  12. Donor Desmopressin Treatment Does Not Affect Transplant Outcome in the Fischer to Lewis Rat Renal Transplant Model. (United States)

    Mundt, Heiko M; Höger, Simone; Waldherr, Rüdiger; Schnuelle, Peter; Krämer, Bernhard K; Yard, Benito A; Göttmann, Uwe; Benck, Urs


    Retrospective studies suggest that donor desmopressin (DDAVP) treatment improves renal transplant outcome. The present study tests the hypothesis that desmopressin neutralizes the graft's endothelium from proinflammatory angiopoietin 2 containing Weibel-Palade bodies in the donor, resulting in reduced Weibel-Palade body release at the time of reperfusion in the recipient. Using rat models, we examined the influence of desmopressin treatment on the expression of vasopressin 2 receptors and adhesion molecules in brain-dead donors, with renal function examined in allogeneic recipients. The influence of desmopressin on the expression of adhesion molecules also was tested in vitro. Vasopressin 2 receptors were restricted to collecting ducts and distal tubules and only scarcely found in the renal vasculature. Vasopressin 2 receptor expression was down-regulated in brain-dead rats by desmopressin. Renal expression of vascular cellular adhesion molecule 1 and intercellular adhesion molecule 1 were significantly reduced in these rats. In contrast, angiopoietin 2 did not influence the expression of adhesion molecules in in vitro cultured endothelial cells after tumor necrosis factor ? stimulation. Donor desmopressin treatment improved neither renal function nor histology in allogeneic renal transplant recipients. Our data do not support the hypothesis that the clinically observed salutary effect of desmopressin is mediated by depletion of Weibel-Palade bodies in renal allografts.

  13. Creation of Superheterojunction Polymers via Direct Polycondensation: Segregated and Bicontinuous Donor-Acceptor π-Columnar Arrays in Covalent Organic Frameworks for Long-Lived Charge Separation. (United States)

    Jin, Shangbin; Supur, Mustafa; Addicoat, Matthew; Furukawa, Ko; Chen, Long; Nakamura, Toshikazu; Fukuzumi, Shunichi; Irle, Stephan; Jiang, Donglin


    By developing metallophthalocyanines and diimides as electron-donating and -accepting building blocks, herein, we report the construction of new electron donor-acceptor covalent organic frameworks (COFs) with periodically ordered electron donor and acceptor π-columnar arrays via direct polycondensation reactions. X-ray diffraction measurements in conjunction with structural simulations resolved that the resulting frameworks consist of metallophthalocyanine and diimide columns, which are ordered in a segregated yet bicontinuous manner to form built-in periodic π-arrays. In the frameworks, each metallophthalocyanine donor and diimide acceptor units are exactly linked and interfaced, leading to the generation of superheterojunctions-a new type of heterojunction machinery, for photoinduced electron transfer and charge separation. We show that this polycondensation method is widely applicable to various metallophthalocyanines and diimides as demonstrated by the combination of copper, nickel, and zinc phthalocyanine donors with pyrommellitic diimide, naphthalene diimide, and perylene diimide acceptors. By using time-resolved transient absorption spectroscopy and electron spin resonance, we demonstrated that the COFs enable long-lived charge separation, whereas the metal species, the class of acceptors, and the local geometry between donor and acceptor units play roles in determining the photochemical dynamics. The results provide insights into photoelectric COFs and demonstrate their enormous potential for charge separation and photoenergy conversions.

  14. Improving the Outcomes of Organs Obtained From Controlled Donation After Circulatory Death Donors Using Abdominal Normothermic Regional Perfusion. (United States)

    Miñambres, E; Suberviola, B; Dominguez-Gil, B; Rodrigo, E; Ruiz-San Millan, J C; Rodríguez-San Juan, J C; Ballesteros, M A


    The use of donation after circulatory death (DCD) has increased significantly during the past decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared with donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow before organ recovery in cDCD has been proposed as better than rapid recovery to reverse the effect of ischemia and improve recipients' outcome. Here, the first Spanish series using abdominal nRP as an in situ conditioning method is reported. A specific methodology to avoid restoring circulation to the brain after death determination is described. Twenty-seven cDCD donors underwent abdominal nRP during at least 60 min. Thirty-seven kidneys, 11 livers, six bilateral lungs, and one pancreas were transplanted. The 1-year death-censored kidney survival was 91%, and delayed graft function rate was 27%. The 1-year liver survival rate was 90.1% with no cases of ischemic cholangiopathy. Transplanted lungs and pancreas exhibited primary function. The use of nRP may represent an advance to increase the number and quality of grafts in cDCD. Poor results in cDCD livers could be reversed with nRP. Concerns about restoring brain circulation after death are easily solved. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  15. Magnetic field enhanced electroluminescence in organic light emitting diodes based on electron donor-acceptor exciplex blends (United States)

    Baniya, Sangita; Basel, Tek; Sun, Dali; McLaughlin, Ryan; Vardeny, Zeev Valy


    A useful process for light harvesting from injected electron-hole pairs in organic light emitting diodes (OLED) is the transfer from triplet excitons (T) to singlet excitons (S) via reverse intersystem crossing (RISC). This process adds a delayed electro-luminescence (EL) emission component that is known as thermally activated delayed fluorescence (TADF). We have studied electron donor (D)/acceptor(A) blends that form an exciplex manifold in which the energy difference, ΔEST between the lowest singlet (S1) and triplet (T1) levels is relatively small (field of 50 mT at ambient. Moreover the MEL response is activated with activation energy similar that of the EL emission. This suggests that the large magneto-EL originates from an additional spin-mixing channel between singlet and triplet states of the generated exciplexes, which is due to TADF. We will report on the MEL dependencies on the temperature, bias voltage, and D-A materials for optimum OLED performance. Supported by SAMSUNG Global Research Outreach (GRO) program, and also by the NSF-Material Science & Engineering Center (MRSEC) program at the University of Utah (DMR-1121252).

  16. Effect of a lung protective strategy for organ donors on eligibility and availability of lungs for transplantation: a randomized controlled trial. (United States)

    Mascia, Luciana; Pasero, Daniela; Slutsky, Arthur S; Arguis, M Jose; Berardino, Maurizio; Grasso, Salvatore; Munari, Marina; Boifava, Silvia; Cornara, Giuseppe; Della Corte, Francesco; Vivaldi, Nicoletta; Malacarne, Paolo; Del Gaudio, Paolo; Livigni, Sergio; Zavala, Elisabeth; Filippini, Claudia; Martin, Erica L; Donadio, Pier Paolo; Mastromauro, Ilaria; Ranieri, V Marco


    Many potential donor lungs deteriorate between the time of brain death and evaluation for transplantation suitability, possibly because of the ventilatory strategy used after brain death. To test whether a lung protective strategy increases the number of lungs available for transplantation. Multicenter randomized controlled trial of patients with beating hearts who were potential organ donors conducted at 12 European intensive care units from September 2004 to May 2009 in the Protective Ventilatory Strategy in Potential Lung Donors Study. Interventions Potential donors were randomized to the conventional ventilatory strategy (with tidal volumes of 10-12 mL/kg of predicted body weight, positive end-expiratory pressure [PEEP] of 3-5 cm H(2)O, apnea tests performed by disconnecting the ventilator, and open circuit for airway suction) or the protective ventilatory strategy (with tidal volumes of 6-8 mL/kg of predicted body weight, PEEP of 8-10 cm H(2)O, apnea tests performed by using continuous positive airway pressure, and closed circuit for airway suction). The number of organ donors meeting eligibility criteria for harvesting, number of lungs harvested, and 6-month survival of lung transplant recipients. The trial was stopped after enrolling 118 patients (59 in the conventional ventilatory strategy and 59 in the protective ventilatory strategy) because of termination of funding. The number of patients who met lung donor eligibility criteria after the 6-hour observation period was 32 (54%) in the conventional strategy vs 56 (95%) in the protective strategy (difference of 41% [95% confidence interval {CI}, 26.5% to 54.8%]; P <.001). The number of patients in whom lungs were harvested was 16 (27%) in the conventional strategy vs 32 (54%) in the protective strategy (difference of 27% [95% CI, 10.0% to 44.5%]; P = .004). Six-month survival rates did not differ between recipients who received lungs from donors ventilated with the conventional strategy compared with the

  17. Spectroscopic and electrochemical properties of organic framework of macrocylic OONNOO-donor ligand with its metal organic framework: Host/guest stability measurements (United States)

    Kumar, Rajiv; Singh, R. P.; Singh, R. P.


    In this study, we synthesized 1,2-di( o-aminophenoxy)ethane, as the starting material, used in the preparation of a novel hexadentate OONNOO-donor macrocyclic ligand-1,4,11,14-tetraoxo-7,8-diaza-5,6:9,10;15,16:19,20-terabezocyclododeca-8,17-iene. It has twenty membered organic framework (OF), which has been designed, synthesized and characterized. Our main findings of this paper are related to the organic framework of ligand, its capacity to digest the metal ions and the stability of metal organic framework (MOFs) with cobalt(II), nickel(II) and manganese(II). The authenticity of the used organic framework and its metal complexes have been detected and observed in solid state as well as in aqueous solutions. The main observations were made on the basis of physiochemical measurements viz.: elemental analyses, molar conductance measurements, magnetic susceptibility measurements, IR, 1H NMR, 13C NMR, mass spectroscopy, electronic, ESR spectroscopy. In addition, the magnetic susceptibility and electrochemistry measurements have been made. The 1H NMR spectra suggest stereochemistry and proton movement interaction. Considering the used organic framework there are a lot of carbon atoms in the molecule reflected by the 13C NMR spectrum. All these observations gave a clear view to confirming the encapsulation; arrive at the composition, structure and geometry of encapsulated complexes. In simple words, it confirms the host/guest coordination and its stability. Electrochemical properties of the complexes have been investigated to confirm the various changes in oxidation state of metals with change in potentials with respect to current at different scan rate.

  18. Spectroscopic and electrochemical properties of organic framework of macrocylic OONNOO-donor ligand with its metal organic framework: host/guest stability measurements. (United States)

    Kumar, Rajiv; Singh, R P; Singh, R P


    In this study, we synthesized 1,2-di(o-aminophenoxy)ethane, as the starting material, used in the preparation of a novel hexadentate OONNOO-donor macrocyclic ligand-1,4,11,14-tetraoxo-7,8-diaza-5,6:9,10;15,16:19,20-terabezocyclododeca-8,17-iene. It has twenty membered organic framework (OF), which has been designed, synthesized and characterized. Our main findings of this paper are related to the organic framework of ligand, its capacity to digest the metal ions and the stability of metal organic framework (MOFs) with cobalt(II), nickel(II) and manganese(II). The authenticity of the used organic framework and its metal complexes have been detected and observed in solid state as well as in aqueous solutions. The main observations were made on the basis of physiochemical measurements viz.: elemental analyses, molar conductance measurements, magnetic susceptibility measurements, IR, 1H NMR, 13C NMR, mass spectroscopy, electronic, ESR spectroscopy. In addition, the magnetic susceptibility and electrochemistry measurements have been made. The 1H NMR spectra suggest stereochemistry and proton movement interaction. Considering the used organic framework there are a lot of carbon atoms in the molecule reflected by the 13C NMR spectrum. All these observations gave a clear view to confirming the encapsulation; arrive at the composition, structure and geometry of encapsulated complexes. In simple words, it confirms the host/guest coordination and its stability. Electrochemical properties of the complexes have been investigated to confirm the various changes in oxidation state of metals with change in potentials with respect to current at different scan rate.

  19. Investigations on quinquethiophenes as donor materials in organic solar cells; Untersuchungen an Quinquethiophenen zur Verwendung als Donator in Organischen Solarzellen

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, Kerstin


    Organic photovoltaics could in the future represent a possibility for energy production from renewable energy sources. The advance consists here first of all in the potential of a very reasonable fabrication, for instance a production in the role-to-role procedurre, which can be prusued so on flexible substrates like for instance foils. Although the material costs are low, until the commercialization of organic solar cells among others an increasement of their power efficiency is necessary. Preferably in organic solar cells donor and acceptor materials should be applied, the absorption spectra and energy levels of which are ideally matched, because so can high zero-current voltages be reached. Additionally high absorption coefficents of the materials over a large spectral range can lead to high current densities in these photovoltaic components. In this thesis novel quinquethiophenes as donors in organic solar cells are studied, which consist as basic unit of five thiophene rings as well as dicyanovinyl end groups and alkyl side chains. The studied materials possess a high absorption coefficient and reach because of the high ionization potential high zero-current voltages in organic solar cells under application of the fullerenet C{sub 60} as acceptor. Simultaneously a efficient separation of the excitons on the acceptor-donor interface occurs. However the high ionization potential of the quinquethiophenes puts special requirements to the further solar-cell structure. Within this thesis it is shown that adifference between internal voltage and zero-current voltage influences decidingly the shape of the solar-cell characteristic and can generate a S-shape in the neighbourhood of the zero-current voltage. The internal voltage is hereby determined by the contacting of the photoactive layers. An increasement of the internal voltage of the solar cell can be reached by a corresponding material choice. So in this thesis it is shown that organic solar cells based on these

  20. Toward Additive-Free Small-Molecule Organic Solar Cells: Roles of the Donor Crystallization Pathway and Dynamics

    KAUST Repository

    Abdelsamie, Maged


    The ease with which small-molecule donors crystallize during solution processing is directly linked to the need for solvent additives. Donor molecules that get trapped in disordered (H1) or liquid crystalline (T1) mesophases require additive processing to promote crystallization, phase separation, and efficient light harvesting. A donor material (X2) that crystallizes directly from solution yields additive-free solar cells with an efficiency of 7.6%. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Organ Facts (United States)

    ... have died Transplants from living donors Finding a living donor Being a living donor Liver Heart Lung Pancreas Intestine VCA Common ... Living donation What is living donation? Organs Types Being a living donor First steps Being asked to donate Qualifications ...

  2. Matching Organs (United States)

    ... have died Transplants from living donors Finding a living donor Being a living donor Liver Heart Lung Pancreas Intestine VCA Common ... Living donation What is living donation? Organs Types Being a living donor First steps Being asked to donate Qualifications ...

  3. Kidney transplantation with organs from donors after circulatory death type 3: a prospective multicentric Spanish study (GEODAS 3). (United States)

    Portolés Pérez, J; Lafuente, O; Sánchez-Sobrino, B; Pérez Sáez, M J; Fernández García, A; Llamas, F; López-Sánchez, P; Rodriguez-Ferrero, M L; Zarraga, S; Ramos, A; Pascual, J


    To increase the number of kidney donors, new strategies are needed such as living donor programs, expanded criteria donors, or donors after circulatory death (DCD) kidney transplantation programs. The GEODAS group has started an observational, prospective, multicenter clinical study, collecting data from all DCD type-3 kidney transplantations performed in seven Spanish hospitals from January 2012 to January 2014. The preliminary results have shown a delayed graft function of 40.4% and graft survival of 93.7% with a nadir creatinine of 1.3 mg/dL. From all 33 potential donors included in the study, 32 were effective and 63 kidney grafts were transplanted with a utilization rate of 98.5%. Creatinine evolution (median [range]) was in the first month: 2.1 [0.6-5.6]; third month: 1.6 [0.8, 4.2]; first year: 1.6 [0.9-2.2]. These results are similar to kidney transplantation from donors after brain death as shown in the literature, especially in the graft and recipient survival rates. In addition, the controlled programs are easier and less expensive than uncontrolled DCD programs with a higher rate of graft use. Copyright © 2015 Elsevier Inc. All rights reserved.


    Directory of Open Access Journals (Sweden)

    A. E. Skvortsov


    Full Text Available Aim. The global shortage of deceased organ donors caused increasing interest to the transplant program based on the use of organs from the donors with sudden irreversible cardiac arrest, or asystolic donors (DCD. Ischemia-reperfusion injury as a result of cardiac arrest remains a key problem that limits the use of organs from DCD. Our clinical study was intended to determine the acceptability of renal transplants derived from the DCD using extracorporeal perfusion in situ after 60 minutes of asystole. Materials and methods. In 2009–2014, St. Petersburg Organ Procurement Organization (OPO obtained kidneys from 29 DCD with critically expanded warm ischemic time (WIT. The design of this study was approved by the Scientifi c Board and Ethics Committee of the State Research Institute for Emergency Medicine (Decision 7/0615/09. Initially, no one of died patients was considered as potential organ donors. In case of failed advanced CPR the death of a patient was declared initiating the protocol of subnormothermic extracorporeal abdominal perfusion with ECMO, thrombolytics (strepokinase 1.5 mln U, and LD. The procedures were established by the authorized OPO team which arrived with perfusion equipment in 30–40 minutes after declaration of donors’ death. Mean WIT was 58.1 (19.39 minutes (Mean (SD. Resuscitated grafts were transplanted into 58 recipients. The outcomes of transplantation of resuscitated kidneys were compared to those of 112 KTx from 115 brain death donors (BDDs. Results. Immediate functioning of kidney grafts was observed in 28 (48.3% of 58 recipients. There were 4 cases of primary graft non-function. By the end of the fi rst post-transplant year there was an acute rejection rate of 12.1% (9 episodes of rejection in the DCD group vs. 23.2% (26 episodes of rejection in the BDD group (p < 0.05. The actuarial 5-year graft survival rate was 82.8% (n = 48 in DCD group, and 87.5% (n = 98 in BDD group (p > 0.05. Creatinine levels at the end

  5. You've got mail! An examination of a statewide direct-mail marketing campaign to promote deceased organ donor registrations. (United States)

    Quick, Brian L; LaVoie, Nicole R; Morgan, Susan E; Bosch, Dave


    This study extends previous direct-mail campaigns by evaluating the effectiveness of a marketing campaign promoting organ donation message strategies from the vantage point of organ donors, organ recipients, individuals on the waiting list, or a combination of these three frames. Illinois residents were randomly assigned to one of four organ donation brochures disseminated via U.S. postal mail. Registrations occurred via the Internet and U.S. postal mail. Individuals register at a greater rate following exposure to the combination framed message compared to organ donor, organ recipient, and waiting list narratives. The campaign revealed that individuals are more likely to register via U.S. postal mail than the Internet. Direct-mail marketing efforts were shown to be an effective approach to promote organ and tissue donation registrations. The results demonstrated a preference for the combination framed brochure. The results are discussed with an emphasis on the practical implications of utilizing direct-mail marketing efforts to promote organ donation among young adults. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Primary Cytomegalovirus Infection in Seronegative Kidney Transplant Patients Is Associated with Protracted Cold Ischemic Time of Seropositive Donor Organs. (United States)

    Schlott, Fabian; Steubl, Dominik; Hoffmann, Dieter; Matevossian, Edouard; Lutz, Jens; Heemann, Uwe; Hösel, Volker; Busch, Dirk H; Renders, Lutz; Neuenhahn, Michael


    Human Cytomegalovirus (CMV) can lead to primary infection or reactivation in CMV-seronegative or -seropositive kidney transplant recipients, respectively. Complications comprise severe end-organ diseases and acute or chronic transplant rejection. Risk for CMV manifestation is stratified according to the CMV-IgG-serostatus, with donor+/recipient- (D+/R-) patients carrying the highest risk for CMV-replication. However, risk factors predisposing for primary infection in CMV-seronegative recipients are still not fully elucidated. Therefore, we monitored D+/R- high-risk patients undergoing kidney transplantation in combination with antiviral prophylaxis for the incidence of CMV-viremia for a median follow-up time of 784 days (156-1155 days). In this period, we analyzed the functional CMV-specific T cell response by intracellular cytokine staining and CMV-serology by ELISA. Only four of eight D+/R- patients developed clinically relevant CMV-viremia followed by seroconversion. Viremia triggered expansion of functional CMV-specific T cells correlating with protection against secondary CMV-reactivations. In contrast, all other patients remained permanently aviremic and showed no immunological correlate of infection after discontinuation of antiviral prophylaxis for up to three years. Comparing cold ischemic times (CIT) of viremic (median = 1020 min; 720-1080 min) and aviremic patients (median = 335 min; 120-660 min) revealed significantly (p = 0.0286) protracted CIT in patients with primary CMV-infection. Taken together, primary CMV-infection affects only a subgroup of D+/R- patients correlating with length of CIT. Therefore, patients with extended CIT should be thoroughly monitored for CMV-replication well beyond discontinuation of antiviral prophylaxis. In contrast, patients with short CIT remained permanently uninfected and might benefit from shorter prophylactic treatment.

