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Sample records for standard criteria donors

  1. Comparative study between kidney transplantation with deceased donor expanded criteria and donor standard criteria in a single center in Brazil.

    Science.gov (United States)

    Mota, Luana Soriano; Oliveira, Claudia Maria Costa de; Pinheiro, Francisco Martho Leal; Santos, Larissa Costa de Oliveira; Nóbrega, Danilo Gonçalves; Fernandes, Paula Fbc; Costa, Alda Angélica de Melo; Silva, Sônia Leite da

    2016-01-01

    Kidney transplants with expanded criteria donor have been associated with improved patient survival compared to those who remain on dialysis. To compare renal function and survival of the kidney graft of deceased donor with expanded criteria and standard criteria over a year in a single transplant center. 255 kidney transplant recipients with deceased donor were included in the study between the years 2011 to 2013 and they were separated into two groups according to the type of donor (expanded criteria donor - ECD - and standard criteria donor - SCD). 231 deceased donor transplants (90.6%) were performed with standard criteria donor (SCD) and 24 (9.4%) with expanded criteria donor (ECD). There was no difference in the prevalence of delayed graft function - DGF - (62.9% vs. 70.8%; p = 0.44). Expanded criteria donor group had lower glomerular filtration rate (GFR) at the end of the 1st year (56.8 ± 26.9 vs. 76.9 ± 23.7; p = 0.001). Patient survival was significantly lower in the ECD group, but the graft survival was not different after death-censored analysis. The ECD group was associated with significantly lower levels of GFR during the first year of transplant and a lower patient survival at the 1st year when compared to the SCD. A aceitação dos rins com critério expandido de doação tem sido associada com melhor sobrevida do paciente em comparação àqueles que permanecem em terapia dialítica. Comparar a função renal e a sobrevida do enxerto renal de doador falecido critério expandido com os de doador falecido critério padrão ao longo de um ano em um único centro de transplantes. Foram incluídos 255 receptores de transplante renal com doador falecido, realizados entre os anos de 2011 a 2013, sendo divididos em dois grupos segundo o tipo de doador (critério expandido - DCE - ou padrão -DCP). Foram avaliados 231 receptores com doador critério ideal (90,6%) e 24 com doador critério expandido (9,4%). Não houve diferença na prevalência de fun

  2. Hypertension in standard criteria deceased donors is associated with inferior outcomes following kidney transplantation.

    Science.gov (United States)

    Singh, Rajinder P; Farney, Alan C; Rogers, Jeffrey; Gautreaux, Michael; Reeves-Daniel, Amber; Hartmann, Erica; Doares, William; Iskandar, Samy; Adams, Patricia; Stratta, Robert J

    2011-01-01

    Hypertension may be a either a cause or an effect of kidney disease. Although hypertension is an important component of the expanded criteria donor definition, risks of transplanting deceased donor kidneys from hypertensive standard criteria donors (SCD) are less well understood. Retrospective single-center study in all adult patients who received a deceased donor kidney transplant from a SCD to evaluate the role of donor hypertension as a pre-transplant risk factor for death-censored graft loss (DCGL) and renal function. From October 2001 through May 2008, 297 kidney transplants were performed from donation after brain death SCDs. A total of 47 (15.8%) grafts were lost, including 19 (6.4%) deaths with functioning grafts. Univariate analysis of death-censored cases (n = 278) identified history of donor hypertension, cold ischemia time (CIT) >30 h, and African American (AA) recipients as significant pre-transplant risk factors predictive for DCGL at five yr follow-up (mean 38 months, all p hypertension (relative risk 2.2, p = 0.04) to be a significant risk factor for DCGL, whereas CIT >30 h and AA recipient ethnicity showed only trends toward DCGL. Renal function as determined by serum creatinine levels was significantly higher in recipients of hypertensive compared with non-hypertensive SCD kidneys at all time points out to 48 months follow-up and the disparity in renal function increased over time. Transplanting SCD kidneys from hypertensive donors is associated with worse graft function and an increased risk of graft loss. © 2011 John Wiley & Sons A/S.

  3. Donor selection criteria and procurement

    International Nuclear Information System (INIS)

    Agcaoili, N.R.

    1999-01-01

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

  4. Eye bank procedures: donor selection criteria.

    Science.gov (United States)

    Sousa, Sidney Júlio de Faria E; Sousa, Stella Barretto de Faria E

    2018-01-01

    Eye banks use sterile procedures to manipulate the eye, antiseptic measures for ocular surface decontamination, and rigorous criteria for donor selection to minimize the possibility of disease transmission due to corneal grafting. Donor selection focuses on analysis of medical records and specific post-mortem serological tests. To guide and standardize procedures, eye bank associations and government agencies provide lists of absolute and relative contraindications for use of the tissue based on donor health history. These lists are guardians of the Hippocratic principle "primum non nocere." However, each transplantation carries risk of transmission of potentially harmful agents to the recipient. The aim of the procedures is not to eliminate risk, but limit it to a reasonable level. The balance between safety and corneal availability needs to be maintained by exercising prudence without disproportionate rigor.

  5. Criteria for selecting organ donors and recipients.

    Science.gov (United States)

    Michielsen, P

    1990-11-01

    As there is a world-wide shortage of organs for transplantation, the selection of the patients is more defined by the availability of transplantable organs than by the medical condition of the potential recipient. This shortage of cadaveric organs is mainly responsible for the use of living donors. With HLA identical sibling donors the results are better than with cadaveric organs, but the ethical problems are usually underestimated. For the parent-to-child donation, the HLA compatibility is less than what could be achieved with well-matched cadaveric donors. The use of genetically unrelated donors is unacceptable from the ethical as well as from the medical point of view. The short- and long-term risk of donation has been insufficiently documented. The experience with the introduction of an opting-out legislation in Belgium in 1987 demonstrates that the shortage of cadaveric organs can be overcome. Harmonization of the legislation is, however, necessary so as to achieve comparable organ retrieval rates between countries participating in organ-exchange organisations.

  6. Expanded criteria donor kidneys for younger recipients: acceptable outcomes.

    Science.gov (United States)

    Goplani, K R; Kute, V B; Vanikar, A V; Shah, P R; Gumber, M R; Patel, H V; Modi, P R; Trivedi, H L

    2010-12-01

    European senior programme (ESP) is well known for acceptable outcomes using expanded criteria donor (ECD) kidneys from donors older than 65 years for recipients older than 65 years. The incidence of end-stage renal disease (ESRD) is 229/million in India with a mean age of 45 years. We performed a retrospective analysis of transplantation of ECD versus standard criteria donor (SCD) kidneys into younger recipients. Forty-three ECD transplantations among 158 deceased donor organ transplantation (DDOT) were performed between January 2006 and December 2009. Among 43 transplantation from 30 donors, 14 were dual kidney transplantations (DKT) performed based upon biopsy evaluation. All recipients received thymoglobulin (rATG) induction followed by immunosuppression with a steroid, mycophenolate mofetil (MMF), and a calcineurin inhibitor. Statistical analysis used chi-square test and unpaired Student t test. Kaplan-Meier curves were used for survival analysis. For ECD the mean donor age was 64 ± 11 years. Cerebrovascular accidents (CVA) were the cause of death among 60% of donors, 73.13% of whom were hypertensive and 23.13% diabetic. Mean DKT donor age was 75 ± 9.17 years versus 60 ± 8.0 years for single kidney transplantation (SKT). Mean recipient age of DKT versus SKT was 44 ± 12.4 years versus 43 ± 14 years. Mean serum creatinine (SCr; mg/dL) of SKT patients was 1.64 ± 0.75 versus 1.68 ± 0.46 in DKT. Mean follow-up was 455 ± 352 days. Mean SCr of 43 ECD recipients of mean age, 43.4 ± 14.2 years was 1.61 ± 0.61 mg/dL. Among 43 recipients, 23.25% were diabetic, 41.86% displayed delayed graft function (DGF), and 23.25% experienced biopsy-proven acute rejection (BPAR). Patient survival rate was 72.09% and graft survival rate was 67.44%. For SCD transplantations (n = 115), the mean donor age was 36 ± 14 years and recipient mean age was 32.8 ± 14.07 years. Mean SCr was 1.32 ± 0.46 mg/dL with 26.95% recipients displaying DGF, whereas 20.86% had BPAR. In the SCD

  7. Deceased donor organ transplantation with expanded criteria donors: a single-center experience from India.

    Science.gov (United States)

    Goplani, K R; Firoz, A; Ramakrishana, P; Shah, P R; Gumber, M R; Patel, H V; Vanikar, A V; Trivedi, H L

    2010-01-01

    Deceased donor organ transplantation (DDOT) accounts for DKT) and 19 single (SKT). Fourteen donors had hypertension, a cerebrovascular accident as the cause of death, 9 had both, and 4 had diabetes. Mean donor age was 70.3 +/- 8.9 years. Decisions on the procedure were based upon frozen section biopsy in 13 of 21 donors. Mean DKT donor age was 76 +/- 9.7 years versu 64 +/- 5.7 years of SKT donors. The native kidney diseases were chronic glomerulonephritis (n = 14), diabetic nephropathy (n = 7), tubulointerstitial nephritis (n = 4) and polycystic kidney disease, focal segmental glomerulosclerosis, lupus nephritis and patchy cortical necrosis, (n = 1 each). Mean recipient age of DKT versus SKT was 43.5 versus 42.3 years. All recipients received rabbit anti-thymocyte globulin, followed by steroid, mycophenolate mofetil/calcinueurin inhibitor. Over a mean follow-up of 341 days, the mean serum creatinine (SCr) of 25/29 patients was 1.60 mg/dL (range, 1.0-2.6). The mean SCr of SKT patients was 1.59 +/- 0.63 mg/dL and of DKT, 1.62 +/- 0.48 mg/dL. Ten patients had delayed graft function and 11 had biopsy proven acute tubular necrosis. Seven (24%) patients had rejection (grade 3 Banff update '05, type IA; 4, type 2A); 6 responded to antirejection; 1 graft was lost at 7 months due to chronic rejection. Three (10.3%) patients were lost, 1 each due to AMI, sepsis, and CMV disease. In the circumstances of organ shortage, DDOT with expanded criteria donor is a feasible option.

  8. DOE Standard: Fire protection design criteria

    International Nuclear Information System (INIS)

    1999-07-01

    The development of this Standard reflects the fact that national consensus standards and other design criteria do not comprehensively or, in some cases, adequately address fire protection issues at DOE facilities. This Standard provides supplemental fire protection guidance applicable to the design and construction of DOE facilities and site features (such as water distribution systems) that are also provided for fire protection. It is intended to be used in conjunction with the applicable building code, National Fire Protection Association (NFPA) Codes and Standards, and any other applicable DOE construction criteria. This Standard replaces certain mandatory fire protection requirements that were formerly in DOE 5480.7A, ''Fire Protection'', and DOE 6430.1A, ''General Design Criteria''. It also contains the fire protection guidelines from two (now canceled) draft standards: ''Glove Box Fire Protection'' and ''Filter Plenum Fire Protection''. (Note: This Standard does not supersede the requirements of DOE 5480.7A and DOE 6430.1A where these DOE Orders are currently applicable under existing contracts.) This Standard, along with the criteria delineated in Section 3, constitutes the basic criteria for satisfying DOE fire and life safety objectives for the design and construction or renovation of DOE facilities

  9. Nonreactor nuclear facilities: standards and criteria guide

    International Nuclear Information System (INIS)

    Brynda, W.J.; Junker, L.; Karol, R.C.; Lobner, P.R.; Goldman, L.A.

    1981-09-01

    This guide is a source document that identifies standards, codes, and guides that address the nuclear safety considerations pertinent to nuclear facilities as defined in DOE Order 5480.1, Chapter V, Safety of Nuclear Facilities. The guidance and criteria provided are directed toward areas of safety usually addressed in a Safety Analysis Report. The areas of safety include, but are not limited to, siting, principal design criteria and safety system design guidelines, radiation protection, accident analysis, and quality assurance. The guide is divided into two sections: general guidelines and appendices. Those guidelines that are broadly applicable to most nuclear facilities are presented in the general guidelines. These general guidelines may have limited applicability to subsurface facilities such as waste repositories. Guidelines specific to the various types or categories of nuclear facilities are presented in the appendices. These facility-specific appendices provide guidelines and identify standards and criteria that should be considered in addition to, or in lieu of, the general guidelines

  10. Nonreactor nuclear facilities: Standards and criteria guide

    International Nuclear Information System (INIS)

    Brynda, W.J.; Scarlett, C.H.; Tanguay, G.E.; Lobner, P.R.

    1986-09-01

    This guide is a source document that identifies standards, codes, and guides that address the nuclear safety considerations pertinent to nuclear facilities as defined in DOE 5480.1A, Chapter V, ''Safety of Nuclear Facilities.'' The guidance and criteria provided is directed toward areas of safety usually addressed in a Safety Analysis Report. The areas of safety include, but are not limited to, siting, principal design criteria and safety system design guidelines, radiation protection, accident analysis, conduct of operations, and quality assurance. The guide is divided into two sections: general guidelines and appendices. Those guidelines that are broadly applicable to most nuclear facilities are presented in the general guidelines. Guidelines specific to the various types or categories of nuclear facilities are presented in the appendices. These facility-specific appendices provide guidelines and identify standards and criteria that should be considered in addition to, or in lieu of, the general guidelines. 25 figs., 62 tabs

  11. Rabbit antithymocyte globulin is more beneficial in standard kidney than in extended donor recipients.

    Science.gov (United States)

    Hardinger, Karen L; Brennan, Daniel C; Schnitzler, Mark A

    2009-05-15

    In a randomized, international study comparing rabbit antithymocyte globulin (TMG) and basiliximab (BAS) induction in renal transplant recipients at risk for delayed graft function or acute rejection (n=278), TMG was associated with less acute rejection at 1 year. This study analyzed outcomes stratified by standard criteria donor (SCD), extended criteria donor (ECD), and hypertensive donor. Data-capture limitations necessitated defining ECD as donor age more than 60 years or 50 to 60 years with hypertension and renal insufficiency. Seventy-five recipients received ECD-kidneys (28.4% TMG vs. 25.6% BAS, P=NS) and 203 recipients received SCD-kidneys (72.6% TMG vs. 74.4% BAS, P=NS). Recipients of an ECD or hypertensive donor-kidney had similar outcomes between treatment groups. Recipients of an SCD-kidney treated with TMG had less rejection (odds ratio [OR] 0.48). Recipients of a normotensive donor-kidney treated with TMG had less rejection (OR 0.56). Recipients of a normotensive, SCD-kidney treated with TMG had less rejection (OR 0.47) and death (OR 0.17) than their counterparts treated with BAS. Contrary to its perceived niche in recipients of ECD-kidneys, TMG was most beneficial in patients who received a normotensive, deceased SCD kidney.

  12. The impact of meeting donor management goals on the number of organs transplanted per expanded criteria donor: a prospective study from the UNOS Region 5 Donor Management Goals Workgroup.

    Science.gov (United States)

    Patel, Madhukar S; Zatarain, John; De La Cruz, Salvador; Sally, Mitchell B; Ewing, Tyler; Crutchfield, Megan; Enestvedt, C Kristian; Malinoski, Darren J

    2014-09-01

    The shortage of organs available for transplant has led to the use of expanded criteria donors (ECDs) to extend the donor pool. These donors are older and have more comorbidities and efforts to optimize the quality of their organs are needed. To determine the impact of meeting a standardized set of critical care end points, or donor management goals (DMGs), on the number of organs transplanted per donor in ECDs. Prospective interventional study from February 2010 to July 2013 of all ECDs managed by the 8 organ procurement organizations in the southwestern United States (United Network for Organ Sharing Region 5). Implementation of 9 DMGs as a checklist to guide the management of every ECD. The DMGs represented normal cardiovascular, pulmonary, renal, and endocrine end points. Meeting the DMG bundle was defined a priori as achieving any 7 of the 9 end points and was recorded at the time of referral to the organ procurement organization, at the time of authorization for donation, 12 to 18 hours later, and prior to organ recovery. The primary outcome measure was 3 or more organs transplanted per donor and binary logistic regression was used to identify independent predictors with P organs transplanted per donor. Ten percent of the ECDs had met the DMG bundle at referral, 15% at the time of authorization, 33% at 12 to 18 hours, and 45% prior to recovery. Forty-three percent had 3 or more organs transplanted per donor. Independent predictors of 3 or more organs transplanted per donor were older age (odds ratio [OR] = 0.95 per year [95% CI, 0.93-0.97]), increased creatinine level (OR = 0.73 per mg/dL [95% CI, 0.63-0.85]), DMGs met prior to organ recovery (OR = 1.90 [95% CI, 1.35-2.68]), and a change in the number of DMGs achieved from referral to organ recovery (OR = 1.11 per additional DMG [95% CI, 1.00-1.23]). Meeting DMGs prior to organ recovery with ECDs is associated with achieving 3 or more organs transplanted per donor. An increase in the number

  13. 76 FR 51041 - Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop

    Science.gov (United States)

    2011-08-17

    ...] Hemoglobin Standards and Maintaining Adequate Iron Stores in Blood Donors; Public Workshop AGENCY: Food and... Donors.'' The purpose of this public workshop is to discuss blood donor hemoglobin and hematocrit qualification standards in the United States, its impact on donor safety and blood availability, and potential...

  14. Dual Kidney Allocation Score: A Novel Algorithm Utilizing Expanded Donor Criteria for the Allocation of Dual Kidneys in Adults.

    Science.gov (United States)

    Johnson, Adam P; Price, Thea P; Lieby, Benjamin; Doria, Cataldo

    2016-09-08

    BACKGROUND Dual kidney transplantation (DKT) of expanded-criteria donors is a cost-intensive procedure that aims to increase the pool of available deceased organ donors and has demonstrated equivalent outcomes to expanded-criteria single kidney transplantation (eSKT). The objective of this study was to develop an allocation score based on predicted graft survival from historical dual and single kidney donors. MATERIAL AND METHODS We analyzed United Network for Organ Sharing (UNOS) data for 1547 DKT and 26 381 eSKT performed between January 1994 and September 2013. We utilized multivariable Cox regression to identify variables independently associated with graft survival in dual and single kidney transplantations. We then derived a weighted multivariable product score from calculated hazard ratios to model the benefit of transplantation as dual kidneys. RESULTS Of 36 donor variables known at the time of listing, 13 were significantly associated with graft survival. The derived dual allocation score demonstrated good internal validity with strong correlation to improved survival in dual kidney transplants. Donors with scores less than 2.1 transplanted as dual kidneys had a worsened median survival of 594 days (24%, p-value 0.031) and donors with scores greater than 3.9 had improved median survival of 1107 days (71%, p-value 0.002). There were 17 733 eSKT (67%) and 1051 DKT (67%) with scores in between these values and no differences in survival (p-values 0.676 and 0.185). CONCLUSIONS We have derived a dual kidney allocation score (DKAS) with good internal validity. Future prospective studies will be required to demonstrate external validity, but this score may help to standardize organ allocation for dual kidney transplantation.

  15. Aerosol exposure: Concepts, criteria, standards and applications

    International Nuclear Information System (INIS)

    Vincent, James H

    2009-01-01

    This paper places Inhaled Particles X in the context of the whole sequence of such symposia, going back to the first one in 1961. It draws together some of the essential principles that have been learned since that earlier meeting about the nature of exposure and exposure assessment and thus provides a framework by which to integrate the new knowledge presented at this latest one. In the process, the importance of understanding the formal definition of aerosol exposure is stressed, including the distinction between exposure intensity and exposure history, and how that relates to some measure of cumulative dose which, in turn, may be linked with knowledge about intrinsic toxicity, etc. This then leads to a definition of exposure standards, and the important ingredients of criteria, sampling and limit values. A summary is provided of the current set of particle size-selective criteria that have been widely agreed in the international occupational and environmental health community. Some ideas are presented about how this set might be expanded for certain applications, the important case of ultrafine aerosols being one of them.

  16. Crew Transportation Technical Standards and Design Evaluation Criteria

    Science.gov (United States)

    Lueders, Kathryn L.; Thomas, Rayelle E. (Compiler)

    2015-01-01

    Crew Transportation Technical Standards and Design Evaluation Criteria contains descriptions of technical, safety, and crew health medical processes and specifications, and the criteria which will be used to evaluate the acceptability of the Commercial Providers' proposed processes and specifications.

  17. Inflammatory markers as selection criteria of hepatocellular carcinoma in living-donor liver transplantation.

    Science.gov (United States)

    Na, Gun Hyung; Kim, Dong Goo; Han, Jae Hyun; Kim, Eun Young; Lee, Soo Ho; Hong, Tae Ho; You, Young Kyoung

    2014-06-07

    To investigate that inflammatory markers can predict accurately the prognosis of hepatocelluar carcinoma (HCC) patients in living-donor liver transplantation (LDLT). From October 2000 to November 2011, 224 patients who underwent living donor liver transplantation for HCC at our institution were enrolled in this study. We analyzed disease-free survival (DFS) and overall survival (OS) after LT in patients with HCC and designed a new score model using pretransplant neutrophil-lymphocyte ratio (NLR) and C-reactive protein (CRP). The DFS and OS in patients with an NLR level ≥ 6.0 or CRP level ≥ 1.0 were significantly worse than those of patients with an NLR level < 6.0 or CRP level < 1.0 (P = 0.049, P = 0.003 for NLR and P = 0.010, P < 0.001 for CRP, respectively). Using a new score model using the pretransplant NLR and CRP, we can differentiate HCC patients beyond the Milan criteria with a good prognosis from those with a poor prognosis. Combined with the Milan criteria, new score model using NLR and CRP represent new selection criteria for LDLT candidates with HCC, especially beyond the Milan criteria.

  18. Early declaration of death by neurologic criteria results in greater organ donor potential.

    Science.gov (United States)

    Resnick, Shelby; Seamon, Mark J; Holena, Daniel; Pascual, Jose; Reilly, Patrick M; Martin, Niels D

    2017-10-01

    Aggressive management of patients prior to and after determination of death by neurologic criteria (DNC) is necessary to optimize organ recovery, transplantation, and increase the number of organs transplanted per donor (OTPD). The effects of time management are understudied but potentially pivotal component. The objective of this study was to analyze specific time points (time to DNC, time to procurement) and the time intervals between them to better characterize the optimal timeline of organ donation. Using data over a 5-year time period (2011-2015) from the largest US OPO, all patients with catastrophic brain injury and donated transplantable organs were retrospectively reviewed. Active smokers were excluded. Maximum donor potential was seven organs (heart, lungs [2], kidneys [2], liver, and pancreas). Time from admission to declaration of DNC and donation was calculated. Mean time points stratified by specific organ procurement rates and overall OTPD were compared using unpaired t-test. Of 1719 Declaration of Death by Neurologic Criteria organ donors, 381 were secondary to head trauma. Smokers and organs recovered but not transplanted were excluded leaving 297 patients. Males comprised 78.8%, the mean age was 36.0 (±16.8) years, and 87.6% were treated at a trauma center. Higher donor potential (>4 OTPD) was associated with shorter average times from admission to brain death; 66.6 versus 82.2 hours, P = 0.04. Lung donors were also associated with shorter average times from admission to brain death; 61.6 versus 83.6 hours, P = 0.004. The time interval from DNC to donation varied minimally among groups and did not affect donation rates. A shorter time interval between admission and declaration of DNC was associated with increased OTPD, especially lungs. Further research to identify what role timing plays in the management of the potential organ donor and how that relates to donor management goals is needed. Copyright © 2017 Elsevier Inc. All rights

  19. Estimation of standard liver volume in Chinese adult living donors.

    Science.gov (United States)

    Fu-Gui, L; Lu-Nan, Y; Bo, L; Yong, Z; Tian-Fu, W; Ming-Qing, X; Wen-Tao, W; Zhe-Yu, C

    2009-12-01

    To determine a formula predicting the standard liver volume based on body surface area (BSA) or body weight in Chinese adults. A total of 115 consecutive right-lobe living donors not including the middle hepatic vein underwent right hemi-hepatectomy. No organs were used from prisoners, and no subjects were prisoners. Donor anthropometric data including age, gender, body weight, and body height were recorded prospectively. The weights and volumes of the right lobe liver grafts were measured at the back table. Liver weights and volumes were calculated from the right lobe graft weight and volume obtained at the back table, divided by the proportion of the right lobe on computed tomography. By simple linear regression analysis and stepwise multiple linear regression analysis, we correlated calculated liver volume and body height, body weight, or body surface area. The subjects had a mean age of 35.97 +/- 9.6 years, and a female-to-male ratio of 60:55. The mean volume of the right lobe was 727.47 +/- 136.17 mL, occupying 55.59% +/- 6.70% of the whole liver by computed tomography. The volume of the right lobe was 581.73 +/- 96.137 mL, and the estimated liver volume was 1053.08 +/- 167.56 mL. Females of the same body weight showed a slightly lower liver weight. By simple linear regression analysis and stepwise multiple linear regression analysis, a formula was derived based on body weight. All formulae except the Hong Kong formula overestimated liver volume compared to this formula. The formula of standard liver volume, SLV (mL) = 11.508 x body weight (kg) + 334.024, may be applied to estimate liver volumes in Chinese adults.

  20. The Standardization of Tests: Criteria and Criticisms

    Science.gov (United States)

    Weiner, Paul S.; Hoock, William C.

    1973-01-01

    Following a review of the procedures involved in the establishment of norms for standardized tests, the specific procedures used to establish norms for three tests commonly used in speech and language pathology are critically examined. (LS)

  1. Extended criteria donor kidney transplantation: comparative outcome analysis between single versus double kidney transplantation at 5 years.

    Science.gov (United States)

    Lucarelli, G; Bettocchi, C; Battaglia, M; Impedovo, S V; Vavallo, A; Grandaliano, G; Castellano, G; Schena, F P; Selvaggi, F P; Ditonno, P

    2010-05-01

    Dual kidney transplantation (DKT), using extended criteria donor (ECD) grafts not suitable for single kidney transplantation (SKT), has been suggested to expand the kidney donor pool. Herein, we reviewed the long-term outcomes of DKT to assess its results versus a control group of 179 ECD SKTs. The allocation policy was based on a Remuzzi score obtained from a pretransplant biopsy. We analyzed SKT in 179 (31.8%) and DKT in 41 (7.3%) of 563 cadaveric transplants from 2000 to 2008. Patients with DKT versus SKT showed mean recipient ages of 54 versus 51 years. We performed 17 ipsilateral and 24 bilateral DKT. The mean score was 2.78 for SKT and 4.3/4.6 for DKT. Delayed graft function requiring dialysis occurred in 23 (56.1%) DKT and 70 (39.1%) SKT recipients. Primary nonfunction was observed in 1 (2.4%) DKT and 7 (3.9%) SKT recipients respectively. One DKT patient underwent monolateral transplantectomy. In the DKT versus SKT group, patient survivals were 92% versus 95%, 89% versus 93%, and 89 versus 91% at 12, 36, and 60 months, respectively (P = .3). Graft survivals were 100% versus 94%, 95% versus 90%, and 89% versus 78% at 12, 36, and 60 months, respectively (P DKT. ECD graft survival using DKT provided better results compared with SKT, despite the use of organs from higher-risk donors. At 5 years follow-up, DKT was a safe strategy to face the organ shortage. To optimize the use of available kidneys, the criteria for DKT require further refinement and standardization. Preimplantation evaluation must maximize transplant success and protect recipients from receiving organs at increased risk of premature failure. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  2. Who should donate blood? Policy decisions on donor deferral criteria should protect recipients and be fair to donors.

    Science.gov (United States)

    Brailsford, S R; Kelly, D; Kohli, H; Slowther, A; Watkins, N A

    2015-08-01

    An important element in the development of voluntary blood donation schemes throughout the world has been the attention given to minimising the risk to recipients of donated blood, primarily the risk of transfusion transmitted infections. In response to the appearance of human immunodeficiency virus (HIV) in the 1980s a range of national policies emerged that excluded populations at high risk of contracting HIV from donating blood, with a particular focus on men who have sex with men (MSM), the primary reason being the protection of recipients of donated blood. Recently some countries, including the UK, have revised their policies, informed by advances in screening tests, epidemiological evidence of transmission rates and an increasing concern about unfair discrimination of specific groups in society. Policy makers face a difficult task of balancing safety of recipients; an adequate blood supply for those who require transfusion; and societal/legal obligations to treat everyone fairly. Given that no transfusion is risk free, the question is what degree of risk is acceptable in order to meet the needs of recipients and society. Decisions about acceptance of risk are complex and policy makers who set acceptable risk levels must provide ethically justifiable reasons for their decisions. We suggest it is possible to provide a set of reasons that stakeholders could agree are relevant based on careful evaluation of the evidence of all relevant risks and explicit acknowledgement of other morally relevant values. We describe using such a process in the Safety of Blood Tissue and Organs (SaBTO) review of donor deferral criteria related to sexual behaviour. © 2015 British Blood Transfusion Society.

  3. Top-level regulatory criteria for the standard MHTGR

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1986-10-15

    The Licensing Plan for the Standard MHTGR (Ref. 1) describes a program to support a U.S. Nuclear Regulatory Commission (NRC) design review and approval. The Plan calls for the submittal of Top-Level Regulatory Criteria to the NRC for concurrence with their completeness and acceptability for the MHTGR program. The Top-Level Regulatory Criteria are defined as the standards for judging licensability that directly specify acceptable limits for protection of the public health and safety and the environment. The criteria proposed herein are for normal plant operation and a broad spectrum of anticipated events, including accidents. The approach taken is to define a set of criteria which are general as opposed to being design specific. Specifically, it is recommended that criteria be met which: 1. Are less prescriptive than current regulation, thereby encouraging maximum flexibility in design approaches. 2. Are measurable. 3. Are not more strict than the criteria for current power plants.

  4. Resource utilization associated with procurement of transplantable organs from donors that do not meet OPTN eligible death criteria.

    Science.gov (United States)

    DuBay, Derek A; Redden, David T; Bryant, Mary K; Dorn, David P; Fouad, Mona N; Gray, Stephen H; White, Jared A; Locke, Jayme E; Meeks, Christopher B; Taylor, Garry C; Kilgore, Meredith L; Eckhoff, Devin E

    2014-05-27

    The strategy of evaluating every donation opportunity warrants an investigation into the financial feasibility of this practice. The purpose of this investigation is to measure resource utilization required for procurement of transplantable organs in an organ procurement organization (OPO). Donors were stratified into those that met OPTN-defined eligible death criteria (ED donors, n=589) and those that did not (NED donors, n=703). Variable direct costs and time utilization by OPO staff for organ procurement were measured and amortized per organ transplanted using permutation methods and statistical bootstrapping/resampling approaches. More organs per donor were procured (3.66±1.2 vs. 2.34±0.8, Pdonors compared with NED donors. The variable direct costs were significantly lower in the NED donors ($29,879.4±11590.1 vs. $19,019.6±7599.60, Porgan transplanted were significantly higher in the NED donors ($8,414.5±138.29 vs. $9,272.04±344.56, Pdonors where thoracic organ procurement occurred were 67% more expensive than in abdominal-only organ procurement. The total time allocated per donor was significantly shorter in the NED donors (91.2±44.9 hr vs. 86.8±78.6 hr, P=0.01). In contrast, the amortized time per organ transplanted was significantly longer in the NED donors (23.1±0.8 hr vs. 36.9±3.2 hr, Porgan transplanted is significantly higher in donors that do not meet the eligible death criteria.

  5. Section 4. Further expanding the criteria for HCC in living donor liver transplantation: the Tokyo University experience.

    Science.gov (United States)

    Tamura, Sumihito; Sugawara, Yasuhiko; Kokudo, Norihiro

    2014-04-27

    In Asia, evidence-based guidelines for the management of hepatocellular carcinoma (HCC) have evolved, including the option of liver transplantation. Because of the continuing serious organ shortage, however, living donor liver transplantation (LDLT) remains the mainstream in Japan. Unlike deceased donor transplantation, living donor transplantation is not always limited by the restrictions imposed by the nationwide organ allocation system. The decision for transplantation may depend on institutional or case-by-case considerations, balancing the will of the donor, the operative risk, and the overall survival benefit. Cumulative data from the Japanese national multicenter registry analysis as well as individual center experiences suggest further expanding the criteria for LDLT for HCC from the Milan criteria is feasible with acceptable outcomes.

  6. Dual kidney transplantation involving organs from expanded criteria donors: a review of our series and an update on current indications.

    Science.gov (United States)

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

    2014-12-01

    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 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.

  7. Standards, criteria, comparative study. Final report 1993-1994

    International Nuclear Information System (INIS)

    David, M.

    1995-01-01

    The goal of this report is to compare standards and criteria used for the design of seismic resistant Nuclear Power plants in former USSR and Eastern Europe to the actual practice in Western Europe and USA. A review of USSR and Czech-Slovak standards for design of WWER-1000 NPPs is included. Comparative study deals involves a general comparison of standards and the comparison of seismic loads according to Eastern standards with the to-day practices. According to these comparisons it can be theoretically concluded that despite some differences the structural seismic forces calculated according to Soviet-Russian standards are in good agreement with the ones resulting from Western Standards

  8. Evolving minimum standards in responsible international sperm donor offspring quota

    NARCIS (Netherlands)

    Janssens, Pim M. W.; Thorn, Petra; Castilla, Jose A.; Frith, Lucy; Crawshaw, Marilyn; Mochtar, Monique; Bjorndahl, Lars; Kvist, Ulrik; Kirkman-Brown, Jackson C.

    2015-01-01

    An international working group was established with the aim of making recommendations on the number of offspring for a sperm donor that should be allowable in cases of international use of his sperm. Considerations from genetic, psychosocial, operational and ethical points of view were debated. For

  9. Validation of KDRI/KDPI for the selection of expanded criteria kidney donors

    Directory of Open Access Journals (Sweden)

    Raimundo M. García del Moral Martín

    2018-05-01

    Full Text Available Introduction: KDRI/KDPI are tools use in kidney donor evaluation. It has been proposed as a substitute of, or complementary to preimplantation renal biopsy. These scores have not been validated in Spain. Objective: (1 To investigate the concordance between KDPI and histological scores (preimplantation renal biopsy and (2 to assess the relationship between KDRI, KDPI and histological score on graft survival in the expanded criteria donors group. Methodology: Retrospective cohort study from 1 January 1998 to 31 December 2010. Results: During the study 120 donors were recruited, that resulted in 220 preimplantation renal biopsies. 144 (65% grafts were considered suitable for kidney transplantation. 76 (34.5% were discarded. Median follow up has been 6.4 years (sd 3.9. Median age 63.1 years (sd 8.2, males (145; 65.9%, non-diabetic (191; 86.8% and without another cardiovascular risk factors (173; 78.6%. 153 (69.5% donors died of cerebrovascular disease. There were significant differences in KDRI/KDPI score in both groups 1.56/89 (sd 0.22 vs 1.66/93 (sd 0.15, p < 0.01. The KDPI showed moderate concordance and correlation with the histological score (AUC 0.64/correlation coefficient 0.24, p < 0.01. KDPI (HR 24.3, p < 0.01 and KDRI (HR 23.3, p < 0.01 scores were associated with graft survival in multivariate analysis. Conclusion: (1 KPDI and histological scores show moderate concordance. The utility of both scores as combined tools it has to be determined. (2 KDPI score, and especially KDRI score, are valid for estimating graft survival and combined with the biopsy can help to individualized decision making in the expanded criteria donors pool. Resumen: Introducción: El KDRI y su variante KDPI son dos herramientas utilizadas para la valoración del donante renal. Se ha propuesto la utilidad del KDPI como sustituto/complementario a la biopsia renal preimplantación. Estos scores no están validados en España. Objetivo: 1 Investigar la

  10. Safety Criteria and Standards for Bearing Capacity of Foundation

    Directory of Open Access Journals (Sweden)

    Yanlong Li

    2017-01-01

    Full Text Available This paper focuses on the evaluation standards of factor of safety for foundation stability analysis. The problem of foundation stability is analyzed via the methods of risk analysis of engineering structures and reliability-based design, and the factor of safety for foundation stability is determined by using bearing capacity safety-factor method (BSFM and strength safety-factor method (SSFM. Based on a typical example, the admissible factors of safety were calibrated with a target reliability index specified in relevant standards. Two safety criteria and their standards of bearing capacity of foundation for these two methods (BSFM and SSFM were established. The universality of the safety criteria and their standards for foundation reliability was verified based on the concept of the ratio of safety margin (RSM.

  11. Dual kidney transplantation as a strategy to use expanded criteria donors: a systematic review.

    Science.gov (United States)

    Montero, Nuria; Redondo-Pachón, Dolores; Pérez-Sáez, María José; Crespo, Marta; Cruzado, Josep M; Pascual, Julio

    2018-03-27

    The objective of this review was to assess whether dual kidney transplantation (DKT) is better than single KT (SKT) for optimizing the use of expanded criteria donor kidneys. We did a systematic literature search and meta-analyses when possible, pooling data for calculating relative risks (RR) of major outcomes. Twenty-five studies met the inclusion criteria. One-year serum creatinine was better after DKT vs. SKT (mean difference -0.27 [-0.37, -0.17], P DKT (RR 0.88 [0.76, 1.02], P = 0.09). Mortality at 1 and 3 years was similar after dual or SKT, but mortality at five years was lower after DKT (RR 0.71 [0.53, 0.94], P = 0.02). One-year graft loss was similar between dual (n = 4158) and SKT (n = 51 800) (RR 0.97 [0.87, 1.09], P = 0.62). Three- and five-year graft loss was not considered because of high heterogeneity between studies. In conclusion, short-term graft function and long-term patient survival are better in recipients receiving DKT vs. SKT. However, these differences are based on few retrospective reports with a relatively low number of cases. Good quality randomized controlled trials are needed to assess whether the investment of two kidneys in one recipient is justified in face of the current organ shortage. © 2018 Steunstichting ESOT.

  12. Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial

    Directory of Open Access Journals (Sweden)

    Alwayn Ian PJ

    2010-03-01

    Full Text Available Abstract Background Transplantation is the only treatment offering long-term benefit to patients with chronic kidney failure. Live donor nephrectomy is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves. In order to guarantee the donor's safety, it is important to optimise the surgical approach. Recently we demonstrated the benefit of laparoscopic nephrectomy experienced by the donor. However, this method is characterised by higher in hospital costs, longer operating times and it requires a well-trained surgeon. The hand-assisted retroperitoneoscopic technique may be an alternative to a complete laparoscopic, transperitoneal approach. The peritoneum remains intact and the risk of visceral injuries is reduced. Hand-assistance results in a faster procedure and a significantly reduced operating time. The feasibility of this method has been demonstrated recently, but as to date there are no data available advocating the use of one technique above the other. Methods/design The HARP-trial is a multi-centre randomised controlled, single-blind trial. The study compares the hand-assisted retroperitoneoscopic approach with standard laparoscopic donor nephrectomy. The objective is to determine the best approach for live donor nephrectomy to optimise donor's safety and comfort while reducing donation related costs. Discussion This study will contribute to the evidence on any benefits of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy. Trial Registration Dutch Trial Register NTR1433

  13. On criteria for examining analysis quality with standard reference material

    International Nuclear Information System (INIS)

    Yang Huating

    1997-01-01

    The advantages and disadvantages and applicability of some criteria for examining analysis quality with standard reference material are discussed. The combination of the uncertainties of the instrument examined and the reference material should be determined on the basis of specific situations. Without the data of the instrument's uncertainty, it would be applicable to substitute the standard deviation multiplied by certain times for the uncertainty. The result of the examining should not result in more error reported in routine measurements than it really is. Over strict examining should also be avoided

  14. EPA's LLW standards program: Below regulatory concern criteria development

    International Nuclear Information System (INIS)

    Holcomb, W.F.; Gruhlke, J.M.