  7. Do not resuscitate, brain death, and organ transplantation: Islamic perspective (United States)

    Chamsi-Pasha, Hassan; Albar, Mohammed Ali


    Muslim patients and families are often reluctant to discuss and accept fatal diagnoses and prognoses. In many instances, aggressive therapy is requested by a patient's family, prolonging the life of the patient at all costs. Islamic law permits the withdrawal of futile treatment, including life support, from terminally ill patients allowing death to take its natural course. “Do not resuscitate” is permitted in Islamic law in certain situations. Debate continues about the certainty of brain death criteria within Islamic scholars. Although brain death is accepted as true death by the majority of Muslim scholars and medical organizations, the consensus in the Muslim world is not unanimous, and some scholars still accept death only by cardiopulmonary criteria. Organ transplantation has been accepted in Islamic countries (with some resistance from some jurists). Many fatwas (decrees) of Islamic Jurisprudence Councils have been issued and allowed organs to be donated from living competent adult donor; and from deceased (cadavers), provided that they have agreed to donate or their families have agreed to donate after their death (usually these are brain-dead cases). A clear and well-defined policy from the ministry of health regarding do not resuscitate, brain death, and other end-of-life issues is urgently needed for all hospitals and health providers in most (if not all) Muslim and Arab countries. PMID:28469984

  8. Photo-induced absorption spectroscopy on organic, photovoltaically active donor-acceptor heterojunctions; Photoinduzierte Absorptionsspektroskopie an organischen, photovoltaisch aktiven Donor-Akzeptor-Heterouebergaengen

    Energy Technology Data Exchange (ETDEWEB)

    Schueppel, Rico


    Starting from some general considerations about organic semiconductors first the foundations of molecular crystals, their spectroscopic properties, as well as the mechanisms, on which the exharge-carrier generation is based, are presented. The functionality of the organic solar cells is then explained. The applied experimental techniques are thereafter explained. Special regards gets the photo-induced and transient absorption. Thed the dicyanovinyl-oligothiophene studied in this thesis are presented, whereby the characteristics fitted to the heterojunction with the fullerene C{sub 60} are discussed. Then the photo-induced absorption in this system is presented. In these studies an indirect occupation of the triplet starte of the oligothiophene derivates at the heterojunction with C{sub 60} is observed. The application of the oligothiophene derivates in organic solar cells is thereafter described. Thereby especially the correlation between reached zero voltage and the fitting of the energy levels at the DCVnT:C{sub 60} junction is considered. Furthermore the data of the solar cells are discussed in view of the statements on the charge-carrier separation at the heterojunction with C{sub 60} obtained from the photo-induced absorption.

  9. Circumventing the “Ick” Factor: A Randomized Trial of the Effects of Omitting Affective Attitudes Questions to Increase Intention to Become an Organ Donor

    Directory of Open Access Journals (Sweden)

    Sally Doherty


    Full Text Available Objectives: Including or excluding certain questions about organ donation may influence peoples’ intention to donate. We investigated the effect of omitting certain affective attitudinal items on potential donors’ intention and behavior for donation.Design: A cross-sectional survey with a subgroup nested randomized trial.Methods: A total of 578 members of the public in four shopping centers were surveyed on their attitudes to organ donation. Non-donors (n = 349 were randomly assigned to one of three groups: Group 1 completed items on affective and cognitive attitudes, anticipated regret, intention, subjective norm and perceived behavioral control. Group 2 completed all items above but excluded affective attitudes. Group 3 completed all items but omitted negatively worded affective attitudes. The primary outcome was intention to donate, taking a donor card after the interview was a secondary behavioral outcome, and both were predicted using linear and logistic regression with group 1 as the reference.Results: Mean (SD 1–7 intention scores for groups 1, 2 and 3 were, respectively: 4.43 (SD 1.89, 4.95 (SD 1.64 and 4.88 (SD 1.81, with group 2 significantly higher than group 1 (β = 0.518, 95% confidence interval [CI] 0.18 to 0.86.At the end of the interview, people in group 2 (66.7%; OR = 1.40, 95% CI 0.94 to 2.07, p = 0.096 but not those in group 3 (61.7%; OR = 1.10, 95% CI 0.69 to 1.75, p = 0.685, were marginally more likely to accept a donor card from the interviewer than people in group 1 (59.7%.Conclusion: Omitting affective attitudinal items results in higher intention to donate organs and marginally higher rates of acceptance of donor cards, which has important implications for future organ donation public health campaigns.

  10. 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.

  11. Organ transplantation: a Sunni Islamic perspective. (United States)

    Albar, Mohammed


    This paper reviews the standpoints of Muslim jurists within the Sunni tradition on organ transplantation. Muslim jurists allowed different forms of bone grafts (autograft, allograft and xenograft) for widely broken bones. Ibn Sina in 1037 discussed this subject in Al-Kanoon 1000 years ago. In 1959, the Muftis of Egypt and Tunisia allowed, under specific conditions, corneal transplants from dead persons. Thereafter, many fatwas (jurisprudence) on organ trans-plantation have been issued from different parts of the Muslim world. In Amman, Jordan, the International Islamic Jurist Council recognized brain-death as a recognized sign of death in Islam in October 1986. This paved the way for organ transplantation from brain-dead persons, which started immediately in Saudi Arabia. In 1990 and 2003, the International Islamic Fiqh Academy (IIFA) and the Islamic Fiqh Academy (IFA) issued important fatwas on organ transplantation. By the end of 2008, more than 3600 organs were transplanted from brain-dead persons in Saudi Arabia.

  12. Ternary Organic Solar Cells with Coumarin7 as the Donor Exhibiting Greater Than 10% Power Conversion Efficiency and a High Fill Factor of 75. (United States)

    Chen, Xin-Wei; Tao, Si-Lu; Fan, Cong; Chen, Dong-Cheng; Zhou, Ling; Lin, Hui; Zheng, Cai-Jun; Su, Shi-Jian


    Ternary bulk heterojunction (BHJ) is a brilliant photovoltaic technology for improving the performance of organic solar cells (OSCs), because the light absorption range can be significantly extended by using multiple donors or acceptor materials. In this paper, coumarin7 (C7), a small organic molecule typical led used in organic light-emitting diodes, was initially exploited as second electron-donor component in ternary bulk heterojunction OSCs along with conventional blend system spolythieno[3,4-b]-thiophene/benzodithiophene(PTB7) and [6,6]-phenyl-C71 -butyric acid methyl(PC 71 BM). A champion PCE value of 10.28% was realized in the ternary OSCs when incorporated with 10 wt % C7 doping ratio in the donors, corresponding to about 35% enhancement compared with the PTB7:PC 71 BM-based OSCs, a high fill factor (FF) of 75.03%, a short-circuit currentdensity (J sc ) of 18.72 mA cm -2 and an open-circuit voltage (V oc ) of 0.73 V. The enhanced performance of the ternary OSCs can be attributed to the simultaneous improvement of the FF and the J sc . In addition to extended light absorption, a perfect nanofiber filament active layer morphology is obtained due to the good compatibility between C7 and PTB7, which facilitates the balance of charge transportation and the suppression of charge recombination. This investigation suggests that coumarin derivatives, which have completely different structure with polymer donors, can also be used to fabricate ternary solar cells and have the potential applications to obtain amazing performance after further device engineering and optimization.

  13. A model to estimate the probability of human immunodeficiency virus and hepatitis C infection despite negative nucleic acid testing among increased-risk organ donors. (United States)

    Annambhotla, Pallavi D; Gurbaxani, Brian M; Kuehnert, Matthew J; Basavaraju, Sridhar V


    In 2013, guidelines were released for reducing the risk of viral bloodborne pathogen transmission through organ transplantation. Eleven criteria were described that result in a donor being designated at increased infectious risk. Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission risk from an increased-risk donor (IRD), despite negative nucleic acid testing (NAT), likely varies based on behavior type and timing. We developed a Monte Carlo risk model to quantify probability of HIV among IRDs. The model included NAT performance, viral load dynamics, and per-act risk of acquiring HIV by each behavior. The model also quantifies the probability of HCV among IRDs by non-medical intravenous drug use (IVDU). Highest risk is among donors with history of unprotected, receptive anal male-to-male intercourse with partner of unknown HIV status (MSM), followed by sex with an HIV-infected partner, IVDU, and sex with a commercial sex worker. With NAT screening, the estimated risk of undetected HIV remains small even at 1 day following a risk behavior. The estimated risk for HCV transmission through IVDU is likewise small and decreases quicker with time owing to the faster viral growth dynamics of HCV compared with HIV. These findings may allow for improved organ allocation, utilization, and recipient informed consent. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Metal–organic hybrid materials built with tetrachlorophthalate acid and different N-donor coligands: Structure diversity and photoluminescence

    Energy Technology Data Exchange (ETDEWEB)

    Xiao, Zhenyu; Yang, Xiao; Zhao, Siwei; Wang, Debao, E-mail:; Yang, Yu; Wang, Lei, E-mail:


    Eight new metal–organic hybrid materials, namely {Cd(Tcph)(4,4′-bipy)_1_/_2} (1), {[Cd_2(Tcph)_2(1,4-bimb)_1_/_2(H_2O)_4]·H_2O} (2), {Cd_2(Tcph)_2(1,4-bmimb)_1_/_2(H_2O)_4} (3), {Cd(Tcph)(1,2-bmimb)} (4), {Cu(Tcph)(1,4-bimb)(H_2O)} (5), {[Co(Tcph)(1,4-bimb)_1_/_2(H_2O)_3]·(H_2O)} (6), {Zn(Tcph)(1,2-bimb)} (7), {Cu_2(Tcph)_2(1,2-bimb)(H_2O)_4} (8), where Tcph=tetrachlorophthalate acid, 4,4′-bipy=4,4′-bipyridine, 1,4-bimb=1,4-bis(imidazol-1-ylmethyl)benzene, 1,4-bmimb=1,4-bis(2-methylimidazol-1-ylmethyl)benzene, 1,2-bimb=1,2-bis(imidazol-1-ylmethyl)-benzene, 1,2-bmimb=1,2-bis(2-methylimidazol-1-ylmethyl)benzene, have been synthesized and characterized. Their structures are determined by single crystal X-ray diffraction and further characterized by infrared spectra (IR) and thermogravimetric (TG) analyses. Complex 1, 4 and 7 display 2D layer structures. 1 possesses two-dimensional sheet containing an unusual [Cd(Tcph)] chains linked by 4,4′-bipy co-ligand, while 4 and 7 hold the similar 4-connected 4{sup 4}-sql nets. Complex 2 and 3 feature a similar three dimensional (3D) internal compensation structure with a topology of {4"2·6"3·8}{sub 2}{6"3}. 5 is a novel 2-fold self-penetrating 3D network with 4-coordinated 6{sup 5}·8–CdSO{sub 4} subnets. The ladder-like chains of 6 are further connected through O–H···O interactions to yield a 3D supramolecular structure. 8 is a discrete tetranuclear complex. The thermal stabilities of 1–8 and the luminescent properties of 1–4 and 7 in the solid state are also discussed. - Graphical abstract: Structure diversity and photoluminescence of eight new metal–organic hybrid materials constructed by Tetrachlorophthalate acid and different N-donor coligands are discussed in the context. - Highlights: • Eight new coordination polymers were synthesized based on mix-ligand strategy. • Complex 2 and 3 feature a similar 3D structure with {4"2·6"3·8}{sub 2}{6"3} topology. • Seven coordination modes of

  15. 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.

  16. Open-Circuit Voltage in Organic Solar Cells: The Impacts of Donor Semicrystallinity and Coexistence of Multiple Interfacial Charge-Transfer Bands

    KAUST Repository

    Ngongang Ndjawa, Guy Olivier


    In organic solar cells (OSCs), the energy of the charge-transfer (CT) complexes at the donor-acceptor interface, E , determines the maximum open-circuit voltage (V ). The coexistence of phases with different degrees of order in the donor or the acceptor, as in blends of semi-crystalline donors and fullerenes in bulk heterojunction layers, influences the distribution of CT states and the V enormously. Yet, the question of how structural heterogeneities alter CT states and the V is seldom addressed systematically. In this work, we combine experimental measurements of vacuum-deposited rubrene/C bilayer OSCs, with varying microstructure and texture, with density functional theory calculations to determine how relative molecular orientations and extents of structural order influence E and V . We find that varying the microstructure of rubrene gives rise to CT bands with varying energies. The CT band that originates from crystalline rubrene lies up to ≈0.4 eV lower in energy compared to the one that arises from amorphous rubrene. These low-lying CT states contribute strongly to V losses and result mainly from hole delocalization in aggregated rubrene. This work points to the importance of realizing interfacial structural control that prevents the formation of low E configurations and maximizes V .

  17. 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 ...

  18. Applying Thienyl Side Chains and Different π-Bridge to Aromatic Side-Chain Substituted Indacenodithiophene-Based Small Molecule Donors for High-Performance Organic Solar Cells. (United States)

    Wang, Jin-Liang; Liu, Kai-Kai; Liu, Sha; Liu, Feng; Wu, Hong-Bin; Cao, Yong; Russell, Thomas P


    A pair of linear tetrafluorinated small molecular donors, named as ThIDTTh4F and ThIDTSe4F, which are with tetrathienyl-substituted IDT as electron-rich central core, electron-deficient difluorobenzothiadiazole as acceptor units, and donor end-capping groups, but having differences in the π-bridge (thiophene and selenophene), were successfully synthesized and evaluated as donor materials in organic solar cells. Such π-bridge and core units in these small molecules play a decisive role in the formation of the nanoscale separation of the blend films, which were systematically investigated through absorption spectra, grazing incidence X-ray diffraction pattern, transmission electron microscopy images, resonant soft X-ray scattering profiles, and charge mobility measurement. The ThIDTSe4F (with selenophene π-bridge)-based device exhibited superior performance than devices based on ThIDTh4F (with thiophene π-bridge) after post annealing treatment owing to optimized film morphology and improved charge transport. Power conversion efficiency of 7.31% and fill factor of ∼0.70 were obtained by using a blend of ThIDTSe4F and PC71BM with thermal annealing and solvent vapor annealing treatments, which is the highest PCE from aromatic side-chain substituted IDT-based small molecular solar cells. The scope of this study is to reveal the structure-property relationship of the aromatic side-chain substituted IDT-based donor materials as a function of π-bridge and the post annealing conditions.

  19. In situ cornea harvesting through the Red Cross Organization: a new approach to relieving severe cornea donor shortage in Chinese eye banks

    Directory of Open Access Journals (Sweden)

    Su-Xia Li


    Full Text Available Corneal diseases are currently the second main cause of blindness in China. Although most of the corneal blindness could be treated by corneal transplantation, only about 10 000 operations were carried out each year owing to the severe shortage of corneal donors and limited eye bank programs. A feasible cornea donation program was established through the organization of the Red Cross, and in situ corneal removal techniques were developed to avoid conflicts with Chinese traditions of keeping the deceased intact. The number of donated corneas, which had a safe and secure quality, increased significantly year by year.

  20. In situ cornea harvesting through the Red Cross Organization: a new approach to relieving severe cornea donor shortage in Chinese eye banks. (United States)

    Li, Su-Xia; Wang, Fu-Hua; Wang, Ting; Han, Sha-Sha; Shi, Wei-Yun


    Corneal diseases are currently the second main cause of blindness in China. Although most of the corneal blindness could be treated by corneal transplantation, only about 10 000 operations were carried out each year owing to the severe shortage of corneal donors and limited eye bank programs. A feasible cornea donation program was established through the organization of the Red Cross, and in situ corneal removal techniques were developed to avoid conflicts with Chinese traditions of keeping the deceased intact. The number of donated corneas, which had a safe and secure quality, increased significantly year by year.

  1. A Novel Model on DST-Induced Transplantation Tolerance by the Transfer of Self-Specific Donor tTregs to a Haplotype-Matched Organ Recipient

    DEFF Research Database (Denmark)

    Gregoriussen, Angelica Maria Mohr; Bohr, Henrik Georg


    Donor-specific blood transfusion (DST) can lead to significant prolongation of allograft survival in experimental animal models and sometimes human recipients of solid organs. The mechanisms responsible for the beneficial effect on graft survival have been a topic of research and debate for decades...... during the course of tolerance induction. Based on the immunological status of the recipients, we suggest that one H2-haplotype-matched self-specific Tregs derived from the transfusion blood can be activated and multiply in the host by binding to antigen-presenting cells presenting allopeptides...

  2. The core of after death care in relation to organ donation - a grounded theory study. (United States)

    Forsberg, Anna; Flodén, Anne; Lennerling, Annette; Karlsson, Veronika; Nilsson, Madeleine; Fridh, Isabell


    The aim of this study was to investigate how intensive and critical care nurses experience and deal with after death care i.e. the period from notification of a possible brain dead person, and thereby a possible organ donor, to the time of post-mortem farewell. Grounded theory, based on Charmaz' framework, was used to explore what characterises the ICU-nurses concerns during the process of after death and how they handle it. Data was collected from open-ended interviews. The core category: achieving a basis for organ donation through dignified and respectful care of the deceased person and the close relatives highlights the main concern of the 29 informants. This concern is categorised into four main areas: safeguarding the dignity of the deceased person, respecting the relatives, dignified and respectful care, enabling a dignified farewell. After death care requires the provision of intense, technical, medical and nursing interventions to enable organ donation from a deceased person. It is achieved by extensive nursing efforts to preserve and safeguard the dignity of and respect for the deceased person and the close relatives, within an atmosphere of peace and tranquillity. Copyright © 2014 Elsevier Ltd. All rights reserved.


    CERN Multimedia


    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 Multimedia


    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


    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


    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 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. Organ Donation: from Point of View of Students Doing Medical Internship in India

    Directory of Open Access Journals (Sweden)

    Bharambe Vaishaly K.


    Full Text Available Introduction. To study the knowledge and attitude of a medical student doing internship with regards to organ donation. Methods. A total of 50 specially designed questionnaires were distributed among medical students doing internship at a medical college. Those who gave their consent to participate in the study were asked to fill out the questionnaire. Results. 86% gave their consent to participate in the study. 100% were aware of the concept of organ donation. 68% had obtained this knowledge from newspapers. 4% had obtained knowledge from the Medical College. 48%, 48% and 34% believed that an organ donor was live, brain dead and cardiac dead, respectively. Awareness regarding kidney, eye, liver, heart and skin donation was found to be 82%, 80%, 80%, 62% and 64%, respectively. 54% were aware of Law pertaining to organ donation. 90% were either positive or willing to consider organ donation themselves. 10% felt that the donated organ might be misused. Conclusion. Health care professionals are the first to establish relationship with the potential donor’s family and are a crucial link in the organ procurement process. Their attitude and level of knowledge regarding organ donation would reflect directly on the organ donation activity of any region. The interns in the present study had positive attitude towards organ donation but were lacking in knowledge about some key aspects such as brain death and legality involved in organ donation. Majority of the medical professionals had obtained their knowledge from newspapers and very few were taught about organ donation in the medical college. If education on organ donation and its various aspects was included in medical curriculum, it could empower the future medical care professionals with knowledge to further study the cause of organ donation and serve the society better.

  9. Syntheses, structures and photoluminescence of lanthanide-organic frameworks assembled from multifunctional N,O-donor ligand

    Energy Technology Data Exchange (ETDEWEB)

    Che, Guang-Bo, E-mail: [Key Laboratory of Preparation and Applications of Environmental Friendly Materials, Jilin Normal University, Chinese Ministry of Education, Siping 136000 (China); Liu, Shu-Yu [Key Laboratory of Preparation and Applications of Environmental Friendly Materials, Jilin Normal University, Chinese Ministry of Education, Siping 136000 (China); Zhang, Qing [Institute of Functional Nano and Soft Materials (FUNSOM), Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou 215123 (China); Liu, Chun-Bo, E-mail: [School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang 212013 (China); Zhang, Xing-Jing [Key Laboratory of Preparation and Applications of Environmental Friendly Materials, Jilin Normal University, Chinese Ministry of Education, Siping 136000 (China)


    Four new lanthanide complexes [Ln(O–NCP){sub 2}(NO{sub 3})]{sub n} based on multifunctional N,O-donor ligand 2-(2-carboxyphenyl)imidazo(4,5-f)-(1,10)phenanthroline (O–HNCP) and Ln(NO{sub 3}){sub 3}·6H{sub 2}O (Ln=Nd(1), La(2), Sm(3), Eu(4)) have been achieved under hydrothermal conditions and characterized by elemental analyses, infrared spectra and single crystal X-ray diffraction. Structural analyses revealed that all of these four complexes possess similar two-dimensional layer structures. In addition, thermal stability and luminescent properties of these complexes were also investigated. - Graphical abstract: A series of lanthanide(III) coordination polymers with intriguing structures based on 2-(2-carboxyphenyl)imidazo(4,5-f)-(1,10)phenanthroline ligand have been hydrothermally synthesized. The thermal stabilities and photoluminescence properties of these complexes have been investigated. - Highlights: • Four lanthanide(III) complexes have been hydrothermally synthesized. • The N,O-donor O–HNCP was used as the ligand. • TGA and PL properties of complexes 1–4 have been investigated.

  10. Vibrational properties of organic donor-acceptor molecular crystals: Anthracene-pyromellitic-dianhydride (PMDA) as a case study

    KAUST Repository

    Fonari, A.


    We establish a reliable quantum-mechanical approach to evaluate the vibrational properties of donor-acceptor molecular crystals. The anthracene-PMDA (PMDA = pyromellitic dianhydride) crystal, where anthracene acts as the electron donor and PMDA as the electron acceptor, is taken as a representative system for which experimental non-resonance Raman spectra are also reported. We first investigate the impact that the amount of nonlocal Hartree-Fock exchange (HFE) included in a hybrid density functional has on the geometry, normal vibrational modes, electronic coupling, and electron-vibrational (phonon) couplings. The comparison between experimental and theoreticalRaman spectra indicates that the results based on the αPBE functional with 25%-35% HFE are in better agreement with the experimental results compared to those obtained with the pure PBE functional. Then, taking αPBE with 25% HFE, we assign the vibrational modes and examine their contributions to the relaxation energy related to the nonlocal electron-vibration interactions. The results show that the largest contribution (about 90%) is due to electron interactions with low-frequency vibrational modes. The relaxation energy in anthracene-PMDA is found to be about five times smaller than the electronic coupling.

  11. Vibrational properties of organic donor-acceptor molecular crystals: Anthracene-pyromellitic-dianhydride (PMDA) as a case study

    Energy Technology Data Exchange (ETDEWEB)

    Fonari, A.; Corbin, N. S.; Coropceanu, V., E-mail:, E-mail: [School of Chemistry and Biochemistry and Center for Organic Photonics and Electronics, Georgia Institute of Technology, Atlanta, Georgia 30332-0400 (United States); Vermeulen, D.; McNeil, L. E. [Department of Physics and Astronomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-3255 (United States); Goetz, K. P.; Jurchescu, O. D. [Department of Physics, Wake Forest University, Winston-Salem, North Carolina 27109-7507 (United States); Bredas, J. L., E-mail:, E-mail: [School of Chemistry and Biochemistry and Center for Organic Photonics and Electronics, Georgia Institute of Technology, Atlanta, Georgia 30332-0400 (United States); Solar and Photovoltaics Engineering Research Center, Division of Physical Science and Engineering, King Abdullah University of Science and Technology, Thuwal 23955-6900 (Saudi Arabia)


    We establish a reliable quantum-mechanical approach to evaluate the vibrational properties of donor-acceptor molecular crystals. The anthracene-PMDA (PMDA = pyromellitic dianhydride) crystal, where anthracene acts as the electron donor and PMDA as the electron acceptor, is taken as a representative system for which experimental non-resonance Raman spectra are also reported. We first investigate the impact that the amount of nonlocal Hartree-Fock exchange (HFE) included in a hybrid density functional has on the geometry, normal vibrational modes, electronic coupling, and electron-vibrational (phonon) couplings. The comparison between experimental and theoretical Raman spectra indicates that the results based on the αPBE functional with 25%-35% HFE are in better agreement with the experimental results compared to those obtained with the pure PBE functional. Then, taking αPBE with 25% HFE, we assign the vibrational modes and examine their contributions to the relaxation energy related to the nonlocal electron-vibration interactions. The results show that the largest contribution (about 90%) is due to electron interactions with low-frequency vibrational modes. The relaxation energy in anthracene-PMDA is found to be about five times smaller than the electronic coupling.

  12. Parental Grief Following the Brain Death of a Child: Does Consent or Refusal to Organ Donation Affect Their Grief? (United States)

    Bellali, Thalia; Papadatou, Danai


    The purpose of this study was to investigate the grieving process of parents who were faced with the dilemma of donating organs and tissues of their underage brain dead child, and to explore the impact of their decision on their grief process. A grounded theory methodology was adopted and a semi-structured interview was conducted with 11 bereaved…

  13. Synthesis, crystal structures, and properties of two novel cadmium(II)-organic frameworks based on asymmetric dicarboxylate and N-donor ligands (United States)

    Chen, Xiaoli; Gao, Loujun; Zhang, Xiaoge; Han, Xuhua; Wang, Yao; Sun, Rong


    Two novel cadmium(II)-organic frameworks with asymmetric dicarboxylate and N-donor ligands, namely [Cd(cpa)(phen)]n (1) and {[Cd2(cpa)2(bpy)1.5]·0.5H2O}n (2) (H2cpa = 3-(4-benzoic)propionic acid, phen = 1,10-phenanthroline, bpy = 4,4";-bipyridine) have been hydrothermally synthesized and characterized by elemental analyses, FT-IR spectra, single-crystal X-ray diffraction analyses, TGA, powder XRD and fluorescent measurements. 1 displays a double zigzag chain structure containing 8-number and 22-number circles. 2 Shows a 6-connected 3D polymer network based on tetranuclear cadmium cluster units. The most striking feature of 2 is that a pair of identical 3D networks are interlocked with each other to the form a 2-fold interpenetrated 3D α-Po structural topology. The diverse structures of two complexes indicate that the skeleton of N-donor ligands plays a great role in the assembly of such different frameworks. In addition, the thermal stabilities, XRD and photoluminescence properties of 1-2 were also studied.

  14. Predictors of non-transplantation of adult donor organs--an observational study using routine data from Eurotransplant. (United States)

    Drewitz, Karl Philipp; Loss, Martin; Loss, Julika; Apfelbacher, Christian Joachim


    The majority of pancreases, offered in allocation, are not transplanted. This pancreas under-utilisation is a phenomenon observed in all transplant systems in North-America and Europe. It was the aim of this study to analyse factors predictive of pancreas non-transplantation in Germany. Routine Eurotransplant data of 3,666 deceased German donors (from 2002-2011) were used for multivariate modelling. Socio-demographic and medical factors were considered as independent variables in logistic regression models with non-transplantation as dependent variable. Male gender, advanced age, overweight/obesity, long ICU stay, a history of smoking, non-traumatic brain death, elevated levels of sodium, serum glucose, lipase/amylase and the liver not being considered for procurement were significant independent predictors of non-transplantation. In line with previous research, advanced age, high BMI, long ICU stay and the liver not being considered for procurement were the strongest predictors of pancreas non-transplantation in Germany. About three quarters of the variance remained unexplained, suggesting that factors not assessed or unknown may play a decisive role.

  15. Recombination dynamics as a key determinant of open circuit voltage in organic bulk heterojunction solar cells: a comparison of four different donor polymers

    Energy Technology Data Exchange (ETDEWEB)

    Maurano, Andrea; Hamilton, Rick; Shuttle, Chris G.; O' Regan, Brian; Zhang, Weimin; McCulloch, Iain; Durrant, James R. [Departments of Chemistry, Imperial College London, South Kensington SW7 2AZ (United Kingdom); Ballantyne, Amy M.; Nelson, Jenny [Departments of Physics, Imperial College London, South Kensington SW7 2AZ (United Kingdom); Azimi, Hamed [Konarka Austria, Altenbergerstrasse 69, A-4040 Linz (Austria); Christian Doppler Laboratory for Surface Optics, Johannes Kepler University, Linz (Austria); Morana, Mauro; Brabec, Christoph J. [Konarka Austria, Altenbergerstrasse 69, A-4040 Linz (Austria)


    Transient photovoltage and charge extraction analyses are employed to analyzes charge carrier densities and bimolecular recombination dynamics in organic polymer: fullerene solar cells under open circuit operating conditions, employing four different donor polymers. An equation is derived which allows us to calculate the device V{sub OC} from these kinetic measurements. This equation allows us to calculate voltage output of devices within {+-} 25 meV of directly measured values. This analysis thus allows us to relate device open circuit voltage directly to the kinetics of bimolecular recombination, and thereby the influence of nanomorphology upon device voltage output. (Copyright copyright 2010 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  16. Magneto-ionic phase control in a quasi-layered donor/acceptor metal-organic framework by means of a Li-ion battery system (United States)

    Taniguchi, Kouji; Narushima, Keisuke; Yamagishi, Kayo; Shito, Nanami; Kosaka, Wataru; Miyasaka, Hitoshi


    Electrical magnetism control is realized in a Li-ion battery system through a redox reaction involving ion migrations; “magneto-ionic control”. A quasi-layered metal-organic framework compound with a cross-linked π-conjugated/unconjugated one-dimensional chain motifs composed of electron-donor/acceptor units is developed as the cathode material. A change in magnetic phase from paramagnetic to ferrimagnetic is demonstrated by means of electron-filling control for the acceptor units via insertion of Li+-ions into pores in the material. The transition temperature is as high as that expected for highly π-conjugated layered systems, indicating an extension of π-conjugated exchange paths by rearranging coordination bonds in the first discharge process.

  17. 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

  18. Beware Cold Agglutinins in Organ Donors! Ex Vivo Lung Perfusion From an Uncontrolled Donation After Circulatory-Determination-of-Death Donor With a Cold Agglutinin: A Case Report. (United States)

    Venkataraman, A; Blackwell, J W; Funkhouser, W K; Birchard, K R; Beamer, S E; Simmons, W T; Randell, S H; Egan, T M


    We began to recover lungs from uncontrolled donation after circulatory determination of death to assess for transplant suitability by means of ex vivo lung perfusion (EVLP) and computerized tomographic (CT) scan. Our first case had a cold agglutinin with an interesting outcome. A 60-year-old man collapsed at home and was pronounced dead by Emergency Medical Services personnel. Next-of-kin consented to lung retrieval, and the decedent was ventilated and transported. Lungs were flushed with cold Perfadex, removed, and stored cold. The lungs did not flush well. Medical history revealed a recent hemolytic anemia and a known cold agglutinin. Warm nonventilated ischemia time was 51 minutes. O2-ventilated ischemia time was 141 minutes. Total cold ischemia time was 6.5 hours. At cannulation for EVLP, established clots were retrieved from both pulmonary arteries. At initiation of EVLP with Steen solution, tiny red aggregates were observed initially. With warming, the aggregates disappeared and the perfusate became red. After 1 hour, EVLP was stopped because of florid pulmonary edema. The lungs were cooled to 20°C; tiny red aggregates formed again in the perfusate. Ex vivo CT scan showed areas of pulmonary edema and a pyramidal right middle lobe opacity. Dissection showed multiple pulmonary emboli-the likely cause of death. However, histology showed agglutinated red blood cells in the microvasculature in pre- and post-EVLP biopsies, which may have contributed to inadequate parenchymal preservation. Organ donors with cold agglutinins may not be suitable owing to the impact of hypothermic preservation. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Long-range coupling of electron-hole pairs in spatially separated organic donor-acceptor layers (United States)

    Nakanotani, Hajime; Furukawa, Taro; Morimoto, Kei; Adachi, Chihaya


    Understanding exciton behavior in organic semiconductor molecules is crucial for the development of organic semiconductor-based excitonic devices such as organic light-emitting diodes and organic solar cells, and the tightly bound electron-hole pair forming an exciton is normally assumed to be localized on an organic semiconducting molecule. We report the observation of long-range coupling of electron-hole pairs in spatially separated electron-donating and electron-accepting molecules across a 10-nanometers-thick spacer layer. We found that the exciton energy can be tuned over 100 megaelectron volts and the fraction of delayed fluorescence can be increased by adjusting the spacer-layer thickness. Furthermore, increasing the spacer-layer thickness produced an organic light-emitting diode with an electroluminescence efficiency nearly eight times higher than that of a device without a spacer layer. Our results demonstrate the first example of a long-range coupled charge-transfer state between electron-donating and electron-accepting molecules in a working device. PMID:26933691

  20. Intermediate-Sized Conjugated Donor Molecules for Organic Solar Cells: Comparison of Benzodithiophene and Benzobisthiazole-Based Cores

    KAUST Repository

    Zhang, Siyuan


    Two intermediate-sized donor molecules, BBTz-X and BDT-X, have been synthesized by the Stille coupling between 4-(4,4-bis(2-ethylhexyl)-6-(trimethylstannyl)-4H-silolo[3,2-b:4,5-b′]dithiophen-2-yl)-7-(5′-hexyl-[2,2′-bithiophen]-5-yl)-[1,2,5]thiadiazolo[3,4-c]pyridine and either 4,8-bis(5-(2-ethylhexyl)thiophen-2-yl)-2,6-diiodobenzo[1,2-d:4,5-d′]bis(thiazole) or 2,6-dibromo-4,8-bis(5-(2-ethylhexyl)thiophen-2-yl)benzo[1,2-b:4,5-b′]dithiophene, respectively. Both oxidation and reduction potentials for BBTz-X are anodically shifted relative to those for BDT-X, but the oxidation potential is more sensitive to the identity of the core; this is consistent with what is seen for DFT-calculated HOMO and LUMO energies and with a slightly blue-shifted absorption maximum for BBTz-X. Although DFT calculations, along with crystal structures of related compounds, suggest more planar molecular structures for BBTz-X than for BDT-X, film structures and the effects of various annealing processes on these films, as revealed by GIWAXS, are similar. The performance of BDT-X:PC61BM bulk-heterojunction solar cells is more sensitive to annealing conditions than that of BBTz-X:PC61BM cells, but under appropriate conditions, both yield power conversion efficiencies of >7%.

  1. A clinical group's attempt to raise awareness of organ and tissue donation. (United States)

    Rykhoff, Margot E; Coupland, Catherine; Dionne, Joanna; Fudge, Brad; Gayle, Charlene; Ortner, Terri-Lynn; Quilang, Kristina; Savu, Geta; Sawany, Fatima; Wrobleska, Marzena


    Little is known about factors that influence attitudes and beliefs about organ and tissue donation among health science college students. To assess health sciences college students' knowledge, attitudes, and beliefs about organ donation and to determine if an educational session increases awareness and influences their attitudes and beliefs related to organ donation. Quantitative quasi-experimental study with semistructured questions administered to a convenience sample. School of health sciences in a large, urban, multicultural community college in Ontario, Canada. 240 health sciences' college students from 6 academic programs: bachelor of nursing from first and fourth year, practical nursing, paramedic, funeral services, and occupational therapy/physical therapy assistant. An educational session and 7-minute audiovisual presentation on organ donation. The educational session included a 20-minute PowerPoint presentation addressing statistics of organ and tissue need and donation; types of donation--deceased (brain-dead), live, and tissue; clarification on the criteria for brain death; donor cards; family consent, including clarification that the family member has the ultimate decision to sign it and the importance of communicating one's wishes to one's family; and religious beliefs and common myths and misconceptions. Of 235 students who completed the postintervention survey, 86% (n = 202) were more aware of organ donation, and 85% (n = 199) were more aware of living donation. Awareness of the need for family consent for donation increased significantly (from 52% to 96%, P donate their organs increased from 52% to 63% (n = 26, P donate their organs, the predominant rationale was "fear." Educational sessions in the health sciences curriculum can increase awareness of organ and tissue donation.

  2. Family perception of the process of organ donation. Qualitative psychosocial analysis of the subjective interpretation of donor and nondonor families. (United States)

    López Martínez, Jorge S; Martín López, María Jesús; Scandroglio, Barbara; Martínez García, José Manuel


    Family perception of organ donation has been explored by numerous authors using statements by the people who decided whether or not to donate the organs of a relative in a situation of brain death. Within this tradition, in this work, we analyze the discourse of six families who granted permission for organ donation and three who refused. We describe the process-based interpretation of this experience and identify psychosocial variables and processes that further our understanding of the decision finally adopted. We have identified two heuristics that guide family decision when organ donation is requested: the explicit or inferred will of the deceased and family attitudes to organ donation and transplant. It is postulated that the interaction of these two factors explains a large amount of the decisions made. We also hypothesize that a marked discrepancy between these two factors increases the importance of other aspects, especially the role of the transplant coordinator and of other healthcare personnel. These results support, at a social level, the implementation of transplant promotion programs; and at a healthcare level, the combined use of techniques of crisis intervention and attitude change.

  3. Anaesthesia and peri-operative care for laparoscopic donor nephrectomy

    NARCIS (Netherlands)

    I.R.A.M. Mertens Zur Borg (Ingrid)


    textabstractA successful renal transplant for patients with kidney failure reduces mortality rate when compared to patients who continue dialysis. Organ donation from living donors has significant better results over organ donation from deceased donors. Traditionally the surgical

  4. 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.

  5. Assignment of C1q-binding HLA antibodies as unacceptable HLA antigens avoids positive CDC-crossmatches prior to transplantation of deceased donor organs. (United States)

    Juhl, David; Marget, Matthias; Hallensleben, Michael; Görg, Siegfried; Ziemann, Malte


    Soon, a virtual crossmatch shall replace the complement-dependent cytotoxicity (CDC) allocation crossmatch in the Eurotransplant region. To prevent positive CDC-crossmatches in the recipient centre, careful definition of unacceptable antigens is necessary. For highly sensitized patients, this is difficult by CDC alone. Assignment of all antibodies detected by sensitive assays, however, could prevent organ allocation. To assess the usefulness of the Luminex C1q-assay to prevent positive CDC-crossmatches, all CDC-crossmatches performed prior to deceased kidney transplantation in a 16-month-period were reviewed. Sera causing positive crossmatches were investigated by the C1q-assay. 31 out of 1432 crossmatches (2.2%) were positive. Sera involved in 26 positive crossmatches were available. C1q-binding donor-specific antibodies were detected in 19 sera (73.1%). The other sera were from recipients without any HLA antibodies detectable by CDC or common solid phase assays. Three patients had known Non-HLA antibodies causing positive CDC-results. Four crossmatches were only weak positive. Therefore, avoidance of donors with HLA antigens against whom C1q-binding antibodies were detected would have prevented all positive crossmatches due to HLA antibodies. Provided that all HLA specificities against which antibodies are detected by the Luminex C1q-assay are considered as unacceptable antigens, CDC-crossmatches prior to transplantation might safely be omitted in many patients. They should be maintained in highly immunized patients, however, for whom assignment of all C1q-positive antibodies as unacceptable antigens could lead to a significant delay or even prevention of transplantation. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. C–H arylation of unsubstituted furan and thiophene with acceptor bromides: access to donor–acceptor–donor-type building blocks for organic electronics. (United States)

    Matsidik, Rukiya; Martin, Johannes; Schmidt, Simon; Obermayer, Johannes; Lombeck, Florian; Nübling, Fritz; Komber, Hartmut; Fazzi, Daniele; Sommer, Michael


    Pd-catalyzed direct arylation (DA) reaction conditions have been established for unsubstituted furan (Fu) and thiophene (Th) with three popular acceptor building blocks to be used in materials for organic electronics, namely 4,7-dibromo-2,1,3-benzothiadiazole (BTBr2), N,N′-dialkylated 2,6-dibromonaphthalene-1,4,5,8-bis(dicarboximide) (NDIBr2), and 1,4-dibromotetrafluorobenzene (F4Br2). Reactions with BTBr2, F4Br2, and NDIBr2 require different solvents to obtain high yields. The use of dimethylacetamide (DMAc) is essential for the successful coupling of BTBr2 and F4Br2, but detrimental for NDIBr2, as the electron-deficient NDI core is prone to nucleophilic core substitution in DMAc as solvent but not in toluene. NDIFu2 is much more planar compared to NDITh2, resulting in an enhanced charge-transfer character, which makes it an interesting building block for conjugated systems designed for organic electronics. This study highlights direct arylation as a simple and inexpensive method to construct a series of important donor–acceptor–donor building blocks to be further used for the preparation of a variety of conjugated materials.

  7. 2-Alkyl-5-thienyl-substituted benzo[1,2-b:4,5-b']dithiophene-based donor molecules for solution-processed organic solar cells. (United States)

    Patra, Dhananjaya; Huang, Tzu-Yen; Chiang, Chao-Cheng; Maturana, Ramon Orlando Valencia; Pao, Chun-Wei; Ho, Kuo-Chuan; Wei, Kung-Hwa; Chu, Chih-Wei


    In this study, we have strategically designed and convergently synthesized two novel, symmetrical, and linear A-D-A-type π-conjugated donor molecules (TBDTCNR, TBDTCN), each containing a planar electron-rich 2-octylthiene-5-yl-substituted benzodithiophene (TBDT) unit as the core, flanked by octylthiophene units and end-capped with electron-deficient cyanoacetate (CNR) or dicyanovinyl (CN) units. We thoroughly characterized both of these materials and investigated the effects of the end groups (CNR, CN) on their optical, electrochemical, morphological, and photovoltaic properties. We then fabricated solution-processed bulk heterojunction organic solar cells incorporating TBDTCNR and TBDTCN. Among our tested devices, the one containing TBDTCNR and [6,6]-phenyl-C61-butyric acid methyl ester in a 1:0.40 ratio (w/w) exhibited the highest power conversion efficiency (5.42%) with a short-circuit current density (Jsc) of 9.08 mA cm(-2), an open circuit voltage (Voc) of 0.90 V, and an impressive fill factor (FF) of 0.66 under AM 1.5G irradiation (100 mW cm(-2)). The FFs of these solution-processed small-molecule organic solar cells (SMOSCs) are outstanding when compared with those recently reported for benzodithiophene (BDT)-based SMOSCs, because of the high crystallinity and excellent stacking properties of the TBDT-based compounds.