    1987-01-01

    The Environmental Protection Agency (EPA) is developing generally applicable environmental standards for land disposal of low-level radioactive wastes. These standards will include criteria for determining which wastes have sufficiently low levels of radioactivity to be considered ''Below Regulatory Concern'' (BRC) in regards to their radiation hazard. Risk assessments to support the BRC criteria include an analysis of 18 surrogate radioactive waste streams, generated by nuclear power reactors and other fuel cycle facilities, industrial, medical and educational facilities, and consumers. Deregulated disposal alternatives, such as sanitary landfills, municipal dumps, incinerators and on-site landfills, situated in diverse demographic settings are used in the analysis. A number of waste streams which contributed only small doses or fractions of a health effect over 10,000 years were identified. Disposal of such wastes without consideration of their very low radioactivity could result in significant cost savings to the commercial fuel cycle and government operations as well as to medical, educational, and industrial facilities, and with minimal risk to the public. The concept of BRC wastes appears both feasible and cost effective

  15. Standard guide for design criteria for plutonium gloveboxes

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2009-01-01

    1.1 This guide defines criteria for the design of glovebox systems to be used for the handling of plutonium in any chemical or physical form or isotopic composition or when mixed with other elements or compounds. Not included in the criteria are systems auxiliary to the glovebox systems such as utilities, ventilation, alarm, and waste disposal. Also not addressed are hot cells or open-face hoods. The scope of this guide excludes specific license requirements relating to provisions for criticality prevention, hazards control, safeguards, packaging, and material handling. Observance of this guide does not relieve the user of the obligation to conform to all federal, state, and local regulations for design and construction of glovebox systems. 1.2 The values stated in SI units are to be regarded as the standard. The values given in parentheses are for information only. 1.3 This standard does not purport to address all of the safety problems, if any, associated with its use. It is the responsibility of the user...

  16. Comparative Analysis of Norwegian Passive House Criteria and of Criteria related to the Concept of International Passive House Standard

    DEFF Research Database (Denmark)

    Anton, Karin; Vestergaard, Inge

    2013-01-01

    The analysis shows differences in definition of apssive house criterias. It also communicates issues os the passive house concept that are nor completely transferred by the Norwegian passive house standard.......The analysis shows differences in definition of apssive house criterias. It also communicates issues os the passive house concept that are nor completely transferred by the Norwegian passive house standard....

  17. The effect of a standardized protocol for iron supplementation to blood donors low in hemoglobin concentration.

    Science.gov (United States)

    Magnussen, Karin; Bork, Nanna; Asmussen, Lisa

    2008-04-01

    Iron deficiency leading to low hemoglobin concentration (cHb) is a common problem for blood donors as well as for blood banks. A standardized protocol offering iron supplementation based on P-ferritin determination may help to reduce the problem and retain donors. This was a prospective study where 879 blood donors, presenting with cHb at or below the limit of acceptance for donation, were included. The predonation cHb result was read after donation. The donors received 50 iron tablets (JernC or Ferrochel, 100 or 25 mg elemental iron, respectively), and samples for P-ferritin, mean corpuscular volume, and control of cHb were secured. Based on a P-ferritin level of less than 60 microg per L, 20 iron tablets were offered after all following donations. Mean cHb was 7.6 mmol per L (122 g/L) and 8.2 mmol per L (132 g/L) in women and men, respectively. In 80 percent of the women and 48 percent of the men, iron stores were low (P-ferritin protocol offering iron supplementation and simple oral and written advice based on P-ferritin measurements is effective in normalizing cHb and retaining donors presenting with cHb at or below the limit of acceptance for donation.

  18. 78 FR 38735 - Autopsy Performance Criteria: Standards, Guidelines and Best Practices

    Science.gov (United States)

    2013-06-27

    ... DEPARTMENT OF JUSTICE Office of Justice Programs [OJP (NIJ) Docket No. 1626] Autopsy Performance Criteria: Standards, Guidelines and Best Practices AGENCY: National Institute of Justice, DOJ. ACTION... entitled, ``Autopsy Performance Criteria: Standards, Guidelines and Best Practices''. The opportunity to...

  19. 29 CFR 1630.7 - Standards, criteria, or methods of administration.

    Science.gov (United States)

    2010-07-01

    ... Standards, criteria, or methods of administration. It is unlawful for a covered entity to use standards, criteria, or methods of administration, which are not job-related and consistent with business necessity... 29 Labor 4 2010-07-01 2010-07-01 false Standards, criteria, or methods of administration. 1630.7...

  20. Common Risk Criteria Standards for National Test Ranges

    Science.gov (United States)

    2016-08-01

    supplemental) document to RCC Document 321. a. Modified aircraft vulnerability criteria for business class jets. b. Modified the aircraft vulnerability... successful , the logical relationships among criteria used at the test ranges and across different hazards are often difficult to comprehend. The...provides a common set of range safety policies, risk criteria, and guidelines for managing risk to people and assets during manned and unmanned

  1. The safety of donor skin preserved with glycerol - Evaluating the Euro Skin Bank preservation procedures of human donor skin against the prEN 12442 standard

    NARCIS (Netherlands)

    Geertsma RE; Wassenaar C; LGM

    2000-01-01

    The procedures for preservation of human donor skin with glycerol, as applied by the Euro Skin Bank (ESB), were evaluated against the prEN 12442 standard: animal tissues and their derivatives used in the manufacture of medical devices. The focus chosen for this review is on risks related to the

  2. Implementation of multimode release criteria and dose standard alternatives

    International Nuclear Information System (INIS)

    Klett, R.

    1993-01-01

    The current standard that regulates the disposal of high-level radioactive wastes (HLW) and transuranic (TRU) wastes evaluates the cumulative risk of all repositories with a single derived set of generic release limits. This paper reviews the technical basis, attributes, and deficiencies of the present approach and two alternative modifications and extensions. The alternatives are the multimode release limits applied at the point of release and a dose standard alternative suggested at the first Electric Power Research Institute (EPRI) waste disposal workshop. Methods of developing and applying the alternatives are presented and some suggestions are given for incorporating them in the standards

  3. [Measurement of CO diffusion capacity (II): Standardization and quality criteria].

    Science.gov (United States)

    Salcedo Posadas, A; Villa Asensi, J R; de Mir Messa, I; Sardón Prado, O; Larramona, H

    2015-08-01

    The diffusion capacity is the technique that measures the ability of the respiratory system for gas exchange, thus allowing a diagnosis of the malfunction of the alveolar-capillary unit. The most important parameter to assess is the CO diffusion capacity (DLCO). New methods are currently being used to measure the diffusion using nitric oxide (NO). There are other methods for measuring diffusion, although in this article the single breath technique is mainly referred to, as it is the most widely used and best standardized. Its complexity, its reference equations, differences in equipment, inter-patient variability and conditions in which the DLCO is performed, lead to a wide inter-laboratory variability, although its standardization makes this a more reliable and reproductive method. The practical aspects of the technique are analyzed, by specifying the recommendations to carry out a suitable procedure, the calibration routine, calculations and adjustments. Clinical applications are also discussed. An increase in the transfer of CO occurs in diseases in which there is an increased volume of blood in the pulmonary capillaries, such as in the polycythemia and pulmonary hemorrhage. There is a decrease in DLCO in patients with alveolar volume reduction or diffusion defects, either by altered alveolar-capillary membrane (interstitial diseases) or decreased volume of blood in the pulmonary capillaries (pulmonary embolism or primary pulmonary hypertension). Other causes of decreased or increased DLCO are also highlighted. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  4. Technical evaluation of draft ANSI Standard N13.30, ''performance criteria for radiobioassay''

    International Nuclear Information System (INIS)

    MacLellan, J.A.; Traub, R.J.

    1986-03-01

    The Pacific Northwest Laboratory (PNL) is conducting a research program to evaluate the appropriateness of criteria in the ANSI draft Standard N13.30, ''Performance Criteria for Radiobioassay.'' The evaluation has progressed parallel with the preparation of the Standard by evaluating the performance of existing bioassay laboratories against the criteria specified. Recommendations for revision of the Standard and implementation of a testing/accreditation program have been formulated based on study results. The current performance testing program includes both in-vivo counting and in-vitro sample measurements. Test criteria specified in the Standard include relative bias, relative precision, and acceptable minimum detectable activity (AMDA). Results to date have indicated that the acceptance criteria in the Standard are appropriate for the existing state of the industry and are achievable by a majority of the participating laboratories. Specific conclusions are that the AMDA criteria are most difficult for the laboratories to achieve; the relative bias criterion is second in difficulty, and the precision criterion presents no problem for the laboratories; most of the participating laboratories can meet the Standard; and failure rates may decrease as the laboratories become more knowledgeable of the performance criteria. 3 refs., 11 figs., 6 tabs

  5. 78 FR 20252 - Water Quality Standards; Withdrawal of Certain Federal Water Quality Criteria Applicable to...

    Science.gov (United States)

    2013-04-04

    ... Water Quality Standards; Withdrawal of Certain Federal Water Quality Criteria Applicable to California... aquatic life water quality criteria applicable to waters of New Jersey, Puerto Rico, and California's San Francisco Bay. In 1992, EPA promulgated the National Toxics Rule or NTR to establish numeric water quality...

  6. Development of criteria and standards for management of low-level radioactive waste

    International Nuclear Information System (INIS)

    Grey, A.E.; Falconer, K.L.

    1980-08-01

    The basic need for criteria and standards for radioactive waste management is to ensure compliance with Federal and State regulations applicable to this activity. In addition, criteria and standards can establish the parameters by which a radioactive waste disposal site is selected, the form in which the waste is to be disposed, how a disposal site is to be operated, and how that site is to be closed when it reaches the end of its useful life. For developing criteria and standards, this report discusses the nature of low-level radioactive waste and the role government agencies play in regulating its management. It describes subject areas for which criteria and standards could be developed, current and evolving requirements, and future suggested analyses

  7. Alternative donor transplantation--"mixing and matching": the role of combined cord blood and haplo-identical donor transplantation (haplo-cord SCT) as a treatment strategy for patients lacking standard donors?

    Science.gov (United States)

    Liu, Hongtao; van Besien, Koen

    2015-03-01

    In the past decade, haplo-cord stem cell transplantation (SCT) using myeloablative or reduced intensive conditioning regimens has been shown to result in reliable and fast engraftment of neutrophils and platelets comparable to HLA-matched donors and much faster than after cord stem cell transplant. Haplo-cord SCT also has a low incidence of early non-relapse mortality, low incidences of acute and chronic graft-vs-host disease (GVHD), and excellent graft-vs-leukemia (GVL) effects. Favorable long-term outcomes for high-risk patients with hematologic malignancies have been reported, including older patients. Haplo-cord SCT will likely overcome the limitations of cell dose during cord stem cell selection and might significantly expand the use of cord stem cell transplant in the adult population. The comparable survival outcomes of matched related donor (MRD), matched unrelated donor (MUD), and haplo-cord stem cell transplant strongly argue that haplo-cord SCT should be considered as effective alternative stem cell transplant for high-risk patients lacking standard donors. Further improvement in supportive care and incorporation of a better understanding of the human fetal immune development into the haplo-cord SCT are required to further improve this strategy.

  8. Proposals for new standardized general diagnostic criteria for the secondary headaches

    DEFF Research Database (Denmark)

    Olesen, J; Steiner, T; Bousser, M-G

    2009-01-01

    headache and chronic migraine. These changes made apparent a further need for broader revisions to the standard formulation of diagnostic criteria for the secondary headaches. Currently, the fourth criterion makes impossible the definitive diagnosis of a secondary headache until the underlying cause has...... propose maintaining a standard approach to the secondary headaches using a set of four criteria A, B, C and D, but we construct these so that the requirement for resolution or successful treatment is removed. The proposal for general diagnostic criteria for the secondary headaches will be entered...... classification are then foreseen for the next 10 years. Until the printing of ICHD-IIR, the printed ICHD-II criteria remain in place for all other purposes. We issue a plea to the headache community to use and study these proposed general criteria for the secondary headaches in order to provide more evidence...

  9. What are the attributes of a good standard and associated criteria?

    International Nuclear Information System (INIS)

    Allentuck, J.

    1987-01-01

    The Department of Energy (DOE) Standards and Criteria (S and C) provide the framework upon which Office of Security Evaluations (OSE) inspections of safeguards and security at DOE facilities are conducted. The S and C were created to assure that inspections are comprehensive, standardized to the extent possible and accurately reported in meaningful terms, and that assessments are objective. With these goals in mind, the desirable attributes of a standard and its associated criteria are relevance, inspectability, and limited need for inspector judgement. 1 fig

  10. [Criteria for the assessment of the noise-induced occupational hearing loss: international and national standards].

    Science.gov (United States)

    Izmerov, N F; Denisov, É I; Adeninskaia, E E; Gorblianskiĭ, Iu Iu

    2014-01-01

    The objective of the present paper was to review international and national standards for the criteria of assessment of the noise-induced occupational loss of hearing. The importance of healthy hearing for the occupational safety is emphasized which implies the necessity of the more rigorous criteria for hearing conservation in the workers engaged in the noisy technological environment compared with those for the general population. A rationale for the development of the standard program of hearing conservation in the workers engaged in the noisy technological environment is proposed including hygienic norms and rules or national state standards.

  11. Technical evaluation of draft ANSI Standard N13.30, ''Performance Criteria for Radiobioassay''

    International Nuclear Information System (INIS)

    MacLellan, J.A.; Traub, R.J.

    1986-01-01

    To evaluate the appropriateness of the draft Standard, a research program, entitled Technical Evaluation of Draft ANSI Standard N13.30, ''Performance Criteria for Radiobioassay,'' was initiated at the Pacific Northwest Laboratory (PNL). This program incorporates a number of tasks including a nationwide, two-round intercomparison study to test the analytical performance of both in-vitro and in-vivo bioassay laboratories and determine their ability to meet the minimum performance criteria specified in the American National Standards Institute (ANSI) draft Standard, and other tasks related to the establishment of an accreditation laboratory. Based on two rounds of in-vitro testing and the in-vivo pilot study, the project staff has concluded that the criteria selected are appropriate for the existing state of the industry and achievable by most participating laboratories. Specific conclusions are as follows: the AMDA criteria are most difficult for the laboratories to achieve, the relative bias criterion is second in difficulty, and the precision criterion presents no problem for the laboratories, most of the participating laboratories can meet the Standard, and failure rates may decrease as the laboratories become knowledgeable of the performance criteria

  12. Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

    Science.gov (United States)

    Kim, Ha-Young; Shin, Sang-Wan

    2014-01-01

    PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva

  13. Noise producing toys and the efficacy of product standard criteria to protect health and education outcomes.

    Science.gov (United States)

    McLaren, Stuart J; Page, Wyatt H; Parker, Lou; Rushton, Martin

    2013-12-19

    An evaluation of 28 commercially available toys imported into New Zealand revealed that 21% of these toys do not meet the acoustic criteria in the ISO standard, ISO 8124-1:2009 Safety of Toys, adopted by Australia and New Zealand as AS/NZS ISO 8124.1:2010. While overall the 2010 standard provided a greater level of protection than the earlier 2002 standard, there was one high risk toy category where the 2002 standard provided greater protection. A secondary set of toys from the personal collections of children known to display atypical methods of play with toys, such as those with autism spectrum disorders (ASD), was part of the evaluation. Only one of these toys cleanly passed the 2010 standard, with the remainder failing or showing a marginal-pass. As there is no tolerance level stated in the standards to account for interpretation of data and experimental error, a value of +2 dB was used. The findings of the study indicate that the current standard is inadequate in providing protection against excessive noise exposure. Amendments to the criteria have been recommended that apply to the recently adopted 2013 standard. These include the integration of the new approaches published in the recently amended European standard (EN 71) on safety of toys.

  14. Noise Producing Toys and the Efficacy of Product Standard Criteria to Protect Health and Education Outcomes

    Directory of Open Access Journals (Sweden)

    Stuart J. McLaren

    2013-12-01

    Full Text Available An evaluation of 28 commercially available toys imported into New Zealand revealed that 21% of these toys do not meet the acoustic criteria in the ISO standard, ISO 8124-1:2009 Safety of Toys, adopted by Australia and New Zealand as AS/NZS ISO 8124.1:2010. While overall the 2010 standard provided a greater level of protection than the earlier 2002 standard, there was one high risk toy category where the 2002 standard provided greater protection. A secondary set of toys from the personal collections of children known to display atypical methods of play with toys, such as those with autism spectrum disorders (ASD, was part of the evaluation. Only one of these toys cleanly passed the 2010 standard, with the remainder failing or showing a marginal-pass. As there is no tolerance level stated in the standards to account for interpretation of data and experimental error, a value of +2 dB was used. The findings of the study indicate that the current standard is inadequate in providing protection against excessive noise exposure. Amendments to the criteria have been recommended that apply to the recently adopted 2013 standard. These include the integration of the new approaches published in the recently amended European standard (EN 71 on safety of toys.

  15. 40 CFR 260.31 - Standards and criteria for variances from classification as a solid waste.

    Science.gov (United States)

    2010-07-01

    ... from classification as a solid waste. 260.31 Section 260.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) HAZARDOUS WASTE MANAGEMENT SYSTEM: GENERAL Rulemaking Petitions § 260.31 Standards and criteria for variances from classification as a solid waste. (a) The...

  16. Guidelines, Criteria, and Rules of Thumb for Evaluating Normed and Standardized Assessment Instruments in Psychology.

    Science.gov (United States)

    Cicchetti, Domenic V.

    1994-01-01

    In the context of developing assessment instruments in psychology, issues of standardization, norming procedures, and test reliability and validity are discussed. Criteria, guidelines, and rules of thumb are provided to help the clinician with instrument selection for a given psychological assessment. (SLD)

  17. Setting standards for CSR : a comparative case study on criteria-formulating organizations

    NARCIS (Netherlands)

    Ingenbleek, P.T.M.; Binnekamp, M.H.A.; Goddijn, S.T.

    2007-01-01

    Though criteria-formulating organizations (CFOs) ¿ organizations in which business and community stakeholders cooperate to formulate standards for ethical issues ¿ play an important role in the relationship between firms and society, they receive scant attention from CSR researchers. Adopting an

  18. Teachers' Use of a Self-Assessment Procedure: The Role of Criteria, Standards, Feedback and Reflection

    Science.gov (United States)

    van Diggelen, Migchiel; den Brok, Perry; Beijaard, Douwe

    2013-01-01

    This article reports on the way teachers assess their own coaching competencies regarding the development of vocational education students' reflection skills. The participating teachers used a self-assessment procedure in which they had to judge themselves with the help of criteria and standards, received feedback from a colleague based on the…

  19. Teachers' use of a self-assessment procedure : the role of criteria, standards, feedback and reflection

    NARCIS (Netherlands)

    Diggelen, van M.R.; Brok, den P.J.; Beijaard, D.

    2013-01-01

    This article reports on the way teachers assess their own coaching competencies regarding the development of vocational education students’ reflection skills. The participating teachers used a self-assessment procedure in which they had to judge themselves with the help of criteria and standards,

  20. Standards & Criteria for the Development and Evaluation of a Comprehensive Employee Assistance Program.

    Science.gov (United States)

    Health Resources and Services Administration, Rockville, MD. Bureau of Health Care Delivery and Assistance.

    This document was designed for use by persons or agencies interested in both establishing and evaluating employee assistance programs (EAP) for federal employees. It contains essential elements, standards, and assessment criteria which have been developed to assist in the planning and implementation of services, and to provide a framework for…

  1. Hypothermic machine perfusion reduces delayed graft function and improves one-year graft survival of kidneys from expanded criteria donors: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Baoping Jiao

    Full Text Available BACKGROUND: Expanded criteria donors (ECDs are currently accepted as potential sources to increase the donor pool and to provide more chances of kidney transplantation for elderly recipients who would not survive long waiting periods. Hypothermic machine perfusion (HMP is designed to mitigate the deleterious effects of simple cold storage (CS on the quality of preserved organs, particularly when the donor is in a marginal status. METHODS: We compared the transplant outcomes in patients receiving ECD kidneys with either HMP or CS graft preservation. Articles from the MEDLINE, EMBASE and Cochrane Library databases were searched and all studies reporting outcomes from HMP versus CS methods of kidney preservation were included in this meta-analysis. The parameters analyzed included the incidence of delayed graft function (DGF, primary non-function (PNF and one-year graft and patient survival. RESULTS: A total of seven studies qualified for the review, involving 2374 and 8716 kidney grafts with HMP or CS preservation respectively, all from ECD donors. The incidence of delayed graft function (DGF was significantly reduced with an odd ratio(OR of 0.59 (95% CI 0.54-0.66, P<0.001 and one-year graft survival was significantly improved with an OR of 1.12 (95% CI 1.03-1.21, P = 0.005 in HMP preservation compared to CS. However, there was no difference in the incidence of PNF (OR 0.54, 95% CI 0.21-1.40, P = 0.20, and one-year patient survival (OR 0.98, 95% CI 0.94-1.02, P = 0.36 between HMP and CS preservation. CONCLUSIONS: HMP was associated with a reduced incidence of DGF and an with increased one-year graft survival, but it was not associated with the incidence of PNF and one-year patient survival.

  2. Alpha-fetoprotein and (18)F-FDG positron emission tomography predict tumor recurrence better than Milan criteria in living donor liver transplantation.

    Science.gov (United States)

    Hong, Geun; Suh, Kyung-Suk; Suh, Suk-Won; Yoo, Tae; Kim, Hyeyoung; Park, Min-Su; Choi, YoungRok; Paeng, Jin Chul; Yi, Nam-Joon; Lee, Kwang-Woong

    2016-04-01

    Given the organ shortage for liver transplantation (LT) and the limitations of the current morphology-based selection criteria, improved criteria are needed to achieve the maximum benefit of LT for hepatocellular carcinoma (HCC). We hypothesized that a combination of biological markers may better predict the prognosis than the Milan criteria. HCC patients (n=123) with preoperative data on serum alpha-fetoprotein (AFP) levels and (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) positivity underwent live-donor LT between January 2003 and December 2009. The cut-off values for serum AFP levels (200 ng/ml) and (18)F-FDG PET positivity (1.10) for tumor recurrence were determined by c-statistics using receiver operating characteristic curves. Univariate and multivariate analyses with preoperative variables were performed to find pre-transplant prognostic factors. Disease-free survival rates and overall survival rates were analysed with regard to serum AFP levels and (18)F-FDG PET positivity. The 5-year disease-free survival rates and overall survival rates were 80.3% and 81.6% respectively. (18)F-FDG PET positivity (hazard ratio (HR) 9.766, 95% CI 3.557-26.816; p<0.001) and serum AFP level (HR 6.234, 95% CI 2.643-14.707; p<0.001) were the only significant pre-transplant prognostic factors in the multivariate analysis; tumor number and size were not significant. A combination of criteria showed that the biologically high-risk group (AFP level ⩾200 ng/ml and PET-positive) had an HR of 29.069 (95% CI 8.797-96.053; p<0.001) compared with the double-negative group. Use of the Milan criteria yielded an HR of 1.351 (95% CI 0.500-3.652; p=0.553). The combination of the serum AFP level and (18)F-FDG PET data predicted better outcomes than those using the Milan criteria, improving objectivity when adult-to-adult living donor LT is contemplated. Copyright © 2015 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2012-10-01

    Many organ procurement organizations have implemented critical care end points as donor management goals in efforts to increase organs transplanted per donor after neurologic determination of death. Although retrospective studies have demonstrated an association between meeting donor management goals and organ yield, prospective studies are lacking. In June 2008, nine donor management goals were prospectively implemented as a checklist and every donor after neurologic determination of death was managed to meet them. The donor management goals represented normal cardiovascular, pulmonary, renal, and endocrine end points. Data were collected for 7 months. Donor management goals "met" was defined a priori as achieving any seven of the nine donor management goals, and this was recorded at the time of consent, 12-18 hrs later, and prior to organ recovery. The primary outcome measure was ≥4 organs transplanted per donor, and binary logistic regression was used to identify independent predictors of this outcome with a porgan procurement organizations in the five Southwestern United States (United Network for Organ Sharing Region 5). All standard criteria donors after neurologic determination of deaths. Prospective implementation of a donor management goal checklist. There were 380 standard criteria donors with 3.6±1.7 organs transplanted per donor. Fifteen percent had donor management goals met at the time of consent, 33% at 12-18 hrs, and 38% prior to organ recovery. Forty-eight percent had ≥4 organs transplanted per donor. Donors with ≥4 organs transplanted per donor had significantly more individual donor management goals met at all three time points. Independent predictors of ≥4 organs transplanted per donor were age (odds ratio=0.95 per year), final creatinine (odds ratio=0.75 per 1-unit increase), donor management goals "met" at consent (odds ratio=2.03), donor management goals "met" prior to organ recovery (odds ratio=2.34), and a change in the number of

  4. Objectives, standards and criteria for radioactive waste disposal in the European Community

    International Nuclear Information System (INIS)

    Orlowski, S.; Schaller, K.H.

    1989-01-01

    The present report, edited by a working group within the framework of the European Commission research programme on radioactive waste management and disposal, reviews the objectives, standards and criteria for radioactive waste disposal in the European Community with a view to identifying common features and differences in the regulatory frameworks of its Member States. Suggestions for possible harmonization are made. A few common general principles form the basis for legal and regulatory measures. These principles apply to and are discussed for the following: radiation protection (with the systems of dose limitation and control), ethical and sociological questions, environmental and natural resources protection, and nuclear safeguards. A description is given of the implementation of common principles, standards and requirements at Community level, in line with requirements laid down in the European Community Treaties, and in international conventions and recommendations. This is followed by a review of the implementation of basic criteria by national safety authorities. Regulatory measures and national policies, and the approaches used in devising criteria are discussed for both near-surface disposal of low-level waste, and for deep geological disposal of waste in continental geological formations. Finally, the roles and duties of the operators of radioactive waste facilities are reported. More detailed information on particular aspects is presented in the annexes

  5. Guide to nondestructive assay standards: Preparation criteria, availability, and practical considerations

    International Nuclear Information System (INIS)

    Hsue, S.T.; Stewart, J.E.; Sampson, T.E.; Butler, G.W.; Rudy, C.R.; Rinard, P.M.

    1997-10-01

    For certification and measurement control, nondestructive assay (NDA) instruments and methods used for verification measurements of special nuclear materials (SNMs) require calibrations based on certified reference materials (CRMs), or working reference materials (WRMs), traceable to the national system of measurements, and adequately characteristic of the unknowns. The Department of Energy Office of Safeguards and Security is sponsoring production of a comprehensive guide to preparation of NDA standards. The scope of the report includes preparation criteria, current availability of CRMs and WRMs, practical considerations for preparation and characterization, and an extensive bibliography. In preparing the report, based primarily on experience at Los Alamos, they have found that standards preparation is highly dependent on the particular NDA method being applied. They therefore include sections that contain information specific to commonly used neutron and gamma-ray NDA techniques. They also present approaches that are alternatives to, or minimize requirements for physical standards

  6. Determination of water environment standards based on water quality criteria in China: Limitations and feasibilities.

    Science.gov (United States)

    Wang, Tieyu; Zhou, Yunqiao; Bi, Cencen; Lu, Yonglong; He, Guizhen; Giesy, John P

    2017-07-01

    There is a need to formulate water environment standards (WESs) from the current water quality criteria (WQC) in China. To this end, we briefly summarize typical mechanisms applied in several countries with longer histories of developing WESs, and three limitations to formulating WESs in China were identified. After analyzing the feasibility factors including economic development, scientific support capability and environmental policies, we realized that China is still not ready for a complete change from its current nation-wide unified WES system to a local-standard-based system. Thus, we proposed a framework for transformation from WQC to WESs in China. The framework consists of three parts, including responsibilities, processes and policies. The responsibilities include research authorization, development of guidelines, and collection of information, at both national and local levels; the processes include four steps and an impact factor system to establish water quality standards; and the policies include seven specific proposals. Copyright © 2016. Published by Elsevier B.V.

  7. Safety of dual kidney transplantation compared to single kidney transplantation from expanded criteria donors: a single center cohort study of 39 recipients.

    Science.gov (United States)

    Mendel, Lionel; Albano, Laetitia; Bentellis, Imad; Yandza, Thierry; Bernardi, Caroline; Quintens, Herve; Tibi, Brannwel; Jourdan, Jacques; Durand, Matthieu; Amiel, Jean; Chevallier, Daniel

    2018-05-17

    Our objective was to compare the outcomes of dual kidney transplanataion (DKT) to single kidney transplantation (SKT) performed with grafts from expanded criteria donors (ECD) in recipients ≥65 years, focusing on surgical complications. All kidney transplantations (KT) performed between 2006 and 2014 in our institution were analysed. DKT was indicated according to the criteria of the French national Agence de la Biomedecine. Thirty-nine DKT and 155 SKT were included, with a median follow-up of 36 and 26.5 months, respectively. The rate of early surgical revisions was not significantly higher after DKT (23.1% vs 15.5% (P = 0.2593)) but more venous graft thromboses (12.8% vs 3.2% (P = 0.02)) were reported. The glomerular filtration rate (GFR) 24 months after KT was significantly higher after DKT (45.0 ± 16.3 vs 39.8 ± 13.8 ml/min/1.73m 2 ; P = 0.04) and allowed shorter waiting time without a significant increased risk of surgical revision, excepted for venous graft thrombosis, more frequent after DKT. Graft survivals were not significantly different and GFR was higher after DKT. DKT seems to remain an appropriate strategy to address the growing graft shortage in elderly patients. © 2018 Steunstichting ESOT.

  8. Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

    Science.gov (United States)

    Ichwan, Brian; Darbha, Subrahmanyam; Shah, Manish N; Thompson, Laura; Evans, David C; Boulger, Creagh T; Caterino, Jeffrey M

    2015-01-01

    We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. We studied a retrospective cohort of injured patients aged 16 years or older in the 2006 to 2011 Ohio Trauma Registry. Patients aged 70 years or older were considered geriatric. We identified whether each patient met the geriatric and the adult triage criteria. The outcome measure was need for trauma center care, defined by surrogate markers: Injury Severity Score greater than 15, operating room in fewer than 48 hours, any ICU stay, and inhospital mortality. We calculated sensitivity and specificity of both triage criteria for both age groups. We included 101,577 patients; 33,379 (33%) were geriatric. Overall, 57% of patients met adult criteria and 68% met geriatric criteria. Using Injury Severity Score, for older adults geriatric criteria were more sensitive for need for trauma center care (93%; 95% confidence interval [CI] 92% to 93%) than adult criteria (61%; 95% CI 60% to 62%). Geriatric criteria decreased specificity in older adults from 61% (95% CI 61% to 62%) to 49% (95% CI 48% to 49%). Geriatric criteria in older adults (93% sensitivity, 49% specificity) performed similarly to the adult criteria in younger adults (sensitivity 87% and specificity 44%). Similar patterns were observed for other outcomes. Standard adult EMS triage guidelines provide poor sensitivity in older adults. Ohio's geriatric trauma triage guidelines significantly improve sensitivity in identifying Injury Severity Score and other surrogate markers of the need for trauma center care, with modest decreases in specificity for older adults. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  9. Proceedings of the international symposium on radioactive waste disposal: Health and environmental criteria and standards

    International Nuclear Information System (INIS)

    Hultcrantz, K.

    1999-04-01

    The co-organisers of the International Symposium on Health and Environmental Criteria and Standards for Radioactive Waste Disposal are pleased to present these proceedings. This Symposium succeeded in bringing together a wide range of participants and perspectives in order to address in a common forum the technical and non-technical issues related to long-term storage of radioactive waste. The papers presented herein reflect both the diversity of the participants and the complexity of the issues addressed. The sessions, panels, and papers developed for the symposium focused on some of the daunting challenges posed by long-term isolation and storage of high level radioactive waste. Panel sessions addressed the basic principles of criteria and standards, the context of the risks involved, and an overview of relevant philosophical, social, and ethical issues. Paper sessions considered national laws, policies and experiences; criteria formulation; environmental protection; compliance; human intrusion; and fundamental philosophical, social, and ethical issues. The presentations stimulated lively discussion and debate, and the contributors received valuable feedback. The interplay between technical and social aspects reflected in some papers and in the discussion highlights the changing role of the public in radioactive waste issues. The average citizen has become more aware of and more involved in radioactive waste matters in recent years. Solutions that were previously analysed through a technological lens are now being viewed in a much broader perspective that better addresses the concerns of local communities as well as national and international interests. Public involvement must begin earlier, last longer, and improve in quality so as to create an ongoing dialogue and debate rather than cycles of dictates and discord. The symposium has offered suggestions as to how government, industry, and the public can foster a broader dialogue on the formulation and

  10. [Lack of donor organs as an argument for living donors?].

    Science.gov (United States)

    Kirste, G

    2010-09-01

    In Germany more than 12,000 patients are presently waiting for an organ donation. Living donation makes sense for the long waiting time for a kidney, but it is not a permanent solution for the lack of organ donations. In the future topics which should be discussed are intensified public relations, a better family care and the allocation of rights and duties at the German coordinating agency. For all the prospects of success after a living donation the high standards of quality and security, which are targeted by the German donor organization in recipient protection, responsible evaluation of the expanded donor criteria and immunosuppressive therapy are all in favor of post-mortem organ donation. For all the phenomenal chance of success the priority of the post-mortem organ donation is regulated by law. The living donation remains an individual decision of the donor and the personal situation of life.

  11. Guide to nondestructive assay standards: Preparation criteria, availability, and practical considerations

    International Nuclear Information System (INIS)

    Stewart, J.E.; Hsue, S.T.; Sampson, T.E.

    1997-01-01

    For certification and measurement control, nondestructive assay (NDA) instruments and methods used for verification measurement of special nuclear materials (SNMs) require calibrations based on certified reference materials (CRMs), or working reference materials (WRMs), traceable to the national system of measurements, and adequately characteristic of the unknowns. The Department of Energy Office of Safeguards and Security is sponsoring production of a comprehensive guide to preparation of NDA standards. The scope of the report includes preparation criteria, current availability of CRMs and WRMs, practical considerations for preparation and characterization, and an extensive bibliography. In preparing the report, based primarily on experience at Los Alamos, we have found that standards preparation is highly dependent on the particular NDA method being applied. We therefore include sections that contain information specific to commonly used neutron and gamma-ray NDA techniques. 16 refs., 4 figs., 2 tabs

  12. The development and significance of the DOE Safeguards and Security standards and criteria

    International Nuclear Information System (INIS)

    Toman, J.

    1987-01-01

    In October 1985, the DOE Assistant Secretary for Defense Programs created a task force to develop inspection standards and criteria for Safeguards and Security. These standards and criteria (S/C) would provide the DOE Inspection and Evaluation (I and E) teams with the guidance needed to assess the security posture of DOE's nuclear and other important facilities. The Lawrence Livermore National Laboratory was designated the lead management organization for the structuring, administration, and execution of the overall task force effort and appointed the Executive Secretary. The Office of Security Evaluations (OSE) became the responsible DOE organization, and its Director assumed the role of Chairman of the Task Force Executive Committee. At its peak, the Task Force consisted of approximately 200 people who were considered to be experts in eight major topical areas. The composition of the experts was almost evenly divided between DOE and contractor employees. The collective wisdom of these experts was used in a consensus process to develop the S/C that are now published in draft form. These S/C have been used in more than ten inspections since May 1986 with much success. This paper discusses the process used to achieve the desired end result and the significance of the Task Force's accomplishments

  13. Standards and guidelines pertinent to the development of decommissioning criteria for sites contaminated with radioactive material

    International Nuclear Information System (INIS)

    Dickson, H.W.

    1978-08-01

    A review of existing health and safety standards and guidelines has been undertaken to assist in the development of criteria for the decontamination and decommissioning of property contaminated with radioactive material. During the early years of development of the nuclear program in the United States, a number of sites were used which became contaminated with radioactive material. Many of these sites are no longer useful for nuclear activities, and the U.S. DOE desires to develop criteria for the management of these sites for future uses. Radiation protection standards promulgated by ICRP, NCRP, and ANSI have been considered. Government regulations, from the Code of Federal Regulations and the legal codes of various states, as well as regulatory guidelines with specific application to decommissioning of nuclear facilities also have been reviewed. In addition, recommendations of other scientific organizations such as the National Academy of Sciences/National Research Council Advisory Committee on the Biological Effects of Ionizing Radiations and the United Nations Scientific Committee on the Effects of Atomic Radiation were considered. Finally, a few specific recommendations and discussions from current literature were included. 28 references

  14. Anonymous living liver donation: donor profiles and outcomes.

    Science.gov (United States)

    Reichman, T W; Fox, A; Adcock, L; Wright, L; Abbey, S E; Levy, G; Grant, D R

    2010-09-01

    There are no published series of the assessment process, profiles and outcomes of anonymous, directed or nondirected live liver donation. The outcomes of 29 consecutive potential anonymous liver donors at our center were assessed. We used our standard live liver assessment process, augmented with the following additional acceptance criteria: a logical rationale for donation, a history of social altruism, strong social supports and a willingness to maintain confidentiality of patient information. Seventeen potential donors were rejected and 12 donors were ultimately accepted (six male, six female). All donors were strongly motivated by a desire and sense of responsibility to help others. Four donations were directed toward recipients who undertook media appeals. The donor operations included five left lateral segmentectomies and seven right hepatectomies. The overall donor morbidity was 40% with one patient having a transient Clavien level 3 complication (a pneumothorax). All donors are currently well. None expressed regret about their decision to donate, and all volunteered the opinion that donation had improved their lives. The standard live liver donor assessment process plus our additional requirements appears to provide a robust assessment process for the selection of anonymous live liver donors. Acceptance of anonymous donors enlarges the donor liver pool. © 2010 The Authors Journal compilation © 2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

  15. Design and validation of standardized clinical and functional remission criteria in schizophrenia

    Science.gov (United States)

    Mosolov, Sergey N; Potapov, Andrey V; Ushakov, Uriy V; Shafarenko, Aleksey A; Kostyukova, Anastasiya B

    2014-01-01

    Background International Remission Criteria (IRC) for schizophrenia were developed recently by a group of internationally known experts. The IRC detect only 10%–30% of cases and do not cover the diversity of forms and social functioning. Our aim was to design a more applicable tool and validate its use – the Standardized Clinical and Functional Remission Criteria (SCFRC). Methods We used a 6-month follow-up study of 203 outpatients from two Moscow centers and another further sample of stable patients from a 1-year controlled trial of atypical versus typical medication. Diagnosis was confirmed by International Classification of Diseases Version 10 (ICD10) criteria and the Mini-International Neuropsychiatric Interview (MINI). Patients were assessed by the Positive and Negative Syndrome Scale, including intensity threshold, and further classified using the Russian domestic remission criteria and the level of social and personal functioning, according to the Personal and Social Performance Scale (PSP). The SCFRC were formulated and were validated by a data reanalysis on the first population sample and on a second independent sample (104 patients) and in an open-label prospective randomized 12-month comparative study of risperidone long-acting injectable (RLAI) versus olanzapine. Results Only 64 of the 203 outpatients (31.5%) initially met the IRC, and 53 patients (26.1%) met the IRC after 6 months, without a change in treatment. Patients who were in remission had episodic and progressive deficit (39.6%), or remittent (15%) paranoid schizophrenia, or schizoaffective disorder (17%). In addition, 105 patients of 139 (51.7%), who did not meet symptomatic IRC, remained stable within the period. Reanalysis of data revealed that 65.5% of the patients met the SCFRC. In the controlled trial, 70% of patients in the RLAI group met the SCFRC and only 19% the IRC. In the routine treatment group, 55.9% met the SCFRC and only 5.7% the IRC. Results of the further independent

  16. 76 FR 16818 - Central Valley Project Improvement Act, Standard Criteria for Ag and Urban Water Management Plans

    Science.gov (United States)

    2011-03-25

    ... Valley Project water conservation best management practices (BMPs) that shall develop Criteria for... project contractors using best available cost- effective technology and best management practices.'' The... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act, Standard...