  8. Charge transport studies in donor-acceptor block copolymer PDPP-TNT and PC71BM based inverted organic photovoltaic devices processed in room conditions

    Energy Technology Data Exchange (ETDEWEB)

    Srivastava, Shashi B.; Singh, Samarendra P., E-mail: [Department of Physics, Shiv Nadar University, Gautam Buddha Nagar, Uttar Pradesh, India-201307 (India); Sonar, Prashant [School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, Australia-4001 (Australia)


    Diketopyrrolopyrole-naphthalene polymer (PDPP-TNT), a donor-acceptor co-polymer, has shown versatile behavior demonstrating high performances in organic field-effect transistors (OFETs) and organic photovoltaic (OPV) devices. In this paper we report investigation of charge carrier dynamics in PDPP-TNT, and [6,6]-phenyl C{sub 71} butyric acid methyl ester (PC71BM) bulk-heterojunction based inverted OPV devices using current density-voltage (J-V) characteristics, space charge limited current (SCLC) measurements, capacitance-voltage (C-V) characteristics, and impedance spectroscopy (IS). OPV devices in inverted architecture, ITO/ZnO/PDPP-TNT:PC71BM/MoO{sub 3}/Ag, are processed and characterized at room conditions. The power conversion efficiency (PCE) of these devices are measured ∼3.8%, with reasonably good fill-factor 54.6%. The analysis of impedance spectra exhibits electron’s mobility ∼2 × 10{sup −3} cm{sup 2}V{sup −1}s{sup −1}, and lifetime in the range of 0.03-0.23 ms. SCLC measurements give hole mobility of 1.12 × 10{sup −5} cm{sup 2}V{sup −1}s{sup −1}, and electron mobility of 8.7 × 10{sup −4} cm{sup 2}V{sup −1}s{sup −1}.

  9. Prevalence of IgG and IgM anti-Toxoplasma gondii Antibodies in Blood Donors at Urmia Blood Transfusion Organization, Iran. (United States)

    Tappeh, Khosrow Hazrati; Musavi, Jalil; Safa, Mohammad Baradaran; Galavani, Hosein; Alizadeh, Hamid


    The importance of toxoplasmosis lies in its global spread, opportunistic nature, and causative role in abortion or irreparable adverse effects on infants of infected pregnant women. Toxoplasma gondii has different transmission routes to humans, including blood transfusion. The objective of the present study was to evaluate the prevalence of IgG and IgM antibodies specific for T. gondii in blood donors at the Urmia Blood Transfusion Organization in west Azerbaijan, Iran. The present analytical, descriptive study evaluated the plasma of 270 randomly selected blood bags donated in 2013. The enzyme-linked immunosorbent assay (ELISA) test was employed to measure anti-T. gondii IgG and IgM antibodies. The results of the ELISA test showed that 102 samples (37.8%) from 270 blood bags had IgG antibodies in their plasma and none of them were IgM-positive, whereas 98 were men and four were women. Any increase in the level of IgM antibodies indicates the presence of an acute disease because the parasite is inside white blood cells and contaminates blood transfusion. Fortunately, all samples were IgM-negative. However, a province-wide seroepidemiological study is required for the Blood Transfusion Organization to consider including screening for anti-T. gondii antibodies in its screening programs.

  10. Species dependence of the redox potential of the primary electron donor p700 in photosystem I of oxygenic photosynthetic organisms revealed by spectroelectrochemistry. (United States)

    Nakamura, Akimasa; Suzawa, Tomoyuki; Kato, Yuki; Watanabe, Tadashi


    The redox potential of the primary electron donor P700, E(m)(P700/P700(+)), of Photosystem I (PSI) has been determined for 10 oxygenic photosynthesis organisms, ranging from cyanobacteria, red algae, green algae to higher plants, by spectroelectrochemistry with an optically transparent thin-layer electrode (OTTLE) cell to elucidate the scattering by as much as 150 mV in reported values of E(m)(P700/P700(+)). The E(m)(P700/P700(+)) values determined within error ranges of ± 1-4 mV exhibited a significant species dependence, with a span >70 mV, from +398 to +470 mV vs. the standard hydrogen electrode (SHE). The E(m)(P700/P700(+)) value appears to change systematically in going from cyanobacteria and primitive eukaryotic red algae, then to green algae and higher plants. From an evolutionary point of view, this result suggests that the species believed to appear later in evolution of photosynthetic organisms exhibit higher values of E(m)(P700/P700(+)). Further, the species dependence of E(m)(P700/P700(+)) seems to originate in the species-dependent redox potentials of soluble metalloproteins, Cyt c(6) and plastocyanin, which re-reduce the oxidized P700 in the electron transfer chain.

  11. The role of religiosity, religious norms, subjective norms, and bodily integrity in signing an organ donor card. (United States)

    Stephenson, Michael T; Morgan, Susan E; Roberts-Perez, Samaria D; Harrison, Tyler; Afifi, Walid; Long, Shawn D


    This article examines the influence of religiosity, religious norms, subjective norms, and bodily integrity (the extent to which people think the body should remain unaltered after death) on intent to donate organs postmortem. A total of 4,426 participants from 6 universities completed surveys for this study. The results indicate that religiosity and religious norms had a nonsignificant effect on willingness to donate. In addition, attitudes toward donation had a weak positive relationship on intent to donate, whereas subjective norms exerted a modest positive relationship on intent to donate. Finally, the results reveal a strong direct and indirect effect of bodily integrity on intent to donate.

  12. Genomic analysis of teicoplanin resistance emerging during treatment of vanB vancomycin-resistant Enterococcus faecium infections in solid organ transplant recipients including donor-derived cases. (United States)

    Holmes, Natasha E; Ballard, Susan A; Lam, Margaret M C; Johnson, Paul D R; Grayson, M Lindsay; Stinear, Timothy P; Howden, Benjamin P


    We noted four cases of apparent in vivo emergence of teicoplanin resistance during failed therapy for initially teicoplanin-susceptible vanB vancomycin-resistant Enterococcus faecium (VREfm) infections in solid organ transplant recipients at our institution over a 12 month period. We investigated if in vivo emergence of resistance had occurred, if transplant-related vancomycin-resistant Enterococcus (VRE) infections had occurred and identified clinical predictors of resistance emergence. Whole genome sequencing was performed on nine VREfm isolates for phylogenetic analysis and to identify determinants of teicoplanin resistance. Clinical treatment details were compared with other patients who received teicoplanin for confirmed vanB VRE infections but did not develop resistance during the same year at our institution. A high-resolution, core genome phylogeny was inferred for nine VREfm isolates and confirmed in vivo development of resistance during failed therapy in four cases. Four different non-synonymous single nucleotide polymorphisms (SNPs) were observed in the vanRS genes of teicoplanin-resistant strains compared with the index teicoplanin-susceptible strains, and these SNPs were predicted to confer teicoplanin resistance. VREfm within a cluster of early transplant-related infections were phylogenetically identical at the core genome level, indicating a common source donor. Focus eradication and absence of prosthetic material were characteristics of those patients treated successfully. Clinicians should be cautious of resistance emerging during teicoplanin therapy for vanB VRE, particularly in immunosuppressed patients or where source control is difficult.

  13. Theoretical Insight into Organic Dyes Incorporating Triphenylamine-Based Donors and Binary π-Conjugated Bridges for Dye-Sensitized Solar Cells

    Directory of Open Access Journals (Sweden)

    Shuxian Wei


    Full Text Available The design of light-absorbent sensitizers with sustainable and environment-friendly material is one of the key issues for the future development of dye-sensitized solar cells (DSSCs. In this work, a series of organic sensitizers incorporating alkoxy-substituted triphenylamine (tpa donors and binary π-conjugated bridges were investigated using density functional theory (DFT and time-dependent DFT (TD-DFT. Molecular geometry, electronic structure, and optical absorption spectra are analyzed in the gas phase, chloroform, and dimethylformamide (DMF solutions. Our results show that properly choosing the heteroaromatic atoms and/or adding one more alkoxy-substituted tpa group can finely adjust the molecular orbital energy. The solvent effect renders the HOMO-LUMO gaps of the tpa-based sensitizers decrease in the sequence of DMF solution < chloroform solution < gas phase. The absorption spectra are assigned to the ligand-to-ligand charge transfer (LLCT characteristics via transitions mainly from tpa, 3,4-ethylenedioxythiophene (edot, and alkyl-substituted dithienosilole (dts groups to edot, dts, and cyanoacrylic acid groups. The binary π-conjugated bridges play different roles in balancing the electron transfer and recombination for the different tpa-based sensitizers. The protonation/deprotonation effect has great effect on the HOMO-LUMO gaps and thus has great influence on the bands at the long wavelength region, but little influence on the bands at the short wavelength region.

  14. Mental health status after living donor hepatectomy. (United States)

    Wang, Szu-Han; Lin, Ping-Yi; Wang, Jiun-Yi; Huang, Mei-Feng; Lin, Hui-Chuan; Hsieh, Chia-En; Hsu, Ya-Lan; Chen, Yao-Li


    Donor safety and preservation of donor health after living liver donation are of paramount importance. In addition, the preoperative mental state of a donor is an important factor in determining the psychological impact of donor hepatectomy. Thus, we aimed to explore the mental health status of living liver donors after hepatectomy. We enrolled 60 donors who were scheduled to undergo living donor hepatectomy during the period January 2014 to March 2015 at a single medical center. Mental health status was measured before and 3 months after surgery using 3 self-report questionnaires, namely the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms, the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire to measure quality of life, and the Chinese Health Questionnaire (CHQ) to screen for minor psychiatric disorders. A comparison of the pre- and postdonation CES-D scores revealed a significant reduction in depressive symptoms after surgery (P = .031). There were significant improvements in the physical health domain (P = .031), the psychological health domain (P = .005), the social relationships domain (P = .005), and the environmental health domain (P = .010) of the WHOQOL-BREF. There were no significant changes in CHQ scores after donor hepatectomy (P = .136). All donors reported that they would donate again if required. Approximately one-third (33.3%) of donors experienced more pain than they had anticipated in the immediate postoperative period, and 20.0% of donors had complications after donor hepatectomy. Donor mental health status tended to improve as donors regained physical function during the 1st 3 months of recovery. Long-term monitoring of living donors' mental health is needed to minimize the adverse psychological outcomes of living liver donation.

  15. Actions of a hydrogen sulfide donor (NaHS) on transient sodium, persistent sodium, and voltage-gated calcium currents in neurons of the subfornical organ. (United States)

    Kuksis, Markus; Ferguson, Alastair V


    Hydrogen sulfide (H2S) is an endogenously found gasotransmitter that has been implicated in a variety of beneficial physiological functions. This study was performed to investigate the cellular mechanisms underlying actions of H2S previously observed in subfornical organ (SFO), where H2S acts to regulate blood pressure through a depolarization of the membrane and an overall increase in the excitability of SFO neurons. We used whole cell patch-clamp electrophysiology in the voltage-clamp configuration to analyze the effect of 1 mM NaHS, an H2S donor, on voltage-gated potassium, sodium, and calcium currents. We observed no effect of NaHS on potassium currents; however, both voltage-gated sodium currents (persistent and transient) and the N-type calcium current had a depolarized activation curve and an enhanced peak-induced current in response to a series of voltage-step and ramp protocols run in the control and NaHS conditions. These effects were not responsible for the previously observed depolarization of the membrane potential, as depolarizing effects of H2S were still observed following block of these conductances with tetrodotoxin (5 μM) and ω-conotoxin-GVIA (100 nM). Our studies are the first to investigate the effect of H2S on a variety of voltage-gated conductances in a single brain area, and although they do not explain mechanisms underlying the depolarizing actions of H2S on SFO neurons, they provide evidence of potential mechanisms through which this gasotransmitter influences the excitability of neurons in this important brain area as a consequence of the modulation of multiple ion channels. Copyright © 2015 the American Physiological Society.

  16. The existence of experience and frequency and severity of related concerns of ethical issues in nursing practice encountered in organ transplantation. (United States)

    Tanimizu, N; Shuda, A; Imanishi, T; Akazawa, C; Hayashi, Y; Hagiwara, K


    The purpose of this study was to elucidate the existence of the experience of and the frequency and severity of related concerns of distressful ethical situations encountered by nursing professionals in organ transplantation. An anonymous self-administered questionnaire was mailed to 569 nurses in 79 facilities that performed organ transplantation with living or brain-dead donors who provided approval for this study. The questionnaire, developed according to the Likert method, was composed of 12 items referring to the basic attributes of nursing professionals based on the results of previous studies and the scientific literature, as well as 27 items referring to the presence or absence and the frequency and severity of concerns regarding ethical situations. The data were analyzed using descriptive statistics. The questionnaire was distributed to 569 nursing professionals working in 79 facilities that had provided consent for study participation. Responses were obtained from 218 participants (recovery rate: 38.3%). Among the 3 highest-ranking items, those in the first and second positions in terms of the presence or absence and the frequency of worries were the same as those in the second and third positions in terms of the severity of concerns. In addition, the 3 lower-ranking items also were the same. Among the ethical situations encountered by nursing professionals, the ones most often experienced that caused the most concern were the following: "I have questioned whether it was better for the recipient, who could not do self-care after the transplant, to undergo transplantation", and "I have felt that a recipient decided to receive a transplant without considering the importance of posttransplant self-management when making a decision about transplant surgery." The results indicate that most of the ethical issues related to organ transplantation in nursing practice were experienced because recipients, their families, and donors could not foresee the various

  17. 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.

  18. From motivation to acceptability: a survey of public attitudes towards organ donation in Denmark. (United States)

    Nordfalk, Francisca; Olejaz, Maria; Jensen, Anja M B; Skovgaard, Lea Larsen; Hoeyer, Klaus


    Over the past three decades, public attitudes to organ donation have been a subject of numerous studies focusing on donor motivation. Here, we present a fresh approach. We suggest focusing on public acceptability instead of motivation. The point is to understand public attitudes well enough to avoid risking public support for organ transplantation. We conducted the study in Denmark because there have been significant developments in public attitudes to organ donation in this country. In the 1990s, Denmark was a country with very low public support for organ donation and Denmark was the last country in Europe to introduce brain death as a legal criterion of death, whereas today Eurobarometer surveys rate Denmark as one of the European countries with the highest support for deceased organ donation from brain dead donors. We conducted a telephone survey in Denmark (N = 1195). A questionnaire was developed on the basis of preceding qualitative studies and pilot testing and included reuse of one item from earlier surveys to facilitate historical comparison. The analysis of the data was carried out using IBM SPSS Statistics 22 and focused on descriptive statistics. A clear majority of 91.9 % are positive or very positive towards organ donation; 85.8 % like the idea of their body being used after their death, 85.0 % is willing to donate their own organs, 82.1 % to donate their tissue and only 2.3 % find that too much has been done to promote organ donation. There is limited support for monetary incentives for organ donation (5.8 %) and presumed consent (30.4 %), while a majority (63.9 %) supports making it mandatory to register a personal decision. Religious self-identification has limited impact on attitudes. We can identify a shift over the past three decades from marked opposition to organ transplantation to strong support as well as a pattern in the contemporary public attitudes, which can help explain what is central to public acceptability: self

  19. FORUM Paediatric living donor liver transplantation

    African Journals Online (AJOL)

    Liver transplantation (LT) is the definitive treatment for children with end-stage liver disease (ESLD). The greatest limitation for LT is scarcity of deceased donor organs. This is particularly critical for smaller children (weighing <10 kg). Living donor liver transplantation. (LDLT) has emerged over the last 2 decades as a viable ...

  20. Influence of the Terminal Electron Donor in D-D-π-A Organic Dye-Sensitized Solar Cells: Dithieno[3,2-b:2',3'-d]pyrrole versus Bis(amine). (United States)

    Dai, Panpan; Yang, Lin; Liang, Mao; Dong, Huanhuan; Wang, Peng; Zhang, Chunyao; Sun, Zhe; Xue, Song


    With respect to the electron-withdrawing acceptors of D-A-π-A organic dyes, reports on the second electron-donating donors for D-D-π-A organic dyes are very limited. Both of the dyes have attracted significant attention in the field of dye-sensitized solar cells (DSCs). In this work, four new D-D-π-A organic dyes with dithieno[3,2-b:2',3'-d]pyrrole (DTP) or bis(amine) donor have been designed and synthesized for a investigation of the influence of the terminal electron donor in D-D-π-A organic dye-sensitized solar cells. It is found that DTP is a promising building block as the terminal electron donor when introduced in the dithiophenepyrrole direction, but not just a good bridge, which exhibits several characteristics: (i) efficiently increasing the maximum molar absorption coefficient and extending the absorption bands; (ii) showing stronger charge transfer interaction as compared with the pyrrole direction; (iii) beneficial to photocurrent generation of DSCs employing cobalt electrolytes. DSCs based on M45 with the Co-phen electrolyte exhibit good light-to-electric energy conversion efficiencies as high as 9.02%, with a short circuit current density (JSC) of 15.3 mA cm(-2), open circuit voltage (VOC) of 867 mV and fill factor (FF) of 0.68 under AM 1.5 illumination (100 mW cm(-2)). The results demonstrate that N,S-heterocycles such as DTP unit could be promising candidates for application in highly efficient DSCs employing cobalt electrolyte.

  1. Family donor care management: principles and recommendations. (United States)

    van Walraven, S M; Nicoloso-de Faveri, G; Axdorph-Nygell, U A I; Douglas, K W; Jones, D A; Lee, S J; Pulsipher, M; Ritchie, L; Halter, J; Shaw, B E


    The World Marrow Donor Association (WMDA) is an international organization fostering collaboration in clinical transplantation and promoting the interests of unrelated stem cell donors. The WMDA has developed standards for the recruitment, counseling, work-up and subsequent donations to protect the interests of donors. Although the care of family donors has been carefully considered and managed in transplant centers (TCs) internationally over numerous years (and increasingly TCs are facing accreditation programs, which address this issue) there is currently a lack of standardized guidelines for the management of family donors. The underlying principles of family donor care are in many ways identical to those concerning unrelated donors, although key ethical considerations differ. Although the WMDA is primarily involved in the field of unrelated donors, we believe that it is important to collaborate with those involved with family donors, to standardize the care. This document hopes to encourage increased collaboration between those caring for related and unrelated donors, and build on the extensive work, which has already been undertaken in this field to homogenize care. We recognize that there will be financial, regulatory and logistic differences in different countries and that the manner in which these principles are achieved may vary.

  2. Living kidney donors: current state of affairs. (United States)

    Davis, Connie L


    Living kidney donation continues as the cornerstone of transplantation. In order to determine with ever-renewing assurance that living donation is safe for the donor, we need to periodically review the literature, review the United Network for Organ Sharing database for donor characteristics that may put them in danger, and scour databases for donors starting dialysis and/or listed for transplant. Additionally, we must encourage financing studies that follow large diverse cohorts of donors over their entire lifetimes in order to detect key characteristics that influence outcomes. Currently, it can be stated that living donation is, on the whole, safe, with few perioperative deaths, complications, or long-term medical issues. Additionally, the living donor reflects the demographics of the general population including increased rates of obesity with some donors having hypertension and low-grade proteinuria. In the long run, death rates (for the white donor) are no different than for the general population, whereas end-stage renal disease rates are slightly increased over the general population, ranging from 0.1% to 1.1%. The higher risk is especially notable in the black donor. Preeclampsia in female donors may also be marginally greater than in those with 2 kidneys. Thus, the new health age brings a rejuvenated responsibility of the medical community and those in governance to design systems that allow more complete and continued follow-up of the living kidney donor, especially those of color.