  17. PET/CT assessment in follicular lymphoma using standardized criteria: central review in the PRIMA study

    Energy Technology Data Exchange (ETDEWEB)

    Tychyj-Pinel, Christelle [Service de Medecine Nucleaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Benite (France); Ricard, Fabien [Service de Medecine Nucleaire, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Benite (France); Universite de Lyon, Faculte de Medecine, UCB Lyon 1, Lyon (France); Fulham, Michael [Royal Prince Alfred Hospital, Department of PET and Nuclear Medicine, Sydney (Australia); University of Sydney, Sydney Medical School, Sydney (Australia); Fournier, Marion [Centre Hospitalier Lyon Sud, The Lymphoma Academic Research Organisation (LYSARC), Pierre-Benite (France); Meignan, Michel [CHU Henri Mondor, Medicine Nucleaire, Creteil (France); Lamy, Thierry [Service d' Hematologie, CHU, Rennes (France); Vera, Pierre [Centre Henri Becquerel, Service de Medecine Nucleaire, Rouen (France); Rouen University, QuantIF (Litis EA4108), Rouen (France); Salles, Gilles [Universite de Lyon, Faculte de Medecine, UCB Lyon 1, Lyon (France); Service d' Hematologie, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Benite (France); Trotman, Judith [University of Sydney, Sydney Medical School, Sydney (Australia); Concord Hospital, Department of Haematology, Concord, NSW (Australia)

    2014-03-15

    We aimed to compare the standardized central review of {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scans performed after induction therapy for follicular lymphoma (FL) in the PRIMA study (Salles et al., Lancet 377:42-51, 2011; Trotman et al., J Clin Oncol 29:3194-3200, 2011) to scan review at local centres. PET/CT scans were independently evaluated by two nuclear medicine physicians using the 2007 International Harmonization Project (IHP) criteria (Cheson et al., J Clin Oncol 25:579-586, 2007; Juweid et al., J Clin Oncol 25:571-578, 2007; Shankar et al., J Nucl Med 47:1059-1066, 2006) and Deauville 5-point scale (5PS) criteria (Meignan et al., Leuk Lymphoma 50:1257-1260, 2009; Meignan et al., Leuk Lymphoma 51:2171-2180, 2010; Barrington et al., Eur J Nucl Med Mol Imaging 37:1824-1833, 2010). PET/CT status was compared with prospectively recorded patient outcomes. Central evaluation was performed on 119 scans. At diagnosis, 58 of 59 were recorded as positive, with a mean maximum standardized uptake value (SUV{sub max}) of 11.7 (range 4.6-35.6). There was no significant association between baseline SUV{sub max} and progression-free survival (PFS). Sixty post-induction scans were interpreted using both the IHP criteria and 5PS. Post-induction PET-positive status failed to predict progression when applying the IHP criteria [p = 0.14; hazard ratio (HR) 1.9; 95 % confidence interval (CI) 0.8-4.6] or 5PS with a cut-off ≥3 (p = 0.12; HR 2.0; 95 % CI 0.8-4.7). However, when applying the 5PS with a cut-off ≥4, there was a significantly inferior 42-month PFS in PET-positive patients of 25.0 % (95 % CI 3.7-55.8 %) versus 61.4 % (95 % CI 45.4-74.1 %) in PET-negative patients (p = 0.01; HR 3.1; 95 % CI 1.2-7.8). The positive predictive value (PPV) of post-induction PET with this liver cut-off was 75 %. The 42-month PFS for patients remaining PET-positive by local assessment was 31.1 % (95 % CI 10.2-55.0 %) vs 64.6 % (95 % CI 47.0-77.6 %) for PET

  18. Design and validation of standardized clinical and functional remission criteria in schizophrenia

    Directory of Open Access Journals (Sweden)

    Mosolov SN

    2014-01-01

    Full Text Available Sergey N Mosolov,1 Andrey V Potapov,1 Uriy V Ushakov,2 Aleksey A Shafarenko,1 Anastasiya B Kostyukova11Department of Mental Disorders Therapy, Moscow Research Institute of Psychiatry, Moscow, Russia; 2Moscow Psychiatric Outpatient Services #21, Moscow, RussiaBackground: International Remission Criteria (IRC for schizophrenia were developed recently by a group of internationally known experts. The IRC detect only 10%–30% of cases and do not cover the diversity of forms and social functioning. Our aim was to design a more applicable tool and validate its use – the Standardized Clinical and Functional Remission Criteria (SCFRC.Methods: We used a 6-month follow-up study of 203 outpatients from two Moscow centers and another further sample of stable patients from a 1-year controlled trial of atypical versus typical medication. Diagnosis was confirmed by International Classification of Diseases Version 10 (ICD10 criteria and the Mini-International Neuropsychiatric Interview (MINI. Patients were assessed by the Positive and Negative Syndrome Scale, including intensity threshold, and further classified using the Russian domestic remission criteria and the level of social and personal functioning, according to the Personal and Social Performance Scale (PSP. The SCFRC were formulated and were validated by a data reanalysis on the first population sample and on a second independent sample (104 patients and in an open-label prospective randomized 12-month comparative study of risperidone long-acting injectable (RLAI versus olanzapine.Results: Only 64 of the 203 outpatients (31.5% initially met the IRC, and 53 patients (26.1% met the IRC after 6 months, without a change in treatment. Patients who were in remission had episodic and progressive deficit (39.6%, or remittent (15% paranoid schizophrenia, or schizoaffective disorder (17%. In addition, 105 patients of 139 (51.7%, who did not meet symptomatic IRC, remained stable within the period. Reanalysis of

  19. Validation by simulation of a clinical trial model using the standardized mean and variance criteria.

    Science.gov (United States)

    Abbas, Ismail; Rovira, Joan; Casanovas, Josep

    2006-12-01

    To develop and validate a model of a clinical trial that evaluates the changes in cholesterol level as a surrogate marker for lipodystrophy in HIV subjects under alternative antiretroviral regimes, i.e., treatment with Protease Inhibitors vs. a combination of nevirapine and other antiretroviral drugs. Five simulation models were developed based on different assumptions, on treatment variability and pattern of cholesterol reduction over time. The last recorded cholesterol level, the difference from the baseline, the average difference from the baseline and level evolution, are the considered endpoints. Specific validation criteria based on a 10% minus or plus standardized distance in means and variances were used to compare the real and the simulated data. The validity criterion was met by all models for considered endpoints. However, only two models met the validity criterion when all endpoints were considered. The model based on the assumption that within-subjects variability of cholesterol levels changes over time is the one that minimizes the validity criterion, standardized distance equal to or less than 1% minus or plus. Simulation is a useful technique for calibration, estimation, and evaluation of models, which allows us to relax the often overly restrictive assumptions regarding parameters required by analytical approaches. The validity criterion can also be used to select the preferred model for design optimization, until additional data are obtained allowing an external validation of the model.

  20. Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor.

    Science.gov (United States)

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

    2011-10-01

    There is a national shortage of organs available for transplantation. Implementation of preset donor management goals (DMGs) to improve outcomes is recommended, but uniform practices and data are lacking. We hypothesized that meeting DMGs before organ procurement would result in more organs transplanted per donor (OTPD). The eight organ procurement organization in United Network for Organ Sharing Region 5 selected 10 critical care end points as DMGs. Each organ procurement organization submitted retrospective data from 40 standard criteria donors. "DMGs met" was defined as achieving any eight DMGs before procurement. The primary outcome was ≥4 OTPD. Binary logistic regression was used to determine independent predictors of ≥4 OTPD with a pdonors had 3.6±1.6 OTPD. Donors with DMGs met had more OTPD (4.4 vs. 3.3, p50% (OR=4.0), Pao2:FIO2>300 (OR=4.6), and serum sodium 135 to 160 mEq/L (OR=3.4). Meeting DMGs before procurement resulted in more OTPD. Donor factors and critical care end points are independent predictors of organ yield. Prospective studies are needed to determine the true impact of each DMG on the number and function of transplanted organs.

  1. Development, enhancement, and evaluation of aircraft measurement techniques for national ambient air quality standard criteria pollutants

    Science.gov (United States)

    Brent, Lacey Cluff

    The atmospheric contaminants most harmful to human health are designated Criteria Pollutants. To help Maryland attain the national ambient air quality standards (NAAQS) for Criteria Pollutants, and to improve our fundamental understanding of atmospheric chemistry, I conducted aircraft measurements in the Regional Atmospheric Measurement Modeling Prediction Program (RAMMPP). These data are used to evaluate model simulations and satellite observations. I developed techniques for improving airborne observation of two NAAQS pollutants, particulate matter (PM) and nitrogen dioxide (NO2). While structure and composition of organic aerosol are important for understanding PM formation, the molecular speciation of organic ambient aerosol remains largely unknown. The spatial distribution of reactive nitrogen is likewise poorly constrained. To examine water-soluble organic aerosol (WSOA) during an air pollution episode, I designed and implemented a shrouded aerosol inlet system to collect PM onto quartz fiber filters from a Cessna 402 research aircraft. Inlet evaluation conducted during a side-by-side flight with the NASA P3 demonstrated agreement to within 30%. An ion chromatographic mass spectrometric method developed using the NIST Standard Reference Material (SRM) 1649b Urban Dust, as a surrogate material resulted in acidic class separation and resolution of at least 34 organic acids; detection limits approach pg/g concentrations. Analysis of aircraft filter samples resulted in detection of 8 inorganic species and 16 organic acids of which 12 were quantified. Aged, re-circulated metropolitan air showed a greater number of dicarboxylic acids compared to air recently transported from the west. While the NAAQS for NO2 is rarely exceeded, it is a precursor molecule for ozone, America's most recalcitrant pollutant. Using cavity ringdown spectroscopy employing a light emitting diode (LED), I measured vertical profiles of NO2 (surface to 2.5 km) west (upwind) of the Baltimore

  2. Donor Lung Procurement by Surgical Fellow with an Expectation of High Rate of Lung Utilisation.

    Science.gov (United States)

    Smail, Hassiba; Saxena, Pankaj; Wallinder, Andreas; Lin, Enjarn; Snell, Gregory I; Hobson, Jamie; Zimmet, Adam D; Marasco, Silvana F; McGiffin, David C

    2017-12-22

    There is an ever increasing demand for donor lungs in patients waiting for transplantation. Lungs of many potential donors will be rejected if the standard criteria for donor assessment are followed. We have expanded our donor lung pool by accepting marginal donors and establishing a donation after circulatory death program. We have achieved comparable results using marginal donors and accepting donor lungs following donation after circulatory death. We present our assessment and technical guidelines on lung procurement taking into consideration an increasingly complex cohort of lung donors. These guidelines form the basis of the lung procurement training program involving surgical Fellows at the Alfred Hospital in Melbourne, Australia. Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  3. Standard duplex criteria overestimate the degree of stenosis after eversion carotid endarterectomy.

    Science.gov (United States)

    Benzing, Travis; Wilhoit, Cameron; Wright, Sharee; McCann, P Aaron; Lessner, Susan; Brothers, Thomas E

    2015-06-01

    The eversion technique for carotid endarterectomy (eCEA) offers an alternative to longitudinal arteriotomy and patch closure (pCEA) for open carotid revascularization. In some reports, eCEA has been associated with a higher rate of >50% restenosis of the internal carotid when it is defined as peak systolic velocity (PSV) >125 cm/s by duplex imaging. Because the conformation of the carotid bifurcation may differ after eCEA compared with native carotid arteries, it was hypothesized that standard duplex criteria might not accurately reflect the presence of restenosis after eCEA. In a case-control study, the outcomes of all patients undergoing carotid endarterectomy by one surgeon during the last 10 years were analyzed retrospectively, with a primary end point of PSV >125 cm/s. Duplex flow velocities were compared with luminal diameter measurements for any carotid computed tomography arteriography or magnetic resonance angiography study obtained within 2 months of duplex imaging, with the degree of stenosis calculated by the methodology used in the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST) as well as cross-sectional area (CSA) reduction. Simulations were generated and analyzed by computational model simulations of the eCEA and pCEA arteries. Eversion and longitudinal arteriotomy with patch techniques were used in 118 and 177 carotid arteries, respectively. Duplex follow-up was available in 90 eCEA arteries at a median of 16 (range, 2-136) months and in 150 pCEA arteries at a median of 41 (range, 3-115) months postoperatively. PSV >125 cm/s was present at some time during follow-up in 31% of eCEA and pCEA carotid arteries, each, and in the most recent duplex examination in 7% after eCEA and 21% after pCEA (P = .003), with no eCEA and two pCEA arteries occluding completely during follow-up (P = .29). In 19 carotid arteries with PSV >125 cm/s after angle correction (median, 160 cm/s; interquartile range

  4. CeasIng Cpap At standarD criteriA (CICADA): predicting a successful outcome.

    Science.gov (United States)

    Yin, Yue; Broom, Margaret; Wright, Audrey; Hovey, Donna; Abdel-Latif, Mohamed E; Shadbolt, Bruce; Todd, David A

    2016-01-01

    This is a retrospective analysis of a multicentre randomised controlled trial (RCT) where we concluded that CeasIng Cpap At standerD criteriA (CICADA) in premature babies (PBs) CPAP. To identify factors that may influence the number of attempts to cease CPAP, we reviewed the records of 50 PBs from the RCT who used the CICADA method. PBs were grouped according to number of attempts to cease CPAP (fast group ≤2 attempts and slow group >2 attempts to cease CPAP). There were 26 (fast group) and 24 (slow group) PBs included in the analysis. Results showed significant differences in mean GA (27.8 ± 0.3 vs 26.9 ± 0.3 [weeks ± SE], p = 0.03) and birth weight ([Bwt]; 1080 ± 48.8 vs 899 ± 45.8 [grams ± SE], p = 0.01) between groups. Significantly fewer PBs in the fast group had a patent ductus arteriosus (PDA) compared to the slow group (5/26 (19.2%) vs 13/24 (54.2 %), p = 0.02). Bwt was a significant negative predictor of CPAP duration (r = -0.497, p = 0.03) and CPAP ceasing attempts (r = -0.290, p = 0.04). PBs with a higher GA and Bwt without a PDA ceased CPAP earlier using the CICADA method. Bwt was better than GA for predicting CPAP duration and attempts to cease CPAP. Our previous studies showed that CeasIng Cpap At standarD criteriA (CICADA) significantly reduces CPAP time, oxygen requirements and caffeine use. Some PBs however using the CICADA method required >2 attempts to cease CPAP ('slow CICADA' group). PBs in the 'fast CICADA' group (CPAP) (a) have longer gestational age and higher birth weight, (b) shorter mechanical ventilation and (c) lower incidence of patent ductus arteriosus. Attempts to cease CPAP decreased by 0.5 times per 1 week increase in GA and 0.3 times per 100-g increase in birth weight for PBs <30 weeks gestation.

  5. Active Donor Management During the Hospital Phase of Care Is Associated with More Organs Transplanted per Donor.

    Science.gov (United States)

    Patel, Madhukar S; De La Cruz, Salvador; Sally, Mitchell B; Groat, Tahnee; Malinoski, Darren J

    2017-10-01

    Meeting donor management goals when caring for potential organ donors has been associated with more organs transplanted per donor (OTPD). Concern persists, however, as to whether this indicates that younger/healthier donors are more likely to meet donor management goals or whether active management affects outcomes. A prospective observational study of all standard criteria donors was conducted by 10 organ procurement organizations across United Network for Organ Sharing Regions 4, 5, and 6. Donor management goals representing normal critical care end points were measured at 2 time points: when a catastrophic brain injury was recognized and a referral was made to the organ procurement organization by the DH; and after brain death was declared and authorization for organ donation was obtained. Donor management goals Bundle "met" was defined as achieving any 7 of 9 end points. A positive Bundle status change was defined as not meeting the Bundle at referral and subsequently achieving it at authorization. The primary outcomes measure was having ≥4 OTPD. Data were collected for 1,398 standard criteria donors. Of the 1,166 (83%) who did not meet the Bundle at referral, only 254 (22%) had a positive Bundle status change. On adjusted analysis, positive Bundle status change increased the odds of achieving ≥4 OTPD significantly (odds ratio 2.04; 95% CI 1.49 to 2.81; p management goal Bundle status change during donor hospital management is associated with a 2-fold increase in achieving ≥4 OTPD. Active critical care management of the potential organ donor, as evidenced by improvement in routinely measured critical care end points can be a means by which to substantially increase the number of organs available for transplantation. Published by Elsevier Inc.

  6. American National Standard: criteria and guidelines for assessing capability for surface faulting at nuclear power plant sites

    International Nuclear Information System (INIS)

    Anon.

    1982-01-01

    This standard provides applicants and consultants with criteria and guidelines for investigations directed toward the assessment of the capability for surface faulting at nuclear power plant sites. Assessment of vibratory ground motion resulting from faulting is not treated in these guidelines

  7. Standardized deceased donor kidney donation rates in the UK reveal marked regional variation and highlight the potential for increasing kidney donation: a prospective cohort study†

    Science.gov (United States)

    Summers, D. M.; Johnson, R. J.; Hudson, A. J.; Collett, D.; Murphy, P.; Watson, C. J. E.; Neuberger, J. M.; Bradley, J. A.

    2014-01-01

    Background The UK has implemented a national strategy for organ donation that includes a centrally coordinated network of specialist nurses in organ donation embedded in all intensive care units and a national organ retrieval service for deceased organ donors. We aimed to determine whether despite the national approach to donation there is significant regional variation in deceased donor kidney donation rates. Methods The UK prospective audit of deaths in critical care was analysed for a cohort of patients who died in critical care between April 2010 and December 2011. Multivariate logistic regression was used to identify the factors associated with kidney donation. The logistic regression model was then used to produce risk-adjusted funnel plots describing the regional variation in donation rates. Results Of the 27 482 patients who died in a critical care setting, 1528 (5.5%) became kidney donors. Factors found to influence donation rates significantly were: type of critical care [e.g. neurointensive vs general intensive care: OR 1.53, 95% confidence interval (CI) 1.34–1.75, P69 vs age 18–39 yr: OR 0.2, 0.15–0.25, Pdonation rates for the 20 UK kidney donor regions showed marked variation. The overall standardized donation rate ranged from 3.2 to 7.5%. Four regions had donation rates of >2 standard deviations (sd) from the mean (two below and two above). Regional variation was most marked for donation after circulatory death (DCD) kidney donors with 9 of the 20 regions demonstrating donation rates of >2 sd from the mean (5 below and 4 above). Conclusions The marked regional variation in kidney donation rates observed in this cohort after adjustment for factors strongly associated with donation rates suggests that there is considerable scope for further increasing kidney donation rates in the UK, particularly DCD. PMID:24335581

  8. Kidney transplantation from donors with rhabdomyolysis and acute renal failure.

    Science.gov (United States)

    Chen, Chuan-Bao; Zheng, Yi-Tao; Zhou, Jian; Han, Ming; Wang, Xiao-Ping; Yuan, Xiao-Peng; Wang, Chang-Xi; He, Xiao-Shun

    2017-08-01

    Rhabdomyolysis in deceased donors usually causes acute renal failure (ARF), which may be considered a contraindication for kidney transplantation. From January 2012 to December 2016, 30 kidneys from 15 deceased donors with severe rhabdomyolysis and ARF were accepted for transplantation at our center. The peak serum creatinine (SCr) kinase, myoglobin, and SCr of the these donors were 15 569±8597 U/L, 37 092±42 100 μg/L, and 422±167 μmol/L, respectively. Two donors received continuous renal replacement therapy due to anuria. Six kidneys exhibited a discolored appearance (from brown to glossy black) due to myoglobin casts. The kidney transplant results from the donors with rhabdomyolysis donors were compared with those of 90 renal grafts from standard criteria donors (SCD). The estimated glomerular filtration rate at 2 years was similar between kidney transplants from donors with rhabdomyolysis and SCD (70.3±14.6 mL/min/1.73 m 2 vs 72.3±15.1 mL/min/1.73 m 2 ). We conclude that excellent graft function can be achieved from kidneys donors with ARF caused by rhabdomyolysis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. A Criteria Standard for Conflict Resolution: A Vision for Guaranteeing the Safety of Self-Separation in NextGen

    Science.gov (United States)

    Munoz, Cesar; Butler, Ricky; Narkawicz, Anthony; Maddalon, Jeffrey; Hagen, George

    2010-01-01

    Distributed approaches for conflict resolution rely on analyzing the behavior of each aircraft to ensure that system-wide safety properties are maintained. This paper presents the criteria method, which increases the quality and efficiency of a safety assurance analysis for distributed air traffic concepts. The criteria standard is shown to provide two key safety properties: safe separation when only one aircraft maneuvers and safe separation when both aircraft maneuver at the same time. This approach is complemented with strong guarantees of correct operation through formal verification. To show that an algorithm is correct, i.e., that it always meets its specified safety property, one must only show that the algorithm satisfies the criteria. Once this is done, then the algorithm inherits the safety properties of the criteria. An important consequence of this approach is that there is no requirement that both aircraft execute the same conflict resolution algorithm. Therefore, the criteria approach allows different avionics manufacturers or even different airlines to use different algorithms, each optimized according to their own proprietary concerns.

  10. Use of the hCONSORT criteria as a reporting standard for herbal interventions for common dermatoses: a systematic review.

    Science.gov (United States)

    Ornelas, J; Routt, E; Kallis, P; Lev-Tov, H

    2018-04-01

    The use of complementary and alternative medicine (CAM) is increasing in Western countries, including in the area of dermatology. However, Western healthcare providers have not integrated CAM into regular practice owing to a lack of reliable data supporting its use. To encourage high-quality research related to the use of CAM and specifically herbal interventions, the CONsolidated Standards Of Reporting Trials (CONSORT) extension criteria on reporting herbal interventions (hCONSORT) were published in 2006. To evaluate the adherence of randomized controlled trials (RCTs) investigating herbal interventions for acne, atopic dermatitis (AD) and psoriasis to the hCONSORT criteria. A comprehensive search of the PubMed, Embase and Cochrane Library databases was conducted. RCTs published between 2009 and 2014 assessing therapeutic outcomes of plant-based interventions for acne, AD or psoriasis were included. Investigators determined the number of unique hCONSORT criteria satisfied per report. anova was used to examine differences in scores by disease entity. The vast majority of reviewed studies reported reports based on language and lack of assessment of overall adherence to CONSORT criteria. Our data indicate lack of adherence to hCONSORT extension criteria. Adherence to hCONSORT guidelines should be encouraged in order to provide high-quality reporting of research on herbal interventions in dermatology. Doing so may ease the integration of CAM into conventional medical practice and provide actionable data to providers. © 2017 British Association of Dermatologists.

  11. Deceased Organ Donors and PHS Risk Identification: Impact on Organ Usage and Outcomes.

    Science.gov (United States)

    Pruett, Timothy L; Clark, Marissa A; Taranto, Sarah E

    2017-07-01

    In 2013, the public health service (PHS) changed the criteria intended to identify organ donors that put the associated organ recipients at increased risk for acquiring human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). The changing donor demographics, organ utilization, and outcomes associated with this change are not known. A review of the Organ Procurement and Transplantation Network database was performed to assess the impact of PHS donor designation on organ utilization and outcomes. After the 2013 modification, over 20% of all deceased organ donors in the United States were identified as PHS increased risk. Compared with the standard risk deceased organ donor, the PHS donor was younger, male, died from anoxia, more likely to be HCV and antibody reacting to hepatitis B core antigen+, and less likely to have diabetes or hypertension. Organs from the 18- to 34-year-old deceased donors with PHS risks (but relatively few medical comorbidities) and tested negative for HCV were less frequently transplanted compared with the standard risk donors (3.9 vs 4.2 organs transplanted per donor). However, the transplant patient and graft survival as well as risk of unexpected transmission of HIV, HBV, and HCV were equivalent, irrespective of PHS donor status. The rationale of using PHS donor designation that negatively impacts utilization of high-quality organs without the benefit of identifying the subset of organs with demonstrable proclivity to transmit HIV, HBV, or HCV needs to be reexamined.

  12. Laparoscopic donor nephrectomy

    Directory of Open Access Journals (Sweden)

    Gupta Nitin

    2005-01-01

    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.

  13. Criteria and quality standards for aquatic life protection; Criteri e standard di qualita` per la protezione della vita acquatica

    Energy Technology Data Exchange (ETDEWEB)

    Volterra, L.; De Nava, V.; Mancini, L. [Istituto Superiore di Sanita`, Rome (Italy). Lab. di Igiene Ambientale

    1998-12-31

    The report concerns two Italian laws, n.130/92 and 131/92 derived from the EEC directives n. 659/78 and 923/91 concerning water quality respectively for freshwater and for marine water suitable for shellfish. The meaning of each parameter, included in the two laws, is explained considering that their purpose is protection and promotion of aquatic life. This review was originated by a request that Ministry of the Environment directed to the `Istituto Superiore of Sanita` to supply information necessary for a possible definition of lacking standards and to draw up appropriate monitoring plans. [Italiano] Il rapporto si riferisce a due decreti, il numero 130/92 e il 131/92 recepiti dalle direttive comunitarie 659/78 e 923/91 riguardanti rispettivamente la qualita` delle acque dolci che richiedono protezione e miglioramento per la vita dei pesci e i requisiti di qualita` delle acque per la molluschiocoltura. Si elencano isignificati dei singoli parametri introdotti nelle due normative il cui scopo e` quello di proteggere e favorire lo sviluppo della vita acquatica in ambienti di acqua dolce e marina. La rassegna e` nata da una richiesta formulata all`Istituto Superiore di Sanita` da parte del Ministero dell`Ambiente per fornire indicazioni necessarie per la eventuale definizione degli standard mancanti ed indirizzi per la formulazione di idonei piani di sorveglianza.

  14. Prospective, randomized, blinded evaluation of donor semen quality provided by seven commercial sperm banks.

    Science.gov (United States)

    Carrell, Douglas T; Cartmill, Deborah; Jones, Kirtly P; Hatasaka, Harry H; Peterson, C Matthew

    2002-07-01

    To evaluate variability in donor semen quality between seven commercial donor sperm banks, within sperm banks, and between intracervical insemination and intrauterine insemination. Prospective, randomized, blind evaluation of commercially available donor semen samples. An academic andrology laboratory. Seventy-five cryopreserved donor semen samples were evaluated. Samples were coded, then blindly evaluated for semen quality. Standard semen quality parameters, including concentration, motility parameters, World Health Organization criteria morphology, and strict criteria morphology. Significant differences were observed between donor semen banks for most semen quality parameters analyzed in intracervical insemination samples. In general, the greatest variability observed between banks was in percentage progressive sperm motility (range, 8.8 +/- 5.8 to 42.4 +/- 5.5) and normal sperm morphology (strict criteria; range, 10.1 +/- 3.3 to 26.6 +/- 4.7). Coefficients of variation within sperm banks were generally high. These data demonstrate the variability of donor semen quality provided by commercial sperm banks, both between banks and within a given bank. No relationship was observed between the size or type of sperm bank and the degree of variability. The data demonstrate the lack of uniformity in the criteria used to screen potential semen donors and emphasize the need for more stringent screening criteria and strict quality control in processing samples.

  15. Standards and criteria of international organizations concerning agricultural aspects of radiological emergency situations

    International Nuclear Information System (INIS)

    Richards, J.I.; Hance, R.J.; Crick, M.J.

    1997-01-01

    The nuclear facilities are not generally located in densely populated zones, but usually in rural rather agricultural environment. The Chernobyl accident has shown that farming activities may be affected over hundreds if not thousands kilometers from the accident site. Emergency plans must be implemented in order to trigger countermeasures aiming at reducing agricultural product contamination even in countries having not nuclear facilities or programmes of their own. In Introduction the paper presents the principal objectives to be taken into account by the governmental authorities (at central and local level) after an agricultural countermeasure strategy has been elaborated. The second section deals with the development of criteria and intervening levels. On the basis of the new Recommendations of International Commission on Radiological Protection and the Guidelines concerning the Intervention Levels for Protecting the Public in the Event of a Nuclear Accident or Radiological Emergency issued by an IAEA Consultative Group, IAEA and FAO have published in 1994 common directives concerning the measures to be taken at agricultural level in case of an accidental release of radioactivity. The section 3 presents the concepts and criteria for selecting efficient and appropriate countermeasures. It discusses the importance of planning and intervention preparations, the management of accidents and the proper protection measures. The generic activity levels requiring intervention for withdraw from market of alimentary products are presented in the Section 4. The paper discusses also specific level s of intervention (for milk and meat for instance adopted in Belarus, Ukraine and Russia) as well as future prospects

  16. Guidelines and algorithms: strategies for standardization of referral criteria in diagnostic radiology

    International Nuclear Information System (INIS)

    Kainberger, Franz; Pokieser, Peter; Imhof, Herwig; Czembirek, Heinrich; Fruehwald, Franz

    2002-01-01

    Guidelines can be regarded as special forms of algorithms and have been shown to be useful tools for supporting medical decision making. With the Council Directive 97/43/Euratom recommendations concerning referral criteria for medical exposure have to be implemented into national law of all EU member states. The time- and cost-consuming efforts of developing, implementing, and updating such guidelines are balanced by the acceptance in clinical practice and eventual better health outcomes. Clearly defined objectives with special attention drawn on national and regional differences among potential users, support from organisations with expertise in evidence-based medicine, separated development of the evidence component and the recommendations component, and large-scale strategies for distribution and implementation are necessary. Editors as well as users of guidelines for referral criteria have to be aware which expectations can be met and which cannot be fulfilled with this instrument; thus, dealing with guidelines requires a new form of ''diagnostic reasoning'' based on medical ethics. (orig.)

  17. Terminology and reporting criteria for radiofrequency ablation of tumors in the scientific literature: Systematic review of compliance with reporting standards

    International Nuclear Information System (INIS)

    Kang, Tae Wook; Rhim, Hyun Chul; Lee, Min Woo; Kim, Young Sun; Choi, Dongil; Lim, Hyo Keun

    2014-01-01

    To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. The proposal for standardization of terminology and reporting criteria for RF tumor ablation has been gaining support according to the recently published scientific reports, especially in the field of radiology

  18. Terminology and reporting criteria for radiofrequency ablation of tumors in the scientific literature: systematic review of compliance with reporting standards.

    Science.gov (United States)

    Kang, Tae Wook; Rhim, Hyunchul; Lee, Min Woo; Kim, Young-sun; Choi, Dongil; Lim, Hyo Keun

    2014-01-01

    To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. The proposal for standardization of terminology and reporting criteria for RF tumor ablation has been gaining support according to the recently published scientific reports, especially in the field of radiology

  19. Standardization of a Protocol for Obtaining Platelet Rich Plasma from blood Donors; a Tool for Tissue Regeneration Procedures.

    Science.gov (United States)

    Gómez, Lina Andrea; Escobar, Magally; Peñuela, Oscar

    2015-01-01

    To develop a protocol for obtaining autologous platelet rich plasma in healthy individuals and to determine the concentration of five major growth factors before platelet activation. This protocol could be integrated into the guidelines of good clinical practice and research in regenerative medicine. Platelet rich plasma was isolated by centrifugation from 38 healthy men and 42 women ranging from 18 to 59 years old. The platelet count and quantification of growth factors were analyzed in eighty samples, stratified for age and gender of the donor. Analyses were performed using parametric the t-test or Pearson's analysis for non-parametric distribution. P platelet counts from 1.6 to 4.9 times (mean = 2.8). There was no correlation between platelet concentration and the level of the following growth factors: VEGF-D (r = 0.009, p = 0.4105), VEGF-A (r = 0.0068, p = 0.953), PDGF subunit AA (p = 0.3618; r = 0.1047), PDGF-BB (p = 0.5936; r = 0.6095). In the same way, there was no correlation between donor gender and growth factor concentrations. Only TGF-β concentration was correlated to platelet concentration (r = 0.3163, p = 0.0175). The procedure used allowed us to make preparations rich in platelets, low in leukocytes and red blood cells, and sterile. Our results showed biological variations in content of growth factors in PRP. The factors influencing these results should be further studied.

  20. Skeletal stability of surgery-first bimaxillary orthognathic surgery for skeletal class III malocclusion, using standardized criteria.

    Science.gov (United States)

    Park, K-H; Sandor, G K; Kim, Y-D

    2016-01-01

    The purpose of this study was to compare the postoperative stability following bimaxillary surgery performed either with or without preoperative orthodontic treatment, in class III malocclusion patients. These patients were enrolled using standardized inclusion criteria. Forty patients with a class III malocclusion were included in this retrospective study. Inclusion criteria were class III malocclusion with and without premolar extraction, stability. With respect to postsurgical changes, significant differences were observed in the changes for the vertical reference plane to the posterior nasal spine, horizontal reference plane to B-point, and occlusal plane angle in both groups. No statistically significant differences in the relapse rates were observed between the two groups. No significant differences were observed between the two groups in terms of the postoperative stability. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Standard for design criteria for decommissioning of nuclear fuel reprocessing plants

    International Nuclear Information System (INIS)

    Graham, H.B.

    1976-01-01

    This paper was developed by the ANSI Standards Committee N46. Deactivation or shutdown followed by continued operation on the same site does not constitute decommissioning. It is felt that abandonment with entombment of the highly radioactive parts of the plant is the only economically feasible alternative

  2. 78 FR 76590 - Physical Qualification of Drivers; Standards; Changes to Vision Exemption Program Criteria

    Science.gov (United States)

    2013-12-18

    ...) hold a valid license; (2) are at least 21 years old; and (3) have 3 years of intrastate CMV driving... eliminate the driving experience criterion. The basis for this change is derived from the Medical Exemption... CFR 391.41(b). Adequate visual function is necessary for safe driving. The current vision standard...

  3. 29 CFR 1904.9 - Recording criteria for cases involving medical removal under OSHA standards.

    Science.gov (United States)

    2010-07-01

    ... surveillance requirements of an OSHA standard, you must record the case on the OSHA 300 Log. (b) Implementation—(1) How do I classify medical removal cases on the OSHA 300 Log? You must enter each medical removal case on the OSHA 300 Log as either a case involving days away from work or a case involving restricted...

  4. The egg-sharing model for human therapeutic cloning research: managing donor selection criteria, the proportion of shared oocytes allocated to research, and amount of financial subsidy given to the donor.

    Science.gov (United States)

    Heng, Boon Chin; Tong, Guo Qing; Stojkovic, Miodrag

    2006-01-01

    Recent advances in human therapeutic cloning made by Hwang and colleagues have opened up new avenues of therapy for various human diseases. However, the major bottleneck of this new technology is the severe shortage of human donor oocytes. Egg-sharing in return for subsidized fertility treatment has been suggested as an ethically justifiable and practical solution to overcome the shortage of donor oocytes for therapeutic cloning. Because the utilization of shared oocytes in therapeutic cloning research does not result in any therapeutic benefit to a second party, this would necessitate a different management strategy compared to their use for the assisted conception of infertile women who are unable to produce any oocytes of their own. It is proposed that the pool of prospective egg-sharers in therapeutic cloning research be limited only to younger women (below 30 years of age) with indications for either male partner sub-fertility or tubal blockage. With regards to the proportion of the shared gametes being allocated to research, a threshold number of retrieved oocytes should be set that if not exceeded, would result in the patient being automatically removed from the egg-sharing scheme. Any excess supernumerary oocyte above this threshold number can be contributed to science, and allocation should be done in a randomized manner. Perhaps, a total of 10 retrieved oocytes from the patient may be considered a suitable threshold, since the chances of conception are unlikely to be impaired. With regards to the amount of subsidy being given to the patient, it is suggested that the proportion of financial subsidy should be equal to the proportion of the patient's oocytes being allocated to research. No doubt, the promise of future therapeutic benefit may be offered to the patient instead of financial subsidy. However, this is ethically controversial because therapeutic cloning has not yet been demonstrated to be a viable model of clinical therapy and any promises made to

  5. Radioactive waste management: review on clearance levels and acceptance criteria legislation, requirements and standards.

    Science.gov (United States)

    Maringer, F J; Suráň, J; Kovář, P; Chauvenet, B; Peyres, V; García-Toraño, E; Cozzella, M L; De Felice, P; Vodenik, B; Hult, M; Rosengård, U; Merimaa, M; Szücs, L; Jeffery, C; Dean, J C J; Tymiński, Z; Arnold, D; Hinca, R; Mirescu, G

    2013-11-01

    In 2011 the joint research project Metrology for Radioactive Waste Management (MetroRWM)(1) of the European Metrology Research Programme (EMRP) started with a total duration of three years. Within this project, new metrological resources for the assessment of radioactive waste, including their calibration with new reference materials traceable to national standards will be developed. This paper gives a review on national, European and international strategies as basis for science-based metrological requirements in clearance and acceptance of radioactive waste. © 2013 Elsevier Ltd. All rights reserved.

  6. Standard criteria for disposal of liquid radioactive wastes from nuclear power plants into surface waters (river systems)

    International Nuclear Information System (INIS)

    Pisarev, V.V.; Tsybizov, I.S.

    1976-01-01

    Radioactive products discharge into natural water streams results in the necessity to regulate nuclear power plant discharges to ensure radiation safety (RS) for population using a river and surrounding river territory. To ensure RS it is necessary to set scientific-founded standards of permissible discharge level of liquid radioactive wastes (LRW) from nuclear power plant assuring observance of hygienic requirements for surface water puring. Volume of permissible LRW discharge into river systems must be set both with provision for concrete physical-geographycal conditions, specficity of utilizing the river and river valley and social-economical peculiarities of crtical population groups. The value of permissible LRW discharge into river systems is determined by three criterion groups: radiological, ecological and hydrological ones. By means of radiological group the internal and external irradiation doses for the whole body and its separate organs are set and RS of population is determined. Ecological criteria include a number of parameters (coefficients of accumulation, distribution and transition) determining quantitative ratios between radioactive element contents in water and separate links of biological chains: soil/water, fish/water, vegetables/water and others. Hydrological criteria determine the degree of waste dilution in rivers, control radioactive contamination of flood-lands areas and in common with ecological criteria determine radionuclide contents in soil and food products. A method of determining average annual values of LRW dilution in river waters is presented [ru

  7. The standard genetic code and its relation to mutational pressure: robustness and equilibrium criteria

    International Nuclear Information System (INIS)

    Hernandez Caceres, Jose Luis; Hong, Rolando; Martinez Ortiz, Carlos; Sautie Castellanos, Miguel; Valdes, Kiria; Guevara Erra, Ramon

    2004-10-01

    Under the assumption of even point mutation pressure on the DNA strand, rates for transitions from one amino acid into another were assessed. Nearly 25% of all mutations were silent. About 48% of the mutations from a given amino acid stream either into the same amino acid or into an amino acid of the same class. These results suggest a great stability of the Standard Genetic Code respect to mutation load. Concepts from chemical equilibrium theory are applicable into this case provided that mutation rate constants are given. It was obtained that unequal synonymic codon usage may lead to changes in the equilibrium concentrations. Data from real biological species showed that several amino acids are close to the respective equilibrium concentration. However in all the cases the concentration of leucine nearly doubled its equilibrium concentration, whereas for the stop command (Term) it was about 10 times lower. The overall distance from equilibrium for a set of species suggests that eukaryotes are closer to equilibrium than prokaryotes, and the HIV virus was closest to equilibrium among 15 species. We obtained that contemporary species are closer to the equilibrium than the Last Universal Common Ancestor (LUCA) was. Similarly, nonpreserved regions in proteins are closer to equilibrium than the preserved ones. We suggest that this approach can be useful for exploring some aspects of biological evolution in the framework of Standard Genetic Code properties. (author)

  8. Pilot test of ANSI draft standard N13.29 environmental dosimetry -- Performance criteria for testing

    International Nuclear Information System (INIS)

    Klemic, G.; Shebell, P.; Monetti, M.; Raccah, F.; Sengupta, S.

    1998-09-01

    American National Standards Institute Draft N13.29 describes performance tests for environmental radiation dosimetry providers. If approved it would be the first step toward applying the types of performance testing now required in personnel dosimetry to environmental radiation monitoring. The objective of this study was to pilot test the draft standard, before it undergoes final balloting, on a small group of dosimetry providers that were selected to provide a mix of facility types, thermoluminescent dosimeter designs and monitoring program applications. The first phase of the pilot test involved exposing dosimeters to laboratory photon, beta, and x-ray sources at routine and accident dose levels. In the second phase, dosimeters were subjected to ninety days of simulated environmental conditions in an environmental chamber that cycled through extremes of temperature and humidity. Two out of seven participants passed all categories of the laboratory testing phase, and all seven passed the environmental test phase. While some relatively minor deficiencies were uncovered in the course of the pilot test, the results show that draft N13.29 describes useful tests that could be appropriate for environmental dosimetry providers. An appendix to this report contains recommendations that should be addressed by the N13.29 working group before draft N13.29 is submitted for balloting

  9. Comparison of the thermodynamic and correlation criteria for internal standard selection in laser-induced breakdown spectrometry

    International Nuclear Information System (INIS)

    Labutin, Timur A.; Zaytsev, Sergey M.; Popov, Andrey M.; Seliverstova, Irina V.; Bozhenko, Sergey E.; Zorov, Nikita B.

    2013-01-01

    The use of the reference line of an internal standard in LIBS is a usual way to eliminate or reduce the fluctuations of plasma parameters from pulse to pulse as well as from sample to sample. Thermodynamic criterion, i.e. closeness of excitation potentials of the analytical line and the reference one, is often used to select an appropriate reference line. In this work, we propose an alternative criterion based on searching the best correlated pairs of lines under the variations of laser energy. Two criteria were compared for high-alloy steels and soils of different origins. The discrepancy among the values of plasma temperature calculated from Fe I, Mn I and Cr I transitions was found under the conditions of slightly changed laser fluence on steel samples. On the other hand, the agreement between plasma temperatures, obtained for Fe I and Mn I transitions, was demonstrated in plasma on soil samples. Calibration results obtained for manganese in steels and lead in soils show that thermodynamic criterion can be an appropriate way for choosing an internal standard only under LTE conditions. Two lines of Mn I at 403.07 nm and 404.14 nm and Pb I at 405.78 nm were the analytical lines for the quantification of manganese in steels and lead in soils, respectively. The use of the correlative criterion seems to be suitable for internal standardization under LTE or non-LTE conditions. Probable limitations of the correlative criterion and its possibilities to identify weak lines are discussed in the article. - Highlights: • Novel criterion for internal standard selection, based on the correlation of analytical line and reference one • Comparison of correlation and thermodynamic criteria • Correlation analysis of the spectrum can be useful for atomic line identification. • Correlation approach can be used in LTE and non-LTE conditions

  10. Developing glovebox robotics to meet the national robot safety standard and nuclear safety criteria

    International Nuclear Information System (INIS)

    McMahon, T.T.; Sievers, R.H.

    1991-09-01

    Development of a glove box based robotic system by the Lawrence Livermore National Laboratory (LLNL) is reported. Safety issues addressed include planning to meet the special constraints of operations within a hazardous material glove box and with hostile environments, compliance with the current and draft national robotic system safety standards, and eventual satisfaction of nuclear material handling requirements. Special attention has been required for the revision to the robot and control system models which antedate adoption of the present national safety standard. A robotic test bed, using non-radioactive surrogates is being activated at the Lawrence Livermore National Laboratory to develop the material handling system and the process interfaces for future special nuclear material processing applications. Part of this effort is to define, test, and revise adequate safety controls to ensure success when the system is eventually deployed at a DOE site. The current system is primarily for demonstration and testing, but will evolve into the baseline configuration from which the production system is to be derived. This results in special hazards associated with research activities which may not be present on a production line. Nuclear safety is of paramount importance and has been successfully addressed for 50 years in the DOE weapons production complex. It carries its particular requirements for robot systems and manual operations, as summarized below: Criticality must be avoided (materials cannot consolidate or accumulate to approach a critical mass). Radioactive materials must be confined. The public and workers must be protected from accountable radiation exposure. Nuclear material must be readily retrievable. Nuclear safety must be conclusively demonstrated through hazards analysis. 7 refs

  11. Enhancement of Recreation Service to Disabled Children. Part II, Recommended Standards with Evaluative Criteria for Recreation Services in Residential Institutions. Final Report.

    Science.gov (United States)

    Berryman, Doris L.

    The suggested standards and evaluative criteria are designed to assist hospitals and other residential institutions in evaluating recreation services provided to residents, primarily children and youth. Described are the development of the standards and the rating instrument, guidelines for using the standards, evaluation and scoring procedures,…

  12. Terminology and reporting criteria for radiofrequency ablation of tumors in the scientific literature: Systematic review of compliance with reporting standards

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Tae Wook; Rhim, Hyun Chul; Lee, Min Woo; Kim, Young Sun; Choi, Dongil; Lim, Hyo Keun [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-02-15

    To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. The proposal for standardization of terminology and reporting criteria for

  13. Analytic study of the chain dark decomposition reaction of iodides - atomic iodine donors - in the active medium of a pulsed chemical oxygen-iodine laser: 1. Criteria for the development of the branching chain dark decomposition reaction of iodides

    International Nuclear Information System (INIS)

    Andreeva, Tamara L; Kuznetsova, S V; Maslov, Aleksandr I; Sorokin, Vadim N

    2009-01-01

    The scheme of chemical processes proceeding in the active medium of a pulsed chemical oxygen-iodine laser (COIL) is analysed. Based on the analysis performed, the complete system of differential equations corresponding to this scheme is replaced by a simplified system of equations describing in dimensionless variables the chain dark decomposition of iodides - atomic iodine donors, in the COIL active medium. The procedure solving this system is described, the basic parameters determining the development of the chain reaction are found and its specific time intervals are determined. The initial stage of the reaction is analysed and criteria for the development of the branching chain decomposition reaction of iodide in the COIL active medium are determined. (active media)

  14. Ammunition Peculiar Equipment (APE) 1995, NIR Propellant Analyzer, to MIL-STD-398, Military Standard Shields, Operational for Ammunition Operations, Criteria for Design of and Tests for Acceptance

    National Research Council Canada - National Science Library

    2003-01-01

    ... (SJMAC-DEM) to test the Ammunition Peculiar Equipment (APE) 1995 NIR Propellant Analyzer, to MIL-STD-398, "Military Standard Shields, Operational for Ammunition Operations, Criteria for Design of and Tests for Acceptance...

  15. Differences in safety margins between nuclear and conventional design standards with regards to seismic hazard definition and design criteria

    International Nuclear Information System (INIS)

    Elgohary, M.; Saudy, A.; Orbovic, N.; Dejan, D.

    2006-01-01

    With the surging interest in new build nuclear all over the world and a permanent interest in earthquake resistance of nuclear plants, there is a need to quantify the safety margins in nuclear buildings design in comparison to conventional buildings in order to increase the public confidence in the safety of nuclear power plants. Nuclear (CAN3-N289 series) and conventional (NBCC 2005) seismic standards have different approaches regarding the design of civil structures. The origin of the differences lays in the safety philosophy behind the seismic nuclear and conventional standards. Conventional seismic codes contain the minimal requirement destined primarily to safeguard against major structural failure and loss of life. It doesn't limit damage to a certain acceptable degree or maintain function. Nuclear seismic code requires that structures, systems and components important to safety, withstand the effects of earthquakes. The requirement states that for equipment important to safety, both integrity and functionality should be ascertained. The seismic hazard is generally defined on the basis of the annual probability of exceedence (return period). There is a major difference on the return period and the confidence level for design earthquakes between the conventional and the nuclear seismic standards. The seismic design criteria of conventional structures are based on the use of Force Modification Factors to take into account the energy dissipation by incursion in non-elastic domain and the reserve of strength. The use of such factors to lower intentionally the seismic input is consistent with the safety philosophy of the conventional seismic standard which is the 'non collapse' rather than the integrity and/or the operability of the structures or components. Nuclear seismic standard requires that the structure remain in the elastic domain; energy dissipation by incursion in non-elastic domain is not allowed for design basis earthquake conditions. This is

  16. Neonatal Near Miss: the need for a standard definition and appropriate criteria and the rationale for a prospective surveillance system

    Directory of Open Access Journals (Sweden)

    Juliana P. Santos

    2015-12-01

    Full Text Available In Latin American, there is currently a regional action with the main purposes of putting the concept of severe neonatal morbidity in practice and formulating proposals for interventions. A general overview of neonatal health conditions, including morbidity and mortality, is provided to update regional knowledge on the topic. An example of the development and implementation of the concept of maternal near miss is also provided, followed by results from a systematic review covering all previously published studies on Neonatal Near Miss. Finally, some proposals for building a common concept on the topic and for launching a prospective surveillance study are presented. A Neonatal Near Miss is a neonate who had a severe morbidity (organ dysfunction or failure but who survived this condition within the first 27 days of life. The pragmatic criteria recommended to be used are as follows: birth weight below 1700 g, Apgar score below 7 at 5 minutes of life and gestational age below 33 weeks. As a proxy for organ dysfunction, the following management criteria are also confirmed: parenteral therapeutic antibiotics; nasal continuous positive airway pressure; any intubation during the first 27 days of life; phototherapy within the first 24 h of life; cardiopulmonary resuscitation; the use of vasoactive drugs, anticonvulsants, surfactants, blood products and steroids for refractory hypoglycemia and any surgical procedure. Although this study starts from a regional perspective, this topic is clearly globally relevant. All nations, especially low and middle-income countries, could benefit from the proposed standardization.

  17. Testing Standard Reliability Criteria

    Science.gov (United States)

    Sherry, David

    2017-01-01

    Maul's paper, "Rethinking Traditional Methods of Survey Validation" (Andrew Maul), contains two stages. First he presents empirical results that cast doubt on traditional methods for validating psychological measurement instruments. These results motivate the second stage, a critique of current conceptions of psychological measurement…

  18. Standards and general criteria for the planning and certification of need of megavoltage radiation oncology units in health care facilities

    International Nuclear Information System (INIS)

    1977-01-01

    Minimum standards and guidelines to be applied by State agencies and New Jersey health systems agencies in the examination of certificate-of-need applications and in the development of planning activities for radiation oncology units in health care facilities are presented. Radiation oncology is a medical discipline devoted to education and research in the use of ionizing radiation for the treatment of neoplastic disease. The proper application of radiation can be directed at either curative or palliative intent. It is an important and effective technique for the management of cancer. Radiotherapy equipment in clinical use is divided into four main categories: superficial, orthovoltage, megavoltage, and treatment planning facilities. Particular attention is given to megavoltage equipment which emits or generates rays over 1,000 kilovolts. These high energy rays effect better penetration of human tissue and are skin-sparing in nature, thus allowing for better tumor-to- skin dose ratios. The regionalization of megavoltage therapy services is discussed. Data on hospital megavoltage facilities in New Jersey for 1974, 1975, and 1976 are provided. The standards and guidelines pertain to utilization, personnel, and general criteria. A form for use by megavoltage radiation therapy units is appended

  19. Iron deficiency among blood donors

    DEFF Research Database (Denmark)

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

    2017-01-01

    Blood components collected from blood donors are an invaluable part of modern-day medicine. A healthy blood donor population is therefore of paramount importance. The results from the Danish Blood Donor Study (DBDS) indicate that gender, number of previous donations, time since last donation...... 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...

  20. Organ utilization from increased infectious risk donors: An observational study.

    Science.gov (United States)

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

    2017-12-01

    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 multiple factors contribute to the perception of infectious risk from such organs. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Index of Non-Government Standards on Human Engineering Design Criteria and Program Requirements/Guidelines. Version 3

    National Research Council Canada - National Science Library

    Poston, Alan

    2002-01-01

    .... Since the designation of documents as standards by non-government standards bodies tends to be somewhat flexible, the scope of non-government standards for the Index was kept quite loose and includes...

  2. Alternative allogeneic donor sources for transplantation for childhood diseases: unrelated cord blood and haploidentical family donors.

    Science.gov (United States)

    Cairo, Mitchell S; Rocha, Vanderson; Gluckman, Eliane; Hale, Gregory; Wagner, John

    2008-01-01

    Allogeneic stem cell transplantation has been demonstrated to be curative in a wide variety of pediatric malignant and nonmalignant diseases, and can be traced back over 50 years ago to the original report of Thomas et al. HLA matched sibling donors have been the gold standard for pediatric recipients requiring allogeneic donors for both nonmalignant and malignant conditions. However, only 25% of potential pediatric recipients possesses an HLA-matched sibling donor, and the frequency is even less in those with genetic nonmalignant conditions because of genetically affected other siblings within the family. Therefore, 75% to 90% of potential pediatric recipients require alternative allogeneic donor cells for treatment of their underlying conditions. Potential alternative allogeneic donor sources include unrelated cord blood donors, unrelated adult donors, and haploidentical family donors. In this article we review the experience of both unrelated cord blood donor and haploidentical family donor transplants in selected pediatric malignant and nonmalignant conditions.

  3. Comparison of Test Procedures and Energy Efficiency Criteria in Selected International Standards & Labeling Programs for Copy Machines, External Power Supplies, LED Displays, Residential Gas Cooktops and Televisions

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Nina [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Zhou, Nan [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Fridley, David [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2012-03-01

    This report presents a technical review of international minimum energy performance standards (MEPS), voluntary and mandatory energy efficiency labels and test procedures for five products being considered for new or revised MEPS in China: copy machines, external power supply, LED displays, residential gas cooktops and flat-screen televisions. For each product, an overview of the scope of existing international standards and labeling programs, energy values and energy performance metrics and description and detailed summary table of criteria and procedures in major test standards are presented.

  4. Recruitment of feces donors among blood donors

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  5. Strategies for Meeting High Standards: Quality Management and the Baldrige Criteria in Education. Lessons from the States.

    Science.gov (United States)

    Barth, John; Burk, Zona Sharp; Serfass, Richard; Harms, Barbara Ann; Houlihan, G. Thomas; Anderson, Gerald; Farley, Raymond P.; Rigsby, Ken; O'Rourke, John

    This document, one of a series of reports, focuses on the adoption of principles of quality management, originally developed by W. Edwards Deming, and the Baldrige Criteria for use in education. These processes and tools for systemic organizational management, when comprehensively applied, produce performance excellence and continuous improvement.…

  6. A Content Analysis of the Congruence between the Evaluation Criteria of Superintendents and the Iowa Standards for School Leaders

    Science.gov (United States)

    Adams, Matthew J.

    2011-01-01

    The Problem: This study was designed to analyze the evaluation criteria of the instruments used to evaluate superintendents, the job descriptions for those superintendents, and the goals written as part of their Individual Administrator Professional Development Plans (IAPDPs) to determine whether superintendents are being held accountable for…

  7. Outcome of organs procured from donors on extracorporeal membrane oxygenation support: an analysis of kidney and liver allograft data.

    Science.gov (United States)

    Carter, Timothy; Bodzin, Adam S; Hirose, Hitoshi; West, Sharon; Hasz, Richard; Maley, Warren R; Cavarocchi, Nicholas C

    2014-07-01

    Extracorporeal membrane oxygenation has become rescue therapy for adults with overwhelming cardiac and/or respiratory failure. Not all patients are saved, creating a new cohort of potential organ donors. This study examines the outcomes of liver and kidney allografts procured from donors on extracorporeal membrane oxygenation (ECMO). A retrospective review was conducted through the local organ procurement organization. Donors on ECMO prior to notification were classified into donation after brain death (DBD) and donation after cardiac death (DCD). We compared short-term outcome data against published standards. Between 1995 and 2012, 97 organs were procured from 41 donors supported on ECMO. There were 68 kidneys donated, 51 were transplanted and 17 discarded. Excluding extended criteria donors, 29 DBD and 13 DCD kidneys were transplanted from donors supported on ECMO. Delayed graft function occurred in 34% of DBD kidneys and 38% of DCD kidneys. Kidney allograft survival at one yr was 93%. Twenty-four livers were procured, nine discarded, and 15 transplanted. Ninety-three percent of liver transplant recipients were alive with graft function at one yr. Donation after brain death kidneys procured from donors on ECMO perform similarly to non-ECMO organs with regard to delayed graft function (DGF), one-yr graft survival and function. Livers from ECMO donors have a higher discard rate than non-ECMO donors, but function similarly at six months and one yr. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Steps to standardization and validation of hippocampal volumetry as a biomarker in clinical trials and diagnostic criteria for Alzheimer’s disease

    Science.gov (United States)

    Jack, Clifford R; Barkhof, Frederik; Bernstein, Matt A; Cantillon, Marc; Cole, Patricia E; DeCarli, Charles; Dubois, Bruno; Duchesne, Simon; Fox, Nick C; Frisoni, Giovanni B; Hampel, Harald; Hill, Derek LG; Johnson, Keith; Mangin, Jean-François; Scheltens, Philip; Schwarz, Adam J; Sperling, Reisa; Suhy, Joyce; Thompson, Paul M; Weiner, Michael; Foster, Norman L

    2012-01-01

    Background The promise of Alzheimer’s disease (AD) biomarkers has led to their incorporation in new diagnostic criteria and in therapeutic trials; however, significant barriers exist to widespread use. Chief among these is the lack of internationally accepted standards for quantitative metrics. Hippocampal volumetry is the most widely studied quantitative magnetic resonance imaging (MRI) measure in AD and thus represents the most rational target for an initial effort at standardization. Methods and Results The authors of this position paper propose a path toward this goal. The steps include: 1) Establish and empower an oversight board to manage and assess the effort, 2) Adopt the standardized definition of anatomic hippocampal boundaries on MRI arising from the EADC-ADNI hippocampal harmonization effort as a Reference Standard, 3) Establish a scientifically appropriate, publicly available Reference Standard Dataset based on manual delineation of the hippocampus in an appropriate sample of subjects (ADNI), and 4) Define minimum technical and prognostic performance metrics for validation of new measurement techniques using the Reference Standard Dataset as a benchmark. Conclusions Although manual delineation of the hippocampus is the best available reference standard, practical application of hippocampal volumetry will require automated methods. Our intent is to establish a mechanism for credentialing automated software applications to achieve internationally recognized accuracy and prognostic performance standards that lead to the systematic evaluation and then widespread acceptance and use of hippocampal volumetry. The standardization and assay validation process outlined for hippocampal volumetry is envisioned as a template that could be applied to other imaging biomarkers. PMID:21784356

  9. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group.

    Science.gov (United States)

    Rodeghiero, Francesco; Stasi, Roberto; Gernsheimer, Terry; Michel, Marc; Provan, Drew; Arnold, Donald M; Bussel, James B; Cines, Douglas B; Chong, Beng H; Cooper, Nichola; Godeau, Bertrand; Lechner, Klaus; Mazzucconi, Maria Gabriella; McMillan, Robert; Sanz, Miguel A; Imbach, Paul; Blanchette, Victor; Kühne, Thomas; Ruggeri, Marco; George, James N

    2009-03-12

    Diagnosis and management of immune thrombocytopenic purpura (ITP) remain largely dependent on clinical expertise and observations more than on evidence derived from clinical trials of high scientific quality. One major obstacle to the implementation of such studies and in producing reliable meta-analyses of existing data is a lack of consensus on standardized critical definitions, outcome criteria, and terminology. Moreover, the demand for comparative clinical trials has dramatically increased since the introduction of new classes of therapeutic agents, such as thrombopoietin receptor agonists, and innovative treatment modalities, such as anti-CD 20 antibodies. To overcome the present heterogeneity, an International Working Group of recognized expert clinicians convened a 2-day structured meeting (the Vicenza Consensus Conference) to define standard terminology and definitions for primary ITP and its different phases and criteria for the grading of severity, and clinically meaningful outcomes and response. These consensus criteria and definitions could be used by investigational clinical trials or cohort studies. Adoption of these recommendations would serve to improve communication among investigators, to enhance comparability among clinical trials, to facilitate meta-analyses and development of therapeutic guidelines, and to provide a standardized framework for regulatory agencies.

  10. Dual kidney transplants from adult marginal donors successfully expand the limited deceased donor organ pool.

    Science.gov (United States)

    Stratta, Robert J; Farney, Alan C; Orlando, Giuseppe; Farooq, Umar; Al-Shraideh, Yousef; Palanisamy, Amudha; Reeves-Daniel, Amber; Doares, William; Kaczmorski, Scott; Gautreaux, Michael D; Iskandar, Samy S; Hairston, Gloria; Brim, Elizabeth; Mangus, Margaret; El-Hennawy, Hany; Khan, Muhammad; Rogers, Jeffrey

    2016-04-01

    The need to expand the organ donor pool remains a formidable challenge in kidney transplantation (KT). The use of expanded criteria donors (ECDs) represents one approach, but kidney discard rates are high because of concerns regarding overall quality. Dual KT (DKT) may reduce organ discard and optimize the use of kidneys from marginal donors. We conducted a single-center retrospective review of outcomes in adult recipients of DKTs from adult marginal deceased donors (DD) defined by limited renal functional capacity. If the calculated creatinine clearance in an adult DD was DKT. Over 11.5 yr, 72 DKTS were performed including 45 from ECDs, 17 from donation after cardiac death (DCD) donors, and 10 from standard criteria donors (SCD). Mean adult DD and recipient ages were both 60 yr, including 29 DDs and 26 recipients ≥65 yr of age. Mean pre-DKT waiting and dialysis vintage times were 12 months and 25 months, respectively. Actual patient and graft survival rates were 84.7% and 70.8%, respectively, with a mean follow-up of 58 months. One yr and death-censored graft survival rates were 90% and 80%, respectively. Outcomes did not differ by DD category, recipient age, or presence of delayed graft function (DGF). Eleven patients died at a mean of 32 months post-DKT (eight with functioning grafts) and 13 other patients experienced graft losses at a mean of 33 months. The incidence of DGF was 25%; there were two cases (2.8%) of primary non-function. Mean length of initial hospital stay was 7.2 d. Mean serum creatinine and glomerular filtration rate levels at 12 and 24 months were 1.5 and 53 and 1.5 mg/dL and 51 mL/min/1.73 m(2) , respectively. DKT graft survival and function were superior to concurrent single ECD and similar to concurrent SCD KTs. Two patients underwent successful kidney retransplantation, so the dialysis-free rate in surviving patients was 87%. The proportion of total renal function transplanted from adult DD to DKT recipients was 77% compared to 56% for

  11. An Evaluation of Forest Road Standards and Road Gradients in Turkey in View of FAO Criteria and Some EU Practices

    Directory of Open Access Journals (Sweden)

    Sadık Çağlar

    2009-04-01

    Full Text Available Forest roads are one of the inevitable infrastructures in conducting forestry operations. Around 1000 km under standardized forest roads have been largely repaired in addition to construction of 1000 km new forest roads in Turkey. Implementing uniform road gradient along the road sections is very important in terms of transportation techniques and safety, as well as the geometrical standardizations of the forest road. In this study, current road standards, longitudinal gradient values and their limitations in forest road constructions recommended by Food and Agriculture Organization of the United Nations (FAO and some Europe Union (EU countries were examined. Firstly, the forest road standards and their gradient values have been defined in Turkish forest road construction practices. Afterwards, the forest road standards and the gradient values applied by FAO and some EU countries were presented, and finally, the specifications were examined by comparing them with the current practices in Turkish forestry.

  12. Comparison of Test Procedures and Energy Efficiency Criteria in Selected International Standards and Labeling Programs for Clothes Washers, Water Dispensers, Vending Machines and CFLs

    Energy Technology Data Exchange (ETDEWEB)

    Fridley, David; Zheng, Nina; Zhou, Nan

    2010-06-01

    Since the late 1970s, energy labeling programs and mandatory energy performance standards have been used in many different countries to improve the efficiency levels of major residential and commercial equipment. As more countries and regions launch programs covering a greater range of products that are traded worldwide, greater attention has been given to harmonizing the specific efficiency criteria in these programs and the test methods for measurements. For example, an international compact fluorescent light (CFL) harmonization initiative was launched in 2006 to focus on collaboration between Australia, China, Europe and North America. Given the long history of standards and labeling programs, most major energy-consuming residential appliances and commercial equipment are already covered under minimum energy performance standards (MEPS) and/or energy labels. For these products, such as clothes washers and CFLs, harmonization may still be possible when national MEPS or labeling thresholds are revised. Greater opportunity for harmonization exists in newer energy-consuming products that are not commonly regulated but are under consideration for new standards and labeling programs. This may include commercial products such as water dispensers and vending machines, which are only covered by MEPS or energy labels in a few countries or regions. As China continues to expand its appliance standards and labeling programs and revise existing standards and labels, it is important to learn from recent international experiences with efficiency criteria and test procedures for the same products. Specifically, various types of standards and labeling programs already exist in North America, Europe and throughout Asia for products in China's 2010 standards and labeling programs, namely clothes washers, water dispensers, vending machines and CFLs. This report thus examines similarities and critical differences in energy efficiency values, test procedure specifications and

  13. Permit to Work System Conformity Analysis based on the System Standard Criteria in an Oil and Gas Extraction Company

    Directory of Open Access Journals (Sweden)

    A. Ghahramani

    2007-04-01

    Full Text Available Background and Aims   Permit to work (PTW system as an operational control methods, is an accepted system for control of maintenance activities hazards in chemical industries. The main objective of this study was degree of conformity analysis between existing situation of PTW system and audit criteria.     Methods   In this cross - sectional study, PTW system was audited in an oil and gas extracting   industry by checklist.     Results   Major nonconformities include outdating of system legal and regulation, non existence of permit for majority of dangerous activities, unidentified training needs, incomplete  identification and risk assessment of maintenance hazards before doing them, unspecified   inspection and survey frequencies during works and nonexistence of scheduled auditing for the system.     Conclusion   PTW audit results showed that there is a noticeable gap between audit criteria and  audit evidences. So that the examined system had nonconformities in all of the checklist sections; system, training and competency, permit, coordination and monitoring.  

  14. Prevalence of HIV positive blood donors among screened ...

    African Journals Online (AJOL)

    hope&shola

    2006-04-03

    Apr 3, 2006 ... Department of Physiology, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University Teaching. Hospital ... screening volunteer donors by initial criteria alone does not fully eliminate all HIV positive donors. The prevalence of HIV ... HIV test criteria alone to qualify for blood donation in the.

  15. Living donor liver transplantation for hepatocellular carcinoma achieves better outcomes.

    Science.gov (United States)

    Lin, Chih-Che; Chen, Chao-Long

    2016-10-01

    Liver transplantation (LT) for hepatocellular carcinoma (HCC) at Kaohsiung Chang Gung Memorial Hospital mainly relies on live donor LT (LDLT). Owing to taking the risk of LD, we are obligated to adopt strict selection criteria for HCC patients and optimize the pre-transplant conditions to ensure a high disease-free survival similar to those without HCC, even better than deceased donor LT (DDLT). Better outcomes are attributed to excellent surgical results and optimal patient selection. The hospital mortality of primary and salvage LDLT are lower than 2% in our center. Although Taiwan Health Insurance Policy extended the Milan to University of California, San Francisco (UCSF) criteria in 2006, selection criteria will not be consolidated to take into account only by the morphologic size/number of tumors but also by their biology. The criteria are divided into modifiable image morphology, alpha fetoprotein (AFP), and positron emission tomography (PET) scan with standard uptake value (SUV) and unmodifiable unfavorable pathology such as HCC combined with cholangiocarcinoma (CC), sarcomatoid type, and poor differentiation. Downstaging therapy is necessary for HCC patients beyond criteria to fit all modifiable standards. The upper limit of downstaging treatment seems to be extended by more effective drug eluting transarterial chemoembolization in cases without absolute contraindications. In contrast, the pitfall of unmodifiable tumor pathology should be excluded by the findings of pretransplant core biopsy/resection if possible. More recently, achieving complete tumor necrosis in explanted liver could almost predict no recurrence after transplant. Necrotizing therapy is advised if possible before transplant even the tumor status within criteria to minimize the possibility of tumor recurrence. LDLT with low surgical mortality in experienced centers provides the opportunities of optimizing the pre-transplant tumor conditions and timing of transplant to achieve better

  16. Data Acceptance Criteria for Standardized Human-Associated Fecal Source Identification Quantitative Real-Time PCR Methods

    Science.gov (United States)

    There is a growing interest in the application of human-associated fecal sourceidentification quantitative real-time PCR (qPCR) technologies for water quality management. The transition from a research tool to a standardized protocol requires a high degree of confidence in data q...

  17. Using system architecture, review entry criteria, and standard work package data to enable rapid development of integrated master schedules

    OpenAIRE

    Porter, Burton W., Jr.

    2016-01-01

    Approved for public release; distribution is unlimited While engineers must participate in the construction of the Integrated Master Schedule, this thesis proposes a way to reduce that effort through automation. When standardized sub processes exist, automated task name construction with consistent action/object naming convention can be applied to multiple system artifacts. These repeating sub processes also allow the derivation of task sequence and dependencies. The Architecture-Based Uti...

  18. Does the Gold Standard label hold its promise in delivering higher Sustainable Development benefits? A multi-criteria comparison of CDM projects

    International Nuclear Information System (INIS)

    Drupp, Moritz A.

    2011-01-01

    The Clean Development Mechanism (CDM) has a twin objective: to help developed countries reduce GHG emissions, and to support developing countries in achieving Sustainable Development (SD). As a response to the widespread criticism of the CDM's unsatisfactory SD record, initiatives have developed premium labels like the Gold Standard, which applies two additional 'screens' to filter CDM projects for higher SD benefits. In order to determine whether Gold Standard projects can be associated with higher local SD benefits, this paper evaluates the potential benefits of 48 CDM projects using a multi-criteria method and building on existing work. The 18 evaluated Gold Standard projects are compared to a 'representative portfolio' of 30 unlabeled CDM projects in order to capture the 'full' effect of the additional Gold Standard requirements, which is further decomposed into the two 'screen' effects. The results suggest that Gold Standard Certified Emission Reductions can be associated with higher potential local SD benefits when compared to the 'representative portfolio' of unlabeled CDM projects, while the comparison of projects of the same type remains inconclusive. The results support previous findings showing that renewable energy projects may deliver comparatively high SD benefits. - Research highlights: → This study evaluates and compares the potential contribution of unlabeled- and Gold Standard labeled CDM projects to Sustainable Development (SD), extending the previously assessed projects as well as the methodological approach. → Gold Standard labeled Certified Emission Reductions (CER) can be associated with higher potential SD benefits compared to unlabeled projects. → A decomposition analysis shows that the Gold Standard s SD surplus must be primarily attributed to the favorable contribution of renewable energy projects to SD. → Policy makers might thus shift incentives towards renewable energy projects and buyers of CERs may shift their offset

  19. Nyretransplantation med levende donor

    DEFF Research Database (Denmark)

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

    2000-01-01

    In recent years transplantation from living donors has accounted for 25-30% of all kidney transplants in Denmark corresponding to 40-45 per year. Most of these living donors are parents or siblings, although internationally an increasing number are unrelated donors. Donor nephrectomy is associate...... in cadaver transplantation. The ethical and psychological aspects related to transplantation from a living donor are complex and need to be carefully evaluated when this treatment is offered to the patients....

  20. IEEE standard criteria for type tests of class 1E modules used in nuclear power generating stations

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    The Institute of Electrical and Electronics Engineers has generated this document to provide direction for type testing Class 1E modules and obtaining specific type test data. It supplements IEEE Std 323-1974, Standard for Qualifying Class 1E Equipment for Nuclear Power Generating Stations, which describes the basic requirements for Class 1E equipment qualification. Adherence to this document alone may not suffice for assuring public health and safety because it is the integrated performance of the structures, the fluid systems, the electrical systems, the instrumentation systems of the station, and in particular, the plant protection system of which these modules are a part that prevents accidents or limits the consequences of accidents. Each applicant to the Nuclear Regulatory Commission for a license to operate a nuclear power generating station has the responsibility to assure himself and others that this document, if used, is pertinent to his application and that the integrated performance of his station is adequate

  1. Improving Standards of Care in Obstructed Labour: A Criteria-Based Audit at a Referral Hospital in a Low-Resource Setting in Tanzania

    Science.gov (United States)

    2016-01-01

    Objective In low-resource settings, obstructed labour is strongly associated with severe maternal morbidity and intrapartum asphyxia, and consequently maternal and perinatal deaths. This study evaluated the impact of a criteria-based audit of the diagnosis and management of obstructed labour in a low-resource setting. Methods A baseline criteria-based audit was conducted from October 2013 to March 2014, followed by a workshop in which stakeholders gave feedback on interventions agreed upon to improve obstetric care. The implemented interventions included but were not limited to introducing standard guidelines for diagnosis and management of obstructed labour, agreeing on mandatory review by specialist for cases that are assigned caesarean section, re-training and supervision on use and interpretation of partograph and, strengthening team work between doctors, mid-wives and theatre staff. After implementing these interventions in March, a re-audit was performed from July 2015 to November, 2015, and the results were compared to those of the baseline audit. Results Two hundred and sixty deliveries in the baseline survey and 250 deliveries in the follow-up survey were audited. Implementing the new criteria improved the diagnosis from 74% to 81% (p = 0.049) and also the management of obstructed labour from 4.2% at baseline audit to 9.2% at re-audit (p = 0.025). Improved detection of prolonged labour through heightened observation of regular contractions, protracted cervical dilatation, protracted descent of presenting part, arrested cervical dilation, and severe moulding contributed to improved standards of diagnosis (all p labour using available resources. Some of the observed changes in practice were of modest magnitude implying demand for further improvements, while sustaining those already put in place. PMID:27893765

  2. PATHOMORPHOLOGY OF ZERO BIOPSIES OF DONOR KIDNEYS

    Directory of Open Access Journals (Sweden)

    M. L. Arefjev

    2011-01-01

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

  3. Adverse events and retention of donors of double red cell units by apheresis

    Science.gov (United States)

    Keshelashvili, Ketevan; O’Meara, Alix; Stern, Martin; Jirout, Zuzana; Pehlic, Vildana; Holbro, Andreas; Buser, Andreas; Sigle, Jörg; Infanti, Laura

    2016-01-01

    Background Safety of double-erythrocyte (2RBC) collection and reasons for ceasing 2RBC donation were retrospectively analysed in the blood donor population of Basel, Switzerland. Methods Donors with at least 1 2RBC apheresis were included in the study. Minimal requirements were Hb ≥140 g/L and body weight ≥70 kg; serum ferritin (SF) values were measured routinely, but were not part of the selection criteria. 2RBC collections were performed with ALYX devices at 6-month intervals. Adverse events (AEs) were systematically recorded and classified according to the ISBT EHN 2008 criteria. Data of procedures were retrieved from the ALYX software. Demographics, apheresis data and AEs were analysed with descriptive statistics. Results Data of 4,377 2RBC aphereses performed in 793 donors (779 males) between 1st January 2003 and 31st May 2015 were evaluated. Mean donor age at first 2RBC donation was 44 years (standard deviation [SD] 21), median number of donations was 4 (interquartile range [IQR] 8); 32% of the donors underwent a single procedure. There were 161 AEs, mostly local haematomas (55%) and vasovagal reactions (20%); fatigue was reported in 6% of the cases and was more frequent than citrate toxicity. Two severe AEs were observed. The most frequent reasons for abandoning 2RBC donation were low SF levels and donor choice (both 11%), but most donors simply did not reply to invitations (16%). Overall, procedure-related causes (AEs, low SF levels, no time for apheresis, inadequate venous access) were observed in 14% of the cases. At the end of the observation period, 40% of the donors were still active blood donors, but only 20% were donating 2RBC. Discussion 2RBC donation is overall safe. Donor retention was low over a period of 11 years. An important reason for abandoning 2RBC was the detection of low SF levels. The impact of fatigue on donor retention and the course of iron stores after repeated 6-monthly 2RBC apheresis require further investigation. PMID:27136442

  4. Sero-prevalence of brucellosis among blood donors in Ahvaz, Southwest Iran

    Directory of Open Access Journals (Sweden)

    Abdolhussein Shakurnia

    2014-02-01

    Full Text Available Objective: To identify sero-prevalence of brucellosis among blood donors in Ahvaz city, Southwest Iran. Methods: A total number of 1 450 serum samples from blood donation were collected and were screened for the presence of brucella antibody. Rose Bengal Plate Test, Standard Agglutination Test (SAT, and 2-mercaptoethanol (2ME agglutination were tested in the sample. SAT dilution ≥1/80 and 2ME agglutination ≥1/40 were considered positive. Results: Sero-prevalence of brucellosis among the blood donors was 0.70%, 0.34%, and 0.20% by Rose Bengal Plate Test, SAT, and 2ME respectively. Conclusions: Considering the 1/80 titer of SAT as the criteria of contamination with brucella, routine screening of sero-prevalence of brucella in blood donors is not recommended in this area.

  5. What could be learned from a decade with standardized remission criteria in schizophrenia spectrum disorders: An exploratory follow-up study.

    Science.gov (United States)

    Johansson, Madeleine; Hjärthag, Fredrik; Helldin, Lars

    2018-05-01

    A decade has passed since the standardized remission criteria of schizophrenia spectrum disorders-the Andreasen Criteria-were defined. Over 2000 studies have been published, but only a few describe symptomatic remission over time. In this prospective study we followed patients for 3 and 5years, respectively. The aim was to investigate how different symptoms affect the occurrence of remission and how the remission cut-off level affects remission sustainability. The participants were patients diagnosed with schizophrenia spectrum disorders (DSM-IV). First, the importance of each core symptom for remission was examined using the Positive and Negative Syndrome Scale (n=274). Second, we investigated which items affect patients to either go in and out of remission or never achieve remission (n=154). Third, we investigated how the sustainability of remission is affected by a cut-off set to 2 (minimal) and 3 (mild) points, respectively (n=154). All core symptoms affected the occurence of remission, to a higher or lesser extent. Delusions and Hallucinatory behavior contributed the strongest to fluctuation between remission and non-remission, while the contribution of Mannerism and posturing was very marginal. Negative symptoms were enhanced when remission was never achieved. Moreover, the study found that remission duration was significantly longer for the cut-off score 2 rather than 3. The study shows that, over time, remission criteria discriminate between being stable, unstable, or never in remission. Patients with only a minimal occurrence of symptom intensity exhibit a significantly longer remission duration compared to patients with mild symptom intensity, indicating that the treatment goal should be minimal symptom intensity. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Serum neopterin: a potential marker for screening blood donors

    International Nuclear Information System (INIS)

    Ashfaq, A.; Ejaz, A.; Abbas, G.