  3. The use of neoplastic donors to increase the donor pool. (United States)

    Fiaschetti, P; Pretagostini, R; Stabile, D; Peritore, D; Oliveti, A; Gabbrielli, F; Cenci, S; Ricci, A; Vespasiano, F; Grigioni, W F


    The aim of the study was to evaluate the experience of the Centre-Sud Transplant Organization (OCST) area using cadaveric donor with neoplastic diseases to evaluate the possibility of transmission to recipients. From January 1, 2003, to December 31, 2010, the neoplastic risk has been reported to be 5.4% (377/4654 referred donors). In 2003, the number of donors with a tumor and their mean age were respectively: 60 (10.3%) and 59.6 ± 19.9; 2004: 33 (5.2%) and 61.4 ± 15.9; 2005: 32 (6%) and 62.8 ± 15.5; 2006: 46 (7%) and 60.7 ± 19.1; 2007: 51 (7%) and 58.9 ± 16; in 2008: 58 (7%) and 59.7 ± 19.6; 2009: 47 (7%) and 57 ± 26; 2010: 49 (7%) and 64 ± 16. The organ most affected by tumor has been the central nervous system (18%). The tumor was diagnosed before in 325 (86%) cases, versus during organ retrieval in 48 (12.7%) donor operations but before, which four cases (1%) occured after transplantation. According to the histological types and grades, 28 evaluated donors (8.2%) were suitable for transplantation. The histological types were: thyroid carcinoma (n = 3); prostate carcinoma (n = 8), renal clear cell carcinoma (n = 7), oncocytoma (n = 1), meningiomas (n = 2), dermofibrosarcoma (n = 1); verrucous carcinoma of the vulva (n = 1), colon adenocarcinoma (n = 1), grade II astrocytoma (n = 1), adrenal gland tumor (n = 1), gastric GIST (n = 1), oligodendroglioma (n = 1). Forty-five organs were retrieved (22 livers, 19 kidneys, 3 hearts, and 1 pancreas) and transplanted into 44 recipients with 1 liver-kidney combined transplantation. Four recipients died due to causes not related to the tumor. No donor-transmitted tumor was detected among the recipients. Donation is absolutely not indicated in cases of tumors with high metastatic potential and high grades. Performing an accurate evaluation of the donor, taking into account the histological grade, currently can allow, organ retrieval and transplantation with an acceptable risk. Copyright © 2012. Published by Elsevier

  4. Molecular Design of Efficient Organic D-A-pi-A Dye Featuring Triphenylamine as Donor Fragment for Application in Dye-Sensitized Solar Cells

    Czech Academy of Sciences Publication Activity Database

    Ferdowsi, P.; Saygili, Y.; Zhang, W.; Edvinson, T.; Kavan, Ladislav; Mokhtari, J.; Zakeerudin, S. M.; Grätzel, M.; Hagfeldt, A.


    Roč. 11, č. 2 (2018), s. 494-502 ISSN 1864-5631 R&D Projects: GA ČR GA13-07724S Institutional support: RVO:61388955 Keywords : Dye-Sensitized Solar Cells * Electrolytes * Donor-acceptor systems Subject RIV: CG - Electrochemistry Impact factor: 7.226, year: 2016

  5. Coexistence of physiologically similar sulfate reducing bacteria in a full-scale sulfidogenic bioreactor fed with a single organic electron donor

    NARCIS (Netherlands)

    Dar, S.; Stams, A.J.M.; Kuenen, J.G.; Muyzer, G.


    A combination of culture-dependent and independent methods was used to study the co-existence of different sulfate-reducing bacteria (SRB) in an upflow anaerobic sludge bed reactor treating sulfate-rich wastewater. The wastewater was fed with ethanol as an external electron donor. Twenty six strains

  6. Expanding the live kidney donor pool: ethical considerations regarding altruistic donors, paired and pooled programs. (United States)

    Patel, Shaneel Rajendra; Chadha, Priyanka; Papalois, Vassilios


    In renal transplant, there is a well-known deficiency in organ supply relative to demand. Live donation provides superior results when compared with deceased donation including a better rate of graft success and fewer immunologic complications. This deficiency in organs leads to significant morbidity and mortality rates. Alternative avenues have been extensively explored that may expand the live donor pool. They include altruistic donation as well as paired and pooled exchange programs. Altruistic donation is a truly selfless act from a donor unknown to the recipient. Kidney paired donation involves 2 incompatible donor-recipient pairs swapping donors to produce compatibility. Pooled donation involves at least 2 pairs, and can take the form of domino chains in which altruistic input sets up a chain of transplants, in which each recipient's incompatible donor makes a donation for the next recipient. Despite application of these various methods, there lie extensive ethical issues surrounding them. Misconceptions frequently occur; for instance, the perceived benefit that donating an organ to a loved one is greater for a related donor than for an altruistic one. Additionally, it is frequently believed that immunologic incompatibility offers coerced donors liberation from surgery, and that overcoming these barriers by introducing exchange programs provides vulnerable donors less protection. This article explores these and other complex ethical issues surrounding the various methods of expanding the donor pool. The authors offer opinions that challenge the ethical issues and attempt to overcome those views that hinder progress in the field.

  7. The dead donor rule: a defense. (United States)

    Birch, Samuel C M


    Miller, Truog, and Brock have recently argued that the "dead donor rule," the requirement that donors be determined to be dead before vital organs are procured for transplantation, cannot withstand ethical scrutiny. In their view, the dead donor rule is inconsistent with existing life-saving practices of organ transplantation, lacks a cogent ethical rationale, and is not necessary for maintenance of public trust in organ transplantation. In this paper, the second of these claims will be evaluated. (The first and third are not addressed.) The claim that the dead donor rule lacks a cogent ethical rationale will be shown to be an expression of the contemporary rejection of the moral significance of the traditional distinction between killing and allowing to die. The moral significance of this traditional distinction, and the associated norm that doctors should not kill their patients, will be defended, and this critique of it shown to be unsuccessful.

  8. The ethics of donation and transplantation: are definitions of death being distorted for organ transplantation?

    Directory of Open Access Journals (Sweden)

    Joffe Ari R


    Full Text Available Abstract A recent commentary defends 1 the concept of 'brain arrest' to explain what brain death is, and 2 the concept that death occurs at 2–5 minutes after absent circulation. I suggest that both these claims are flawed. Brain arrest is said to threaten life, and lead to death by causing a secondary respiratory then cardiac arrest. It is further claimed that ventilation only interrupts this way that brain arrest leads to death. These statements imply that brain arrest is not death itself. Brain death is a devastating state that leads to death when intensive care, which replaces some of the brain's vital functions such as breathing, is withdrawn and circulation stops resulting in irreversible loss of integration of the organism. Circulatory death is said to occur at 2–5 minutes after absent circulation because, in the context of DCD, the intent is to not attempt reversal of the absent circulation. No defense of this weak construal of irreversible loss of circulation is given. This means that paents in identical physiologic states are dead (in the DCD context or alive (in the resuscitation context; the current state of death (at 2–5 minutes is contingent on a future event (whether there will be resuscitation suggesting backward causation; and the commonly used meaning of irreversible as 'not capable of being reversed' is abandoned. The literature supporting the claim that autoresuscitation does not occur in the context of no cardiopulmonary resuscitation is shown to be very limited. Several cases of autoresuscitation are summarized, suggesting that the claim that these cases are not applicable to the current debate may be premature. I suggest that brain dead and DCD donors are not dead; whether organs can be harvested before death from these patients whose prognosis is death should be debated urgently.

  9. Alkylated indacenodithieno[3,2-b]thiophene-based all donor ladder-type conjugated polymers for organic thin film transistors

    KAUST Repository

    Lu, Rimei


    We report the synthesis of a series of indacenodithieno[3,2-b]thiophene (IDTT) based conjugated polymers by copolymerization with three different electron rich co-monomers [thiophene (T), thieno[3,2-b]thiophene (TT) and dithieno[3,2-b:2\\',3\\'-d]thiophene (DTT)] under Stille coupling conditions. The resulting all-donor polymers show very good solubility in common solvents and exhibit similar optical, thermal and electronic properties. However, the performance of these semiconductors in thin film transistor devices varied and was highly dependent on the nature of the co-monomer. All polymers exhibited unipolar p-type charge transport behaviour, with the mobility values following the trend of IDTT-TT>IDTT-DTT>IDTT-T. The peak saturation mobility value of IDTT-TT was extracted to be 1.1 cm2V-1s-1, amongst the highest mobility for all-donor conjugated polymers reported to date.

  10. Required Equipment for Photo-Switchable Donor-Acceptor (D-A) Dyad Interfacial Self-Assembled Monolayers for Organic Photovoltaic Cells (United States)


    Accessory, 6) a Jelight Co. UVO cleaner, and 7) a Laurell Technologies Spin Coater . These instruments were used to characterize a variety of...goniometer/tensiometer, UVO cleaner, spin coater U U U UU Luis Echegoyen (915) 747-7573 (HBCU) - Required Equipment for Photo-switchable Donor...are exposed to the spin coated photoactive layer over the ITO monolayer, the effectiveness of this monolayer will be difficult to study. We need

  11. External validation of the Donor Risk Index and the Eurotransplant Donor Risk Index on the French liver transplantation registry. (United States)

    Winter, Audrey; Féray, Cyrille; Audureau, Etienne; Écochard, René; Jacquelinet, Christian; Roudot-Thoraval, Françoise; Duvoux, Christophe; Daurès, Jean-Pierre; Landais, Paul


    A major limitation to liver transplantation is organ shortage leading to the use of non-optimal liver grafts. The Donor Risk Index has been validated and recommended to select donors/organs. The Eurotransplant Donor Risk Index was derived from the Donor Risk Index. The objective of our study was to perform an external validation of both Donor Risk Index and Eurotransplant-Donor Risk Index against the French liver transplantation Cristal registry according to recommendations of the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis. Liver transplantations performed in France between 2009 and 2013 were used to perform the validation study for the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively. We applied on the French data the models used to construct the Donor Risk Index and the Eurotransplant-Donor Risk Index respectively. Neither the Donor Risk Index nor the Eurotransplant-Donor Risk Index were validated against this dataset. Discrimination and calibration of these scores were not preserved according to our data. Important donor and candidates differences between our dataset and the Organ Procurement and Transplantation Network or the Eurotransplant datasets may explain why the Donor Risk Index and the Eurotransplant-Donor Risk Index appeared unadapted to the French transplant registry. Neither of these risk indexes were suitable to optimize the French liver allocation system. Thus, our next step will be to propose a general adaptive model for a Donor Risk Index. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. 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.


    Directory of Open Access Journals (Sweden)

    D. V. Perlin


    Full Text Available We modified the method of retroperitoneoscopic live donor nephrectomy and evaluated results of first 10 pro- cedures. We performed four left- and six right-sided donor nephrectomy. There were no conversions to open or hand-assisted surgery. All organs have been successfully transplanted. Retroperitoneoscopic live donor nephrec- tomy is safe and feasible. The method has three main advantages over conventional laparoscopic nephrectomy: the absence of contact with bowel, spleen, liver and other intra-abdominal structures, more comfortable access to the renal artery, absence of intraperitoneal pressure elevation. 


    Directory of Open Access Journals (Sweden)

    B. L. Mironkov


    Full Text Available Aim. To estimate opportunities, prospects and safety of using heart transplants from aged donors who are at high risk of coronary atherosclerosis.Materials and methods. Over the period from March 1987 to May 2014450 heart transplantations (HTx were performed in V.I.Shumakov Federal Research Center of Transplantology and Artifi cial Organs. During the fi rst month after HTx coronarography was made to 152 (37,8% recipients inorder to exclude/confi rm donor-transmitted coronary atherosclerosis (DTCA and to identify tactics of treatment. Coronary atherosclerosis was detected among 16 patients (3,6% of total number of HTx, 15 (93,8% men and 1 (6,2% women. Mean age of recipients with DTCA at the moment of HTx was 48,3 ± 13,1 years.Results. Hemodynamically relevant coronary atherosclerosis was not detected and percutaneous coronary intervention (PCI was not made in the group of patients with the mean age of 42,24 ± 8,91 years. Using heart transplants from aged donors is connected with increasing risk of DTCA among the recipients. DTCA-dependent PCI is not connected with coronary mortality. Actuarial survival rate of patients who underwent PCI is comparable with the same one in the total population of HTx recipients and is equal to 87,5% at 5 years and less.Conclusion. Hearts from aged donors (older than 50 years may be used for HTx with suffi cient level of safety. Due to high level of DTCA using of hearts from such donors is preferable for completing urgent HTx to recipients 1А–В UNOS.

  15. 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'…

  16. An N,N'-dialkyl-4,4'-bipyridinium-modified titanium-dioxide photocatalyst for water remediation--observation and application of supramolecular effects in photocatalytic degradation of pi-donor organic compounds. (United States)

    Bossmann, S H; Göb, S; Siegenthaler, T; Braun, A M; Ranjit, K T; Willner, I


    The photocatalytic activity of TiO2 (Degussa P-25) modified with a 4,4'-bipyridinium monolayer (V2+-TiO2) has been compared with that of conventional TiO2-P-25 by investigating the efficiency of degradation of a series of four organic model compounds with increasing pi-donor capacity (2,4-xylidine, 2,4-dimethylphenol, hydroquinone, and dimethylhydroquinone). As far as the mechanism of the first oxidation reaction is concerned, evidence for the formation of supramolecular donor-acceptor complexes with the bipyridinium units at the semiconductor surface was obtained by comparison of the Langmuir-adsorption characteristics and the efficiencies of photodegradation of the different substrates. Furthermore, the main intermediates of the photocatalytic degradation of 2,4-xylidine were identified, and the presence of 2,4-dimethylphenol indicates that the main pathway of substrate oxidation proceeds via electron transfer from the adsorbed organic substrate to the "holes" within the valence band of the photoexcited semiconductors V2+-TiO2 and TiO2. The efficiencies of photocatalytic degradation by both V2+-TiO2 and TiO2 were limited by the trapping efficiency of the conduction band electrons by molecular oxygen.

  17. An N,N'-dialkyl-4,4'-bipyridinium-modified titanium-dioxide photocatalyst for water remediation - observation and application of supramolecular effects in photocatalytic degradation of {pi}-donor organic compounds

    Energy Technology Data Exchange (ETDEWEB)

    Bossmann, S.H.; Goeb, S.; Siegenthaler, T.; Braun, A.M. [Karlsruhe Univ. (T.H.) (Germany). Engler-Bunte-Institut Bereich 5 - Umweltmesstechnik; Ranjit, K.T.; Willner, I. [Hebrew Univ., Jerusalem (Israel). Chemistry Dept.


    The photocatalytic activity of TiO{sub 2} (Degussa P-25) modified with a 4,4'-bipyridinium monolayer (V{sup 2+}-TiO{sub 2}) has been compared with that of conventional TiO{sub 2}-P-25 by investigating the efficiency of degradation of a series of four organic model compounds with increasing {pi}-donor capacity (2,4-xylidine, 2,4-dimethylphenol, hydroquinone, and dimethylhydroquinone). As far as the mechanism of the first oxidation reaction is concerned, evidence for the formation of supramolecular donor-acceptor complexes with the bipyridinium units at the semiconductor surface was obtained by comparison of the Langmuir-adsorption characteristics and the efficiencies of photodegradation of the different substrates. Furthermore, the main intermediates of the photocatalytic degradation of 2,4-xylidine were identified, and the presence of 2,4-dimethylphenol indicates that the main pathway of substrate oxidation proceeds via electron transfer from the adsorbed organic substrate to the ''holes'' within the valence band of the photoexcited semiconductors V{sup 2+}-TiO{sub 2} and TiO{sub 2}. The efficiencies of photocatalytic degradation by both V{sup 2+}-TiO{sub 2} and TiO{sub 2} were limited by the trapping efficiency of the conduction band electrons by molecular oxygen. (orig.)

  18. Liver Transplantation From Donors With a History of Malignancy: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Tamas Benkö, MD, PhD


    Conclusions. Liver transplantation with organs from donors with a medical history of malignancy is feasible, and the risk of donor-transmitted malignancy appears to be low in this single-center analysis. A careful selection of donors remains mandatory and can expand the donor pool.

  19. Organ donation after circulatory death: vital partnerships. (United States)

    Ringos Beach, Patricia; Hallett, Annette M; Zaruca, Kim


    The authors present the case of a woman in her mid-50s who sustained extensive brain injury in an accident but wasn't declared brain dead. The case highlights some of the clinical and ethical considerations of organ donation after circulatory death (also known as non-heart-beating donation and donation after cardiac death). It also illustrates the interdisciplinary teamwork necessary for organ donation in such cases, involving nurses and other clinicians in the ICU, palliative care, and the local organ procurement organization, among others. cardiac death, circulatory death, donation after cardiac death, end-of-life care, ethics, non-heart-beating donation, organ donation, organ donation after circulatory death, organ transplantation, palliative care.

  20. Organ Donation (United States)

    Organ donation takes healthy organs and tissues from one person for transplantation into another. Experts say that the ... lungs Skin Bone and bone marrow Cornea Most organ and tissue donations occur after the donor has died. But some ...

  1. Enhanced Efficiency of PTB7 : PC61BM Organic Solar Cells by Adding a Low Efficient Polymer Donor

    Directory of Open Access Journals (Sweden)

    Joana Farinhas


    Full Text Available Ternary blend polymer solar cells combining two electron-donor polymers, poly[4,8-bis[(2-ethylhexyloxy]benzo[1,2-b:4,5-b′]dithiophene-2,6-diyl][3-fluoro-2-[(2-ethylhexylcarbonyl]thieno[3,4-b]thiophenediyl] (PTB7 and poly[2,5-bis(3-dodecylthiophen-2-ylthieno[3,2-b]thiophene] (pBTTT and [6,6]-phenyl-C61-butyric acid methyl ester (PC61BM, as electron-acceptor, were fabricated. The power conversion efficiency of the ternary cells was enhanced by 18%, with respect to the reference binary cells, for a blend composition with 25% (wt% of pBTTT in the polymers content. The optimized device performance was related to the blend morphology, nonrevealing pBTTT aggregates, and improved charge extraction within the device.

  2. A comparison of donor and control group quality of life. (United States)

    Tumin, Makmor; Abdul Talib Abdul Mutalib, Muzalwana; Mohd Satar, Nurulhuda; Abdullah, Nawi; Chong, Chin-Sieng; Ng, Kok-Peng; Lim, Soo-Kun


    Informed consent of prospective donors should include information about the quality of life (QoL) of existing donors, especially those within the relevant country. This study aimed to provide information on Malaysian organ donors' QoL relative to a control group. Using a shorter version of the SF-36, QoL of 80 donors from the University of Malaya Medical Center (UMMC), Malaysia was surveyed and compared to QoL of 80 selected healthy individuals. ANOVA and General Linear Model (GLM) procedure were each applied for the QoL comparison, which was based on gender and age. Donors recorded a better QoL relative to the control group. Comparison across gender revealed that differences are more obvious for males than females. Donor/control comparison across age groups reveals that donors aged 56 and above reported significantly better QoL in most domains relative to other age groups. Information on donor QoL should be made available to the public to present a comprehensive picture of the consequences of organ donation. Nonetheless, we also argue that, despite the merits of organ donation, caution is required before concluding that donors have better QoL because the present research outcomes may reflect a self-selection bias in which respondents only included donors engaging in regular follow-ups.

  3. Psychiatric history in living kidney donor candidates. (United States)

    Nishimura, Katsuji; Kobayashi, Sayaka; Ishigooka, Jun


    To critically discuss recent studies of living kidney donor candidates with a past or current psychiatric history and to offer guidance for the psychosocial evaluation of such donors. A global consensus has been developed that active, significant mental illness and substance abuse are absolute contraindications to organ donation due to diminished ability to make a well informed, rational decision about donation or to maintain health status after donation. However, to date, there has been little information published on the suitability for donation and the long-term psychosocial and medical outcomes after donation in donors with mental health issues, especially relatively milder psychiatric disorders, or past significant psychiatric history. To resolve the ethical dilemma of whether living donor candidates with mental health issues should be allowed to donate as is their right or be considered a vulnerable group in need of protection, we need more information. Information should include careful evaluation, possible intervention and follow-up to optimize donation.

  4. The profile of potential organ and tissue donors El perfil de probables donadores de órganos y tejidos O perfil de potenciais doadores de órgãos e tecidos

    Directory of Open Access Journals (Sweden)

    Edvaldo Leal de Moraes


    Full Text Available This study aimed to characterize donors according to gender, age group, cause of brain death; quantify donors with hypernatremia, hyperpotassemia and hypopotassemia; and get to know which organs were the most used in transplantations. This quantitative, descriptive, exploratory and retrospective study was performed at the Organ Procurement Organization of the University of São Paulo Medical School Hospital das Clínicas. Data from the medical records of 187 potential donors were analyzed. Cerebrovascular accidents represented 53.48% of all brain death causes, sodium and potassium disorders occurred in 82.36% of cases and 45.46% of the potential donors were between 41 and 60 years old. The results evidenced that natural death causes exceeded traumatic deaths, and that most donors presented sodium and potassium alterations, likely associated to inappropriate maintenance.Se tuvo como objetivos determinar las características de los donadores según el sexo, el intervalo de edad, y, las causas por muerte encefálica; determinar el número donadores que presentaban hipernatremia, hiperpotasemia y hipopotasemia; conocer los órganos que fueron más utilizados para el trasplante. Es un estudio de tipo cuantitativo, descriptivo, exploratorio y retrospectivo. La investigación fue realizada en una Institución de donación de Órganos perteneciente al Hospital de las Clínicas de Sao Paulo. Fueron analizados los datos de 187 probables donadores. Entre las causas de muerte encefálica el 53,48% fueron por accidente cerebro vascular, en 82,36% de los casos se produjeron alteraciones en los valores de sodio y potasio y los donadores se encontraban entre 41 y 60 años de edad. Los resultados muestran que las causas naturales de muerte superaron a las muertes por traumatismo. La mayoría de los donadores tuvo alteraciones en los niveles de sodio y potasio, estando posiblemente relacionadas a medidas de conservación inadecuadas.Objetivou-se caracterizar os

  5. Rational Design of High-Performance Wide-Bandgap (≈2 eV) Polymer Semiconductors as Electron Donors in Organic Photovoltaics Exhibiting High Open Circuit Voltages (≈1 V). (United States)

    Chochos, Christos L; Katsouras, Athanasios; Gasparini, Nicola; Koulogiannis, Chrysanthos; Ameri, Tayebeh; Brabec, Christoph J; Avgeropoulos, Apostolos


    Systematic optimization of the chemical structure of wide-bandgap (≈2.0 eV) "donor-acceptor" copolymers consisting of indacenodithiophene or indacenodithieno[3,2-b]thiophene as the electron-rich unit and thieno[3,4-c]pyrrole-4,6-dione as the electron-deficient moiety in terms of alkyl side chain engineering and distance of the electron-rich and electron-deficient monomers within the repeat unit of the polymer chain results in high-performance electron donor materials for organic photovoltaics. Specifically, preliminary results demonstrate extremely high open circuit voltages (V oc s) of ≈1.0 V, reasonable short circuit current density (J sc ) of around 11 mA cm-2 , and moderate fill factors resulting in efficiencies close to 6%. All the devices are fabricated in an inverted architecture with the photoactive layer processed by doctor blade equipment, showing the compatibility with roll-to-roll large-scale manufacturing processes. From the correlation of the chemical structure-optoelectronic properties-photovoltaic performance, a rational guide toward further optimization of the chemical structure in this family of copolymers, has been achieved. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Beyond Donor-Acceptor (D-A) Approach: Structure-Optoelectronic Properties-Organic Photovoltaic Performance Correlation in New D-A1-D-A2Low-Bandgap Conjugated Polymers. (United States)

    Chochos, Christos L; Drakopoulou, Sofia; Katsouras, Athanasios; Squeo, Benedetta M; Sprau, Christian; Colsmann, Alexander; Gregoriou, Vasilis G; Cando, Alex-Palma; Allard, Sybille; Scherf, Ullrich; Gasparini, Nicola; Kazerouni, Negar; Ameri, Tayebeh; Brabec, Christoph J; Avgeropoulos, Apostolos


    Low-bandgap near-infrared polymers are usually synthesized using the common donor-acceptor (D-A) approach. However, recently polymer chemists are introducing more complex chemical concepts for better fine tuning of their optoelectronic properties. Usually these studies are limited to one or two polymer examples in each case study so far, though. In this study, the dependence of optoelectronic and macroscopic (device performance) properties in a series of six new D-A 1 -D-A 2 low bandgap semiconducting polymers is reported for the first time. Correlation between the chemical structure of single-component polymer films and their optoelectronic properties has been achieved in terms of absorption maxima, optical bandgap, ionization potential, and electron affinity. Preliminary organic photovoltaic results based on blends of the D-A 1 -D-A 2 polymers as the electron donor mixed with the fullerene derivative [6,6]-phenyl-C 71 -butyric acid methyl ester demonstrate power conversion efficiencies close to 4% with short-circuit current densities (J sc ) of around 11 mA cm -2 , high fill factors up to 0.70, and high open-circuit voltages (V oc s) of 0.70 V. All the devices are fabricated in an inverted architecture with the photoactive layer processed in air with doctor blade technique, showing the compatibility with roll-to-roll large-scale manufacturing processes. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  7. Meet the donors

    DEFF Research Database (Denmark)

    Olejaz, Maria; Hoeyer, Klaus


    For centuries, gross anatomy teaching and anatomical dissection have been fundamental elements in the training of medical doctors and surgeons across the world. Anatomy education and research rely on a stable and reliable supply of bodies in order to take place. Based on qualitative in-depth inte......For centuries, gross anatomy teaching and anatomical dissection have been fundamental elements in the training of medical doctors and surgeons across the world. Anatomy education and research rely on a stable and reliable supply of bodies in order to take place. Based on qualitative in......-depth interviews with 13 whole body donors in Denmark, this article explores what donors think about donation and thus offers a supplement to previous primarily quantitative work on donor motivation. The article presents how interviewed donors relate to three topics: their body, their social relations...

  8. Mini-donor nephrectomy: A viable and effective alternative

    Directory of Open Access Journals (Sweden)

    Sandeep Guleria


    Full Text Available Live kidney donation is an excellent way of increasing the donor pool. The introduction of the laparoscopic donor nephrectomy has resulted in an increase in live organ donation in the western hemisphere. There is no data on its impact on organ donation in India. However attractive as it may seem, the procedure is associated with a definite learning curve and does compromise donor safety. The procedure is also expensive in terms of the equipment required. The mini-donor nephrectomy is an excellent alternative, has no learning curve and is ideally suited for donors in India who have a low BMI. The procedure is also relatively inexpensive. We are in need of a donor registry rather than reports from single institutions to fully evaluate the risks and benefits of both procedures.

  9. Deceased donor uterine transplantation. (United States)

    Flyckt, Rebecca; Kotlyar, Alexander; Arian, Sara; Eghtesad, Bijan; Falcone, Tommaso; Tzakis, Andreas


    To share our experience in performing the first-ever deceased-donor uterine transplant in the United States. This video uses an animation and footage from a uterine transplantation procedure to review the steps and techniques involved in performing a uterine transplant. Academic, multisite medical center. A reproductive-age patient with Mayer-Rokitansky-Kuster-Hauser syndrome. Transplantation of a viable uterus from a deceased donor. Assessment of posttransplantation uterine graft viability. This video article describes the essential steps in the uterine transplant process, including selecting an appropriate donor with no history of infertility or uterine malformations. Furthermore, a deceased donor should exhibit brain death but not cardiac death. We also review our inclusion criteria for suitable recipients. In this video we outline the key steps in a uterine transplantation procedure and demonstrate footage from an actual transplant procedure. These steps include establishing bilateral end-to-side vascular anastomoses between the donor uterine artery and vein and the recipient's external iliac vessels. Once this has been completed and reperfusion noted of the donor uterus, connection to the recipient vaginal cuff is then performed. Uterine transplantation, although currently experimental, has gained the potential to become the first true treatment for uterine factor infertility. This procedure can become a promising option for the approximately 1.5 million women worldwide for whom pregnancy is not possible because of the absence of the uterus or presence of a nonfunctional uterus. Deceased donor uterine transplantation will further serve to broaden accessibility for this procedure. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Expression of intercellular and vascular cell adhesion molecules and class II major histocompatibility antigens in human lungs: lack of influence by conditions of organ preservation. (United States)

    Hasegawa, S; Ritter, J H; Patterson, A; Ockner, D M; Sawa, H; Mohanakumar, T; Cooper, J D; Wick, M R


    The expression of intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and class II major histocompatibility complex antigens was studied in control lung tissue and preserved human donor lungs. The three controls were represented by wedge biopsy specimens taken from non-neoplastic lung surrounding bronchogenic carcinomas. Nine lungs were harvested from six brain-dead donors, flushed with Euro-Collins solution or low potassium-dextran-glucose solution, and stored at 1 degree C or 10 degrees C. Samples of the latter organs were taken at the time of surgical harvest (baseline) and after 2, 12, 24, and 48 hours of preservation time. Immunostains with monoclonal antibodies against intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and class II major histocompatibility complex molecules were performed on all samples, and the relative presence of these determinants was evaluated. In both the controls and preserved lungs, intercellular adhesion molecule-1 expression was intense in the septal capillary endothelium and alveolar pneumocytes, but essentially absent in bronchial epithelium. Vascular cell adhesion molecule-1 was moderately to strongly labeled in the endothelia of large and small blood vessels of all types, and it was not seen in other cell types. Class II major histocompatibility complex antigens were variably observed in pulmonary epithelial cells, but they were not expressed by endothelia. There appeared to be no significant difference in the immunohistologic density of intercellular adhesion molecule-1 or vascular cell adhesion molecule-1 immunostaining in allografts at the specified time points of preservation; this conclusion was confirmed by Western blot analysis. Similar findings pertained to staining results for human leukocyte DR antigens. There was likewise no significant difference in the expression of the three analytes when donor lungs perfused with Euro-Collins solution versus low potassium

  11. Donor Smoking and Older Age Increases Morbidity and Mortality After Lung Transplantation

    DEFF Research Database (Denmark)

    Schultz, H H; Møller, C H; Zemtsovski, M


    survival as well as CLAD-free survival was significantly lower with donors ≥55 years. CONCLUSIONS: Donor smoking history and older donor age impact lung function, mortality, and CLAD-free survival after transplantation. Because of a shortage of organs, extended donor criteria may be considered while taking......BACKGROUND: The lack of lung transplant donors has necessitated the use of donors with a smoking history and donors of older age. We have evaluated the effects of donor smoking history and age on recipient morbidity and mortality with baseline values of pulmonary function and survival free...... of chronic lung allograft dysfunction (CLAD) as morbidity variables. METHODS: This is a retrospective analysis of 588 consecutive lung transplant recipients and their corresponding 454 donors. Donors were divided into three groups: group 1 included smokers, group 2 nonsmokers, and group 3 had unknown smoking...

  12. Lipid peroxidation products in machine perfusion of older donor kidneys

    NARCIS (Netherlands)

    Nagelschmidt, Manfred; Minor, Thomas; Gallinat, Anja; Moers, Cyril; Jochmans, Ina; Pirenne, Jacques; Ploeg, Rutger J.; Paul, Andreas; Treckmann, Juergen

    Background: Owing to the shortage of donors, organs with an increased risk potential such as grafts recovered from expanded criteria donors are increasingly being used in transplants. Machine perfusion (MP) technology offers the possibility of determining the biomarkers in the perfusion solution so

  13. Hybrid super electron donors – preparation and reactivity

    Directory of Open Access Journals (Sweden)

    Jean Garnier


    Full Text Available Neutral organic electron donors, featuring pyridinylidene–imidazolylidene, pyridinylidene–benzimidazolylidene and imidazolylidene–benzimidazolylidene linkages are reported. The pyridinylidene–benzimidazolylidene and imidazolylidene–benzimidazolylidene hybrid systems were designed to be the first super electron donors to convert iodoarenes to aryl radicals at room temperature, and indeed both show evidence for significant aryl radical formation at room temperature. The stronger pyridinylidene–imidazolylidene donor converts iodoarenes to aryl anions efficiently under appropriate conditions (3 equiv of donor. The presence of excess sodium hydride base has a very important and selective effect on some of these electron-transfer reactions, and a rationale for this is proposed.

  14. Transplantation With Livers From Deceased Donors Older Than 75 Years

    DEFF Research Database (Denmark)

    Thorsen, Trygve; Aandahl, Einar Martin; Bennet, William


    BACKGROUND: The availability of donor organs limits the number of patients in need who are offered liver transplantation. Measures to expand the donor pool are crucial to prevent on-list mortality. The aim of this study was to evaluate the use of livers from deceased donors who were older than 75...... years. METHODS: Fifty-four patients who received a first liver transplant (D75 group) from 2001 to 2011 were included. Donor and recipient data were collected from the Nordic Liver Transplant Registry and medical records. The outcome was compared with a control group of 54 patients who received a liver...

  15. Extraordinary Separation of Acetylene-Containing Mixtures with Microporous Metal-Organic Frameworks with Open O Donor Sites and Tunable Robustness through Control of the Helical Chain Secondary Building Units

    KAUST Repository

    Yao, Zizhu


    Acetylene separation is a very important but challenging industrial separation task. Here, through the solvothermal reaction of CuI and 5-triazole isophthalic acid in different solvents, two metal-organic frameworks (MOFs, FJU-21 and FJU-22) with open O donor sites and controllable robustness have been obtained for acetylene separation. They contain the same paddle-wheel {Cu2(COO2)4} nodes and metal-ligand connection modes, but with different helical chains as secondary building units (SBUs), leading to different structural robustness for the MOFs. FJU-21 and FJU-22 are the first examples in which the MOFs\\' robustness is controlled by adjusting the helical chain SBUs. Good robustness gives the activated FJU-22 a, which has higher surface area and gas uptakes than the flexible FJU-21 a. Importantly, FJU-22 a shows extraordinary separation of acetylene mixtures under ambient conditions. The separation capacity of FJU-22 a for 50:50 C2H2/CO2 mixtures is about twice that of the high-capacity HOF-3, and its actual separation selectivity for C2H2/C2H4 mixtures containing 1 % acetylene is the highest among reported porous materials. Based on first-principles calculations, the extraordinary separation performance of C2H2 for FJU-22 a was attributed to hydrogen-bonding interactions between the C2H2 molecules with the open O donors on the wall, which provide better recognition ability for C2H2 than other functional sites, including open metal sites and amino groups. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. A-D-A-type S,N-heteropentacenes: next-generation molecular donor materials for efficient vacuum-processed organic solar cells. (United States)

    Mishra, Amaresh; Popovic, Dusko; Vogt, Astrid; Kast, Hannelore; Leitner, Tanja; Walzer, Karsten; Pfeiffer, Martin; Mena-Osteritz, Elena; Bäuerle, Peter


    A new class of acceptor-substituted S,N-heteropentacenes is developed for vacuum-processed organic solar cells, providing encouraging power conversion efficiencies of up to 6.5%. Atomic force microscopy (AFM) investigations give a direct correlation between the blend film morphology and the photovoltaic parameters, such as short-circuit current density (JSC ) and fill factor (FF). © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. How to kill gamete donation: retrospective legislation and donor anonymity. (United States)

    Pennings, Guido


    Victoria (Australia) is considering retrospective legislation on the abolition of gamete donor anonymity. Retrospective legislation evokes many negative emotions mainly because it is considered unfair. It also makes it impossible for citizens to organize their life with reasonable certainty of the consequences. Introduction of this law for donor anonymity is defended by the right of the child to know its genetic origins. Against this law, people appeal to the right to privacy and confidentiality of the donor. This paper analyses the arguments for and against a retrospective law on donor anonymity by looking at the conditions that should be respected when two principles (the donor's right to privacy and the child's right to genetic information) have to be balanced. It is concluded that the justification for introducing retrospective law is lacking: the conditions are not fulfilled. Moreover, retroactive laws in the context of gamete donation may jeopardize the whole practice by destroying the trust of candidate donors and recipients in the government.

  18. Nyretransplantation med levende donor

    DEFF Research Database (Denmark)

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


    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...

  19. National Marrow Donor Program (United States)


    replacement business analyst to continue working on business and system requirements for HapLogic Phase III ! 100f2l National Marrow Donor Program® NOOOO...NOOOO 14-1 0-1-0204 IID.I. Task 3: Expand Immuno - biology Research QUARTER PROGRESS REPORT Development of Medical Technology for Contingency Response

  20. 2,3-Dipentyldithieno[3,2-f:2',3'-h]quinoxaline-Based Organic Dyes for Efficient Dye-Sensitized Solar Cells: Effect of π-Bridges and Electron Donors on Solar Cell Performance. (United States)

    Huang, Zu-Sheng; Zang, Xu-Feng; Hua, Tao; Wang, Lingyun; Meier, Herbert; Cao, Derong


    Five novel metal-free organic dyes DQ1-5 containing a dipentyldithieno[3,2-f:2',3'-h]quinoxaline (DPQ) unit were synthesized and applied in dye-sensitized solar cells (DSSCs), where DPQ was employed as a π-spacer for the first time. Their photophysical, electrochemical, and theoretical calculations and photovoltaic properties were systematically investigated. All the five dyes show broad photoresponse. Especially the absorption edges of DQ3-5 extend to 800 nm on the TiO2 films. The inserted electron-rich unit 3,4-ethylenedioxythiophene or electron-withdrawing group benzothiadiazole (BTD) in DPQ-based dyes can greatly influence the optoelectronic properties of the dyes. In addition, the different electron donors also significantly affect the performance of the DSSCs. Under standard global AM 1.5 solar light conditions, the DQ5 sensitized solar cell obtained a power conversion efficiency of 7.12%. The result indicates that the rigid DPQ-based organic dye is a promising candidate for efficient DSSCs.

  1. [Ethics and kidney transplants with living donors]. (United States)

    Mamzer Bruneel, Marie-France


    The ethical debate surrounding transplant practices questions our societies. International recommendations set out numerous precautions which must be taken to ensure that donors act with their free will. While in most countries, including France, organ donation is a voluntary and non-commercial act, a black market exists in the world resulting in the trafficking of organs and tragic transplant tourism. Copyright © 2016. Publié par Elsevier Masson SAS.

  2. Mesenchymal Stromal Cells as Anti-Inflammatory and Regenerative Mediators for Donor Kidneys During Normothermic Machine Perfusion

    NARCIS (Netherlands)

    Sierra-Parraga, Jesus Maria; Eijken, Marco; Hunter, James; Moers, Cyril; Leuvenink, Henri; Moller, Bjarne; Ploeg, Rutger J.; Baan, Carla C.; Jespersen, Bente; Hoogduijn, Martin J.


    There is great demand for transplant kidneys for the treatment of end-stage kidney disease patients. To expand the donor pool, organs from older and comorbid brain death donors, so-called expanded criteria donors (ECD), as well as donation after circulatory death donors, are considered for

  3. Evaluation of the Medically Complex Living Kidney Donor

    Directory of Open Access Journals (Sweden)

    Yasar Caliskan


    Full Text Available Due to organ shortage and difficulties for availability of cadaveric donors, living donor transplantation is an important choice for having allograft. Live donor surgery is elective and easier to organize prior to starting dialysis thereby permitting preemptive transplantation as compared to cadaveric transplantation. Because of superior results with living kidney transplantation, efforts including the usage of “Medically complex living donors” are made to increase the availability of organs for donation. The term “Complex living donor” is probably preferred for all suboptimal donors where decision-making is a problem due to lack of sound medical data or consensus guidelines. Donors with advanced age, obesity, asymptomatic microhematuria, proteinuria, hypertension, renal stone disease, history of malignancy and with chronic viral infections consist of this complex living donors. This medical complex living donors requires careful evaluation for future renal risk. In this review we would like to present the major issues in the evaluation process of medically complex living kidney donor.

  4. Nutrition assessment and counseling of the medically complex live kidney donor. (United States)

    Bergen, Carol R; Reese, Peter P; Collins, Donna


    Kidney transplantation is the preferred option for patients with end-stage renal disease facing the need for dialysis because it provides maximum survival benefit. The number of people seeking kidney transplantation greatly exceeds available deceased donor organs. Organs from live donors provide a survival advantage over organs from deceased donors while also broadening the pool of available organs. The purpose of this review is to discuss the clinical guidelines that pertain to live kidney organ donation and to describe the nutrition evaluation and care of live kidney donors. The process for living kidney donation is dictated by policies centered on protecting the donor. In a perfect world, the living donor would present with a flawless medical examination and a benign family health history. The obesity epidemic has emerged as a major health concern. Live donor programs are faced with evaluating increasing numbers of obese candidates. These "medically complex donors" may present with obesity and its associated comorbid conditions, including hypertension, impaired glycemic control, and kidney stone disease. The dietitian's role in the live donor program is not well defined. Participation in the living donor selection meeting, where details of the evaluation are summarized, provides a platform for risk stratification and identification of donors who are at increased lifetime risk for poor personal health outcomes. Guiding the donor toward maintenance of a healthy weight through diet and lifestyle choices is a legitimate goal to minimize future health risks.

  5. Predictors of liver donation without kidney recovery in a cohort of expanded criteria donors: identifying opportunities to improve expanded criteria donor kidney utilization. (United States)

    White, S L; Leichtman, A B; O'Connor, K; Lipkowitz, G; Pietroski, R; Stoff, J S; Luskin, R S; Belcher, J; Meyer, K; Merion, R M; Port, F K; Delmonico, F L


    To maximize deceased donation, it is necessary to facilitate organ recovery from expanded criteria donors (ECDs). Utilization of donors meeting the kidney definition for ECDs increases access to kidney transplantation and reduces waiting times; however, ECDs often do not proceed to kidney recovery. Based on a prospective study of three Organ Procurement Organizations in the United States, we describe the characteristics of donors meeting the Organ Procurement and Transplant Network (OPTN) ECD kidney definition (donor age 60+ or donor age 50-60 years with two of the following: final serum creatinine > 1.5 mg/dL, history of hypertension, or death from cerebral vascular accident) who donated a liver without kidney recovery. ECDs with organs recovered between February 2003 and September 2005 by New England Organ Bank, Gift of Life Michigan, and LifeChoice Donor Services were studied (n = 324). All donors were declared dead by neurological criteria. Data on a wide range of donor characteristics were collected, including donor demographics, medical history, cause of death, donor status during hospitalization, serological status, and donor kidney quality. Logistic regression models were used to identify donor characteristics predictive of liver-alone donation. Seventy-four of the 324 donors fulfilling the ECD definition for kidneys donated a liver alone (23%). History of diabetes, final serum creatinine > 1.5 mg/dL, age 70+, and presence of proteinuria were associated with liver-alone donation in univariate models. On multivariate analysis, only final serum creatinine > 1.5 mg/dL and age 70+ were independently predictive of liver donation alone. Older age and elevated serum creatinine may be perceived as stronger contraindications to kidney donation than the remaining elements of the ECD definition. It is likely that at least a proportion of these liver-alone donors represent missed opportunities for kidney transplantation. Copyright © 2012 Elsevier Inc. All rights

  6. Are Doctors Discarding Donor Kidneys That Could Save Lives? (United States)

    ... Are Doctors Discarding Donor Kidneys That Could Save Lives? Study found suboptimal organs prolonged lives and were ... Formica said. Lower the bar to save more lives? "People don't realize if I turn down ...