    2017-01-01

    To determine serum neopterin levels in blood donors of local population and its association with transfusion ransmitted infections. Study Design: A cross-sectional observational study. Place and Duration of Study:Department of Physiology, Liaquat National Hospital and Medical College (LNHMC) in collaboration with Basic Medical Sciences Institute (BMSI) and Jinnah Postgraduate Medical Centre (JPMC), Blood Bank, Karachi, Pakistan, from January to June 2015. Methodology: During this period, a total of 174 blood donors were selected through random sampling technique. All participants fulfilling the inclusion criteria involving apparently healthy blood donors of either gender within the age bracket of 18 - 60 years and consenting to participate were selected. The participants were screened for transfusion transmitted infections as per WHO recommendations through the standard procedures used for screening at the JPMC blood bank. The demographic profile, anthropometric measurements and vitals were recorded for every participant. Serum neopterin was measured using ELISA kits. Data was analysed on SPSS version 21. ANOVA and chi-square tests were applied as tests of significance at a p-value of <0.05. Results: The neopterin content in the sera of disease negative blood donors was 6.23 +-2.19 nmol/l as compared to disease positive blood donors, in whom the neopterin level was increased to 15.10 +-4.93 nmol/l (p =0.001). Conclusion: The neopterin assay has the potential to detect a number of transfusion transmissible viral diseases; which may, or may not be revealed by the usually employed battery of routine tests. We conclude that the risk of transfusion transmitted pathogens in our population can be reduced significantly, using neopterin assay as a routine in blood banks. (author)

  7. Mesenchymal Stromal Cells as Anti-Inflammatory and Regenerative Mediators for Donor Kidneys During Normothermic Machine Perfusion.

    Science.gov (United States)

    Sierra-Parraga, Jesus Maria; Eijken, Marco; Hunter, James; Moers, Cyril; Leuvenink, Henri; Møller, Bjarne; Ploeg, Rutger J; Baan, Carla C; Jespersen, Bente; Hoogduijn, Martin J

    2017-08-15

    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 transplantation. However, the quality of these organs may be inferior to standard donor organs. A major issue affecting graft function and survival is ischemia/reperfusion injury, which particularly affects kidneys from deceased donors. The development of hypothermic machine perfusion has been introduced in kidney transplantation as a preservation technique and has improved outcomes in ECD and marginal organs compared to static cold storage. Normothermic machine perfusion (NMP) is the most recent evolution of perfusion technology and allows assessment of the donor organ before transplantation. The possibility to control the content of the perfusion fluid offers opportunities for damage control and reparative therapies during machine perfusion. Mesenchymal stromal cells (MSC) have been demonstrated to possess potent regenerative properties via the release of paracrine effectors. The combination of NMP and MSC administration at the same time is a promising procedure in the field of transplantation. Therefore, the MePEP consortium has been created to study this novel modality of treatment in preparation for human trials. MePEP aims to assess the therapeutic effects of MSC administered ex vivo by NMP in the mechanisms of injury and repair in a porcine kidney autotransplantation model.

  8. Evaluation of air quality in environmental impact assessments. Evaluation criteria and standards with a view to effective precautionary care of the environment; Die Bewertung der Luftqualitaet bei Umweltvertraeglichkeitspruefungen. Bewertungsmassstaebe und Standards zur Konkretisierung einer wirksamen Umweltvorsorge

    Energy Technology Data Exchange (ETDEWEB)

    Kuehling, W.; Peters, H.J.

    1994-12-31

    Since the beginning of the debate surrounding the environmental impact statement in Germany, opinion is divided over what yardsticks should be applied in assessing a scheme`s environmental impact, and what consequences they involve for the environment. This book is a comprehensive compilation of air quality standards by substances and objects of protection containing a definition of the term ``active precautionary care of the environment`` as mentioned in section 1 of the act on environmental impact statements (UVPG). The reasons that the book is important for day-to-day work with environmental impact statements lie, for one thing, in its technical relevance and, for the other, in the fact that the proposed assessment criteria are legally unobjectionable. The book stakes out the legal boundaries, points out differentiated criteria for the definition of standards, selects relevant substances, explains the procedure in defining standards and the evaluation grid used, demonstrates how the standards are applied, and contains a tabulated summary. Part two of the book deals with the investigated compounds and groups of compounds. (orig./HP) [Deutsch] Seit der UVP-Debatte in Deutschland ist strittig, welcher Massstab bei der Beurteilung der Umweltvertraeglichkeit einer Massnahme anzulegen ist und wie deren Umweltauswirkungen zu bewerten sind. Mit der vorliegenden Arbeit liegt eine umfassende stoff- und schutzgutorientierte Zusammenstellung von Luftqualitaetsstandards und eine Interpretation des Begriffes ``wirksame Umweltvorsorge`` nach Para. 1 UVPG vor. Die Bedeutung der Arbeit fuer die UVP-Praxis liegt neben der fachwissenschaftlichen Relevanz vor allem auch in der juristischen Absicherung der vorgeschlagenen Bewertungsmassstaebe. (orig./HP)

  9. CeasIng Cpap At standarD criteriA (CICADA): impact on weight gain, time to full feeds and caffeine use.

    Science.gov (United States)

    Broom, Margaret; Ying, Lei; Wright, Audrey; Stewart, Alice; Abdel-Latif, Mohamed E; Shadbolt, Bruce; Todd, David A

    2014-09-01

    In our previous randomised controlled trial (RCT), we have shown in preterm babies (PBs) Cpap At standarD criteriA (CICADA (method 1)) compared with cycling off continuous positive airway pressure (CPAP) gradually (method 2) or cycling off CPAP gradually with low flow air/oxygen during periods off CPAP (method 3) reduces CPAP cessation time in PBs CPAP; the CICADA method, does not adversely affect weight gain, time to reach full feeds and may reduce time to cease caffeine in PBs <30 weeks gestation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. On harm thresholds and living organ donation: must the living donor benefit, on balance, from his donation?

    Science.gov (United States)

    Williams, Nicola Jane

    2018-03-01

    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.

  11. Donor-derived aspergillosis from use of a solid organ recipient as a multiorgan donor.

    Science.gov (United States)

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

    2010-02-01

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

  12. Prevalence of HIV positive blood donors among screened ...

    African Journals Online (AJOL)

    Two thousand five hundred and thirty two (2,532) males, aged 25 – 50 years potential blood donors were randomly selected from the total number of volunteer blood donors who satisfied the initial screening criteria for donating blood, and were screened for HIV using Immunocomb II (HIV 1 and 2 Bispot) and Recombigen ...

  13. Blood donor: nursing care plan

    OpenAIRE

    Marco Antonio Zapata Sampedro; Laura Castro Varela

    2008-01-01

    The standardized nursing care plan can be used as a means through which the nurse will assess and identify the particular needs of the blood donor.To draw up the care plan, we have conducted the evaluation on the basis of the Marjory Gordon’s functional health patterns.The more prevailing diagnosis according to the NANDA taxonomy have been identified, results have been established according to the NOC (Nursing Outcomes Classification) taxonomy, and nursing interventions have been suggested ac...

  14. Trends in organ donor management: 2002 to 2012.

    Science.gov (United States)

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

    2014-10-01

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

  15. Geologic disposal of spent nuclear fuel and nuclear waste: Ethical and technical bases for standards and criteria to protect public health

    International Nuclear Information System (INIS)

    Pigford, T.H.

    1999-01-01

    The proposed geologic repositories being designed in the US and in other countries that have nuclear power plants need well-defined goals and criteria to protect public health. The criteria must be stringent enough to build confidence in the adequacy of public health protection in the face of legal and political challenges. Yet, there are emerging pressures for relaxation of traditional approaches to protect public health when applied to buried radioactive waste. To build acceptance by the scientific community and the public, both the benefits and consequences of proposed relaxed standards must be dealt with openly and understandably. Arguments over safety standards center on six key issues. (1) For how long must public health protection be assured? Should protection be based on calculated radiation doses to people living for many tens of thousands of years in the future, until peak values of calculated radiation have appeared, or should the protection period be limited to a few thousand years? (2) Whom to protect? Should protection be based on protecting the critical group of future people who unknowingly eat food and drink water contaminated by released radioactivity or should it be based on limiting the average exposure, averaged over all persons projected to live within 'the vicinity' of the repository site? (3) How much radiation exposure should be allowed? Should future people be protected to the same level of radiation exposure as now required for licensed nuclear facilities, or should greater exposures be allowed because future people might be better protected by medical breakthroughs or by their taking remedial action to detect and clean up radioactivity that reaches the environment? (4) Can future people be excluded from using contaminated water drawn from near the site? Should protection of future people be based on doses calculated for ground water extracted from present farming wells, where distance and dilution resulted in lower calculated contaminant

  16. Management to optimize organ procurement in brain dead donors.

    Science.gov (United States)

    Mascia, L; Mastromauro, I; Viberti, S; Vincenzi, M; Zanello, M

    2009-03-01

    The demand for donor organs continues to exceed the number of organs available for transplantation. Many reasons may account for this discrepancy, such as the lack of consent, the absence of an experienced coordinator team able to solve logistical problems, the use of strict donor criteria, and suboptimal, unstandardized critical care management of potential organ donors. This has resulted in efforts to improve the medical care delivered to potential organ donors, so as to reduce organ shortages, improve organ procurement, and promote graft survival. The physiological changes that follow brain death entail a high incidence of complications jeopardizing potentially transplantable organs. Adverse events include cardiovascular changes, endocrine and metabolic disturbances, and disruption of internal homeostasis. Brain death also upregulates the release of pro-inflammatory molecules. Recent findings support the hypothesis that a preclinical lung injury characterized by an enhanced inflammatory response is present in potential donors and may predispose recipients to an adverse clinical prognosis following lung transplantation. In clinical practice, hypotension, diabetes insipidus, relative hypothermia, and natremia are more common than disseminated intravascular coagulation, cardiac arrhythmias, pulmonary oedema, acute lung injury, and metabolic acidosis. Strategies for the management of organ donors exist and consist of the normalization of donor physiology. Management has been complicated by the recent use of ''marginal'' donors and donors of advanced age or with ''extended'' criteria. Current guidelines suggest that the priority of critical care management for potential organ donors should be shifted from a ''cerebral protective'' strategy to a multimodal strategy aimed to preserve peripheral organ function.

  17. Organ donors: deceased or alive? Quo vadis?

    Science.gov (United States)

    Rozental, R

    2006-01-01

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

  18. Plutonium storage criteria

    Energy Technology Data Exchange (ETDEWEB)

    Chung, D. [Scientech, Inc., Germantown, MD (United States); Ascanio, X. [Dept. of Energy, Germantown, MD (United States)

    1996-05-01

    The Department of Energy has issued a technical standard for long-term (>50 years) storage and will soon issue a criteria document for interim (<20 years) storage of plutonium materials. The long-term technical standard, {open_quotes}Criteria for Safe Storage of Plutonium Metals and Oxides,{close_quotes} addresses the requirements for storing metals and oxides with greater than 50 wt % plutonium. It calls for a standardized package that meets both off-site transportation requirements, as well as remote handling requirements from future storage facilities. The interim criteria document, {open_quotes}Criteria for Interim Safe Storage of Plutonium-Bearing Solid Materials{close_quotes}, addresses requirements for storing materials with less than 50 wt% plutonium. The interim criteria document assumes the materials will be stored on existing sites, and existing facilities and equipment will be used for repackaging to improve the margin of safety.

  19. 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.

    2017-01-01

    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

  20. Water Quality Criteria

    Science.gov (United States)

    EPA develops water quality criteria based on the latest scientific knowledge to protect human health and aquatic life. This information serves as guidance to states and tribes in adopting water quality standards.

  1. LONG-TERM OUTCOMES OF DECEASED DONOR LIVER TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2014-01-01

    Full Text Available Aim of the study was to evaluate patient and graft survival after liver transplantation (LT and to determine if primary disease diagnosis, early graft dysfunction or other factors affect it. Furthermore, we analyzed the reasonsof short-term and long-term deaths or retransplantations.Materials and methods. 192 LTs from donors with brain death were performed from December 2004 until June 2014. Recipient age varied from 5 to 71 years. Most frequent diagnosis was liver cirrhosis (mainly due to hepatitis C, then hepatocellular carcinoma (HCC, liver graft dysfunction, etc.Results and discussion. 1-year patient survival is 89.5%, graft survival is 87.7%, 3-year –87% and 84.6%, respectively, and 5-year – 83.5% and 83.0%, respectively. Early mortality (in fi rst 30 days after transplantation was 8%, long-term mortality – 5.9%. Primary non-function graft (PNF was the reason of 66.7% early deaths. In the long term, infections and oncology were the reasons of death with the same frequency – 36.4%. Early graft dysfunction including primary non-function signifi cantly decreases short term survival (p = 0.0002. Nevertheless, in the majority of cases graft function improves and doesn’t affect survival. Donor factors play role in outcomes: early dysfunction is higher (40.6% in extended criteria donor group than in standard donor group (р = 0.0431. PNF has the same trend – 8.5% and 0.0%, respectively, but without signifi cance (р =0.0835. 5-year survival is remarkably lower in HCC group 40.8% (p = 0.003 than in other groups.Conclusion: survival after liver transplantation in our Center is comparable with the results of the world’s centers.

  2. Donor insemination: eugenic and feminist implications.

    Science.gov (United States)

    Hanson, F A

    2001-09-01

    One concern regarding developments in genetics is that, when techniques such as genetic engineering become safe and affordable, people will use them for positive eugenics: to "improve" their offspring by enpowering them with exceptional qualities. Another is whether new reproductive technologies are being used to improve the condition of women or as the tools of a patriarchal system that appropriates female functions to itself and exploits women to further its own ends. Donor insemination is relevant to both of these issues. The degree to which people have used donor insemination in the past for positive eugenic purposes may give some insight into the likelihood of developing technologies being so used in the future. Donor insemination provides women with the opportunity to reproduce with only the most remote involvement of a man. To what degree do women take advantage of this to liberate themselves from male dominance? Through questionnaires and interviews, women who have used donor insemination disclosed their criteria for selecting sperm donors. The results are analyzed for the prevalence of positive eugenic criteria in the selection process and women's attitudes toward minimizing the male role in reproduction.

  3. Analyses of 123 Peripheral Human Immune Cell Subsets: Defining Differences with Age and between Healthy Donors and Cancer Patients Not Detected in Analysis of Standard Immune Cell Types

    Directory of Open Access Journals (Sweden)

    Lauren M. Lepone

    2016-03-01

    Full Text Available Recent advances in human immunology have led to the identification of novel immune cell subsets and the biological function of many of these subsets has now been identified. The recent US Food and Drug Administration approval of several immunotherapeutics for the treatment of a variety of cancer types and the results of ongoing immunotherapy clinical studies requires a more thorough interrogation of the immune system. We report here the use of flow cytometry-based analyses to identify 123 immune cell subsets of peripheral blood mononuclear cells. The use of these panels defines multiple differences in younger (< 40 years vs. older (≥ 40 years individuals and between aged-matched apparently healthy individuals and metastatic cancer patients, aspects not seen in the analysis of the following standard immune cell types: CD8, CD4, natural killer, natural killer-T, regulatory T, myeloid derived suppressor cells, conventional dendritic cells (DCs, plasmacytoid DCs and B cells. The use of these panels identifying 123 immune cell subsets may aid in the identification of patients who may benefit from immunotherapy, either prior to therapy or early in the immunotherapeutic regimen, for the treatment of cancer or other chronic or infectious diseases.

  4. Donor Smoking and Older Age Increases Morbidity and Mortality After Lung Transplantation

    DEFF Research Database (Denmark)

    Schultz, H H; Møller, C H; Zemtsovski, M

    2017-01-01

    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...

  5. Donor Telomere Length SAA

    Science.gov (United States)

    A new NCI study has found that, among patients with severe aplastic anemia who received a hematopoietic cell transplant from an unrelated donor, those whose donor white blood cells had longer telomeres had higher survival rates five-years after transplant

  6. Systems of donor transfer

    NARCIS (Netherlands)

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

    1993-01-01

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

  7. A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skane randomized controlled trial protocol (BASRCT)

    NARCIS (Netherlands)

    Liljedahl, S.I.; Helleman, M.; Daukantaite, D.; Westrin, A.; Westling, S.

    2017-01-01

    BACKGROUND: Brief Admission is a crisis and risk management strategy in which self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder self-admit to hospital at times of increasing risk when other efforts to stay safe are failing. Standardized

  8. RESULTS OF THE SPECIAL BLOOD DONOR DAY

    CERN Document Server

    SC Unit

    2008-01-01

    Responding to the HUG (Hôpitaux Universitaires de Genève) hospitals’ urgent appeal for blood donations during this summer season, the CERN medical staff organised a day of blood donations for the Swiss bloodbank CTS on 30 July. They were supported by NOVAE (Restaurant No. 1), who provided donors with a free snack. This specially arranged campaign was a success, as the 135 volunteers included 66 first-time donors, and a total of 99 standard bags of blood was collected. (Swiss hospitals need 1300 bags every day!) The CTS and CERN’s medical staff want to thank the donors and all others who helped make the event a success. Upcoming blood donor days at CERN: 12 November 2008 and 10 March 2009.

  9. RESULTS OF THE SPECIAL BLOOD DONOR DAY

    CERN Document Server

    SC Unit

    2008-01-01

    Responding to the HUG (Hôpitaux Universitaires de Genève) hospitals’ urgent appeal for blood donations during this summer season, the CERN medical staff organised a day of blood donations for the Swiss bloodbank CTS on 30 July. They were supported by NOVAE (Restaurant No. 1), who provided donors with a free snack. This specially arranged campaign was a success, as the 135 volunteers included 66 first-time donors, and a total of 99 standard bags of blood were collected. (Swiss hospitals need 1300 bags every day!) The CTS and CERN’s medical staff wish to thank the donors and all others who helped make the event a success. Upcoming blood donor days at CERN: 12 November 2008 and 10 March 2009.

  10. Marginal kidney donor

    Directory of Open Access Journals (Sweden)

    Ganesh Gopalakrishnan

    2007-01-01

    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. The potential of cardiac allografts from donors after cardiac death at the University of Wisconsin Organ Procurement Organization.

    Science.gov (United States)

    Osaki, Satoru; Anderson, James E; Johnson, Maryl R; Edwards, Niloo M; Kohmoto, Takushi

    2010-01-01

    The purpose of this study is to investigate the potential availability of hearts from adult donation after cardiac death (DCD) donors within an acceptable hypoxic period. We retrospectively reviewed a donor database from the University of Wisconsin Organ Procurement Organization Donor Tracking System between 2004 and 2006. The DCD population (n=78) was screened using our inclusion criteria for DCD cardiac donor suitability, including warm ischaemic time (WIT) limit of 30 min. In the same period, 70 hearts were donated from brain-dead donors. Of 78 DCD donors, 12 (15%) met our proposed DCD cardiac donor criteria. The mean WIT of these 12 DCD donors was 21 min (range 14-29 min). When inclusion criteria are further narrowed to (1) age Based on our proposed DCD cardiac donor criteria, the potential application of DCD cardiac donors would represent an increase in cardiac donation of 17% (12/70) during the 3-year period. When the criteria were narrowed to the initial 'ideal' case, only two donors met such criteria, suggesting that such 'ideal' DCD donors are rare but they do exist. Copyright 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

  12. Analysis of blood donor pre-donation deferral in Dubai: characteristics and reasons

    OpenAIRE

    Al Shaer, Laila; Sharma, Ranjita; AbdulRahman, Mahera

    2017-01-01

    Laila Al Shaer,1 Ranjita Sharma,2 Mahera AbdulRahman2 1College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE; 2Dubai Health Authority, Dubai, UAE Background: To ensure an adequate and safe blood supply, it is crucial to select suitable donors according to stringent eligibility criteria. Understanding the reasons for donor deferral can help in planning more efficient recruitment strategies and evaluating donor selection criteria. This study aims to def...

  13. Frequency and risk factors for donor reactions in an anonymous blood donor survey.

    Science.gov (United States)

    Goldman, Mindy; Osmond, Lori; Yi, Qi-Long; Cameron-Choi, Keltie; O'Brien, Sheila F

    2013-09-01

    Adverse donor reactions can result in injury and decrease the likelihood of donor return. Reaction reports captured in the blood center's database provide an incomplete picture of reaction rates and risk factors. We performed an anonymous survey, mailed to 40,000 donors in 2008, including questions about symptoms, height, weight, sex, and donation status. Reaction rates were compared to those recorded in our database. Possible risk factors were assessed for various reactions. The response rate was 45.5%. A total of 32% of first-time and 14% of repeat donors reported having any adverse symptom, most frequently bruising (84.9 per 1000 donors) or feeling faint or weak (66.2 per 1000). Faint reactions were two to eight times higher than reported in our database, although direct comparison was difficult. Younger age, female sex, and first-time donation status were risk factors for systemic and arm symptoms. In females, low estimated blood volume (EBV) was a risk factor for systemic symptoms. Only 51% of donors who consulted an outside physician also called Canadian Blood Services. A total of 10% of first-time donors with reactions found adverse effects information inadequate. This study allowed us to collect more information about adverse reactions, including minor symptoms and delayed reactions. Based on our findings of the risk factors and frequency of adverse reactions, we are implementing more stringent EBV criteria for younger donors and providing more detailed information to donors about possible adverse effects and their management. © 2012 American Association of Blood Banks.

  14. National Marrow Donor Program

    National Research Council Canada - National Science Library

    Setterholm, Michelle

    2008-01-01

    ... a nationwide contingency response plan. 2. Rapid Identification of Matched Donors : Increase operational efficiencies that accelerate the search process and increase patient access are key to preparedness in a contingency event. pa 3...

  15. Organismal death, the dead-donor rule and the ethics of vital organ procurement.

    Science.gov (United States)

    Symons, Xavier; Chua, Reginald Mary

    2018-06-19

    Several bioethicists have recently discussed the complexity of defining human death, and considered in particular how our definition of death affects our understanding of the ethics of vital organ procurement. In this brief paper, we challenge the mainstream medical definition of human death-namely, that death is equivalent to total brain failure-and argue with Nair-Collins and Miller that integrated biological functions can continue even after total brain failure has occurred. We discuss the implications of Nair-Collins and Miller's argument and suggest that it may be necessary to look for alternative biological markers that reliably indicate the death of a human being. We reject the suggestion that we should abandon the dead-donor criteria for organ donation. Rather than weaken the ethical standards for vital organ procurement, it may be necessary to make them more demanding. The aim of this paper is not to justify the dead donor rule. Rather, we aim to explore the perspective of those who agree with critiques of the whole brain and cardiopulmonary definitions of death but yet disagree with the proposal that we should abandon the dead-donor rule. We will consider what those who want to retain the dead-donor rule must argue in light of Nair-Collins and Miller's critique. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. Donor-derived infections in solid organ transplant patients: toward a holistic approach.

    Science.gov (United States)

    Benamu, Esther; Wolfe, Cameron R; Montoya, José G

    2017-08-01

    Solid organ demand far exceeds organ supply. Strategies to increase the donor pool include the liberalization of selection criteria without increasing the risk of unexpected donor-derived infection (DDI), a rare complication of transplantation carrying high morbidity and mortality. We review the challenging aspects in the prevention of DDI, focusing on the complexities of data sharing and efficient communication and the role infectious diseases specialists play in the process. Advances in donor screening, transmission recognition and reporting allow for a better estimation of the risk of DDI. However, there is great variability in the frequency and methods with which organ procurement organizations report transmission events.Moreover, the Scientific Registry of Transplant Recipients provides limited donor and recipient outcome infectious diseases related data. Infectious disease contribution to the allocation process has been found to improve organ donation efficiency and communication between involved parties. Although communication gaps are strongly associated with infection transmission (relative risk 2.36%, confidence interval 1.48-3.78), effective communication minimizes or prevents infection in transplant recipients (X(1) 13.13, P = 0.0003). Prospective research is still required to define optimal screening protocols and further prevent transmission of infection. A holistic approach is likely to result in enhanced transplantation safety. Toward this goal, development of standards of investigation; improvement in reporting and data sharing; and strategies ensuring coordinated and rapid communication among parties involved in the allocation process need to be pursued.

  17. How to optimize the lung donor.

    Science.gov (United States)

    Sales, Gabriele; Costamagna, Andrea; Fanelli, Vito; Boffini, Massimo; Pugliese, Francesco; Mascia, Luciana; Brazzi, Luca

    2018-02-01

    Over the last two decades, lung transplantation emerged as the standard of care for patients with advanced and terminal lung disease. Despite the increment in lung transplantation rates, in 2016 the overall mortality while on waiting list in Italy reached 10%, whereas only 39% of the wait-list patients were successfully transplanted. A number of approaches, including protective ventilatory strategy, accurate management of fluid balance, and administration of a hormonal resuscitation therapy, have been reported to improve lung donor performance before organ retrieval. These approaches, in conjunction with the use of ex-vivo lung perfusion technique contributed to expand the lung donor pool, without affecting the harvest of other organs and the outcomes of lung recipients. However, the efficacy of issues related to the ex-vivo lung perfusion technique, such as the optimal ventilation strategy, the ischemia-reperfusion induced lung injury management, the prophylaxis of germs transmission from donor to recipient and the application of targeted pharmacologic therapies to treat specific donor lung injuries are still to be explored. The main objective of the present review is to summarize the "state-of-art" strategies to optimize the donor lungs and to present the actual role of ex-vivo lung perfusion in the process of lung transplant. Moreover, different approaches about the technique reported in literature and several issues that are under investigation to treat specific donor lung injury will be discussed.

  18. Will the changes proposed to the conceptual framework’s definitions and recognition criteria provide a better basis for the IASB standard setting?

    NARCIS (Netherlands)

    Brouwer, A.; Hoogendoorn, M.; Naarding, E.

    2015-01-01

    In this paper we evaluate the International Accounting Standards Board’s (IASB) efforts, in a discussion paper (DP) of 2013, to develop a new conceptual framework (CF) in the light of its stated ambition to establish a robust and consistent basis for future standard setting, thereby guiding standard

  19. Criteria CSR

    OpenAIRE

    Vovk, V.; Zateyshikova, O.

    2014-01-01

    In the article the theoretical aspects regarding criteria for assessing CSR proposed by A. Carroll, including: economic, legal, ethical, philanthropic. Based on this, it is proposed to characterize these criteria with respect to the interested parties (stakeholders), including: investors, shareholders suppliers, customers, employees, society and the state. This will make a qualitative assessment of the presence and depth using social responsibility in the company, as well as determine the ext...

  20. Current status of malaria parasite among blood donors in Port ...

    African Journals Online (AJOL)

    This study was carried out to determine the prevalence of malaria parasite among blood donors at the Police Clinic Port Harcourt, Rivers State, Nigeria. The standard parasitological techniques using both thick and thin blood films from the donors for the detection of malaria parasite was followed. Venous blood was ...

  1. [Is there an age limit for cadaveric kidney donors currently?].

    Science.gov (United States)

    Cofán Pujol, F; Oppenheimer Salinas, F; Talbot-Wright, R; Carretero González, P

    1996-12-01

    The insufficient number of kidney transplants has gradually raised the age limit to the cadaver kidney donor. The use of grafts harvested from older donors has been debated due to the existing structural and functional changes that might influence renal function and long-term graft survival. The foregoing aspects are discussed herein. The anatomical, histological and functional changes in the kidney associated with ageing are analyzed. The clinical experience with renal grafts from older donors before and after cyclosporine became available are reviewed. The ethical issues on whether grafts from very old donors should be used and who should receive these grafts are discussed. The use of grafts from donors over 60 years old had no significant short and medium term differences in comparison with younger donors in terms of graft survival, although a higher incidence of acute tubular necrosis and poor renal function have been observed. There are no conclusive studies on the long-term effects on graft survival when kidneys from donors aged over 65 are utilized. In our experience, the results achieved with grafts from donors over 70 has been unsatisfactory. The guidelines utilized in the selection of grafts derived from older donors are presented. Grafts from donors aged 60 to 70 may be utilized in renal transplantation following precise selection criteria. Graft survival has been satisfactory, although a higher incidence of acute tubular necrosis and higher creatinine levels have been observed. We do not advocate the use of grafts from donors over 70, except in very exceptional cases. Long-term multicenter studies on grafts from very old donors and trials using alternative immunosuppressor modalities that might permit optimal use of these grafts are warranted.

  2. Causes of iron overload in blood donors - a clinical study

    DEFF Research Database (Denmark)

    Laursen, A H; Bjerrum, O W; Friis-Hansen, L

    2018-01-01

    BACKGROUND AND OBJECTIVES: Despite the obligate iron loss from blood donation, some donors present with hyperferritinaemia that can result from a wide range of acute and chronic conditions including hereditary haemochromatosis (HH). The objective of our study was to investigate the causes...... of hyperferritinaemia in the blood donor population and explore the value of extensive HH mutational analyses. MATERIALS AND METHODS: Forty-nine consecutive donors (f = 6, m = 43) were included prospectively from the Capital Regional Blood Center. Inclusion criteria were a single ferritin value >1000 μg/l or repeated...... four donors had apparent alternative causes of hyperferritinaemia. CONCLUSION: HH-related mutations were the most frequent cause of hyperferritinaemia in a Danish blood donor population, and it appears that several different HH-genotypes can contribute to hyperferritinaemia. HH screening in blood...

  3. Expanding the pool of kidney donors: use of kidneys with acute renal dysfunction

    OpenAIRE

    Matos, Ana Cristina Carvalho de; Requião-Moura, Lúcio Roberto; Clarizia, Gabriela; Durão Junior, Marcelino de Souza; Tonato, Eduardo José; Chinen, Rogério; Arruda, Érika Ferraz de; Filiponi, Thiago Corsi; Pires, Luciana Mello de Mello Barros; Bertocchi, Ana Paula Fernandes; Pacheco-Silva, Alvaro

    2015-01-01

    ABSTRACT Given the shortage of organs transplantation, some strategies have been adopted by the transplant community to increase the supply of organs. One strategy is the use of expanded criteria for donors, that is, donors aged >60 years or 50 and 59 years, and meeting two or more of the following criteria: history of hypertension, terminal serum creatinine >1.5mg/dL, and stroke as the donor´s cause of death. In this review, emphasis was placed on the use of donors with acute renal failure, ...

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

    LENUS (Irish Health Repository)

    D'Arcy, Frank T

    2009-10-01

    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.

  5. Cancer Incidence and Mortality in a Cohort of US Blood Donors: A 20-Year Study

    International Nuclear Information System (INIS)

    Vahidnia, F.; Busch, M. P.; Custer, B.; Hirschler, N. V.; Chinn, A.; Agapova, M.; Busch, M. P.; Custer, B.

    2013-01-01

    Blood donors are considered one of the healthiest populations. This study describes the epidemiology of cancer in a cohort of blood donors up to 20 years after blood donation. Records from donors who participated in the Retroviral Epidemiology Donor Study (REDS, 1991-2002) at Blood Centers of the Pacific (BCP), San Francisco, were linked to the California Cancer Registry (CCR, 1991-2010). Standardized incidence ratios (SIR) were estimated using standard US 2000 population, and survival analysis used to compare all-cause mortality among donors and a random sample of non donors with cancer from CCR. Of 55,158 eligible allogeneic blood donors followed-up for 863,902 person-years, 4,236 (7.7%) primary malignant cancers were diagnosed. SIR in donors was 1.59 (95% CI = 1.54,1.64). Donors had significantly lower mortality (adjusted HR = 0.70, 95% CI = 0.66-0.74) compared with non donor cancer patients, except for respiratory system cancers (adjusted HR = 0.93, 95% CI = 0.82-1.05). Elevated cancer incidence among blood donors may reflect higher diagnosis rates due to health seeking behavior and cancer screening in donors. A “healthy donor effect” on mortality following cancer diagnosis was demonstrated. This population-based database and sample repository of blood donors with long-term monitoring of cancer incidence provides the opportunity for future analyses of genetic and other bio markers of cancer

  6. BLOOD DONORS CAMPAIGN

    CERN Document Server

    Medical Service

    2002-01-01

    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.

  7. BLOOD DONORS CAMPAIGN

    CERN Multimedia

    2001-01-01

    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.

  8. BLOOD DONORS CAMPAIGN

    CERN Document Server

    2002-01-01

    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.

  9. BLOOD DONORS CAMPAIGN

    CERN Document Server

    2000-01-01

    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.

  10. BLOOD DONORS CAMPAIGN

    CERN Document Server

    2001-01-01

    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.

  11. Donor transplant programme

    International Nuclear Information System (INIS)

    Abu Bakar Sulaiman

    1999-01-01

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

  12. Liver transplantation utilizing old donor organs: a German single-center experience.

    Science.gov (United States)

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

    2010-01-01

    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 donor 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.

  13. Universal donor education and consent: what we know and where we should go.

    Science.gov (United States)

    Wehrli, Gay; Sazama, Kathleen

    2010-11-01

    Each day thousands of blood donors across the country are given educational materials and sign a consent form, thus fulfilling two blood collection accreditation requirements. Very few donors will experience a documented adverse event, although a disproportionate number of these events occur in the youngest donor cohort. The literature reflects this disproportion and suggests mitigation strategies. Studies describe subjective, undocumented donor reactions and decreased donor return rates after a documented or subjective reaction. Additionally, studies have shown donor consent form variability among blood collection facilities and that donor comprehension of the educational materials and consent is limited. There are few standardized donor education materials or consent documents. Current accreditation standards for educational materials are limited to aspects of transfusion-transmitted diseases and for donor consent process and documentation are vague and nonspecific. Recent experiences with young donors and current research compel our community to engage in creating standardized, expanded donor educational materials and standardized donor consent processes and documents. © 2010 American Association of Blood Banks.

  14. Criteria for and Appropriateness of Renal Transplantation in Elderly Patients With End-Stage Renal Disease: A Literature Review and Position Statement on Behalf of the European Renal Association-European Dialysis and Transplant Association Descartes Working Group and European Renal Best Practice.

    Science.gov (United States)

    Segall, Liviu; Nistor, Ionuţ; Pascual, Julio; Mucsi, Istvan; Guirado, Lluis; Higgins, Robert; Van Laecke, Steven; Oberbauer, Rainer; Van Biesen, Wim; Abramowicz, Daniel; Gavrilovici, Cristina; Farrington, Ken; Covic, Adrian

    2016-10-01

    During the last 20 years, waiting lists for renal transplantation (RT) have grown significantly older. However, elderly patients (ie ≥65 years of age) are still more rarely referred or accepted to waiting lists and, if enlisted, have less chances of actually receiving a kidney allograft, than younger counterparts. In this review, we looked at evidence for the benefits and risks of RT in the elderly trying to answer the following questions: Should RT be advocated for elderly patients? What should be the criteria to accept elderly patients on the waiting list for RT? What strategies might be used to increase the rate of RT in waitlisted elderly candidates? For selected elderly patients, RT was shown to be superior to dialysis in terms of patient survival. Virtually all guidelines recommend that patients should not be deemed ineligible for RT based on age alone, although a short life expectancy generally might preclude RT. Concerning the assessment of comorbidities in the elderly, special attention should be paid to cardiac evaluation and screening for malignancy. Comorbidity scores and frailty assessment scales might help the decision making on eligibility. Psychosocial issues should also be evaluated. To overcome the scarcity of organ donors, elderly RT candidates should be encouraged to consider expanded criteria donors and living donors, as alternatives to deceased standard criteria donors. It has been demonstrated that expanded criteria donor RT in patients 60 years or older is associated with higher survival rates than remaining on dialysis, whereas living donor RT is superior to all other options.

  15. Recruitment of prospective donors: what do they expect from a homepage of a blood transfusion service?

    Science.gov (United States)

    Moog, R; Fourné, K

    2007-08-01

    In times of shrinking donor population, the recruitment of donors is of utmost importance. Recruitment can be done by personal communication, advertisement/information, classical mass media (newspaper, radio, TV) or new computerized media. The aim of this study was to gain information about the donors' demands of an Internet presentation of a blood transfusion service. Between October and December 2004 inclusive, prospective donors were asked to complete a survey about the impact of Internet information for blood donors. The survey contained questions measuring demographics, education and motivation for blood donation. In addition, the survey included questions that measured Internet access, duration of online time and donors' demands for an Internet presentation of a blood transfusion service. Donors were asked to tick a box with predefined answers. In cases where no options were applied, donors were requested to specify their answers. One hundred and fourteen prospective donors (71 female, 43 male) with a median age of 25 years (range 18-57 years) completed the survey. Most donors (57.9%) were 18-30 years old. Forty-two (36.8%) of the surveyed donors were repeat donors, whereas 72 (63.2%) were first-time donors. The majority of donors were informed about blood donation from relatives or friends (70.7% repeat donors and 67.7% first-time donors). Most of them had Internet access (85.7% repeat donors and 90.3% first-time donors). Exclusive use of private access was more often reported in repeat donors (77.8%), whereas both private and professional access was more frequently used in first-time donors (32.3%). Most donors used the Internet access daily, followed by weekly and monthly use. Multiple answers were given about the importance of desired information about the topic 'blood donation'. Both first-time and repeat donors wanted to be informed about organizational details of blood donation such as opening times, eligibility criteria, donation process and the kind

  16. Analysis of blood donor pre-donation deferral in Dubai: characteristics and reasons

    Directory of Open Access Journals (Sweden)

    Al Shaer L

    2017-05-01

    Full Text Available Laila Al Shaer,1 Ranjita Sharma,2 Mahera AbdulRahman2 1College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE; 2Dubai Health Authority, Dubai, UAE Background: To ensure an adequate and safe blood supply, it is crucial to select suitable donors according to stringent eligibility criteria. Understanding the reasons for donor deferral can help in planning more efficient recruitment strategies and evaluating donor selection criteria. This study aims to define donor pre-donation deferral rates, causes of deferral, and characteristics of deferred donors in Dubai.Materials and methods: This retrospective study was conducted on all donors who presented for allogeneic blood donation between January 1, 2010, until June 30, 2013, in Dubai Blood Donation Centre, accredited by the American Association of Blood Banks. The donation and deferral data were analyzed to determine the demographic characteristics of accepted and deferred donors, and frequency analyses were also conducted.Results: Among 142,431 individuals presenting during the study period, 114,827 (80.6% were accepted for donation, and 27,604 (19.4% were deferred. The overall proportion of deferrals was higher among individuals less than 21 years old (35%, P<0.000, females (44% were deferred compared to 15% of males, P<0.0001, and first-time donors (22% were deferred vs 14% of repeat donors, P<0.0001. The main causes for a temporary deferral were low hemoglobin and high blood pressure.Discussion: The deferral rate among blood donors in Dubai is relatively high compared to the internationally reported rates. This rate was higher among first-time donors and females, with low hemoglobin as the major factor leading to a temporary deferral of donors. Strategies to mitigate deferral and improve blood donor retention are urged in Dubai to avoid additional stress on the blood supply. Keywords: blood donation, blood safety, donor deferral, selection criteria 

  17. Standard format and content acceptance criteria for the material control and accounting (MC and A) reform amendment: 10 CFR Part 74, Subpart E

    International Nuclear Information System (INIS)

    1987-03-01

    Revisions have been made to the material control and accounting requirements for NRC licensees authorized to possess and use a formula quantity or more of strategic special nuclear material. The revisions require timely monitoring of in-process inventory and discrete items in order to detect anomalies potentially indicative of material losses. Timely detection and enhanced loss localization capabilities will be beneficial to alarm resolution and material recovery in the event of an actual loss. This document presents criteria that can be used by the license applicants and the license reviewers in the preparation and subsequent review of plans to be submitted in response to the the Reform Amendment. General performance objectives, system capabilities, process monitoring, item monitoring, alarm resolution, quality assurance, and accounting are addressed. 43 refs

  18. Criteria for Authorship in Bioethics

    OpenAIRE

    Resnik, David B.; Master, Zubin

    2011-01-01

    Multiple authorship is becoming increasingly common in bioethics research. There are well-established criteria for authorship in empirical bioethics research but not for conceptual research. It is important to develop criteria for authorship in conceptual publications to prevent undeserved authorship and uphold standards of fairness and accountability. This article explores the issue of multiple authorship in bioethics and develops criteria for determining who should be an author on a concept...