  7. Influence of doped-charge transport layers on the photovoltaic performance of donor-acceptor blend p-i-n type organic solar cells

    Directory of Open Access Journals (Sweden)

    D. Gebeyehu


    Full Text Available This report demonstrates external power conversion efficiencies of 2% under 100 mW/cm2 simulated AM1.5 illumination for organic thin-film photovoltaic cells using a phthalocyanine-fullerene (ZnPc/C60 bulk heterojunction as an active layer, embedded into a p-i-n type architecture with doped wide-gap charge transport layers. For an optically optimized device, we found internal quantum efficiency (IQE of above 80% under short circuit conditions. Such optically thin cells with high internal quantum efficiency are an important step towards high efficiency tandem cells. The p-i-n architecture allows for the design of solar cells with high internal quantum efficiency where only the photoactive region absorbs visible light and recombination losses at contacts are avoided. The I-V characteristics, power conversion efficiencies, the dependence of short circuit current on incident white light intensity, incident photon to collected electron efficiency (IPCE and absorption spectra of the active layer system are discussed.

  8. National Marrow Donor Program (United States)


    radiological exposure event. Period 8 Activity: • Attended a meeting with the EBMT Nuclear Accident Committee Ulm, Germany from June 30 to July 1st... nuclear Safety, Bonn o Cullen Case United States National Marrow Donor Program, Minneapolis, Minnesota o Nelson Chao... radioprotection et de sûreté nucléaire, Fontenay-aux-Roses o Dieter Graessle, Dipl.- Math. Oec. Germany Radiation Medicine Research Group, Ulm

  9. Donor transmitted and de novo cancer after liver transplantation. (United States)

    Desai, Rajeev; Neuberger, James


    Cancers in solid organ recipients may be classified as donor transmitted, donor derived, de novo or recurrent. The risk of donor-transmitted cancer is very low and can be reduced by careful screening of the donor but cannot be abolished and, in the United Kingdom series is less than 0.03%. For donors with a known history of cancer, the risks will depend on the nature of the cancer, the interventions given and the interval between diagnosis and organ donation. The risks of cancer transmission must be balanced against the risks of death awaiting a new graft and strict adherence to current guidelines may result increased patient death. Organs from selected patients, even with high-grade central nervous system (CNS) malignancy and after a shunt, can, in some circumstances, be considered. Of potential donors with non-CNS cancers, whether organs may be safely used again depends on the nature of the cancer, the treatment and interval. Data are scarce about the most appropriate treatment when donor transmitted cancer is diagnosed: sometimes substitution of agents and reduction of the immunosuppressive load may be adequate and the impact of graft removal should be considered but not always indicated. Liver allograft recipients are at increased risk of some de novo cancers, especially those grafted for alcohol-related liver disease and hepatitis C virus infection. The risk of lymphoproliferative disease and cancers of the skin, upper airway and bowel are increased but not breast. Recipients should be advised to avoid risk behavior and monitored appropriately.

  10. Transmission of Angiosarcomas From a Common Multiorgan Donor to Four Transplant Recipients

    DEFF Research Database (Denmark)

    Thoning, J; Liu, Ying; Bistrup, C


    We describe the donor tumor transmission of metastatic angiosarcomas to four transplant recipients through transplantation of deceased-donor organs, i.e. kidneys, lung and liver, from an apparently unaffected common female multiorgan donor. Fluorescent in situ hybridization of angiosarcoma cells...

  11. Modulation of Electron Injection Dynamics of Ru-Based Dye/TiO2 System in the Presence of Three Different Organic Solvents: Role of Solvent Dipole Moment and Donor Number. (United States)

    Mahanta, Subrata; Matsuzaki, Hiroyuki; Murakami, Takurou N; Katoh, Ryuzi; Matsumoto, Hajime; Furube, Akihiro


    In the present work, femtosecond transient absorption spectroscopy (fs-TAS) has been employed to investigate the electron injection efficiency (EIE) both from the singlet and triplet excited states of a well-known ruthenium dye (N719) to the conduction band (CB) of nanostructured TiO(2) in presence of three different organic solvents [γ-butylactone (GBL), 3-methoxypropionitrile (MPN), and dimethylformamide (DMF)] with different donor numbers (DNs) and dipole moments (DMs). The DM and DN of a solvent modulates the CB edge energy of TiO(2), and this effect reflects well in the fs-TAS results, which shows an EIE trend following the order GBL≥MPN≫DMF, that is, highest in GBL and lowest in DMF solvent environments. Fs-TAS results indicate a lower contribution of electron injection from both the singlet and triplet states in DMF, for which the dominant adsorption of DMF molecules on the TiO(2) surface seems to play an important role in the mechanism. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Adoptive T-cell Immunotherapy from third-party donors: Characterization of donors and set up of a T-cell donor registry

    Directory of Open Access Journals (Sweden)

    Britta eEiz-Vesper


    Full Text Available Infection with and reactivation of human cytomegalovirus (CMV, Epstein-Barr virus (EBV, and adenovirus (ADV are frequent and severe complications in immunocompromised recipients after hematopoietic stem cell transplantation (HSCT or solid organ transplantation (SOT. These serious adverse events are associated with significant morbidity and mortality. Donor lymphocyte infusions (DLIs are often used to treat both viral infections and leukemia relapses after transplantation but are associated with potentially life-threatening graft-versus-host disease (GvHD. Adoptive immunotherapy with virus-specific cytotoxic effector T cells (CTLs derived from seropositive donors can rapidly reconstitute antiviral immunity after HSCT and organ transplantation. Therefore, it can effectively prevent the clinical manifestation of these viruses with no significant acute toxicity or increased risk of GvHD. In conditions, where patients receiving an allogeneic cord blood transplant or a transplant from a virus-seronegative donor and since donor blood is generally not available for solid organ recipients, allogeneic third party T-cell donors would offer an alternative option. Recent studies showed that during granulocyte colony-stimulating factor (G-CSF mobilization, the functional activity of antiviral memory T cells is impaired for a long period. This finding suggests that even stem cell donors may not be the best source of T cells.Under these circumstances, partially human leukocyte antigen (HLA-matched virus-specific CTLs from healthy seropositive individuals may be a promising option. Therefore frequency assessments of virus-specific memory T cells in HLA-typed healthy donors as well as in HSCT/SOT donors using a high throughput T-cell assay were performed over a period of 4 years at Hannover Medical School. This chapter will address the relevance and potential of a third-party T-cell donor registry and will discuss its clinical implication for adoptive T

  13. Factors predicting the usefulness of deceased donors. (United States)

    Hwang, H P; Yang, J D; Yu, H C; Cho, B H; Kwon, K S; Park, S K; Lee, S


    Preoperative management for deceased donation is important. Deceased donation can failed for several reasons. We analyzed the clinical data of deceased donation after consent for cadaveric donation to evaluate the reasons of failure of organ procurement. We retrospectively reviewed the medical records of 112 deceased donors in a single institution between January 1998 and September 2012. There were no organs from cardiac death donors. Of 112 deceased donors, 51 (45.5%) were traumatic brain deaths and 33 (29.5%), nontraumatic brain hemorrhages. The overall mean age was 37.2 (±16.6) years with 35 (30.7%) of female gender. There were 15 (13.3%) donation failures for all organs. Significant factors for failure were histories of cardiopulmonary resuscitation (odds ratio [OR], 0.17; 95% confidence interval [CI], 0.05-0.58; P = .005), cardiac arrest (OR, 0.03; 95% CI, 0.006-0.14; P donation was associated with cardiac arrest while awaiting organ procurement and the presence of an history of cardiopulmonary resuscitation or presence of acute renal failure. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Expanding the donor pool: can the Spanish model work in the United States? (United States)

    Chang, George J; Mahanty, Harish D; Ascher, Nancy L; Roberts, John P


    Since the creation of the Organizacion Nacional de Trasplantes (ONT) in 1989, the organ donation rate in Spain has doubled. Although often attributed to improved donor recruitment efforts, this increase may also represent higher utilization of marginal donors. Therefore, age-related donor recruitment in Spain and the US was evaluated. Data from the ONT, the US Scientific Registry of Transplant Recipients (SRTR), the US Census Bureau, and the Tempus databank of Spain's Instituto Nacional de Estadistica (INE) were analyzed. Between 1989 and 1999, the number of donors in Spain increased from 14.3 to 33.7 per million population (pmp; 136% increase) compared with an increase in the US from 16.2 to 21.5 donors pmp (33%). The largest difference between Spain and the US in the increased number of donors was in the 45-year-old group, representing 30.3% of donors in Spain in 1999 (44 donors pmp). If the US increased its older donor rates to match Spain's, an incremental 1235 donors per year would be realized. The high Spanish organ donation rates are largely attributable to increased use of older donors. Utilizing similar proportions of older donors in the US would increase the donor pool by almost 40%.

  15. Impact of donor cardiac arrest on heart transplantation. (United States)

    Southerland, Kevin W; Castleberry, Anthony W; Williams, Judson B; Daneshmand, Mani A; Ali, Ayyaz A; Milano, Carmelo A


    Cardiac transplantation is an effective therapy for patients with end-stage heart failure, but it is still hindered by the lack of donor organs. A history of donor cardiac arrest raises trepidation regarding the possibility of poor post-transplant outcomes. The impact of donor cardiac arrest following successful cardiopulmonary resuscitation on heart transplant outcomes is unknown. Therefore, we sought to evaluate the impact of donor cardiac arrest on orthotropic heart transplantation using the United Network for Organ Sharing database. We performed a secondary longitudinal analysis of all cardiac transplants performed between April 1994 and December 2011 through the United Network for Organ Sharing registry. Multiorgan transplants, repeat transplants, and pediatric recipients were excluded. Survival analyses were performed using Kaplan-Meier methods as well as multivariate adjusted logistic regression and Cox proportional hazard models. A total of 19,980 patients were analyzed. In 856 cases, the donors had histories of cardiac arrest, and in the remaining 19,124 cases, there was no history of donor cardiac arrest. The unadjusted 1-, 5-, and 10-year actuarial survival rates between the arrest and the nonarrest groups were not significantly different. Multivariate logistic regression demonstrated no difference in survival in the donor arrest group at 30 days, 1 year, or 3 years. Furthermore, the adjusted Cox proportional hazard model for cumulative survival also showed no survival difference between the 2 groups. If standard recipient and donor transplantation criteria are met, a history of donor cardiac arrest should not prohibit the potential consideration of an organ for transplantation. Copyright © 2013 Mosby, Inc. All rights reserved.

  16. 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.

  17. 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

  18. [Haemovigilance donors: methods and results]. (United States)

    Rebibo, Danielle; Danic, Bruno


    There is no official definition of haemovigilance donors. However, it concerns the observation and management of Serious Adverse Events observed in blood donors (SAEDs), Post Donation Informations (PDI), and donor epidemiologic survey. The French Decree of 1 February 2006 imposes the declaration of the SAEDs. In 2006, 196 SAEDs were notified for 2599978 donations (7.5/100,000 donations). The incidence of the SAEDs was of 7/100,000 whole blood donations and 10.7/100,000 aphaeresis donations. Donors that are more susceptible to present a SAED are: women, women under 30, repeat donor and aphaeresis donor. For 2/3 of donors having presented a SAED, a medical consultation was prescribed and 1/3 was hospitalized. Vasovagal reaction is the most frequent category. Seven thousand three hundred and sixty one PDI were notified in 2005. The risks of infection represented the principal cause (mainly ENT). Concerning donor epidemiologic survey, the viral residual risk clearly decreased since 1992 and for the period of 2003-2005 it 1/2600000 for HIV, 1/6500000 for HCV and 1/1000000 for HBV. The first national data already give useful information. This information will permit a better care of blood donors and of blood component recipients as well.

  19. Microwave assisted synthesis of bithiophene based donor-acceptor-donor oligomers and their optoelectronic performances (United States)

    Bathula, Chinna; Buruga, Kezia; Lee, Sang Kyu; Khazi, Imtiyaz Ahmed M.; Kang, Youngjong


    In this article we present the synthesis of two novel bithiophene based symmetrical π conjugated oligomers with donor-acceptor-donor (D-A-D) structures by microwave assisted PdCl2(dppf) catalyzed Suzuki coupling reaction. These molecules contain electron rich bithiophene as a donor, dithienothiadiazole[3,4-c]pyridine and phthalic anhydride units as acceptors. The shorter reaction time, excellent yields and easy product isolation are the advantages of this method. The photophysical prerequisites for electronic application such as strong and broad optical absorption, thermal stability, and compatible energy levels were determined for synthesized oligomers. Optical band gap for the oligomers is found to be 1.72-1.90 eV. The results demonstrated the novel oligomers to be promising candidates in organic optoelectronic applications.

  20. Fullerene-Free Organic Solar Cells with an Efficiency of 10.2% and an Energy Loss of 0.59 eV Based on a Thieno[3,4-c]Pyrrole-4,6-dione-Containing Wide Band Gap Polymer Donor. (United States)

    Hadmojo, Wisnu Tantyo; Wibowo, Febrian Tri Adhi; Ryu, Du Yeol; Jung, In Hwan; Jang, Sung-Yeon


    Although the combination of wide band gap polymer donors and narrow band gap small-molecule acceptors achieved state-of-the-art performance as bulk heterojunction (BHJ) active layers for organic solar cells, there have been only several of the wide band gap polymers that actually realized high-efficiency devices over >10%. Herein, we developed high-efficiency, low-energy-loss fullerene-free organic solar cells using a weakly crystalline wide band gap polymer donor, PBDTTPD-HT, and a nonfullerene small-molecule acceptor, ITIC. The excessive intermolecular stacking of ITIC is efficiently suppressed by the miscibility with PBDTTPD-HT, which led to a well-balanced nanomorphology in the PBDTTPD-HT/ITIC BHJ active films. The favorable optical, electronic, and energetic properties of PBDTTPD-HT with respect to ITIC achieved panchromatic photon-to-current conversion with a remarkably low energy loss (0.59 eV).

  1. Accepting Hearts From Hepatitis C-Positive Donor: Can We Expand the Donor Pool? (United States)

    Grinstein, Jonathan; Lourenco, Laura M; Te, Helen S; Renz, John F; Jeevanandam, Valluvan; Uriel, Nir


    Until recently, transplantation from hepatitis C-positive donors was relatively contraindicated as eradication of active hepatitis C previously required an interferon-based regimen that has been associated with rejection in solid organ transplantation. New interferon-free treatment regimens for hepatitis C have fewer adverse events and higher cure rates than interferon-based regimens. Interferon-free regimens have been shown to be safe in the liver transplantation literature, but little is known about the safety and efficacy of treatment in heart transplantation. Here we report a case of successful eradication of hepatitis C with a non-interferon-based regimen using ledipasvir-sofosbuvir following combined orthotopic heart and liver transplantation. Based on the prevalence of hepatitis C in the general population, inclusion of hepatitis C-positive donors for heart transplantation can expand this component of the donor pool 3- to 6-fold. In carefully selected patients and recipients, inclusion of hepatitis C-positive donors may allow for expansion of the donor pool. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Utilization of donors who have suffered cardiopulmonary arrest and resuscitation in intestinal transplantation. (United States)

    Matsumoto, Cal S; Kaufman, Stuart S; Girlanda, Raffaele; Little, Cheryl M; Rekhtman, Yuliya; Raofi, Vandad; Laurin, Jaqueline M; Shetty, Kirti; Fennelly, Erin M; Johnson, Lynt B; Fishbein, Thomas M


    Cardiopulmonary resuscitation (CPR) of a person destined to become an organ donor has been associated with overall poor donor quality, especially for the intestinal donor, as splanchnic vasoconstriction that is intended to preserve coronary and cerebral blood flow may result in clinically relevant intestinal ischemia. Outcomes of recipients who receive intestine grafts that have suffered CPR are unknown. We sought to analyze our clinical experience in using intestinal grafts from donors who suffered cardiopulmonary arrest and resuscitation and to evaluate the outcome of recipients of organs coming from resuscitated donors when compared with recipients of nonresuscitated donors. We retrospectively analyzed the donor and recipient charts of all of our intestinal transplants with regard to the performance of donor CPR. Sixty-seven intestinal transplants were performed in 65 patients from November 2003 to December 2007. Twelve donors (18%) were identified as having suffered cardiac arrest and subsequent CPR. Mean duration of CPR was 19.3+/-12.7 min. Terminal laboratory profiles of CPR donors and non-CPR donors were similar. Of the 12 resuscitated grafts, two were used for multivisceral, one for a modified multivisceral, seven for liver-intestine, and two for isolated intestinal transplant. There were no significant differences in outcome parameters such as operative time, blood use, ventilation days, length of stay, time to enteral independence, rejection, enteric bacteremia, and survival between the 12 resuscitated grafts and the 55 nonresuscitated grafts. A donor history of cardiac arrest should not automatically exclude the use of the intestine graft for transplantation.

  3. `Giant' nanocrystal quantum dots (gNQDs) as FRET donors (United States)

    Chern, Margaret; Nguyen, Thuy; Dennis, Allison


    High-quality core/shell CdSe/xCdS quantum dots (QDs) ranging from 3 to 20 nm in diameter were synthesized for use as Förster Resonance Energy Transfer (FRET) donors. gNQDs are carefully characterized for size, emission, absorption, QY, and brightness in both organic and aqueous solution. FRET has been verified in optimally designed systems that use short capping ligands and donor-acceptor pairs that have well-matched emission and absorption spectra. The interplay between shell thickness, donor-acceptor distance, and particle brightness is systematically analyzed to optimize our biosensor design.

  4. Being a donor-child: wishes for parental support, peer support and counseling. (United States)

    Schrijvers, Anne; Bos, Henny; van Rooij, Floor; Gerrits, Trudie; van der Veen, Fulco; Mochtar, Monique; Visser, Marja


    We aimed at exploring the wishes of Dutch donor-conceived offspring for parental support, peer support and counseling and sought to contribute to the improvement of health care for all parties involved with assisted reproductive technologies. We held semi-structured in-depth interviews with 24 donor-conceived offspring (Mage = 26.9, range 17-41) born within father-mother, two-mother and single mother families. The majority of the donor offspring was conceived with semen of anonymous donors. All offspring were recruited by network organizations and snowball sampling. The interviews were fully transcribed and analyzed using the constant comparative method. Donor-conceived offspring wished that their parents had talked openly about donor conception and had missed parental support. They wished that their parents would have received counseling before donor sperm treatment on how to talk with their children about donor conception in several stages of life. They valued the availability of peer contact to exchange stories with other donor-conceived offspring and would have liked assistance in getting access to trustworthy information about characteristics and identifying information of their donor. Donor-conceived offspring wished to know where to find specialist counseling when needed. Peer support and counseling by professionals for donor-conceived offspring should be available for those who need it. The findings also support professional counseling for intended parents before treatment to improve parental support for donor-children.

  5. Belgian modified classification of Maastricht for donors after circulatory death


    Evrard, Patrick; Belgian Working Group on DCD National Protocol; Lois, Fernande; Darius, Tom; De Pauw, Luc; Hantson, Philippe; Jacquemin, Dominique; Schamps, Geneviève; Van Deynse, Dominique; Rondelet, Benoît; Verschuren, Franck


    BACKGROUND: "Non-heart-beating donors," or, in a more recent and international definition, "donors after circulatory death," are a potential and additional group of deceased persons who are able to add organs to the pool. METHODS: A new classification is proposed on the basis of the result of a consensus of experts issued from all Belgian transplant centers. RESULTS: The first level of definition is simple and based on whether the situation is uncontrolled (categories I and II) or contr...

  6. Social Media Use Among Living Kidney Donors and Recipients: Survey on Current Practice and Potential


    Kazley, Abby Swanson; Hamidi, Bashir; Balliet, Wendy; Baliga, Prabhakar K.