  19. Development of methods and criteria for a standardized evaluation of contaminated sites and abandoned waste disposal sites particularly concerning their ground water contamination potential. Pt. 1. Final Report

    International Nuclear Information System (INIS)

    Kerndorff, H.; Schleyer, R.; Arneth, J.D.; Struppe, T.; Milde, G.

    1994-01-01

    Contaminated sites should be evaluated to such an extend, that nearly all risks for man and environment can be safely estimated. An assessment for such sites is presented which combines a substance-specific and a site-specific evaluation. It is a standardized path-specific concept in which - as an example - the contamination path ''waste - groundwater - drinking-water'' is investigated and evaluated in detail. Path-specific main contaminants are established on a statistic basis and ranked according to normalized evaluation numbers of 1-100. Their toxicity potential is calculated for which a particular and standardized method was developed. Main contaminants having a high toxicity potential are called priority contaminants. For the most important exposure/usage on this contamination path, the drinking-water catchment, hygienic and toxicologic based standards are presented. Together with site-specific conditions and the also path-specific and normalized transfer/persistency potential of the priority contaminants it is possible to come to a site- and usage/exposure-specific evaluation of individual sites. (orig.) [de

  20. Oocyte cryopreservation for donor egg banking.

    Science.gov (United States)

    Cobo, Ana; Remohí, José; Chang, Ching-Chien; Nagy, Zsolt Peter

    2011-09-01

    Oocyte donation is an efficient alternative to using own oocytes in IVF treatment for different indications. Unfortunately, 'traditional' (fresh) egg donations are challenged with inefficiency, difficulties of synchronization, very long waiting periods and lack of quarantine measures. Given the recent improvements in the efficiency of oocyte cryopreservation, it is reasonable to examine if egg donation through oocyte cryopreservation has merits. The objective of the current manuscript is to review existing literature on this topic and to report on the most recent outcomes from two established donor cryobank centres. Reports on egg donation using slow freezing are scarce and though results are encouraging, outcomes are not yet comparable to a fresh egg donation treatment. Vitrification on the other hand appears to provide high survival rates (90%) of donor oocytes and comparable fertilization, embryo development, implantation and pregnancy rates to traditional (fresh) egg donation. Besides the excellent outcomes, the ease of use for both donors and recipients, higher efficiency, lower cost and avoiding the problem of synchronization are all features associated with the benefit of a donor egg cryobank and makes it likely that this approach becomes the future standard of care. Oocyte donation is one of the last resorts in IVF treatment for couples challenged with infertility problems. However, traditional (fresh) egg donation, as it is performed today, is not very efficient, as typically all eggs from one donor are given to only one recipient, it is arduous as it requires an excellent synchronization between the donor and recipient and there are months or years of waiting time. Because of the development of an efficient oocyte cryopreservation technique, it is now possible to cryo-store donor (as well as non-donor) eggs, maintaining their viability and allowing their use whenever there is demand. Therefore, creating a donor oocyte cryobank would carry many advantages

  1. Breast Milk and Hair Testing to Detect Illegal Drugs, Nicotine, and Caffeine in Donors to a Human Milk Bank.

    Science.gov (United States)

    Escuder-Vieco, Diana; Garcia-Algar, Óscar; Joya, Xavier; Marchei, Emilia; Pichini, Simona; Pacifici, Roberta; Pallás-Alonso, Carmen Rosa

    2016-08-01

    The use of illegal drugs and tobacco is an exclusion criteria for accepting a nursing mother as a milk donor. The detection window for human milk testing is typically a few hours. Hair testing has been considered the gold standard to assess chronic exposure to these toxic substances. The aim of this study was to determine the levels of illegal drugs, nicotine, and caffeine in breast milk and hair samples from donors to assess whether these substances were being used during the donation period and the months leading up to it. Thirty-six samples of hair and breast milk were obtained from 36 donors. The tests performed identified nicotine, caffeine, morphine, cocaine, cannabis, amphetamines, codeine, methadone, and other substances derived therefrom. No illegal drugs were found in any of the samples analyzed. Nicotine and cotinine were found in 33.3% (12/36) of all hair samples. Among these 12 samples, 10 had cotinine concentrations consistent with cutoff values for unexposed nonsmokers, 1 had concentrations consistent with cutoff values for passive smokers, and 1 had concentrations consistent with cutoff values for active smokers. Caffeine was found in 77.7% of the hair samples and in 50% of the donor milk samples. The correlation for caffeine between donor milk and hair samples was r = 0.288, P = .0881. Donors do not use illegal drugs during either the donation period or the months leading up to it. They are occasionally exposed to tobacco smoke and almost all of them consume caffeine. © The Author(s) 2016.

  2. Scar evaluation of split thickness skin graft donor site

    Directory of Open Access Journals (Sweden)

    Jani Muha

    2014-12-01

    Full Text Available BACKGROUND. Split thickness skin graft harvesting causes a certain degree of scaring on the donor site. Donor site scar can cause aesthetic and functional sequelae on the patient's body. Our goal was to study the process of donor site selection, and then evaluate donor site scars and their impact on patients. PATIENTS AND METHODS. This retrospective study included 45 patients aged 5 to 61 years (in average 36, who have been treated with STSG in the 2004–2010 period. 57.8% of them were men. On a follow-up visit, we photographed healed skin defects and donor sites. We then determined and compared the surface areas of skin defect and the donor site using the Adobe® Illustrator® CS5 computer program. Donor site scars were assessed according to the Vancouver scar scale (VSS. We examined scar’s light touch sensitivity with monofilaments and skin colouring compared to adjacent healthy skin using colorimeter. Patients were also interviewed about their treatment course in a form of a standardized questionnaire. RESULTS. Our research has revealed that 20.0% of patients participated in the decision making process of choosing the donor site, while in 80.0% the donor site was chosen by the surgeon himself. 6.7% of patients were not satisfied with their donor site. Most of the patients (37/45 had donor sites on their thighs. In average, the donor site surface area was 94% bigger than the skin defect area. We found statistically significant differences in VSS values, light touch sensitivity and skin colouring between donor site scaring and adjacent healthy skin. CONCLUSIONS. Donor site scar can represent a lasting aesthetic and functional disability for patients. Our research has shown that most of the patients do not participate in the donor site selection process, but are satisfied with their donor site. In most cases, STGSs are harvested from the thigh, other anatomical regions, where scarring would be aesthetically less obtrusive, are underused

  3. Are drowned donors marginal donors? A single pediatric center experience.

    Science.gov (United States)

    Kumm, Kayla R; Galván, N Thao N; Koohmaraie, Sarah; Rana, Abbas; Kueht, Michael; Baugh, Katherine; Hao, Liu; Yoeli, Dor; Cotton, Ronald; O'Mahony, Christine A; Goss, John A

    2017-09-01

    Drowning, a common cause of death in the pediatric population, is a potentially large donor pool for OLT. Anecdotally, transplant centers have deemed these organs high risk over concerns for infection and graft dysfunction. We theorized drowned donor liver allografts do not portend worse outcomes and therefore should not be excluded from the donation pool. We reviewed our single-center experience of pediatric OLTs between 1988 and 2015 and identified 33 drowned donor recipients. These OLTs were matched 1:2 to head trauma donor OLTs from our center. A chart review assessed postoperative peak AST and ALT, incidence of HAT, graft and recipient survival. Recipient survival at one year between patients with drowned donor vs head trauma donor allografts was not statistically significant (94% vs 97%, P=.63). HAT incidence was 6.1% in the drowned donor group vs 7.6% in the control group (P=.78). Mean postoperative peak AST and ALT was 683 U/L and 450 U/L for drowned donors vs 1119 U/L and 828 U/L in the matched cohort. These results suggest drowned donor liver allografts do not portend worse outcomes in comparison with those procured from head trauma donors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Donor vigilance data of a blood transfusion service: A multicenter analysis.

    Science.gov (United States)

    Burkhardt, T; Dimanski, B; Karl, R; Sievert, U; Karl, A; Hübler, C; Tonn, T; Sopvinik, I; Ertl, H; Moog, R

    2015-10-01

    Donor vigilance is an important part of the quality management system of blood transfusion services. The evaluation of donor side effects helps to improve the donation process and donor compliance. The aim of the present study was to evaluate donor vigilance data in whole blood and plasmapheresis donors of a blood donor service. Donors fulfilling current national and European eligibility criteria underwent whole blood and plasmapheresis donation (PCS and MCS+ (Haemonetics, Braintree, USA), A 200 (Fenwal, Round Lake, USA). Whole blood was collected at fixed and mobile sites while plasmaphereses were performed at 8 plasma centers. From 2011 to 2013 donor information was provided for gender, age, body weight, height, first and repeat donation. Donors were monitored for venipuncture and circulatory associated side effects. The total incidences of adverse events were 5004 (0.56%) in repeat donors and 2111 (2.78%) in first time donors for whole blood donation and 3323 (1.01%) and 514 (7.96%) for plasmaphereses, respectively. Circulatory associated events were 2679 (0.30%) for whole blood donation and 1624 (0.49%) for plasmaphereses. Our donor vigilance data of a blood transfusion service show that whole blood and plasmapheresis are safe with low incidences of adverse events. Repeat donation and age are predictors for low rates of adverse events. On the other hand, first time donation and female gender were associated with higher incidences of adverse events. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Identifying potential kidney donors using social networking web sites.

    Science.gov (United States)

    Chang, Alexander; Anderson, Emily E; Turner, Hang T; Shoham, David; Hou, Susan H; Grams, Morgan

    2013-01-01

    Social networking sites like Facebook may be a powerful tool for increasing rates of live kidney donation. They allow for wide dissemination of information and discussion and could lessen anxiety associated with a face-to-face request for donation. However, sparse data exist on the use of social media for this purpose. We searched Facebook, the most popular social networking site, for publicly available English-language pages seeking kidney donors for a specific individual, abstracting information on the potential recipient, characteristics of the page itself, and whether potential donors were tested. In the 91 pages meeting inclusion criteria, the mean age of potential recipients was 37 (range: 2-69); 88% were US residents. Other posted information included the individual's photograph (76%), blood type (64%), cause of kidney disease (43%), and location (71%). Thirty-two percent of pages reported having potential donors tested, and 10% reported receiving a live-donor kidney transplant. Those reporting donor testing shared more potential recipient characteristics, provided more information about transplantation, and had higher page traffic. Facebook is already being used to identify potential kidney donors. Future studies should focus on how to safely, ethically, and effectively use social networking sites to inform potential donors and potentially expand live kidney donation. © 2013 John Wiley & Sons A/S.

  6. Assessment of metabolic syndrome in Kashmiri population with type 2 diabetes employing the standard criteria's given by WHO, NCEPATP III and IDF.

    Science.gov (United States)

    Lone, Shafat; Lone, Kouser; Khan, Saika; Pampori, Rafiq Ahmed

    2017-12-01

    Around 20-25 percent of the world's adult populations have the metabolic syndrome and they are twice as likely to die from heart attack or stroke compared with people without the syndrome. The World Health Organization proposed a definition for the metabolic syndrome in 1998 and later on NCEP ATPIII and IDF provided new definitions of this syndrome in 2001 and 2003 respectively. Very few studies have compared the different definitions to diagnose the metabolic syndrome in type two diabetics in India while as for Kashmir valley no such documented study has been carried out till date. To study the prevalence of metabolic syndrome in type 2 Kashmir diabetics and to find out the degree of agreement between three different criteria given by WHO, NCEPATPIII and IDF for diagnosis of metabolic syndrome. A cross sectional study was conducted in one of the two tertiary care hospitals of Kashmir, India. About 1000 patients were selected and their demographic, clinical and biochemical parameters were studied after obtaining informed consent from each patient. Prevalance of metabolic syndrome was found to be highest(84.5%) while using WHO definition.Kappa statistic between WHO, ATP III and WHO, IDF definitions was 0.697 (95% CI 0.637-0.754) and 0.775 (95%CI 0.72-0.82) respectively while the degree of agreement between IDF and ATP III definitions was highest with kappa of 0.851 (95%CI 0.810-0.889). Our study warrants for interventions to prevent the progression towards this syndrome among type 2 diabetics as early as the diagnosis of diabetes is made. Copyright © 2017 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

  7. Iron deficiency in blood donors

    Directory of Open Access Journals (Sweden)

    Rodolfo Delfini Cançado

    Full Text Available CONTEXT: Blood donation results in a substantial loss of iron (200 to 250 mg at each bleeding procedure (425 to 475 ml and subsequent mobilization of iron from body stores. Recent reports have shown that body iron reserves generally are small and iron depletion is more frequent in blood donors than in non-donors. OBJECTIVE: The aim of this study was to evaluate the frequency of iron deficiency in blood donors and to establish the frequency of iron deficiency in blood donors according to sex, whether they were first-time or multi-time donors, and the frequency of donations per year. DESIGN: From September 20 to October 5, 1999, three hundred blood donors from Santa Casa Hemocenter of São Paulo were studied. DIAGNOSTIC TESTS: Using a combination of biochemical measurements of iron status: serum iron, total iron-binding capacity, transferrin saturation index, serum ferritin and the erythrocyte indices. RESULTS: The frequency of iron deficiency in blood donors was 11.0%, of whom 5.5% (13/237 were male and 31.7% (20/63 female donors. The frequency of iron deficiency was higher in multi-time blood donors than in first-time blood donors, for male blood donors (7.6% versus 0.0%, P < 0.05 and female ones (41.5% versus 18.5%, P < 0.05. The frequency of iron deficiency found was higher among the male blood donors with three or more donations per year (P < 0.05 and among the female blood donors with two or more donations per year (P < 0.05. CONCLUSIONS: We conclude that blood donation is a very important factor for iron deficiency in blood donors, particularly in multi-time donors and especially in female donors. The high frequency of blood donors with iron deficiency found in this study suggests a need for a more accurate laboratory trial, as hemoglobin or hematocrit measurement alone is not sufficient for detecting and excluding blood donors with iron deficiency without anemia.

  8. Recommendations for use of marginal donors in heart transplantation: Brazilian Association of Organs Transplantation guideline.

    Science.gov (United States)

    Fiorelli, A I; Stolf, N A G; Pego-Fernandes, P M; Oliveira Junior, J L; Santos, R H B; Contreras, C A M; Filho, D D L; Dinkhuysen, J J; Moreira, M C V; Mejia, J A C; Castro, M C R

    2011-01-01

    The high prevalence of heart failure has increased the candidate list for heart transplantation; however, there is a shortage of viable donated organs, which is responsible for the high mortality of patients awaiting a transplantation. Because the marginal donor presents additional risk factors, it is not considered to be an ideal donor. The use of a marginal donor is only justified in situations when the risk of patient death due to heart disease is greater than that offered by the donor. These recommendations sought to expand the supply of donors, consequently increasing the transplant rate. We selected articles based on robust evidence to provide a substratum to develop recommendations for donors who exceed the traditional acceptance criteria. Recipient survival in the immediate postoperative period is intimately linked to allograft quality. Primary allograft failure is responsible for 38% to 40% of immediate deaths after heart transplantation: therefore; marginal donor selection must be more rigorous to not increase the surgical risk. The main donor risk factors with the respective evidence levels are: cancer in the donor (B), female donor (B), donor death due to hemorrhagic stroke (B), donor age above 50 years (relative risk [RR] = 1.5) (B), weight mismatch between donor and recipient 240 minutes (RR = 1.2) (B), left ventricular dysfunction with ejection fraction below 45% (B), and use of high doses of vasoactive drugs (dopamine > 15 mg/kg·min) (B). Factors that impact recipient mortality are: age over 50 years (RR = 1.5); allograft harvest at a distance; adult recipient weighing more than 20% of the donor; high doses of vasoactive drugs (dopamine greater than 15 mg/kg·min) and ischemic time >4 hours. The use of a marginal donor is only justified when it is able to increase life expectancy compared with clinical treatment, albeit the outcomes are interior to those using an ideal donor. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Analysis of blood donor pre-donation deferral in Dubai: characteristics and reasons.

    Science.gov (United States)

    Al Shaer, Laila; Sharma, Ranjita; AbdulRahman, Mahera

    2017-01-01

    To ensure an adequate and safe blood supply, it is crucial to select suitable donors according to stringent eligibility criteria. Understanding the reasons for donor deferral can help in planning more efficient recruitment strategies and evaluating donor selection criteria. This study aims to define donor pre-donation deferral rates, causes of deferral, and characteristics of deferred donors in Dubai. This retrospective study was conducted on all donors who presented for allogeneic blood donation between January 1, 2010, until June 30, 2013, in Dubai Blood Donation Centre, accredited by the American Association of Blood Banks. The donation and deferral data were analyzed to determine the demographic characteristics of accepted and deferred donors, and frequency analyses were also conducted. Among 142,431 individuals presenting during the study period, 114,827 (80.6%) were accepted for donation, and 27,604 (19.4%) were deferred. The overall proportion of deferrals was higher among individuals less than 21 years old (35%, P Dubai is relatively high compared to the internationally reported rates. This rate was higher among first-time donors and females, with low hemoglobin as the major factor leading to a temporary deferral of donors. Strategies to mitigate deferral and improve blood donor retention are urged in Dubai to avoid additional stress on the blood supply.

  10. Optimal screening and donor management in a public stool bank.

    Science.gov (United States)

    Kazerouni, Abbas; Burgess, James; Burns, Laura J; Wein, Lawrence M

    2015-12-17

    Fecal microbiota transplantation is an effective treatment for recurrent Clostridium difficile infection and is being investigated as a treatment for other microbiota-associated diseases. To facilitate these activities, an international public stool bank has been created, which screens donors and processes stools in a standardized manner. The goal of this research is to use mathematical modeling and analysis to optimize screening and donor management at the stool bank. Compared to the current policy of screening active donors every 60 days before releasing their quarantined stools for sale, costs can be reduced by 10.3 % by increasing the screening frequency to every 36 days. In addition, the stool production rate varies widely across donors, and using donor-specific screening, where higher producers are screened more frequently, also reduces costs, as does introducing an interim (i.e., between consecutive regular tests) stool test for just rotavirus and C. difficile. We also derive a donor release (i.e., into the system) policy that allows the supply to approximately match an exponentially increasing deterministic demand. More frequent screening, interim screening for rotavirus and C. difficile, and donor-specific screening, where higher stool producers are screened more frequently, are all cost-reducing measures. If screening costs decrease in the future (e.g., as a result of bringing screening in house), a bottleneck for implementing some of these recommendations may be the reluctance of donors to undergo serum screening more frequently than monthly.

  11. Unconfirmed reactive screening tests and their impact on donor management

    International Nuclear Information System (INIS)

    Rahman, M.; Khan, S.A.

    2008-01-01

    To determine the percentage of false positive testing for transfusion transmitted infections (TTIs) using immunochromatographic test (ICT) as first line of screening tests and its effect on loss of volunteer blood donors. Over a period of three months, samples from blood bags of donors undergoing phlebotomy at teaching hospital blood banks in Lahore were screened for human immunodeficiency virus (HIV), hepatitis B (HBV) and hepatitis C (HCV) by immunochromatographic tests. Those found positive on initial screening were re-tested by ELISA method at the screening laboratory of the Institute of Haematology and Blood Transfusion Service, Punjab. Lahore. Out of a total of 62090 voluntary blood donors, 469 donors were found to be initially reactive for either HIV, HBV or HCV. Amongst these 96 (0.15%) blood donors were found to have tested falsely positive for HIV, HBV or HCV as compared to testing by ELISA. False positive testing rate of 0.15% or 96 out of a total of 62090 donors is rather small in terms of loss of voluntary donors and appropriate utilization of available resources. Although immunochromatographic testing is not the gold standard, however it serves an important purpose of initial donor screening. (author)

  12. Meet the donors

    DEFF Research Database (Denmark)

    Olejaz, Maria; Hoeyer, Klaus

    2016-01-01

    motivations, but rather as something made meaningful in the light of how donors understand their bodies; their social relations; and their societal position and experiences as patients in the healthcare system. The article thus contributes to the field by investigating the nature of the relationship between......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...

  13. Cancer Incidence and Mortality in a Cohort of US Blood Donors: A 20-Year Study

    Science.gov (United States)

    Hirschler, Nora V.; Chinn, Artina; Busch, Michael P.; Custer, Brian

    2013-01-01

    Blood donors are considered one of the healthiest populations. This study describes the epidemiology of cancer in a cohort of blood donors up to 20 years after blood donation. Records from donors who participated in the Retroviral Epidemiology Donor Study (REDS, 1991–2002) at Blood Centers of the Pacific (BCP), San Francisco, were linked to the California Cancer Registry (CCR, 1991–2010). Standardized incidence ratios (SIR) were estimated using standard US 2000 population, and survival analysis used to compare all-cause mortality among donors and a random sample of nondonors with cancer from CCR. Of 55,158 eligible allogeneic blood donors followed-up for 863,902 person-years, 4,236 (7.7%) primary malignant cancers were diagnosed. SIR in donors was 1.59 (95% CI = 1.54,1.64). Donors had significantly lower mortality (adjusted HR = 0.70, 95% CI = 0.66–0.74) compared with nondonor cancer patients, except for respiratory system cancers (adjusted HR = 0.93, 95% CI = 0.82–1.05). Elevated cancer incidence among blood donors may reflect higher diagnosis rates due to health seeking behavior and cancer screening in donors. A “healthy donor effect” on mortality following cancer diagnosis was demonstrated. This population-based database and sample repository of blood donors with long-term monitoring of cancer incidence provides the opportunity for future analyses of genetic and other biomarkers of cancer. PMID:24489545

  14. Cancer Incidence and Mortality in a Cohort of US Blood Donors: A 20-Year Study

    Directory of Open Access Journals (Sweden)

    Farnaz Vahidnia

    2013-01-01

    Full Text Available Blood donors are considered one of the healthiest populations. This study describes the epidemiology of cancer in a cohort of blood donors up to 20 years after blood donation. Records from donors who participated in the Retroviral Epidemiology Donor Study (REDS, 1991–2002 at Blood Centers of the Pacific (BCP, San Francisco, were linked to the California Cancer Registry (CCR, 1991–2010. Standardized incidence ratios (SIR were estimated using standard US 2000 population, and survival analysis used to compare all-cause mortality among donors and a random sample of nondonors with cancer from CCR. Of 55,158 eligible allogeneic blood donors followed-up for 863,902 person-years, 4,236 (7.7% primary malignant cancers were diagnosed. SIR in donors was 1.59 (95% CI = 1.54,1.64. Donors had significantly lower mortality (adjusted HR = 0.70, 95% CI = 0.66–0.74 compared with nondonor cancer patients, except for respiratory system cancers (adjusted HR = 0.93, 95% CI = 0.82–1.05. Elevated cancer incidence among blood donors may reflect higher diagnosis rates due to health seeking behavior and cancer screening in donors. A “healthy donor effect” on mortality following cancer diagnosis was demonstrated. This population-based database and sample repository of blood donors with long-term monitoring of cancer incidence provides the opportunity for future analyses of genetic and other biomarkers of cancer.

  15. IEEE Std 381-1977: IEEE standard criteria for type tests of Class 1E modules used in nuclear power generating stations

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This document describes the basic requirements of a type test program with the objective of verifying that a module used as Class 1E equipment in a nuclear power generating station meets or exceeds its design specifications. This document is limited to class 1E modules from and including the sensor through the logic circuitry of the final actuation devices. Except for those that are part of a module, switchgear, cables, connections, motors, valve actuators, station batteries, and penetrations are not included and are covered by other IEEE documents. The purpose of this document is to supplement the procedures and requirements given in IEEE Std 323-1974 [24] for type testing Class 1E modules, thereby providing directions for establishment of a type test program which will obtain the required test data and yield the required documentation of test methods and results. This standard is structured to present to the user the principal performance characteristics and environmental parameters which must be considered in designing a type test program for any give Class 1E module. These modules range from tiny sensors to complete racks or cabinets full of equipment that may be located inside or outside containment. The Class 1E modules are required to perform their function before, during, or after, or all, any design basis event specified for the module. The vast variety of modules covered by this document precludes the listing here of specific requirements for each type test

  16. [Lack of knowledge among blood donors in Burkina Faso (West Africa); potential obstacle to transfusion security].

    Science.gov (United States)

    Nébié, K Y; Olinger, C M; Kafando, E; Dahourou, H; Diallo, S; Kientega, Y; Domo, Y; Kienou, K; Ouattara, S; Sawadogo, I; Ky, L; Muller, C P

    2007-11-01

    The measures recommended to reduce TTD include clinical selection of donors, based on a standardized questionnaire which aims to find out antecedents and behaviours predicting transmitted diseases within donors. The effectiveness of this measure is well established in the industrialized countries where the level of education of the population may support a greater receptivity of donors about this procedure. What is happening in developing one? This study was carried out to assess knowledge attitude and behaviours among blood donors regarding blood and transfusion safety in Burkina Faso. A cross sectional study was carried out in the blood bank of the teaching hospital of Ouagadougou. In addition to the routine questionnaire, 544 included blood donors were subjected to additional questions seeking to specify their behaviours, knowledge and attitude towards TTD diseases and screening. Donors were from 16 to 57 years of age (mean age : 28+/-7.9 years). The majority of donors were male (71.2%). Family donors represent 52% and first time donors 55%. About 30.8% were illiterate or of primary school level. A percentage of 14.4 donate to access HIV testing and 30.7% will donate blood immediately to check any contamination in case of exposure. There was no difference between donors having been informed about their HIV status in the past and the other donors regarding HIV, HBs Ag and VHC results. This study suggests that there is some great need for donors' education on transfusion safety. There is also need for staff training in donors' management.

  17. Laparoscopic Donor Nephrectomy: Early Experience at a Single Center in Pakistan.

    Science.gov (United States)

    Mohsin, Rehan; Shehzad, Asad; Bajracharya, Uspal; Ali, Bux; Aziz, Tahir; Mubarak, Muhammed; Hashmi, Altaf; Rizvi, Adibul Hasan

    2018-04-01

    Laparoscopic donor nephrectomy has become the criterion standard for kidney retrieval from living donors. There is no information on the experience and outcomes of laparoscopic donor nephrectomy in Pakistan. The objective of the study was to identify benefits and harms of using laparoscopic compared with open nephrectomy techniques for renal allograft retrieval. In this a retrospective study, patient files from May 2014 to September 2015 were analyzed. Patients were divided into 2 groups: those with open donor nephrectomy and those with laparoscopic donor nephrectomy. Donor case files and operative notes were analyzed for age, sex, laterality, body mass index, warm ischemia time, perioperative and postoperative complications, surgery time, and length of hospital stay. Finally, serum creatinine patterns of both donors and recipients were analyzed. Data were analyzed using SPSS version 10 (SPSS: An IBM Company, IBM Corporation, Armonk, NY, USA). Of 388 total donors, 190 (49%) had open donor nephrectomy and 198 (51%) had laparoscopic donor nephrectomy. For both groups, most donors were older than 25 years with male preponderance. Left-to-right kidney donation ratio was markedly higher in the laparoscopic group than in the open donor nephrectomy group, with 6 cases of double renal artery also included in this study. There were no significant differences in surgery times between the 2 groups, whereas the laparoscopic donor nephrectomy group had shorter hospital stay. Analgesic requirements were markedly shorter in the laparoscopic donor nephrectomy group. The 1-year graft function was not significantly different between the 2 groups. The results for laparoscopic donor nephrectomy were comparable to those for open donor nephrectomy, and its acceptability was high. Laparoscopic donor nephrectomy should be the preferred approach for procuring the kidney graft.

  18. Negative peri-donation events among whole blood donors in a blood bank in Ibadan, Nigeria.

    Science.gov (United States)

    Fasola, Foluke A

    2017-12-31

    The existence and sustenance of the blood bank depends on blood donors. It is imperative that the donation experience is satisfactory for the donors. Therefore this study was carried out to determine the frequency of undesirable events experienced by the blood donor as part of donor haemovigilance. This was a retrospective descriptive study of the events that occurred amongst the blood donors of the blood bank of a tertiary institution. The blood donor incident book was reviewed for the period of six months. Negative undesirable events occurred in 2% of the donor populations, of which 45.8% could not complete the blood donation process while only 16.7% completed the blood donation process. Mild vasovagal attack occurred in 0.2% of the donor population. Undisclosed deferrable risk factors/ behaviours were identified by the phlebotomist in the bleeding room which made donors unfit for donation even though they had passed the donor screening criteria. This accounted for 20.8% of those with negative experience. Guidelines are required to identify donors that are not likely to complete donation to avoid wastage of time, blood, resources and reduce undesirable experiences.

  19. A perspective on the selection of unrelated donors and cord blood units for transplantation

    Science.gov (United States)

    Spellman, Stephen R.; Eapen, Mary; Logan, Brent R.; Mueller, Carlheinz; Rubinstein, Pablo; Setterholm, Michelle I.; Woolfrey, Ann E.; Confer, Dennis L.; Hurley, Carolyn K.

    2012-01-01

    Selection of a suitable graft for allogeneic hematopoietic stem cell transplantation involves consideration of both donor and recipient characteristics. Of primary importance is sufficient donor-recipient HLA matching to ensure engraftment and acceptable rates of GVHD. In this Perspective, the National Marrow Donor Program and the Center for International Blood and Marrow Transplant Research provide guidelines, based on large studies correlating graft characteristics with clinical transplantation outcomes, on appropriate typing strategies and matching criteria for unrelated adult donor and cord blood graft selection. PMID:22596257

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

    Science.gov (United States)

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

    2018-01-01

    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.

  1. Do donor oocyte cycles comply with ASRM/SART embryo transfer guidelines? An analysis of 13,393 donor cycles from the SART registry.

    Science.gov (United States)

    Acharya, Kelly S; Keyhan, Sanaz; Acharya, Chaitanya R; Yeh, Jason S; Provost, Meredith P; Goldfarb, James M; Muasher, Suheil J

    2016-09-01

    To analyze donor oocyte cycles in the Society for Assisted Reproductive Technology (SART) registry to determine: 1) how many cycles complied with the 2009 American Society for Reproductive Medicine/SART embryo transfer guidelines; and 2) cycle outcomes according to the number of embryos transferred. For donor oocyte IVF with donor age cycles from 2011 to 2012. Embryos transferred in donor IVF cycles. Percentage of compliant cycles, multiple pregnancy rate. There were 3,157 donor cleavage-stage transfers and 10,236 donor blastocyst transfers. In the cleavage-stage cycles, 88% met compliance criteria. The multiple pregnancy rate (MPR) was significantly higher in the noncompliant cycles. In a subanalysis of compliant cleavage-stage cycles, 91% transferred two embryos and only 9% single embryos. In those patients transferring two embryos, the MPR was significantly higher (33% vs. 1%). In blastocyst transfers, only 28% of the cycles met compliance criteria. The MPR was significantly higher in the noncompliant blastocyst cohort at 53% (compared with 2% in compliant cycles). The majority of donor cleavage-stage transfers are compliant with current guidelines, but the transfer of two embryos results in a significantly higher MPR compared with single-embryo transfer. The majority of donor blastocyst cycles are noncompliant, which appears to be driving an unacceptably high MPR in these cycles. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Barriers to the use of a federal travel grant by living kidney donors.

    Science.gov (United States)

    Hays, Rebecca E; Thomas, Amy Elaine; Mathias, Erin; Mezrich, Joshua; Mandelbrot, Didier A

    2017-02-01

    Living organ donation involves significant out-of-pocket costs, which burden donor candidates and may be an obstacle to donation. There is a single US grant (the National Living Donor Assistance Center-NLDAC) to cover live donor travel costs. Although there may be center-specific variability in grant utilization, prospective donors-and their intended recipients-must also meet eligibility criteria. In fact, the NLDAC grant is used by 300% of the federal poverty level) (n=51; 82%). The remaining exclusions (n=11; 18%) included being a nondirected donor, not meeting residency requirements, and "other." Expanding NLDAC eligibility criteria-by broadening the recipient means test or by taking steps to eliminate it from the NLDAC charter-would reduce financial burdens associated with live donation. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Co-ordinated research programme on benchmark study for the seismic analysis and testing of WWER-type nuclear power plants. V. 2. Generic material: Codes, standards, criteria. Working material

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    The Co-ordinated research programme on the benchmark study for the seismic analysis and testing of WWER-type nuclear power plants was initiated subsequent to the request from representatives of Member States. The conclusions adopted at the Technical Committee Meeting on Seismic Issues related to existing nuclear power plants held in Tokyo in 1991 called for the harmonization of methods and criteria used in Member States in issues related to seismic safety. The Consulltants' Meeting which followed resulted in producing a working document for CRP. It was decided that a benchmark study is the most effective way to achieve the principal objective. Two types of WWER reactors (WWER-440/213 and WWER-1000) were selected as prototypes for the benchmark exercise to be tested on a full scale using explosions and/or vibration generators. The two prototypes are Kozloduy Units 5/6 for WWER-1000 and Paks for WWER-440/213 nuclear power plants. This volume of Working material contains reports related to generic material, namely codes, standards and criteria for benchmark analysis.

  4. Co-ordinated research programme on benchmark study for the seismic analysis and testing of WWER-type nuclear power plants. V. 2. Generic material: Codes, standards, criteria. Working material

    International Nuclear Information System (INIS)

    1995-01-01

    The Co-ordinated research programme on the benchmark study for the seismic analysis and testing of WWER-type nuclear power plants was initiated subsequent to the request from representatives of Member States. The conclusions adopted at the Technical Committee Meeting on Seismic Issues related to existing nuclear power plants held in Tokyo in 1991 called for the harmonization of methods and criteria used in Member States in issues related to seismic safety. The Consulltants' Meeting which followed resulted in producing a working document for CRP. It was decided that a benchmark study is the most effective way to achieve the principal objective. Two types of WWER reactors (WWER-440/213 and WWER-1000) were selected as prototypes for the benchmark exercise to be tested on a full scale using explosions and/or vibration generators. The two prototypes are Kozloduy Units 5/6 for WWER-1000 and Paks for WWER-440/213 nuclear power plants. This volume of Working material contains reports related to generic material, namely codes, standards and criteria for benchmark analysis

  5. Introduction criteria and concepts on energy saving in the technical standards for electric installations; Introduccion de criterios y conceptos de ahorro de energia en las normas tecnicas para instalaciones electricas

    Energy Technology Data Exchange (ETDEWEB)

    Rincon Nader, Jorge A [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1993-12-31

    The project Introduction Criteria and Concepts on Energy Saving in the Technical Standards for electric installations, is described, whose immediate objective is to recommend and in some cases regulate the use of energy saving equipment and devices and the adoption of attitudes and procedures that convey into saving, and the rational and efficient use of the electric energy. [Espanol] Se describe el proyecto Introduccion de Criterios y Conceptos de Ahorro de Energia en las Normas Tecnicas para instalaciones electricas, que tiene como objetivo inmediato recomendar, y en algunos casos reglamentar el uso de equipos y dispositivos ahorradores y la adopcion de actitudes y procedimientos que conduzcan a un ahorro y uso racional y eficiente de la energia electrica.

  6. Introduction criteria and concepts on energy saving in the technical standards for electric installations; Introduccion de criterios y conceptos de ahorro de energia en las normas tecnicas para instalaciones electricas

    Energy Technology Data Exchange (ETDEWEB)

    Rincon Nader, Jorge A. [Instituto de Investigaciones Electricas, Cuernavaca (Mexico)

    1992-12-31

    The project Introduction Criteria and Concepts on Energy Saving in the Technical Standards for electric installations, is described, whose immediate objective is to recommend and in some cases regulate the use of energy saving equipment and devices and the adoption of attitudes and procedures that convey into saving, and the rational and efficient use of the electric energy. [Espanol] Se describe el proyecto Introduccion de Criterios y Conceptos de Ahorro de Energia en las Normas Tecnicas para instalaciones electricas, que tiene como objetivo inmediato recomendar, y en algunos casos reglamentar el uso de equipos y dispositivos ahorradores y la adopcion de actitudes y procedimientos que conduzcan a un ahorro y uso racional y eficiente de la energia electrica.

  7. The Dirt on the Donors.

    Science.gov (United States)

    Walker, Mary Margaret

    1996-01-01

    A discussion of donor records in college and university fund-raising programs looks at a variety of issues, including who sees them (administrators, donors, volunteers, and members of the legal profession), how access to them is controlled, and what is kept in them. Suggestions are offered for managing such records, and the experiences of a number…

  8. Seriously ill patients as living unspecified kidney donors: rationale and justification.

    Science.gov (United States)

    Rakké, Yannick S; Zuidema, Willij C; Hilhorst, Medard T; Erdman, Ruud A M; Massey, Emma K; Betjes, Michiel G H; Dor, Frank J M F; IJzermans, Jan N M; Weimar, Willem

    2015-01-01

    Between 2000 and December 2013, 106 live donor nephrectomies from anonymous living-donors were performed at the Erasmus MC Rotterdam; five of the donors (5.4%) had a life-threatening disease. The aim of the present report is to give the rational and justification for this procedure. All five donors underwent the national standard living-donor screening procedure. Additionally, motivation to donate and psychologic stability were assessed by a psychologist using in-depth interview techniques and a psychologic complaints questionnaire. Post-donor nephrectomy follow-up consisted of standard questionnaires and clinical check-ups. One patient had cerebral and caudal ependymomas, one had severe and progressive emphysema, two had Huntington's disease and one had a grade 2 oligodendroglioma. The psychologic screening revealed genuine motivation, adequate risk perception, and normal sense of reality. No contraindications for donation were found. The five donor nephrectomies made nine kidney transplantations possible. All donors were satisfied with the donation procedure. Three donors died during follow-up (0.6-4.9 years) as a result of their disease. In the absence of apparent additional health risks, medical, and psychologic contraindications, we consider it ethically justified to accept an offer from a cognitively competent patient with a life-threatening disease in view of their self-reported satisfaction during follow-up. Although based on a limited number of patients, we conclude that a stricter psychologic screening for seriously ill donors compared to healthy unspecified anonymous donors to unspecified patients is not necessary.

  9. Heart transplantation from older donors

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2017-01-01

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

  10. First Danish experience with ex vivo lung perfusion of donor lungs before transplantation

    DEFF Research Database (Denmark)

    Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold

    2014-01-01

    INTRODUCTION: The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its...... introduction. MATERIAL AND METHODS: The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were...... otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. RESULTS: In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died...

  11. Perioperative period in cardiac transplantation from donors with brain death due to methanol poisoning

    Directory of Open Access Journals (Sweden)

    V. N. Poptsov

    2017-01-01

    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.

  12. Pupil diameter for confirmation of brain death in adult organ donors in Japan.

    Science.gov (United States)

    Sagishima, Katsuyuki; Kinoshita, Yoshihiro

    2017-01-01

    The criteria for brain death in Japan include a bilateral pupil diameter of ≥4 mm. We evaluated the appropriateness of a 4-mm pupil diameter in adult brain-dead donors in Japan. We retrospectively reviewed the records of 148 consecutive adult brain-dead donors with an average age of 46 years. All records were anonymously registered to the Japanese Ministry of Health, Labour and Welfare (the Japanese Ministry of Health and Welfare before 2001) from the various designated emergency institutes that performed organ donation under brain death from 1999 to 2012 in Japan. All donors had a Glasgow Coma Scale score of 3, absence of all seven brain stem reflexes, an isoelectric electroencephalogram for >30 min, and apnea as tested by the standard method. All of these examinations were repeated approximately 6 h later for confirmation. The pupil diameter (average ± standard deviation) was 6.1 ± 1.1 mm at the first assessment and 6.4 ± 1.1 mm approximately 6 h later. The 95% probability distribution as calculated by statistical analysis was 3.93-8.30 mm in the left eye and 3.88-8.28 mm in the right eye in the first assessment, and 4.25-8.58 mm in the left eye and 4.32-8.43 mm in the right eye approximately 6 h later. Despite the various original causes of brain death, we conclude that a pupil diameter of ≥4 mm is a reasonable criterion for brain death in adults.

  13. 16 CFR 1031.14 - Observation criteria.

    Science.gov (United States)

    2010-01-01

    ....14 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.14 Observation criteria. A Commission official or employee may, on occasion, attend voluntary standards meetings for the...

  14. Criteria for software modularization

    Science.gov (United States)

    Card, David N.; Page, Gerald T.; Mcgarry, Frank E.

    1985-01-01

    A central issue in programming practice involves determining the appropriate size and information content of a software module. This study attempted to determine the effectiveness of two widely used criteria for software modularization, strength and size, in reducing fault rate and development cost. Data from 453 FORTRAN modules developed by professional programmers were analyzed. The results indicated that module strength is a good criterion with respect to fault rate, whereas arbitrary module size limitations inhibit programmer productivity. This analysis is a first step toward defining empirically based standards for software modularization.

  15. The Johns Hopkins RTR Consortium: A Collaborative Approach to Advance Translational Science and Standardize Clinical Monitoring of Restorative Transplantation - Immunomodulation and Tolerance Induction after VCA using Biologic Agent (cTLA4-Ig) and Donor Bone Marrow Cells

    Science.gov (United States)

    2014-10-01

    Standardize Clinical Monitoring of Restorative Transplantation – Immunomodulation and Tolerance Induction after VCA using Biologic Agent (cTLA4-Ig) and...Translational Science and Standardize Clinical Monitoring of Restorative Transplantation – Immunomodulation and Tolerance Induction after VCA using Biologic...wider application. Thus the purpose of this project is to develop novel clinically relevant regimens for immunomodulation and tolerance induction after

  16. Development of standards, criteria, specifications. Vol. 2 - Longlife.. Sustainable, energy efficient and resource saving, residential buildings in consideration of unified procedures and new and adapted technologies. Project in the Baltic Sea region programme 2007-2013

    Energy Technology Data Exchange (ETDEWEB)

    Rueckert, Klaus (ed.)

    2010-07-01

    Energy and Cost Efficiency as the key characteristics of the sustainability have been the main consideration of different parts of research represented in the Longlife 2 Report. Longlife 2 Report is in fact the final result of work package 4 ''Developments of Standards and Criteria for Sustainable Building and Construction''. Work package 4 was created based on the work package 3 ''Analysis and comparison of state of technology, administration and legal procedures, financial situation, demographic needs, similarities and differences in the participant countries: Denmark, Germany, Lithuania, Poland and Russia''. Three competence teams from each participant country studied, analyzed and examined these concepts from different point of view and introduced a framework to define the fundamental concepts of sustainability. This crucial phase of project based on the objectives and activities of each team could be described as follow: Team 1'' Engineering and Building Technology standards'' and related expertise emphasized on the most architectural solutions and characteristics of sustainability in very wide spectrum. That is realized through adaptable methods of design, typology, standards, assessment systems, proper and available materials with the best physical features, the most efficient and advanced structures and technologies in order to have the most possible energy and resource saving beside the less life cycle cost of the residential building. Team 2 '' Method of planning permit and tendering Procedure'' and its expertise from another point of view worked on the legal and administrative aspects of sustainability and examining possibility and capacity of each involved country to realize sustainable construction. Team 3 ''Economical and Financial basis, Industry and quality'' and its related expertise explained and examined the adequate and necessary tools for

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

    NARCIS (Netherlands)

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

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

  18. Anesthesia Management of Organ Donors.

    Science.gov (United States)

    Xia, Victor W; Braunfeld, Michelle

    2017-09-01

    The shortage of suitable organs is the biggest obstacle for transplants. At present, most organs for transplant in the United States are from donation after neurologic determination of death (brain death). Potential organs for transplant need to maintain their viability during a series of insults, including the original disease, physiologic derangements during the dying process, ischemia, and reperfusion. Proper donor management before, during, and after procurement has potential to increase the number and quality of organs from donors. Anesthesiologists need to understand the physiologic derangements associated with brain death and the updated donor management during the periprocurement period. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. New hydrogen donors in germanium

    International Nuclear Information System (INIS)

    Pokotilo, Yu.M.; Petukh, A.N.; Litvinov, V.V.

    2003-01-01

    The electrophysical properties of the n-type conductivity germanium, irradiated through protons, is studied by the volt-farad method. It is shown that the heat treatment of the implanted germanium at the temperature of 200-300 deg C leads to formation of the fast-diffusing second-rate donors. It is established that the diffusion coefficient of the identified donors coincides with the diffusion coefficient of the atomic hydrogen with an account of the capture on the traps. The conclusion is made, that the atomic hydrogen is the second-rate donor center in germanium [ru

  20. Utilization of advanced-age donors in renal transplantation.

    Science.gov (United States)

    Olaverri, J G; Mora Christian, J; Elorrieta, P; Esnaola, K; Rodríguez, P; Marrón, I; Uriarte, I; Landa, M J; Zarraga, S; Gainza, F J; Aranzabal, J; Zabala, J A; Pertusa, C

    2011-11-01

    The shortage of organ availability in recent years has made it necessary to use grafts from advanced-aged donors to maintain the rate of renal transplantation in our country. The objective of this study was to evaluate the graft function and patient survival using kidneys from deceased donors of over 65 year of age. From 2005 until 2010, we compared the outcomes of patients who received grafts from donors over 65 years old vs less than 65 years. We observed no significant difference in sex, time on dialysis, or cold ischemia time between the groups. As expected the recipient age was significantly different. For the analysis of survival, we used the Tablecloth-Haenzel test and the Kaplan-Meier survival estimator. Actuarial survivals at 3 years after transplantation showed 84.8% among patients transplanted with kidneys from donors over 65 years old versus 97.5% in the control group. The graft survival was 78.8% among expanded criteria versus 86.85% in the control group. When we analyzed graft survival using an "exitus-censured" analysis, we obtained graft survivals of 89.1% in the expanded criteria kidney group versus 88.6% among the controls. We concluded that the use of kidney from donors over 65 years of age allows us to increase the rate of renal transplantation to about 15 to 20 per million population, with good graft and patient survivals provided that the protocol for expanded criteria organs ensured proper macroscopic and microscopic evaluation of the organ for transplantation. Copyright © 2011. Published by Elsevier Inc.

  1. Donor milk: current perspectives

    Directory of Open Access Journals (Sweden)

    Giuliani F

    2014-07-01

    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

  2. Governance, resource curse and donor

    OpenAIRE

    Wiig, Arne

    2008-01-01

    Plan Part 1. Governance What is good governance? Why is it important? How can we measure good governance? Part 2. The resource curse and the importance of governance in resource rich countries Focus on political economy (PE) models of the resource curse Policy implications Some donor initiatives Transparency and the EITI Petroleum related aid - Window dressing initiatives or research based? Conclusion Governance, resource curse and donor

  3. Reduction of pain via platelet-rich plasma in split-thickness skin graft donor sites: a series of matched pairs

    Science.gov (United States)

    Miller, John D.; Rankin, Timothy M.; Hua, Natalie T.; Ontiveros, Tina; Giovinco, Nicholas A.; Mills, Joseph L.; Armstrong, David G.

    2015-01-01

    In the past decade, autologous platelet-rich plasma (PRP) therapy has seen increasingly widespread integration into medical specialties. PRP application is known to accelerate wound epithelialization rates, and may also reduce postoperative wound site pain. Recently, we observed an increase in patient satisfaction following PRP gel (Angel, Cytomedix, Rockville, MD) application to split-thickness skin graft (STSG) donor sites. We assessed all patients known to our university-based hospital service who underwent multiple STSGs up to the year 2014, with at least one treated with topical PRP. Based on these criteria, five patients aged 48.4±17.6 (80% male) were identified who could serve as their own control, with mean time of 4.4±5.1 years between operations. In both therapies, initial dressing changes occurred on postoperative day (POD) 7, with donor site pain measured by Likert visual pain scale. Paired t-tests compared the size and thickness of harvested skin graft and patient pain level, and STSG thickness and surface area were comparable between control and PRP interventions (p>0.05 for all). Donor site pain was reduced from an average of 7.2 (±2.6) to 3 (±3.7), an average reduction in pain of 4.2 (standard error 1.1, p=0.0098) following PRP use. Based on these results, the authors suggest PRP as a beneficial adjunct for reducing donor site pain following STSG harvest. PMID:25623477

  4. Reduction of pain via platelet-rich plasma in split-thickness skin graft donor sites: a series of matched pairs

    Directory of Open Access Journals (Sweden)

    John D. Miller

    2015-01-01

    Full Text Available In the past decade, autologous platelet-rich plasma (PRP therapy has seen increasingly widespread integration into medical specialties. PRP application is known to accelerate wound epithelialization rates, and may also reduce postoperative wound site pain. Recently, we observed an increase in patient satisfaction following PRP gel (Angel, Cytomedix, Rockville, MD application to split-thickness skin graft (STSG donor sites. We assessed all patients known to our university-based hospital service who underwent multiple STSGs up to the year 2014, with at least one treated with topical PRP. Based on these criteria, five patients aged 48.4±17.6 (80% male were identified who could serve as their own control, with mean time of 4.4±5.1 years between operations. In both therapies, initial dressing changes occurred on postoperative day (POD 7, with donor site pain measured by Likert visual pain scale. Paired t-tests compared the size and thickness of harvested skin graft and patient pain level, and STSG thickness and surface area were comparable between control and PRP interventions (p>0.05 for all. Donor site pain was reduced from an average of 7.2 (±2.6 to 3 (±3.7, an average reduction in pain of 4.2 (standard error 1.1, p=0.0098 following PRP use. Based on these results, the authors suggest PRP as a beneficial adjunct for reducing donor site pain following STSG harvest.

  5. A prospective randomized controlled study on the treatment outcome of SpineCor brace versus rigid brace for adolescent idiopathic scoliosis with follow-up according to the SRS standardized criteria.

    Science.gov (United States)

    Guo, Jing; Lam, Tsz Ping; Wong, Man Sang; Ng, Bobby Kin Wah; Lee, Kwong Man; Liu, King Lok; Hung, Lik Hang; Lau, Ajax Hong Yin; Sin, Sai Wing; Kwok, Wing Kwan; Yu, Fiona Wai Ping; Qiu, Yong; Cheng, Jack Chun Yiu

    2014-12-01

    SpineCor is a relatively innovative brace for non-operative treatment of adolescent idiopathic scoliosis (AIS). However, the effectiveness of SpineCor still remains controversial. The objective of the current study was to compare the treatment outcomes of SpineCor brace with that of rigid brace following the standardized Scoliosis Research Society (SRS) criteria on AIS brace study. Females subjects with AIS and aged 10-14 were randomly allocated into two groups undergoing treatment of SpineCor (S Group, n = 20) or rigid brace (R Group, n = 18). During SpineCor treatment, patients who had curve progression of >5° would be required to switch to rigid brace treatment. The effectiveness of the two brace treatments was assessed using the SRS standardized criteria. Before skeletal maturity, 7 (35.0%) patients in the S Group and 1 (5.6%) patient in the R Group had curve progression >5° (P = 0.026). At skeletal maturity, 5 of the 7 (71.4%) patients who failed with SpineCor bracing showed control from further progression by changing to rigid bracing. At the latest follow-up with a mean duration of 45.1 months after skeletally maturity, 29.4% of patients who were successfully treated by rigid brace showed further curve progression beyond skeletal maturity, versus 38.5% of patients in the SpineCor group (P > 0.05). For both groups, the primary curves were slightly improved at the time of brace weaning, but additionally increased at the latest follow-up, with a rate of 1.5° per year for post-maturity progression. Curve progression rate was found to be significantly higher in the SpineCor group when compared with the rigid brace group. Changing to rigid bracing could control further curve progression for majority of patients who previously failed with SpineCor bracing. For both SpineCor and rigid brace treatments, 30-40% of patients who were originally successfully treated by bracing would exhibit further curve progression beyond skeletal maturity. The post

  6. Co-ordinated research programme on benchmark study for the seismic analysis and testing of WWER-type nuclear power plants. V. 2B. General material: codes, standards, criteria. Working material

    International Nuclear Information System (INIS)

    1999-01-01

    In August 1991, following the SMiRT-11 Conference in Tokyo, a Technical Committee Meeting was held on the 'Seismic safety issues relating to existing NPPs'. The Proceedings of this TCM was subsequently compiled in an IAEA Working Material. One of the main recommendations of this TCM, called for the harmonization of criteria and methods used in Member States in seismic reassessment and upgrading of existing NPPs. Twenty four institutions from thirteen countries participated in the CRP named 'Benchmark study for the seismic analysis and testing of WWER type NPPs'. Two types of WWER reactors (WWER-1000 and WWER-440/213) selected for benchmarking. Kozloduy NPP Units 5/6 and Paks NPP represented these respectively as prototypes. Consistent with the recommendations of the TCM and the working paper prepared by the subsequent Consultants' Meeting, the focal activity of the CRP was the benchmarking exercises. A similar methodology was followed both for Paks NPP and Kozloduy NPP Unit 5. Firstly, the NPP (mainly the reactor building) was tested using a blast loading generated by a series of explosions from buried TNT charges. Records from this test were obtained at several free field locations (both downhole and surface), foundation mat, various elevations of structures as well as some tanks and the stack. Then the benchmark participants were provided with structural drawings, soil data and the free field record of the blast experiment. Their task was to make a blind prediction of the response at preselected locations. The analytical results from these participants were then compared with the results from the test. Although the benchmarking exercises constituted the focus of the CRP, there were many other interesting problems related to the seismic safety of WWER type NPPs which were addressed by the participants. These involved generic studies, i.e. codes and standards used in original WWER designs and their comparison with current international practice; seismic analysis

  7. A case of Hepatitis E in a blood donor

    Directory of Open Access Journals (Sweden)

    Anita A Tendulkar

    2015-01-01

    Full Text Available The threat of hepatitis E is being felt in blood banks in recent times. The disease is usually self-limiting, but may progress to a fulminant fatal form. We report a unique case of a hepatitis E virus (HEV-positive asymptomatic blood donor who later developed jaundice and informed the blood bank. A blood donor passed all eligibility criteria tests and donated blood. After 20 days, the blood bank was informed by the donor that he had developed vomiting and jaundice 1 day postdonation. He was investigated by a local laboratory 1 day postdonation for liver profile, which was high. There had been a major outbreak in his community of similar symptoms during the same period. HEV IgM antibody by enzyme-linked immunosorbent assay was positive. Silent infections may be lurking in apparently healthy donors. Donors need to be encouraged to revert in case of any significant developments after donation and maintain open channels of communication.

  8. Profile of effective donors from organ and tissue procurement services

    Science.gov (United States)

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

    2014-01-01

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

  9. Transfusion transmissible infections among blood donors from a sub-Himalayan rural tertiary care centre in Darjeeling, India

    Directory of Open Access Journals (Sweden)

    Rupali Mandal

    2016-07-01

    Conclusions: Deployment of implicit inclusion-exclusion criteria is high on demand for reducing the prevalence of TTIs, to increase the donor subpopulation strength and ultimately to institute a safe transfusion protocol.

  10. Philanthropic Motivations of Community College Donors

    Science.gov (United States)

    Carter, Linnie S.; Duggan, Molly H.

    2011-01-01

    This descriptive study surveyed current, lapsed, and major gift donors to explore the impact of college communications on donors' decisions to contribute to the college, the likelihood of donor financial support for various college projects, and the philanthropic motivation profiles of the donors of a midsized, multicampus community college in…

  11. Kidney transplant outcomes from older deceased donors

    DEFF Research Database (Denmark)

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

    2018-01-01

    As the median age of deceased kidney donors rises, updated knowledge of transplant outcomes from older deceased donors in differing donor-recipient age groups is required. Using ERA-EDTA Registry data we determined survival outcomes of kidney allografts donated from the same older deceased donor...

  12. Living related donor liver transplantation.

    Science.gov (United States)

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

    1997-10-01

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

  13. Why Should Donors Care about Corruption?

    OpenAIRE

    Kolstad, Ivar

    2008-01-01

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

  14. 42 CFR 482.102 - Condition of participation: Patient and living donor rights.

    Science.gov (United States)

    2010-10-01

    ... health, disability, or life insurance may be affected; (8) The donor's right to opt out of donation at... donor rights. 482.102 Section 482.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION FOR...

  15. Analytical method for the identification and assay of 12 phthalates in cosmetic products: application of the ISO 12787 international standard "Cosmetics-Analytical methods-Validation criteria for analytical results using chromatographic techniques".

    Science.gov (United States)

    Gimeno, Pascal; Maggio, Annie-Françoise; Bousquet, Claudine; Quoirez, Audrey; Civade, Corinne; Bonnet, Pierre-Antoine

    2012-08-31

    Esters of phthalic acid, more commonly named phthalates, may be present in cosmetic products as ingredients or contaminants. Their presence as contaminant can be due to the manufacturing process, to raw materials used or to the migration of phthalates from packaging when plastic (polyvinyl chloride--PVC) is used. 8 phthalates (DBP, DEHP, BBP, DMEP, DnPP, DiPP, DPP, and DiBP), classified H360 or H361, are forbidden in cosmetics according to the European regulation on cosmetics 1223/2009. A GC/MS method was developed for the assay of 12 phthalates in cosmetics, including the 8 phthalates regulated. Analyses are carried out on a GC/MS system with electron impact ionization mode (EI). The separation of phthalates is obtained on a cross-linked 5%-phenyl/95%-dimethylpolysiloxane capillary column 30 m × 0.25 mm (i.d.) × 0.25 mm film thickness using a temperature gradient. Phthalate quantification is performed by external calibration using an internal standard. Validation elements obtained on standard solutions, highlight a satisfactory system conformity (resolution>1.5), a common quantification limit at 0.25 ng injected, an acceptable linearity between 0.5 μg mL⁻¹ and 5.0 μg mL⁻¹ as well as a precision and an accuracy in agreement with in-house specifications. Cosmetic samples ready for analytical injection are analyzed after a dilution in ethanol whereas more complex cosmetic matrices, like milks and creams, are assayed after a liquid/liquid extraction using ter-butyl methyl ether (TBME). Depending on the type of cosmetics analyzed, the common limits of quantification for the 12 phthalates were set at 0.5 or 2.5 μg g⁻¹. All samples were assayed using the analytical approach described in the ISO 12787 international standard "Cosmetics-Analytical methods-Validation criteria for analytical results using chromatographic techniques". This analytical protocol is particularly adapted when it is not possible to make reconstituted sample matrices. Copyright © 2012

  16. serum immunoglobulin levels in white, asiatic and bantu blood donors

    African Journals Online (AJOL)

    all assays were calculated as a percentage of the mean of. TABLE I. RESULTS OF IMMUNOGLOBULIN ASSAYS OF tOO WHITE, tOO ASIATIC AND 100 BANTU DONORS, EXPRESSED AS A. PERCENTAGE OF A CONTROL SERUM. Parameter. Range. Mean. Variance. Standard deviation. CoefI. of variation.

  17. Function following Living Donor Nephrectomy

    Directory of Open Access Journals (Sweden)

    Jonathan Heldt

    2011-01-01

    Full Text Available Background. While tobacco use by a renal transplant recipient has been shown to negatively affect graft and patient survival, the effect of smoking on the part of the kidney donor remains unknown. Methods. 29 smoking donors (SD and their recipients (SD-R as well as 71 non-smoking donors (ND and their recipients (ND-R were retrospectively reviewed. Preoperative demographics and perioperative variables including serum creatinine (Cr and glomerular filtration rate (GFR were calculated and stratified by amount of tobacco exposure in pack-years. Clinical outcomes were analyzed with a Student's t-test, chi-square, and multiple linear regression analysis (=0.05. Results. At most recent followup, SD-R's had a significantly smaller percent decrease in postoperative Cr than ND-R's (−57% versus −81%; =0.015 and lower calculated GFR's (37.0 versus 53.0 mL/min per 1.73 m2; <0.001. SD's had a larger percent increase in Cr than ND's at most recent followup (57% versus 40%; <0.001, with active smokers having a larger increase than those who quit, although this difference was not statistically significant (68% versus 52%; =0.055. Conclusions. Use of tobacco by kidney donors is associated with decreased posttransplant renal function, although smoking cessation can improve outcomes. Kidneys from donors who smoke should be used with caution.

  18. Dengue antibodies in blood donors.

    Science.gov (United States)

    Ribas-Silva, Rejane Cristina; Eid, Andressa Ahmad

    2012-01-01

    Dengue is an urban arbovirus whose etiologic agent is a virus of the genus Flavorius with four distinct antigen serotypes (DENV-1, DENV-2, DENV-3 and DENV-4) that is transmitted to humans through the bite of the mosquito Aedes aegypti. The Campo Mourão region in Brazil is endemic for dengue fever. OBTECTIVE: The aim of this study was to evaluate the presence of IgG and IgM antibodies specific to the four serotypes of dengue in donors of the blood donor service in the city of Campo Mourão. Epidemiological records were evaluated and 4 mL of peripheral blood from 213 blood donors were collected in tubes without anticoagulant. Serum was then obtained and immunochromatographic tests were undertaken (Imuno-Rápido Dengue IgM/IgG(TM)). Individuals involved in the study answered a social and epidemiological questionnaire on data which included age, gender and diagnosis of dengue. Only three (1.4%) of the 213 blood tests were positive for IgG anti-dengue antibodies. No donors with IgM antibody, which identifies acute infection, were identified. The results of the current analysis show that the introduction of quantitative or molecular serological methods to determine the presence of anti-dengue antibodies or the detection of the dengue virus in blood donors in endemic regions should be established so that the quality of blood transfusions is guaranteed.

  19. Donor Outcomes in Living Donor Liver Transplantation-Analysis of 275 Donors From a Single Centre in India.

    Science.gov (United States)

    Narasimhan, Gomathy; Safwan, Mohamed; Kota, Venugopal; Reddy, Mettu S; Bharathan, Anand; Dabora, Abderrhaim; Kaliamoorthy, Ilankumaran; Kanagavelu, Rathnavel G; Srinivasan, Vijaya; Rela, Mohamed

    2016-06-01

    Live donor liver transplantation is the predominant form of liver transplantation in India and in most Asian countries. Donor outcome reports are an important source of information to be shared with prospective donors at the time of informed consent. This is the first donor outcome series from India. Analysis of donor characteristics and morbidity of 275 live donors from a single large volume center is documented. Two hundred seventy-five patients donated from November 2009 to October 2014, 144 were women and 131 were men, 180 donated to adults and 95 donated to children. Right lobe donors were majority at 62.2% followed by left lateral segment 28%. Two thirds of the live donors did not have any morbidity; 114 complications were encountered in 85 patients. The complications were graded as per Clavien 5 tier grading and major morbidity (grade III b, grade IV grade V) was 4.36%. Postoperative biliary complication was seen in 3 donors. This large single-center study is the first donor outcome report from India, and the results are comparable to other published donor series. Documentation and regular audit of donor outcomes is important to help improve the safety of donor hepatectomy and to provide a database for informed consent of prospective donors.

  20. Improving health profile of blood donors as a consequence of transfusion safety efforts

    DEFF Research Database (Denmark)

    Edgren, Gustaf; Tran, Trung Nam; Hjalgrim, Henrik

    2007-01-01

    BACKGROUND: Transfusion safety rests heavily on the health of blood donors. Although they are perceived as being healthier than average, little is known about their long-term disease patterns and to which extent the blood banks' continuous efforts to optimize donor selection has resulted...... in improvements. Mortality and cancer incidence among blood donors in Sweden and Denmark was investigated. STUDY DESIGN AND METHODS: All computerized blood bank databases were compiled into one database, which was linked to national population and health data registers. With a retrospective cohort study design, 1......,110,329 blood donors were followed for up to 35 years from first computer-registered blood donation to death, emigration, or December 31, 2002. Standardized mortality and incidence ratios expressed relative risk of death and cancer comparing blood donors to the general population. RESULTS: Blood donors had...

  1. A Web-based approach to blood donor preparation.

    Science.gov (United States)

    France, Christopher R; France, Janis L; Kowalsky, Jennifer M; Copley, Diane M; Lewis, Kristin N; Ellis, Gary D; McGlone, Sarah T; Sinclair, Kadian S

    2013-02-01

    Written and video approaches to donor education have been shown to enhance donation attitudes and intentions to give blood, particularly when the information provides specific coping suggestions for donation-related concerns. This study extends this work by comparing Web-based approaches to donor preparation among donors and nondonors. Young adults (62% female; mean [±SD] age, 19.3 [±1.5] years; mean [range] number of prior blood donations, 1.1 [0-26]; 60% nondonors) were randomly assigned to view 1) a study Web site designed to address common blood donor concerns and suggest specific coping strategies (n = 238), 2) a standard blood center Web site (n = 233), or 3) a control Web site where participants viewed videos of their choice (n = 202). Measures of donation attitude, anxiety, confidence, intention, anticipated regret, and moral norm were completed before and after the intervention. Among nondonors, the study Web site produced greater changes in donation attitude, confidence, intention, and anticipated regret relative to both the standard and the control Web sites, but only differed significantly from the control Web site for moral norm and anxiety. Among donors, the study Web site produced greater changes in donation confidence and anticipated regret relative to both the standard and the control Web sites, but only differed significantly from the control Web site for donation attitude, anxiety, intention, and moral norm. Web-based donor preparation materials may provide a cost-effective way to enhance donation intentions and encourage donation behavior. © 2012 American Association of Blood Banks.

  2. Gamete donation: parents' experiences of searching for their child's donor siblings and donor.

    Science.gov (United States)

    Freeman, T; Jadva, V; Kramer, W; Golombok, S

    2009-03-01

    This study investigates the new phenomenon of parents of donor offspring searching for and contacting their child's 'donor siblings' (i.e. donor offspring conceived by the same donor) and donor. Online questionnaires were completed by 791 parents (39% lone-mother, 35% lesbian-couple, 21% heterosexual-couple, 5% non-specified) recruited via the Donor Sibling Registry; a US-based international registry that facilitates contact between donor conception families who share the same donor. Data were collected on parents' reasons for searching for their child's donor siblings and/or donor, the outcome of these searches and parents' and their child's experiences of any resulting contact. Parents' principal motivation for searching for their child's donor siblings was curiosity and for their donor, enhancing their child's sense of identity. Some parents had discovered large numbers of donor siblings (maximum = 55). Most parents reported positive experiences of contacting and meeting their child's donor siblings and donor. This study highlights that having access to information about a child's donor origins is important for some parents and has potentially positive consequences. These findings have wider implications because the removal of donor anonymity in the UK and elsewhere means that increasing numbers of donor offspring are likely to seek contact with their donor relations in the future.

  3. Bone density in apheresis donors and whole blood donors

    NARCIS (Netherlands)

    Boot, C.L.; Luken, J.S.; van den Burg, P.J.M.; de Kort, W.L.A.M.; Koopman, M.M.W.; Vrielink, H.; van Schoor, N.M.; den Heijer, M.; Lips, P.

    2015-01-01

    Apheresis donation using citrate causes acute decrease in serum calcium and increase in serum parathyroid hormone. Long-term consequences, such as decrease in bone mineral density (BMD), are not known. In this study, we compared the BMD of 20 postmenopausal apheresis donors (mean donation number 115

  4. Suicidal hanging donors for lung transplantation

    Science.gov (United States)

    Ananiadou, Olga; Schmack, Bastian; Zych, Bartlomiej; Sabashnikov, Anton; Garcia-Saez, Diana; Mohite, Prashant; Weymann, Alexander; Mansur, Ashham; Zeriouh, Mohamed; Marczin, Nandor; De Robertis, Fabio; Simon, Andre Rüdiger; Popov, Aron-Frederik

    2018-01-01

    Abstract In the context of limited donor pool in cardiothoracic transplantation, utilization of organs from high risk donors, such as suicidal hanging donors, while ensuring safety, is under consideration. We sought to evaluate the outcomes of lung transplantations (LTx) that use organs from this group. Between January 2011 and December 2015, 265 LTx were performed at our center. Twenty-two recipients received lungs from donors after suicidal hanging (group 1). The remaining 243 transplantations were used as a control (group 2). Analysis of recipient and donor characteristics as well as outcomes was performed. No statistically significant difference was found in the donor characteristics between analyzed groups, except for higher incidence of cardiac arrest, younger age and smoking history of hanging donors (P donor cause of death is not associated with poor mid-term survival or chronic lung allograft dysfunction following transplantation. These results encourage assessment of lungs from hanging donors, and their consideration for transplantation. PMID:29620623

  5. Emergency heart retransplantation with a positive donor crossmatch.

    Science.gov (United States)

    Ippoliti, G; Martinelli, L; Minzioni, G; Goggi, C; Graffigna, A; Rinaldi, M; Campana, C; Ascari, E; Vigano, M

    1989-01-01

    We report a case of one patient who underwent emergency retransplantation with a highly positive donor crossmatch. Standard immunosuppression was integrated by the addition of plasma exchange during extracorporeal circulation, polyclonal IgG, and cyclophosphamide for the first 30 days. After transplantation the clinical outcome was normal; immunosuppression induced a complete disappearance of the donor-specific antibody. In spite of the heavy immunosuppression, we did not observe any infectious complications. We suggest that a greater immunosuppression established soon after the transplant and adjusted on the basis of immunological monitoring may allow a heart transplant with a positive crossmatch.

  6. Proposed Diagnostic Criteria for Smartphone Addiction.

    Science.gov (United States)

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han; Lin, Sheng-Hsuan

    2016-01-01

    Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  7. A standardized crisis management model for self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder: The Brief Admission Skåne randomized controlled trial protocol (BASRCT).

    Science.gov (United States)

    Liljedahl, Sophie I; Helleman, Marjolein; Daukantaité, Daiva; Westrin, Åsa; Westling, Sofie

    2017-06-15

    Brief Admission is a crisis and risk management strategy in which self-harming and suicidal individuals with three or more diagnostic criteria of borderline personality disorder self-admit to hospital at times of increasing risk when other efforts to stay safe are failing. Standardized in the current randomized controlled trial, the intensity of Brief Admission Skåne is implemented in durations of three days, with a maximum frequency of three times a month. Brief Admission is integrated into existing treatment plans in advance of crises to prevent reliance on general psychiatric admissions for risk management, as these may be lengthy, unstructured, and of uncertain therapeutic value. The overall objective of the Brief Admission Skåne randomized controlled trial is to determine if Brief Admission can replace general psychiatric admission for self-harming and suicidal individuals with complex mental illness at times of escalating risk. Other objectives of the study are to evaluate whether Brief Admission increases daily functioning and enhances coping, reduces psychiatric symptoms including frequency and severity of self-harm and suicidal behaviours. A final objective is to determine if Brief Admission is an effective crisis management model for this population. Participants are randomized at an individual level to either Brief Admission Skåne plus Treatment as Usual or Treatment As Usual. Based on a priori power analyses, N = 124 participants will be recruited to the study. Data collection is in progress, and will continue until June 2018. All participant data are single-blinded and will be handled with intention-to-treat analysis. Based on the combined clinical experience of our international research group, the Brief Admission Skåne randomized controlled trial upon which the current protocol is based represents the first initiative to standardize, implement and evaluate Brief Admission amongst self-harming and suicidal individuals, including those with

  8. LAPAROSCOPIC LEFT LATERAL SECTIONECTOMY IN LIVING LIVER DONOR

    Directory of Open Access Journals (Sweden)

    S. V. Gautier

    2016-01-01

    Full Text Available Introduction. Living donor liver transplantation has proved to be an effective, safe and radical treatment modality for patients with end-stage liver diseases. Left lateral section (LLS of donor’s liver is used in pediatric recipients. Laparoscopic LLS procurement was fi rst described by D. Cherqui in 2002. At present, this technique is routinely used only by 5 hospitals in the world. However, up to date, some authors consider it to be a new standard to perform such a surgery in living donors.Aim. To analyze the fi rst Russian experience in laparoscopic left lateral sectionectomy (LapLLS in living related donor.Materials and methods. From May to September 2016 fi ve LapLLS were performed in living donors. In all cases donors were women (mothers in 4 cases and aunt in 1 case. Recipients were children aged from 6 months through 3 years with body mass from 5.6 to 12.5 kg. Liver transection was carried out under conditions of maintained blood supply. Parenchymal transection was performed using a harmonic scalpel, bipolar coagulation and ultrasound dissection.Results. Average donor age was 32 ± 5 years. Average operation time was 287 ± 16 min. Average LLS graft weight was 220 ± 16 g. Intraoperative blood loss did not exceed 100 ml (95 ± 5 ml. Donors were discharged on the 3rd–4th post-op day. There were no postoperative complications in donors. Recipients were also characterized by a standard course of the postoperative period.Conclusion. LapLLS is an effective and safe method with several advantages. Primarily, these are early rehabilitation of the donors and shortening of the hospital stay, which are important for the quick return to normal way of live. Excellent visualization of anatomical structures, including vascular and biliary ones, allows performing precise selection. In addition, good cosmetic effect is also an important aspect.

  9. Change in donor profile influenced the percentage of organs transplanted from multiple organ donors.

    Science.gov (United States)

    Meers, C; Van Raemdonck, D; Van Gelder, F; Van Hees, D; Desschans, B; De Roey, J; Vanhaecke, J; Pirenne, J

    2009-03-01

    We hypothesized that the change in donor profile over the years influenced the percentage of transplantations. We reviewed medical records for all multiple-organ donors (MODs) within our network. The percentage of transplanted organs was compared between 1991-1992 (A) and 2006-2007 (B). In period A, 156 potential MODs were identified compared with 278 in period B. Fifteen potential donors (10%) in period A and 114 (41%) in period B were rejected because they were medically not suitable (40% vs 75%) or there was no family consent (60% vs 25%). Of the remaining effective MODs (141 in period A and 164 in period B), mean (standard deviation = SD) age was 34 (5) years vs 49 (17) years (P organs transplanted in periods A vs B was kidneys, 97% vs 79%; livers, 64% vs 85%; hearts, 60% vs 26%; lungs, 7% vs 35%; and pancreas, 6% vs 13% (P organs (17%), mainly because of medical contraindications. The MOD profile changed to older age, fewer traumatic brain deaths, and longer ventilation time. We transplanted more livers, lungs, and pancreases but fewer kidneys and hearts.

  10. For Donors Who Have Everything.

    Science.gov (United States)

    Shubeck, Theresa

    1990-01-01

    Most major donors don't need another plaque or formal dinner. Development officers need to be more imaginative and less materialistic in expressing their institution's thanks, personalizing them by tying the gesture in with something distinctive about the institution or the gift. Development office teamwork and care help promote donor…

  11. Being a Living Donor: Risks

    Science.gov (United States)

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

  12. Blood donor recruitment strategies and their impact on blood safety in Egypt.

    Science.gov (United States)

    Hussein, Eiman

    2014-02-01

    Because of the high incidence of HCV, blood safety presents a serious challenge in Egypt. Given the constrained economy which limits the implementation of nucleic acid amplification technology, proper recruitment of blood donors becomes of paramount importance. To evaluate the effectiveness of blood donor recruitment strategies, the seroprevalence of positive infectious markers among blood donors was studied. Donors' records covering the period from 2006-2012 were reviewed. Blood donations were screened for HCV antibodies, HBs antigen (HBsAg), HIV-1 and 2 and syphilis antibodies. Of 308,762 donors, 63.4% were voluntary donors (VD). VD of 2011-2012 were significantly younger than family replacement donors (RD) .The overall prevalences of HCV antibodies, HBsAg, HIV and syphilis antibodies were 4.3%, 1.22%, 0.07%, and 0.13%, respectively. All tested markers (except HIV) were significantly higher among RD, when compared to VD (P<0.0001). A consistent steady trend for decrease in HCV seropositivity was observed in RD and VD from 8.9% and 4.2% to 3.8% and 1.5%, respectively. A trend for decrease in HBsAg was demonstrated in VD from 1.2% to 0.53%. The decreasing trends in HCV antibody and HBs antigen is promising and may reflect the improved donor selection criteria. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. The effect of pre-donation hypotension on whole blood donor adverse reactions: a systematic review.

    Science.gov (United States)

    Pauwels, Nele S; Cusack, Leila; De Buck, Emmy; Compernolle, Veerle; Vandekerckhove, Philippe

    2014-06-01

    Blood services are reliant upon healthy blood donors to provide a safe and adequate supply of blood products. Inappropriate variables contained within blood donor exclusion criteria can defer potentially appropriate donors. The aim of this systematic review was to examine the effect of low pre-donation blood pressure, as compared with normal blood pressure, on adverse events in allogeneic whole blood donors. A systematic review was performed using highly sensitive search strategies within five databases (Cochrane Central Register of Controlled Trials, CINAHL, Embase, MEDLINE, and Web of Science) from inception date until April 12, 2013. Out of 8305 records, 10 observational studies were identified that addressed the question. Five of these studies (with a combined total of 1,482,020 donations and 2903 donors) included either a statistical analysis or an appropriate study design that controlled for possible confounding factors. Based on the currently available evidence, hypotension has not been shown to be an independent predictive factor for donor complications. However, the overall quality of evidence was rather limited and rated 'low,' using the GRADE approach. In conclusion there is currently no evidence that hypotensive blood donors have a greater risk for donor adverse events compared with their normotensive counterparts. Copyright © 2014 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  14. FHR Generic Design Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Flanagan, George F [ORNL; Holcomb, David Eugene [ORNL; Cetiner, Sacit M [ORNL

    2012-06-01

    The purpose of this document is to provide an initial, focused reference to the safety characteristics of and a licensing approach for Fluoride-Salt-Cooled High-Temperature Reactors (FHRs). The document does not contain details of particular reactor designs nor does it attempt to identify or classify either design basis or beyond design basis accidents. Further, this document is an initial attempt by a small set of subject matter experts to document the safety and licensing characteristics of FHRs for a larger audience. The document is intended to help in setting the safety and licensing research, development, and demonstration path forward. Input from a wider audience, further technical developments, and additional study will be required to develop a consensus position on the safety and licensing characteristics of FHRs. This document begins with a brief overview of the attributes of FHRs and then a general description of their anticipated safety performance. Following this, an overview of the US nuclear power plant approval process is provided that includes both test and power reactors, as well as the role of safety standards in the approval process. The document next describes a General Design Criteria (GDC) - based approach to licensing an FHR and provides an initial draft set of FHR GDCs. The document concludes with a description of a path forward toward developing an FHR safety standard that can support both a test and power reactor licensing process.