    Background In the United States, there is a national shortage of organs donated for transplant. Among the solid organs, most often kidneys are donated by living donors, but the lack of information and complicated processes limit the number of individuals who serve as living kidney donors. Social media can be a tool for advocacy, educating the public about the need, process, and outcomes of live kidney donors, yet little is known about social media use by kidney transplant patients. Objective ...

  7. Donor-derived infections among Chinese donation after cardiac death liver recipients. (United States)

    Ye, Qi-Fa; Zhou, Wei; Wan, Qi-Quan


    To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients. We retrospectively studied the results of blood cultures among our donation after cardiac death (DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors. We extracted the data of donors' and patients' characteristics, culture results and clinical outcomes, especially the post-transplant complications in liver recipients, from electronic medical records. We analyzed the characteristics of the donors and the corresponding liver recipients with emphasis put on donor-derived infections. Head trauma was the most common origin of death among our 67 DCD donors (46.3%). Blood taken prior to the procurement operation was cultured for 53 of the donors, with 17 episodes of bloodstream infections developing from 13 donors. The predominant organism isolated from the blood of donors was Gram-positive bacteria (70.6%). Only three (4.5%) of 67 liver recipients developed confirmed donor-derived bacterial infections, with two isolates of multidrug-resistant Klebsiella pneumoniae and one isolate of multidrug-resistant Enterobacter aerogenes. The liver recipients with donor-derived infections showed relation to higher crude mortality and graft loss rates (33.3% each) within 3 mo post transplantation, as compared to those without donor-derived infections (9.4% and 4.7%, respectively). All three liver recipients received appropriate antimicrobial therapy. Liver recipients have high occurrence of donor-derived infections. The liver recipients with donor-derived multidrug-resistant Enterobacteriaceae infections can have good outcome if appropriate antimicrobial therapy is given.

  8. Urinary biomarkers after donor nephrectomy

    NARCIS (Netherlands)

    Hoogendijk-van den Akker, Judith M; Warlé, Michiel C; van Zuilen, Arjan D.; Kloke, Heinrich J; Wever, Kim E; d'Ancona, Frank C H; Ӧzdemir, Denise M D; Wetzels, Jack F M; Hoitsma, Andries J


    As the beginning of living-donor kidney transplantation, physicians have expressed concern about the possibility that unilateral nephrectomy can be harmful to a healthy individual. To investigate whether the elevated intra-abdominal pressure (IAP) during laparoscopic donor nephrectomy causes early

  9. The rate of brain death and organ donation in patients resuscitated from cardiac arrest: a systematic review and meta-analysis. (United States)

    Sandroni, Claudio; D'Arrigo, Sonia; Callaway, Clifton W; Cariou, Alain; Dragancea, Irina; Taccone, Fabio Silvio; Antonelli, Massimo


    The occurrence of brain death in patients with hypoxic-ischaemic brain injury after resuscitation from cardiac arrest creates opportunities for organ donation. However, its prevalence is currently unknown. Systematic review. MEDLINE via PubMed, ISI Web of Science and the Cochrane Database of Systematic Reviews were searched for eligible studies (2002-2016). The prevalence of brain death in adult patients resuscitated from cardiac arrest and the rate of organ donation among brain dead patients were summarised using a random effect model with double-arcsine transformation. The quality of evidence (QOE) was evaluated according to the GRADE guidelines. 26 studies [16 on conventional cardiopulmonary resuscitation (c-CPR), 10 on extracorporeal CPR (e-CPR)] included a total of 23,388 patients, 1830 of whom developed brain death at a mean time of 3.2 ± 0.4 days after recovery of circulation. The overall prevalence of brain death among patients who died before hospital discharge was 12.6 [10.2-15.2] %. Prevalence was significantly higher in e-CPR vs. c-CPR patients (27.9 [19.7-36.6] vs. 8.3 [6.5-10.4] %; p organ donation among brain dead patients was 41.8 [20.2-51.0] % (9/26 studies, 1264 patients; range 0-100 %). The QOE was very low for both outcomes. In patients with hypoxic-ischaemic brain injury following CPR, more than 10 % of deaths were due to brain death. More than 40 % of brain-dead patients could donate organs. Patients who are unconscious after resuscitation from cardiac arrest, especially when resuscitated using e-CPR, should be carefully screened for signs of brain death.

  10. International variation in volunteer whole blood donor eligibility criteria. (United States)

    Karp, Julie K; King, Karen E


    This study assesses international variation in volunteer whole blood donor eligibility criteria. In February 2008, Web sites of major blood collection organizations in 17 countries were queried for the volume of whole blood donations and six donor eligibility criteria: allowed donation frequency, donor age, hemoglobin (Hb), weight, and deferrals for tattoo and pregnancy/breast-feeding. The allowed frequency of whole blood donation ranged from 56 to 120 days, some with sex- and age-specific limitations. While blood collection agencies in three countries did not have an upper age limit for donation, the remainder mandated donor retirement at ages from 60 to 81 years. The minimum Hb level was 11.5 to 12.5 g/dL for women and 12.5 to 13.5 g/dL for men. Blood collection organizations in only three countries required a minimum donor weight of less than 50 kg. Tattoo and pregnancy deferrals ranged from 4 to 12 months and 6 weeks to 12 months, respectively. The volume of whole blood donations ranged from 300 to 500 mL. The percentage of total blood volume donated, the absolute grams of Hb expected to be restored per deferral period and per day of donor deferral, and the concentration of Hb expected to be restored per deferral period were calculated. International volunteer whole blood donor eligibility criteria demonstrate marked variation. These differences likely cause international variation in the prevalence of adverse donor reactions and iron deficiency anemia. The reasons underlying these dissimilarities are unclear, but may include varying cultural influences and average donor body habitus.

  11. 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

  12. Shortage of donation despite an adequate number of donors : A professional attitude?

    NARCIS (Netherlands)

    Ploeg, RJ; Niesing, J; Sieber-Rasch, MH; Willems, L; Kranenburg, K


    Background A major problem in the field of transplantation is the persistent shortage of donor organs and tissues for transplantation. This study was initiated to (1) chart the donor potential for organs and tissue in The Netherlands and (2) to identify factors influencing whether donation is

  13. 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

  14. 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

  15. 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.

  16. Improvements in kidney transplantation from donors after cardiac death. (United States)

    Hoogland, E R Pieter; Snoeijs, Maarten G J; Habets, Margot A W; Brandsma, D Steven; Peutz-Kootstra, Carine J; Christiaans, Maarten H L; van Heurn, L W Ernest


    To reduce the growing waiting list for kidney transplantation, we explored the limits of kidney transplantation from donors after cardiac death by liberally accepting marginal donor kidneys for transplantation. As the percentage of primary non-function (PNF) increased, we evaluated our transplantation program and implemented changes to reduce the high percentage of PNF in 2005, followed by a second evaluation over the period 2006-2009. Recipients of a kidney from a donor after cardiac death between 1998 and 2005 were analyzed, with PNF as outcome measure. During the period 2002-2005, the percentage of PNF increased and crossed the upper control limits of 12% which was considered as unacceptably high. After implementation of changes, this percentage was reduced to 5%, without changing the number of kidney transplantations from donors after cardiac death. Continuous monitoring of the quality of care is essential as the boundaries of organ donation and transplantation are sought. Meticulous donor, preservation, and recipient management make extension of the donor potential possible, with good results for the individual recipient. Liberal use of kidneys from donors after cardiac death may contribute to a reduction in the waiting list for kidney transplantation and dialysis associated mortality. © 2013 John Wiley & Sons A/S.

  17. Estimation of donor usability for islet isolation with the modified Ricordi method. (United States)

    Matsumoto, S; Noguchi, H; Hatanaka, N; Kobayashi, N; Jackson, A; Naziruddin, B; Levy, M F


    The quality of donor pancreata is important for successful islet isolation. However, in some countries like Japan, the number of donor pancreata is low. Therefore, marginal donor pancreata have been used with less restrictive donor criteria. In order to use marginal donor pancreata, we established the modified Ricordi method. According to the United Network for Organ Sharing (UNOS) in 2005, more than 6000 pancreata were not clinically usable in the United States. In this study, we reevaluated donor usability based on the Japanese islet donor criteria. We reviewed donor charts with well-documented cases in Texas from 2005 to 2006. We counted the number of pancreata for pancreas transplantation or islet transplantation. If not used clinically, the reason was also reviewed. Donors were reevaluated based on the Japanese islet donor criteria. We reviewed 236 donor charts, including 29 pancreata used for whole pancreas transplantations and 13 for islet isolation; therefore, 194 pancreata were not used. Among the 194 cases, we were able to identify the reasons that the pancreata were not used in 186 cases. When we applied the Japanese acceptance criteria, an additional 82 of 186 cases (44%) seemed suitable for islet isolations. With the modified Ricordi method, more than 2500 donor pancreata might be used for islet isolation in the United States when the Japanese criteria are applied.

  18. Attitudes and acceptance of First Person Authorization: a national comparison of donor and nondonor families. (United States)

    Traino, Heather M; Siminoff, Laura A


    First Person Authorization (i.e., donor designation) legislation makes indicating one's intent to be a posthumous organ donor legally binding, much like a living will or advance directive. Such legislation is the most recent in a long history of organ donation policies in the United States and has received little attention in the literature. This retrospective cohort study recruited nine US organ procurement organizations (OPOs) and their staff who make requests for organ donation as well as family decision makers approached by OPO staff about organ donation. Telephone interviews (N = 1,087) with family decision makers assessed the attitudes, perceptions, and behaviors regarding the request for organ donation of families of designated donors as compared with those of patients who did not formally designate themselves as donors. Almost two thirds (65.7%) of the families of registered donors were aware of the decedent's decision to register as a posthumous donor. Family decision makers who authorized donation and those of designated donors exhibited greater knowledge of organ donation and more positive attitudes than decision makers who refused to donate. Families of designated donors had more favorable perceptions of the request for organ donation and were more satisfied with both the time spent discussing donation and the request process; fewer donor designation families were surprised at the request for donation. The enactment of First Person Authorization legislation increases the likelihood of familial authorization and satisfaction with the final donation outcome. As compared with other families approached about the option of organ donation, families of designated donors report having a more positive experience with the organ donation request process overall and greater comfort and satisfaction with the donation decision. Epidemiologic study, level II.

  19. Living and cadaver donor transplant programs in the maghreb

    Directory of Open Access Journals (Sweden)

    Jamil Hachicha


    Full Text Available In the Maghreb, organ failure constitutes a major public health problem, especially given the increasing number of patients with chronic renal failure and the high cost of care. In this study, we attempted to seek the recommendations, through a questionnaire, of various officials related to organ transplantation as well as leaders of ethics committees and religious groups in different countries of the Maghreb. The objective was to improve the rate of organ donation and transplantation. We received 36 replies (62% within the prescribed time limit. In our survey, 83% of the respondents felt that living donor transplantation should be promoted initially, followed gradually by measures to increase cadaver donor transplantation to achieve a target of about 30 transplants with cadaver kidney donors per million inhabitants. To expand the donor pool, 83% of the respondents proposed to expand the family circle to include the spouse and inlaws. To improve the cadaver donation activity, one should improve the organizational aspects to ensure at least 50 renal transplantations per year (100% and provide material motivation to the treatment team proportional to the activity of organ donation and transplantation. Finally, 93% of the respondents suggested suitable moral motivation of the donors.

  20. 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.

  1. Bartonella spp. bacteremia in blood donors from Campinas, Brazil.

    Directory of Open Access Journals (Sweden)

    Luiza Helena Urso Pitassi


    Full Text Available Bartonella species are blood-borne, re-emerging organisms, capable of causing prolonged infection with diverse disease manifestations, from asymptomatic bacteremia to chronic debilitating disease and death. This pathogen can survive for over a month in stored blood. However, its prevalence among blood donors is unknown, and screening of blood supplies for this pathogen is not routinely performed. We investigated Bartonella spp. prevalence in 500 blood donors from Campinas, Brazil, based on a cross-sectional design. Blood samples were inoculated into an enrichment liquid growth medium and sub-inoculated onto blood agar. Liquid culture samples and Gram-negative isolates were tested using a genus specific ITS PCR with amplicons sequenced for species identification. Bartonella henselae and Bartonella quintana antibodies were assayed by indirect immunofluorescence. B. henselae was isolated from six donors (1.2%. Sixteen donors (3.2% were Bartonella-PCR positive after culture in liquid or on solid media, with 15 donors infected with B. henselae and one donor infected with Bartonella clarridgeiae. Antibodies against B. henselae or B. quintana were found in 16% and 32% of 500 blood donors, respectively. Serology was not associated with infection, with only three of 16 Bartonella-infected subjects seropositive for B. henselae or B. quintana. Bartonella DNA was present in the bloodstream of approximately one out of 30 donors from a major blood bank in South America. Negative serology does not rule out Bartonella spp. infection in healthy subjects. Using a combination of liquid and solid cultures, PCR, and DNA sequencing, this study documents for the first time that Bartonella spp. bacteremia occurs in asymptomatic blood donors. Our findings support further evaluation of Bartonella spp. transmission which can occur through blood transfusions.

  2. 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

  3. Ethical issues relating to renal transplantation from prediabetic living donor. (United States)

    Ferreira-Hermosillo, Aldo; Valdez-Martínez, Edith; Bedolla, Miguel


    In Mexico, diabetes mellitus is the main cause of end - stage kidney disease, and some patients may be transplant candidates. Organ supply is limited because of cultural issues. And, there is a lack of standardized clinical guidelines regarding organ donation. These issues highlight the tension surrounding the fact that living donors are being selected despite being prediabetic. This article presents, examines and discusses using the principles of non-maleficience, autonomy, justice and the constitutionally guaranteed right to health, the ethical considerations that arise from considering a prediabetic person as a potential kidney donor. Diabetes is an absolute contraindication for donating a kidney. However, the transplant protocols most frequently used in Mexico do not consider prediabetes as exclusion criteria. In prediabetic persons there are well known metabolic alterations that may compromise the long - term outcomes of the transplant if such donors are accepted. Even so, many of them are finally included because there are not enough donor candidates. Both, families and hospitals face the need to rapidly accept prediabetic donors before the clinical conditions of the recipient and the evolution of the disease exclude him/her as a transplant candidate; however, when using a kidney potentially damaged by prediabetes, neither the donor's nor the recipient's long term health is usually considered.Considering the ethical implication as well as the clinical and epidemiological evidence, we conclude that prediabetic persons are not suitable candidates for kidney donation. This recommendation should be taken into consideration by Mexican health institutions who should rewrite their transplant protocols. We argue that the decision to use a kidney from a living donor known to be pre-diabetic or from those persons with family history of T2DM, obesity, hypertension, or renal failure, should be considered unethical in Mexico if the donor bases the decision to

  4. Mutual tolerance after liver and not after heart transplantation? Evaluation of patient-anti-donor and donor-anti-patient responses by mixed lymphocyte culture

    NARCIS (Netherlands)

    van der Mast, BJ; van Besouw, NM; Hepkema, BG; Weimar, W; van de Berg, AP; Slooff, MJH; Claas, FHJ

    The ultimate goal in organ transplantation is the induction of donor-specific transplantation tolerance. The fact that in some patients it is possible to withdraw immunosuppressive therapy completely, suggests that immunological adaptation or donor-specific nonresponsiveness can occur following

  5. Can value for money be improved by changing the sequence of our donor work-up in the living kidney donor programme?

    DEFF Research Database (Denmark)

    Larsen, Jesper; Sørensen, Søren Schwartz; Feldt-Rasmussen, Bo


    (range 22-69). Sixty-four participants were rejected as donors. Abdominal CT-scan with angiography and urography ruled out 22 of the above 64 potential organ donors; thus, 48% of the volunteers for living kidney donation were unsuited for donation. Abdominal CT-scan with angiography and urography...

  6. [Long live the kidney donor]. (United States)

    de Fijter, Johan W; Meinders, Arend E


    Kidney transplantation offers longer life expectancy and improves quality of life in selected patients with end-stage renal failure. The availability of living donors is critical, particularly to meet the increasing demand and potentially pre-emptive transplantation. In addition, living donor transplantation is associated with better outcomes on comparison with dialysis or transplants from deceased donors. The major disadvantage of living donation is that complications may occur both directly perioperatively and in the long-term. Two recent studies confirmed that the risk of renal failure among selected living donors is extremely low. This implies that there is no need to alter the existing positive attitude towards living donation. Finding a comparable long-term control group with relevant genetic and non-genetic risk factors remains a challenge to studies looking at long-term effects.

  7. 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....

  8. Use of donors who have suffered cardiopulmonary arrest and resuscitation in lung transplantation. (United States)

    Pilarczyk, Kevin; Osswald, Brigitte R; Pizanis, Nikolaus; Tsagakis, Konstantinos; Massoudy, Parwis; Heckmann, Jens; Jakob, Heinz G; Kamler, Markus


    Shortage of donors is one of the major limitations in lung transplantation (LuTX) and an aggressive expansion of criteria for donor selection has been proposed. This study evaluates the outcome of recipients of pulmonary grafts coming from resuscitated donors when compared with recipients of non-resuscitated donors. We retrospectively analyzed the donor and recipient charts of all double LuTX performed at our institution between 2000 and 2008 with regard to the performance of donor-cardiopulmonary resuscitation (CPR). Out of 186 eligible transplants, 22 patients (11.8%) received lungs from donors who have suffered cardiac arrest (CA) and subsequent CPR. Mean duration of CPR was 15.2 ± 11.3 min. Terminal laboratory profiles of CPR donors and non-CPR donors were similar as were ventilation time and paO(2)/FiO(2) ratio before organ harvesting or chest X-ray. CPR-donor status did not affect the following indices of graft function: length of postoperative ventilation, paO(2)/FiO(2) ratio up to 48 h and lung function up to 60 months. Length of intensive care and hospital stay, need for inotropic support and 30-day mortality were not significantly different for the transplantation of CPR or no-CPR donor lungs. One- and 3-year survival rates were comparable as well with 84.4% and 66.3% for CPR donors versus 88.5% and 69.8% no-CPR donors. This study indicates that transplantation of lungs from resuscitated donors may not affect outcome after LuTX. Therefore, donor history of CA should not automatically preclude LuTX. Copyright © 2010. Published by Elsevier B.V.

  9. Perioperative period in cardiac transplantation from donors with brain death due to methanol poisoning

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov


    Full Text Available The successful use of donor hearts from people died of methanol poisoning helps reducing the deficit of donor organs for patients requiring urgent cardiac transplantation [3]. We present our experience of successful cardiac transplantations from 2 donors who died due to methanol poisoning. Given the possibility of performing a cardiac transplant from this group of donors a protocol has been developed at the V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs of the Ministry of Healthcare of the Russian Federation which includes clinical, laboratory and instrumental criteria for the selection of heart donor and recipient. The possibility of delayed onset myocardial contractile dysfunction due to methanol poisoning means that a longer conditioningperiod is vital as well as compulsory clinical, laboratory and expert chocardiographic examinations of the potential donor heart.

  10. Quality of life of liver donors following donor hepatectomy. (United States)

    Chandran, Biju; Bharathan, Viju Kumar; Shaji Mathew, Johns; Amma, Binoj Sivasankara Pillai Thankamony; Gopalakrishnan, Unnikrishnan; Balakrishnan, Dinesh; Menon, Ramachandran Narayana; Dhar, Puneet; Vayoth, Sudheer Othiyil; Surendran, Sudhindran


    Although morbidity following living liver donation is well characterized, there is sparse data regarding health-related quality of life (HRQOL) of donors. HRQOL of 200 consecutive live liver donors from 2011-2014 performed at an Indian center were prospectively collected using the SF-36 version 2, 1 year after surgery. The effect of donor demographics, operative details, post-operative complications (Clavien-Dindo and 50-50 criteria), and recipient mortality on the quality-of-life (QOL) scoring was analyzed. Among 200 donors (female/male=141:59), 77 (38.5%) had complications (14.5%, 16.5%, 4.5%, and 3.5%, Clavien-Dindo grades I-IV, respectively). The physical composite score (PCS) of donors 1 year after surgery was less than ideal (48.75±9.5) while the mental composite score (MCS) was good (53.37±6.16). Recipient death was the only factor that showed a statistically significant correlation with both PCS (prepent the decision to donate.

  11. Advanced Donation Programs and Deceased Donor-Initiated Chains-2 Innovations in Kidney Paired Donation. (United States)

    Wall, Anji E; Veale, Jeffrey L; Melcher, Marc L


    Kidney paired donation (KPD) strategies have facilitated compatible living-donor kidney transplants for end-stage renal disease patients with willing but incompatible living donors. Success has inspired further innovations that expand opportunities for kidney-paired donation. Two such innovations are the advanced donation strategy in which a donor provides a kidney before their recipient is matched, or even in need of, a kidney transplant, and deceased donor initiated chains