  15. Associations of health status with subsequent blood donor behavior-An alternative perspective on the Healthy Donor Effect from Donor InSight

    NARCIS (Netherlands)

    van den Hurk, Katja; Zalpuri, Saurabh; Prinsze, Femmeke J.; Merz, Eva-Maria; de Kort, Wim L. A. M.

    2017-01-01

    In donor health research, the 'Healthy Donor Effect' (HDE) often biases study results and hampers their interpretation. This refers to the fact that donors are a selected 'healthier' subset of a population due to both donor selection procedures and self-selection. Donors with long versus short donor

  16. Blood donor deferral: time for change? An evidence-based analysis

    Directory of Open Access Journals (Sweden)

    Borra V

    2016-05-01

    Full Text Available Vere Borra,1 Giovani Vandewalle,1 Hans Van Remoortel,1 Veerle Compernolle,1,2 Emmy De Buck,1 Philippe Vandekerckhove1–31Belgian Red Cross-Flanders, Mechelen, 2Faculty of Medicine, University of Ghent, Ghent, 3Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, BelgiumAbstract: Donor selection remains an important part in the safety of the blood supply all over the world. Yet, donor deferral criteria seem to be strongly based on the precautionary principle protecting safety and quality, and on supply and expense considerations. This review therefore provides an overview of the available evidence on donor exclusion criteria, as well as on their cost-effectiveness, for the most frequent reasons of donor deferral in our region. PubMed was queried to retrieve primary research studies, systematic reviews, and health technology assessments (HTAs concerning donor exclusion criteria. With a similar approach, HTAs about the different blood-banking safety interventions were included. Reasons for donor deferral were recorded via the blood bank information system of the Belgian Red Cross-Flanders. Seven systematic reviews were identified: four on donor safety (hypotension, hypertension/type 2 diabetes, epilepsy, and higher age and three on recipient safety (hemochromatosis, men who have sex with men, and endoscopy. Forty-three low-quality observational studies were included, as well as 16 HTAs: three about donor exclusion criteria and 13 cost-utility analyses about blood-banking safety interventions. In general, the available evidence for deferral reasons was of low quality, and for 60% of the top 30 reasons for excluding donors, no evidence was found. Blood banking shows its unique position as many safety measures far exceed the normally accepted cost of €50,000/quality-adjusted life-years. The historical model based on the precautionary principle and on supply and expense considerations provides adequate supplies of

  17. Learners' Epistemic Criteria for Good Scientific Models

    Science.gov (United States)

    Pluta, William J.; Chinn, Clark A.; Duncan, Ravit Golan

    2011-01-01

    Epistemic criteria are the standards used to evaluate scientific products (e.g., models, evidence, arguments). In this study, we analyzed epistemic criteria for good models generated by 324 middle-school students. After evaluating a range of scientific models, but before extensive instruction or experience with model-based reasoning practices,…

  18. Criteria for authorship in bioethics.

    Science.gov (United States)

    Resnik, David B; Master, Zubin

    2011-10-01

    Multiple authorship is becoming increasingly common in bioethics research. There are well-established criteria for authorship in empirical bioethics research but not for conceptual research. It is important to develop criteria for authorship in conceptual publications to prevent undeserved authorship and uphold standards of fairness and accountability. This article explores the issue of multiple authorship in bioethics and develops criteria for determining who should be an author on a conceptual publication in bioethics. Authorship in conceptual research should be based on contributing substantially to: (1) identifying a topic, problem, or issue to study; (2) reviewing and interpreting the relevant literature; (3) formulating, analyzing, and evaluating arguments that support one or more theses; (4) responding to objections and counterarguments; and (5) drafting the manuscript. Authors of conceptual publications should participate substantially in at least two of areas (1)-(5) and also approve the final version. [corrected].

  19. A Retrospective Analysis of Apheresis Donor Deferral and Adverse Reactions at a Tertiary Care Centre in India.

    Science.gov (United States)

    Arora, Disha; Garg, Ketan; Kaushik, Ankit; Sharma, Richa; Rawat, D S; Mandal, A K

    2016-11-01

    With increasing demand of platelet component each day, blood bank plays a pivotal role in ensuring supply of safe blood as and when required. Plateletpheresis procedure is a relatively simple, safe and important adjunct to blood bank inventory. However, recruitment of healthy blood donors is a challenge that the health industry is facing today. To determine the reasons and rates of apheresis donor deferral along with investigation of adverse reactions encountered during the procedure. Records of single donor apheresis were retrospectively analysed from 1 st January 2010 to 31 st December 2014. The study was carried out at Blood Bank, Safdarjung Hospital, New Delhi, India. The donor details that were studied included - age, sex, type of donation (voluntary/replacement/ repeat), reason for donor deferral and type of adverse reaction, if encountered during the procedure. Among the 478 donors screened for plateletpheresis procedure during a study period of 5 years, 134 (28.03%) were deferred. Temporary deferrals accounted for majority (93.28%) of the deferrals. Low platelet count (50.75%) was the main reason of donor deferral followed by low haemoglobin (20.89%). Amongst the 344 selected donors, 15 (4.36%) had some type of adverse reaction associated with the procedure. We suggest that the selection criteria for plateletpheresis donors should be revised to deal with shortage of apheresis donors. The criteria regarding minimum pre-procedure platelet count (above1.5 lac/μl) and haemoglobin (above 12.5 g/dl) need to be lowered so as to suit the Indian scenario. The lower adverse reaction rates, 14/344 (4.06%) associated with this procedure encourages safety of donors and is important in recruitment of new donors.

  20. 16 CFR 1031.12 - Membership criteria.

    Science.gov (United States)

    2010-01-01

    ... Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL COMMISSION PARTICIPATION AND COMMISSION EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.12 Membership criteria. (a) The Commissioners, their special assistants, and Commission officials and employees holding the...

  1. Influence of donor-donor transport on excitation energy transfer

    Energy Technology Data Exchange (ETDEWEB)

    Pandey, K K; Joshi, H C; Pant, T C [Kumaun University, Nainital (India). Department of Physics

    1989-01-01

    Energy migration and transfer from acriflavine to rhodamine B and malachite green in poly (methylmethacrylate) have been investigated using the decay function analysis. It is found that the influence of energy migration in energy transfer can be described quite convincingly by making use of the theories of Loring, Andersen and Fayer (LAF) and Huber. At high acceptor concentration direct donor-acceptor transfer occurs through Forster mechanism. (author). 17 refs., 5 figs.

  2. Establishment of an oocyte donor program. Donor screening and selection.

    Science.gov (United States)

    Quigley, M M; Collins, R L; Schover, L R

    1991-01-01

    IVF with donated oocytes, followed by embryo placement in the uterus of a recipient who has been primed with exogenous steroids, is a successful treatment for special cases of infertility. Preliminary results indicate that the success rate in this situation is even greater than that usually seen with normal IVF (with placement of the embryos back into the uteri of the women from whom the oocytes were recovered). Although different sources for donated oocytes have been identified, the use of "excess" oocytes from IVF cycles and the attempted collection of oocytes at the time of otherwise indicated pelvic surgery have ethical and practical problems associated with their use. We have herein described the establishment of a successful program relying on anonymous volunteers who go through ovarian stimulation, monitoring, and oocyte recovery procedures solely to donate oocytes. The potential donors go through an exhaustive screening and education process before they are accepted in the program. Psychological evaluation of our potential donors indicated a great degree of turmoil in their backgrounds and a wide variety of motivations for actually participating. Despite the extensive educational and screening process, a substantial percentage of the donors did not complete a donation cycle, having either voluntarily withdrawn or been dropped because of lack of compliance. Further investigation of the psychological aspects of participating in such a program is certainly warranted. The use of donated oocytes to alleviate specific types of infertility is quite successful, but the application of this treatment is likely to be limited by the relative unavailability of suitable oocyte donors.

  3. Laser Safety Inspection Criteria

    International Nuclear Information System (INIS)

    Barat, K.

    2005-01-01

    A responsibility of the Laser Safety Officer (LSO) is to perform laser audits. The American National Standard Z136.1 Safe Use of Lasers references this requirement through several sections. One such reference is Section 1.3.2.8, Safety Features Audits, ''The LSO shall ensure that the safety features of the laser installation facilities and laser equipment are audited periodically to assure proper operation''. The composition, frequency and rigor of that inspection/audit rests in the hands of the LSO. A common practice for institutions is to develop laser audit checklists or survey forms It is common for audit findings from one inspector or inspection to the next to vary even when reviewing the same material. How often has one heard a comment, ''well this area has been inspected several times over the years and no one ever said this or that was a problem before''. A great number of audit items, and therefore findings, are subjective because they are based on the experience and interest of the auditor to particular items on the checklist. Beam block usage, to one set of eyes might be completely adequate, while to another, inadequate. In order to provide consistency, the Laser Safety Office of the National Ignition Facility Directorate has established criteria for a number of items found on the typical laser safety audit form. The criteria are distributed to laser users. It serves two broad purposes; first, it gives the user an expectation of what will be reviewed by an auditor. Second, it is an opportunity to explain audit items to the laser user and thus the reasons for some of these items, such as labelling of beam blocks

  4. Live donor transplantation--the incompetent donor: comparative law.

    Science.gov (United States)

    Wolfman, Samuel; Shaked, Tali

    2008-12-01

    Informed consent of the patient to medical treatment is an essential prerequisite for any invasive medical procedure. However in emergency cases, when the patient is unable to sign a consent form due to unconsciousness or to psychotic state, than the primary medical consideration shall take place. In such a case, in order to save life or even prevent a major medical hazard to the patient, doctors are allowed, in certain cases and in accordance with well accepted medical practice, to perform invasive procedures, major surgery or risky pharmacological treatment, without the explicit consent of the patient. All the above refers to the cases when avoidance of such non-consented treatment may harm severely the health and wellbeing of the patient and there is no doubt that such treatment is for the ultimate benefit of the patient. The question, however, shall arise when such a medical procedure is not necessarily for the benefit of the patient, but rather for the benefit of somebody else. Such is the case in the transplantation area and the question of living donor-donee relationship. This paper shall analyze the legal situation in cases of non competent donors whose consent cannot be considered legal consent given in full understanding and out of free will. It will also compare three legal systems, the Israeli, the American and the traditional Jewish law, with regard to the different approaches to this human problem, where the autonomy of the donor may be sacrificed for the purpose of saving life of another person.

  5. The 40 donors per million population plan: an action plan for improvement of organ donation and transplantation in Spain.

    Science.gov (United States)

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

    2009-10-01

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

  6. Characteristics of donors who do or do not return to give blood and barriers to their return

    Science.gov (United States)

    Wevers, Anne; Wigboldus, Daniël H.J.; de Kort, Wim L.A.M.; van Baaren, Rick; Veldhuizen, Ingrid J.T.

    2014-01-01

    Background In the Netherlands about 50% of whole blood donors return to give blood after an invitation to donate. This study aimed to investigate the characteristics of donor return behaviour and to gain insight into the barriers to blood donation reported by the donors themselves. Materials and methods A total of 4,901 whole blood donors were invited to donate in week 39 of 2009. Barriers mentioned by donors who informed the blood bank for not donating were registered for 1 month. Logistic regression analyses assessed relevant characteristics of return behaviour, such as age and blood type, in men and women separately. Results Of the invited donors, 55% returned to give a donation, whereas 45% did not return. Male donors were more likely to return when they were older, had a higher previous return rate and had no past deferrals. The same pattern was found among women, but was less strong. The main barriers were: time constraints (35%), preference to postpone donation due to general physical problems although being eligible to donate (29%), and being ineligible to donate due to medical deferral criteria (9%). Discussion Specific donor characteristics are associated with return behaviour. Not donating due to time constraints could mean that donors do not feel the urgency of donating blood. Interventions targeted to increase commitment among specific donor groups should be tested further. PMID:23522891

  7. Survey of U.S. Organ Procurement Organizations Regarding Pediatric Organ Donor Management.

    Science.gov (United States)

    Ream, Robert S; Armbrecht, Eric S

    2016-10-01

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

  8. Laser Safety Inspection Criteria

    International Nuclear Information System (INIS)

    Barat, K

    2005-01-01

    A responsibility of the Laser Safety Officer (LSO) is to perform laser safety audits. The American National Standard Z136.1 Safe use of Lasers references this requirement in several sections: (1) Section 1.3.2 LSO Specific Responsibilities states under Hazard Evaluation, ''The LSO shall be responsible for hazards evaluation of laser work areas''; (2) Section 1.3.2.8, Safety Features Audits, ''The LSO shall ensure that the safety features of the laser installation facilities and laser equipment are audited periodically to assure proper operation''; and (3) Appendix D, under Survey and Inspections, it states, ''the LSO will survey by inspection, as considered necessary, all areas where laser equipment is used''. Therefore, for facilities using Class 3B and or Class 4 lasers, audits for laser safety compliance are expected to be conducted. The composition, frequency and rigueur of that inspection/audit rests in the hands of the LSO. A common practice for institutions is to develop laser audit checklists or survey forms. In many institutions, a sole Laser Safety Officer (LSO) or a number of Deputy LSO's perform these audits. For that matter, there are institutions that request users to perform a self-assessment audit. Many items on the common audit list and the associated findings are subjective because they are based on the experience and interest of the LSO or auditor in particular items on the checklist. Beam block usage is an example; to one set of eyes a particular arrangement might be completely adequate, while to another the installation may be inadequate. In order to provide more consistency, the National Ignition Facility Directorate at Lawrence Livermore National Laboratory (NIF-LLNL) has established criteria for a number of items found on the typical laser safety audit form. These criteria are distributed to laser users, and they serve two broad purposes: first, it gives the user an expectation of what will be reviewed by an auditor, and second, it is an

  9. New facility shield design criteria

    International Nuclear Information System (INIS)

    Howell, W.P.

    1981-07-01

    The purpose of the criteria presented here is to provide standard guidance for the design of nuclear radiation shields thoughout new facilities. These criteria are required to assure a consistent and integrated design that can be operated safely and economically within the DOE standards. The scope of this report is confined to the consideration of radiation shielding for contained sources. The whole body dose limit established by the DOE applies to all doses which are generally distributed throughout the trunk of the body. Therefore, where the whole body is the critical organ for an internally deposited radionuclide, the whole body dose limit applies to the sum of doses received must assure control of the concentration of radionuclides in the building atmosphere and thereby limit the dose from internal sources

  10. [Demography and donation frequencies of blood and plasma donor populations in Germany].

    Science.gov (United States)

    Ritter, Sabine; Willand, L; Reinhard, B; Offergeld, R; Hamouda, O

    2008-08-01

    According to Article 22 of the Transfusion Act, the Robert Koch Institute collects and evaluates nationwide data on the prevalence and incidence of transfusion-relevant infections among blood and plasma donors in Germany. Due to revision of the Transfusion Act in 2005 not only the number of donations but also the number of donors has become available for analysis. Here we give a detailed account on the demographic profile and donation frequencies of German whole blood, plasma and platelet donors in 2006. Overall, 4 % of the German population eligible to donate were active as repeat whole blood donors in 2006; 0.3 % repeatedly donated plasma or platelets. Irrespective of the type of donation, the percentage of donors among the general population was highest among the youngest age group (18 to 24 years). While the age distribution of whole blood repeat donors roughly resembled that of the general population, with the greatest number among those aged 35 to 44, younger age groups were overrepresented among repeat plasma donors. Donation frequency varied depending on donor age and sex, with an average of 1.9 per year for whole blood donations, 11.9 for plasmapheresis and 4.0 for plateletpheresis. With the exception of the latter, men donated more frequently than women. For both sexes, donation frequency increased with age. Detailed knowledge of the demographic profile and changes in the composition of donor populations are essential for planning adequate blood supply. The data presented may serve as reference for assessing the consequences of measures that affect the number of donors and/or donations (for example changing deferral criteria) in Germany.

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

    Science.gov (United States)

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

    2016-07-01

    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.

  12. Renal Transplantation from Elderly Living Donors

    Directory of Open Access Journals (Sweden)

    Jacob A. Akoh

    2013-01-01

    Full Text Available Acceptance of elderly living kidney donors remains controversial due to the higher incidence of comorbidity and greater risk of postoperative complications. This is a review of publications in the English language between 2000 and 2013 about renal transplantation from elderly living donors to determine trends and effects of donation, and the outcomes of such transplantation. The last decade witnessed a 50% increase in living kidney donor transplants, with a disproportionate increase in donors >60 years. There is no accelerated loss of kidney function following donation, and the incidence of established renal failure (ERF and hypertension among donors is similar to that of the general population. The overall incidence of ERF in living donors is about 0.134 per 1000 years. Elderly donors require rigorous assessment and should have a predicted glomerular filtration rate of at least 37.5 mL/min/1.73 m2 at the age of 80. Though elderly donors had lower glomerular filtration rate before donation, proportionate decline after donation was similar in both young and elderly groups. The risks of delayed graft function, acute rejection, and graft failure in transplants from living donors >65 years are significantly higher than transplants from younger donors. A multicentred, long-term, and prospective database addressing the outcomes of kidneys from elderly living donors is recommended.

  13. Development of Organ-Specific Donor Risk Indices

    OpenAIRE

    Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.

    2012-01-01

    Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in devel...

  14. Post-donation telephonic interview of blood donors providing an insight into delayed adverse reactions: First attempt in India.

    Science.gov (United States)

    Tiwari, Aseem K; Aggarwal, Geet; Dara, Ravi C; Arora, Dinesh; Srivastava, Khushboo; Raina, Vimarsh

    2017-04-01

    Blood donor experiences both immediate adverse reactions (IAR) and delayed adverse reactions (DAR). With limited published data available on the incidence of DAR, a study was conducted to estimate incidence and profile of DAR through telephonic interview. Study was conducted over a 45-day period for consecutive volunteer whole blood donations at tertiary care hospital. Donors were divided into first-time, repeat and regular and were monitored for IAR. They were given written copy of post-donation advice. Donors were contacted telephonically three weeks post-donation and enquired about general wellbeing and specific DAR in accordance with a standard n international (International Society of Blood Transfusion) standard format. Donors participated in the study of which 1.6% donors experienced an IAR. Much larger number reported DAR (10.3% vs.1.6% pdonors (age donors (>50 years). First time (12.3%) and repeat donors (13.5%) had similar frequency of DAR but were lower among regular donors (6.7%). DARs are more common than IAR and are of different profile. Post-donation interview has provided an insight into donor experiences and can be used as a valuable tool in donor hemovigilance. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Generation of retinal pigmented epithelium from iPSCs derived from the conjunctiva of donors with and without age related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Zhouhui Geng

    Full Text Available Fidelity in pluripotent stem cell differentiation protocols is necessary for the therapeutic and commercial use of cells derived from embryonic and induced pluripotent stem cells. Recent advances in stem cell technology, especially the widespread availability of a range of chemically defined media, substrates and differentiation components, now allow the design and implementation of fully defined derivation and differentiation protocols intended for replication across multiple research and manufacturing locations. In this report we present an application of these criteria to the generation of retinal pigmented epithelium from iPSCs derived from the conjunctiva of donors with and without age related macular degeneration. Primary conjunctival cells from human donors aged 70-85 years were reprogrammed to derive multiple iPSC lines that were differentiated into functional RPE using a rapid and defined differentiation protocol. The combination of defined iPSC derivation and culture with a defined RPE differentiation protocol, reproducibly generated functional RPE from each donor without requiring protocol adjustments for each individual. This successful validation of a standardized, iPSC derivation and RPE differentiation process demonstrates a practical approach for applications requiring the cost-effective generation of RPE from multiple individuals such as drug testing, population studies or for therapies requiring patient-specific RPE derivations. In addition, conjunctival cells are identified as a practical source of somatic cells for deriving iPSCs from elderly individuals.

  16. Criteria for performance evaluation

    Directory of Open Access Journals (Sweden)

    David J. Weiss

    2009-03-01

    Full Text Available Using a cognitive task (mental calculation and a perceptual-motor task (stylized golf putting, we examined differential proficiency using the CWS index and several other quantitative measures of performance. The CWS index (Weiss and Shanteau, 2003 is a coherence criterion that looks only at internal properties of the data without incorporating an external standard. In Experiment 1, college students (n = 20 carried out 2- and 3-digit addition and multiplication problems under time pressure. In Experiment 2, experienced golfers (n = 12, also college students, putted toward a target from nine different locations. Within each experiment, we analyzed the same responses using different methods. For the arithmetic tasks, accuracy information (mean absolute deviation from the correct answer, MAD using a coherence criterion was available; for golf, accuracy information using a correspondence criterion (mean deviation from the target, also MAD was available. We ranked the performances of the participants according to each measure, then compared the orders using Spearman's rextsubscript{s}. For mental calculation, the CWS order correlated moderately (rextsubscript{s} =.46 with that of MAD. However, a different coherence criterion, degree of model fit, did not correlate with either CWS or accuracy. For putting, the ranking generated by CWS correlated .68 with that generated by MAD. Consensual answers were also available for both experiments, and the rankings they generated correlated highly with those of MAD. The coherence vs. correspondence distinction did not map well onto criteria for performance evaluation.

  17. First Danish experience with ex vivo lung perfusion of donor lungs before transplantation

    DEFF Research Database (Denmark)

    Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold

    2014-01-01

    INTRODUCTION: The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its...... otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. RESULTS: In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died......% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively. CONCLUSION: In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted...

  18. Informed consent and decision-making about adult-to-adult living donor liver transplantation: a systematic review of empirical research.

    Science.gov (United States)

    Gordon, Elisa J; Daud, Amna; Caicedo, Juan Carlos; Cameron, Kenzie A; Jay, Colleen; Fryer, Jonathan; Beauvais, Nicole; Skaro, Anton; Baker, Talia

    2011-12-27

    Adult-to-adult living donor liver transplantation (LDLT) is a complex procedure that poses serious health risks to and provides no direct health benefit for the donor. Because of this uneven risk-benefit ratio, ensuring donor autonomy through informed consent is critical. To assess the current knowledge pertaining to informed consent for LDLT, we conducted a systematic review of the empirical literature on donors' decision-making process, comprehension about risks and outcomes, and information needs for LDLT. Of the 1423 identified articles, 24 met final review criteria, representing the perspective of approximately 2789 potential and actual donors. As donors' decisions to donate often occur before evaluation, they often make uninformed decisions. The review found that 88% to 95% of donors reported understanding information clinicians disclosed about risks and benefits. However, donors reported unmet information needs, knowledge gaps regarding risks, and unanticipated complications. Few donors reported feeling pressure to donate. Most studies were limited by cultural differences, small sample sizes, inconsistent measures, and poor methodological approaches. This systematic review suggests that informed consent for LDLT is sub-optimal as donors do not adequately appreciate disclosed information during the informed consent process, despite United Network for Organ Sharing/CMS regulations requiring formal psychological evaluation of donor candidates. Interventions are needed to improve donor-clinician communication during the LDLT informed consent process such as through the use of comprehension assessment tools and e-health educational tools that leverage adult learning theory to effectively convey LDLT outcome data.

  19. Single versus dual renal transplantation from donors with significant arteriosclerosis on pre-implant biopsy.

    Science.gov (United States)

    Kayler, Liise K; Mohanka, Ravi; Basu, Amit; Shapiro, Ron; Randhawa, Parmjeet S

    2009-01-01

    Transplantation of kidneys from donor with arteriosclerosis seen on pre-implantation biopsy has not been well studied. We retrospectively evaluated 20 dual kidney transplant (DKT) and 28 single (SKT) kidney transplant recipients with >or=12 months follow-up from donors with moderate arteriosclerosis (>or=25% luminal diameter narrowing). Death censored graft survival was 100% and 79%, respectively (p = 0.0339). DKT recipients had significantly lower mean creatinine levels at one, three, six, and nine months and spent somewhat less time on the waiting list (181 +/- 160 vs. 318 +/- 306 d, p = 0.1429). DKT patients received kidneys from significantly older donors (64 +/- 7 vs. 54 +/- 11 yr; p = 0.0012), proportionately more expanded criteria donors (95% vs. 54%; p = 0.0029), and more donors with hypertension (81% vs. 48%, p = 0.0344) and death related to cerebrovascular accident (100% vs. 71%, p = 0.0143); however, more DKT kidneys underwent machine perfusion (95% vs. 57%, p = 0.0068). Baseline recipient variables were comparable between the two groups including age, race, gender, retransplantation, and HLA mismatch. Pre-implant biopsy was notable for similar frequencies of moderate interstitial fibrosis (10% vs. 14%, respectively) and glomerulosclerosis. Among recipients of deceased-donor kidneys with >25% arteriosclerosis, short-term outcomes after DKT were superior to that of SKT grafts. This approach may help to expand the donor-organ pool while optimizing outcomes.

  20. Effect of donor age on long-term survival following cardiac transplantation.

    Science.gov (United States)

    Topkara, Veli K; Cheema, Faisal H; Kesavaramanujam, Satish; Mercando, Michelle L; Forster, Catherine S; Argenziano, Michael; Esrig, Barry C; Oz, Mehmet C; Naka, Yoshifumi

    2006-01-01

    The current shortage of donor hearts has forced the criteria of organ procurement to be extended, leading to increased use of older donor hearts to bridge the gap between demand and availability. Our objective was to analyze the effect of donor age on outcomes after cardiac transplantation. We retrospectively studied 864 patients who underwent cardiac transplantation at New York Presbyterian Hospital - Columbia University between 1992 and 2002. Patients were divided into two groups; donor age or =40 years (Group B, n = 264). Characteristics including gender, body mass index, and cytomegalovirus (CMV) status were significantly different between the two donor age groups. Race, CMV status, toxoplasmosis status, left ventricular assist device prior to transplant, diabetes mellitus, and retransplantation were similar in both the recipient groups, while age, gender, and BMI were different. Early mortality was lower in Group A, 5%, versus 9.5% in Group B. Multivariate analysis revealed recipient female gender (odd ratio (OR) = 1.71), retransplantation (OR = 1.63), and increased donor age (OR = 1.02) as significant predictors of poor survival in the recipient population. Actuarial survival at 1 year (86.7% vs 81%), 5 years (75% vs 65%), and 10 years (56% vs 42%) was significantly different as well with a log rank p = 0.002. These findings suggest that increased donor age is an independent predictor of long-term survival. However, the shortage of organs makes it difficult to follow strict guidelines when placing hearts; therefore, decisions need to be made on a relative basis.

  1. The Renal Allograft Donor with Isolated Microhematuria

    Directory of Open Access Journals (Sweden)

    Karkar Ayman

    2006-01-01

    Full Text Available Recently, there has been extensive debate about extending the criteria for accepting living donors to include the presence of mild renal abnormalities such as isolated microhematuria. Hematuria defined as the detection of greater than five red blood cells per high power field can be associated with abnormalities throughout the urinary tract. Detection of casts or dysmorphic red blood cells in the urine sediment with or without proteinuria could indicate underlying intrinsic renal disease. Anatomic causes, such as stones and tumors, should be excluded; cystoscopy may be indicated to exclude bladder pathology. Obviously, urinary tract infection, uncontrolled hypertension and latent diabetes mellitus must be excluded. Microscopic hematuria could be associated with mesangial IgA deposits; as 10% of first-degree relatives of patients with IgA glomerulonephritis suffer from microhematuria and/or proteinuria that may require consideration of renal biopsy. Microhematuria could also be associated with other known hereditary renal diseases such as C3 deposits disease, IgM nephropathy, autosomal dominant polycystic kidney disease, Alport′s syndrome or thin basement membrane disease. In conclusion, careful assessment of isolated microhematuria, in the context of living kidney donation, is mandatory as results may reveal occult renal disease that may contraindicate kidney donation.

  2. 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

    2015-01-01

    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

  3. 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)

    2010-01-01

    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

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  5. Absence of beta-amyloid in cortical cataracts of donors with and without Alzheimer's disease.

    Science.gov (United States)

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

    2013-01-01

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

  6. Improving preimplantation genetic diagnosis (PGD) reliability by selection of sperm donor with the most informative haplotype.

    Science.gov (United States)

    Malcov, Mira; Gold, Veronica; Peleg, Sagit; Frumkin, Tsvia; Azem, Foad; Amit, Ami; Ben-Yosef, Dalit; Yaron, Yuval; Reches, Adi; Barda, Shimi; Kleiman, Sandra E; Yogev, Leah; Hauser, Ron

    2017-04-26

    The study is aimed to describe a novel strategy that increases the accuracy and reliability of PGD in patients using sperm donation by pre-selecting the donor whose haplotype does not overlap the carrier's one. A panel of 4-9 informative polymorphic markers, flanking the mutation in carriers of autosomal dominant/X-linked disorders, was tested in DNA of sperm donors before PGD. Whenever the lengths of donors' repeats overlapped those of the women, additional donors' DNA samples were analyzed. The donor that demonstrated the minimal overlapping with the patient was selected for IVF. In 8 out of 17 carriers the markers of the initially chosen donors overlapped the patients' alleles and 2-8 additional sperm donors for each patient were haplotyped. The selection of additional sperm donors increased the number of informative markers and reduced misdiagnosis risk from 6.00% ± 7.48 to 0.48% ±0.68. The PGD results were confirmed and no misdiagnosis was detected. Our study demonstrates that pre-selecting a sperm donor whose haplotype has minimal overlapping with the female's haplotype, is critical for reducing the misdiagnosis risk and ensuring a reliable PGD. This strategy may contribute to prevent the transmission of affected IVF-PGD embryos using a simple and economical procedure. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. DNA testing of donors was approved by the institutional Helsinki committee (registration number 319-08TLV, 2008). The present study was approved by the institutional Helsinki committee (registration number 0385-13TLV, 2013).

  7. Nucleic acid amplification test for detection of west nile virus infection in pakistani blood donors

    International Nuclear Information System (INIS)

    Niazi, S.K.; Alam, M.

    2017-01-01

    Background: The study was planned to determine the presence of West Nile Virus (WNV) infection in Pakistani blood donors, using Nucleic Acid Amplification Test (NAT). Methods: The blood donors for study were selected on the basis of the standard questionnaire and routine screening results. Six donors were pooled using an automated pipettor and NAT for WNV was performed on Roche Cobas s 201 NAT system. The reactive pools were resolved in Individual Donation-NAT (ID-NAT) format and a sample from FFP bags of reactive donations was retrieved. NAT was again performed on retrieved plasma bag (RPB) sample to confirm the reactive donations. The donors were also recalled and interviewed about history of illness related to recent WNV infection. Results: After serological screening of 1929 donors during the study period, 1860 donors were selected for NAT test for WNV detection. The mean age of the donors was 28±8.77 (range: 18–57 years). 1847 (99.3%) donors were male and 13 (0.7%) were female. NAT for WNV identified six initially reactive pools (0.32%). On follow-up testing with RPB samples, 4 donors (0.21%) were found confirmed reactive for WNV RNA (NAT yield of 1 in 465 blood donors). Conclusion: WNV is a threat to safety of blood products in Pakistan. A screening strategy can be implemented after a large-scale study and financial considerations. One of the reduced cost screening strategies is seasonal screening of blood donors for WNV, with pooling of samples. (author)

  8. Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India.

    Science.gov (United States)

    Basak, Soham; Basak, Samar K; Biswas, Bani

    2017-11-01

    To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D) and voluntary cornea donors (VC-D) from a large eye bank in Eastern India. This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2%) donors with 94 seropositive reports were noted: 79 (84.9%) from HCRP-D and 14 (15.1%) from VC-D which was statistically significantly higher (P = 0.02). Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%), 38 (40.4%), 36 (38.3%), and eight (8.5%), respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004). Two (0.47%) of 421 hospital donors with prior negative serology were found to be seropositive. Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.

  9. Comparison of seropositivity of human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and syphilis among Hospital Cornea Retrieval Programme-Donors versus voluntary cornea donors at a large eye bank in Eastern India

    Directory of Open Access Journals (Sweden)

    Soham Basak

    2017-01-01

    Full Text Available Purpose: To compare the serology profile of donors from Hospital Cornea Retrieval Programme-donors (HCRP-D and voluntary cornea donors (VC-D from a large eye bank in Eastern India. Methods: This is a retrospective analysis of donor details from January 2011 to December 2016. Donor demographics, cause of death, and serology reports were compiled. Postmortem blood was tested for human immunodeficiency virus 1 and 2 (HIV, hepatitis B virus (HBV, hepatitis C virus (HCV, and syphilis using government-approved kits as per the National Programme for Control of Blindness Standards of Eye Banking. Donors for whom serology was not possible were excluded. Results: A total of 4300 of 4353 donors were included of which 74.3% were hospital donors and 25.7% were voluntary donors. A total of 93 (2.2% donors with 94 seropositive reports were noted: 79 (84.9% from HCRP-D and 14 (15.1% from VC-D which was statistically significantly higher (P = 0.02. Among seropositive reports, HIV, HBV, HCV, and syphilis accounted for 12 (12.8%, 38 (40.4%, 36 (38.3%, and eight (8.5%, respectively. There was no correlation between the cause of death and seropositivity. A statistically significant decreasing trend in seroprevalence among hospital donors was observed over the years (5.3% in 2011 to 1.4% in 2016; P = 0.004. Two (0.47% of 421 hospital donors with prior negative serology were found to be seropositive. Conclusion: Seropositive rates are significantly higher among hospital donors in spite of medical prescreening compared to nonscreened voluntary donors. Serology should be repeated even when prior reports are available.

  10. The Meaning of Being a Living Kidney, Liver, or Stem Cell Donor-A Meta-Ethnography.

    Science.gov (United States)

    Kisch, Annika M; Forsberg, Anna; Fridh, Isabell; Almgren, Matilda; Lundmark, Martina; Lovén, Charlotte; Flodén, Anne; Nilsson, Madeleine; Karlsson, Veronika; Lennerling, Annette

    2018-05-01

    Studies on living donors from the donors' perspective show that the donation process involves both positive and negative feelings involving vulnerability. Qualitative studies of living kidney, liver, and allogeneic hematopoietic stem cell donors have not previously been merged in the same analysis. Therefore, our aim was to synthesize current knowledge of these donors' experiences to deepen understanding of the meaning of being a living donor for the purpose of saving or extending someone's life. The meta-ethnography steps presented by Noblit and Hare in 1988 were used. Forty-one qualitative studies from 1968 to 2016 that fulfilled the inclusion criteria were analyzed. The studies comprised experiences of over 670 donors. The time since donation varied from 2 days to 29 years. A majority of the studies, 25 of 41, were on living kidney donors. The synthesis revealed that the essential meaning of being a donor is doing what one feels one has to do, involving 6 themes; A sense of responsibility, loneliness and abandonment, suffering, pride and gratitude, a sense of togetherness, and a life changing event. The main issue is that one donates irrespective of what one donates. The relationship to the recipient determines the motives for donation. The deeper insight into the donors' experiences provides implications for their psychological care.

  11. Laparoscopic nephrectomy in live donor

    Directory of Open Access Journals (Sweden)

    Mitre Anuar I.

    2004-01-01

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

  12. Laparoscopic nephrectomy in live donor

    Directory of Open Access Journals (Sweden)

    Anuar I. Mitre

    2004-02-01

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

  13. Biological Water Quality Criteria

    Science.gov (United States)

    Page contains links to Technical Documents pertaining to Biological Water Quality Criteria, including, technical assistance documents for states, tribes and territories, program overviews, and case studies.

  14. Molecular blood grouping of donors.

    Science.gov (United States)

    St-Louis, Maryse

    2014-04-01

    For many decades, hemagglutination has been the sole means to type blood donors. Since the first blood group gene cloning in the early 1990s, knowledge on the molecular basis of most red blood cell, platelet and neutrophil antigens brought the possibility of using nucleotide-based techniques to predict phenotype. This review will summarized methodologies available to genotype blood groups from laboratory developed assays to commercially available platforms, and how proficiency assays become more present. The author will also share her vision of the transfusion medicine future. The field is presently at the crossroads, bringing new perspectives to a century old practice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Donor free radical explosive composition

    Science.gov (United States)

    Walker, Franklin E. [15 Way Points Rd., Danville, CA 94526; Wasley, Richard J. [4290 Colgate Way, Livermore, CA 94550

    1980-04-01

    An improved explosive composition is disclosed and comprises a major portion of an explosive having a detonation velocity between about 1500 and 10,000 meters per second and a minor amount of a donor additive comprising an organic compound or mixture of organic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and which is not an explosive, or an inorganic compound or mixture of inorganic compounds capable of releasing low molecular weight free radicals or ions under mechanical or electrical shock conditions and selected from ammonium or alkali metal persulfates.

  16. Redefining design criteria for Pu-238 gloveboxes

    International Nuclear Information System (INIS)

    Acosta, S.V.

    1998-01-01

    Enclosures for confinement of special nuclear materials (SNM) have evolved into the design of gloveboxes. During the early stages of glovebox technology, established practices and process operation requirements defined design criteria. Proven boxes that performed and met or exceeded process requirements in one group or area, often could not be duplicated in other areas or processes, and till achieve the same success. Changes in materials, fabrication and installation methods often only met immediate design criteria. Standardization of design criteria took a big step during creation of ''Special-Nuclear Materials R and D Laboratory Project, Glovebox standards''. The standards defined design criteria for every type of process equipment in its most general form. Los Alamos National Laboratory (LANL) then and now has had great success with Pu-238 processing. However with ever changing Environment Safety and Health (ES and H) requirements and Ta-55 Facility Configuration Management, current design criteria are forced to explore alternative methods of glovebox design fabrication and installation. Pu-238 fuel processing operations in the Power Source Technologies Group have pushed the limitations of current design criteria. More than half of Pu-238 gloveboxes are being retrofitted or replaced to perform the specific fuel process operations. Pu-238 glovebox design criteria are headed toward process designed single use glovebox and supporting line gloveboxes. Gloveboxes that will house equipment and processes will support TA-55 Pu-238 fuel processing needs into the next century and extend glovebox expected design life

  17. Control of charge transfer by conformational and electronic effects: Donor-donor and donor-acceptor phenyl pyrroles

    International Nuclear Information System (INIS)

    Neubauer, Antje; Bendig, Juergen; Rettig, Wolfgang

    2009-01-01

    Derivatives of N-pyrrolobenzene with a para-donor and a para-acceptor substituent on the benzene ring are compared. It is shown that by a suitable increase of the donor strength of the pyrrolo group, CT fluorescence can be achieved even for donor-donor-substituted benzenes. The ICT emission for sterically hindered compounds is more forbidden than that of unhindered phenyl pyrroles. This suggests conformational effects which induce a narrower twist angle distribution around a perpendicular minimum in the excited state.

  18. Liver Transplantation for Hepatocellular Carcinoma beyond Milan Criteria: Multidisciplinary Approach to Improve Outcome

    Science.gov (United States)

    Kornberg, A.

    2014-01-01

    The implementation of the Milan criteria (MC) in 1996 has dramatically improved prognosis after liver transplantation (LT) in patients with hepatocellular carcinoma (HCC). Liver transplantation has, thereby, become the standard therapy for patients with “early-stage” HCC on liver cirrhosis. The MC were consequently adopted by United Network of Organ Sharing (UNOS) and Eurotransplant for prioritization of patients with HCC. Recent advancements in the knowledge about tumor biology, radiographic imaging techniques, locoregional interventional treatments, and immunosuppressive medications have raised a critical discussion, if the MC might be too restrictive and unjustified keeping away many patients from potentially curative LT. Numerous transplant groups have, therefore, increasingly focussed on a stepwise expansion of selection criteria, mainly based on tumor macromorphology, such as size and number of HCC nodules. Against the background of a dramatic shortage of donor organs, however, simple expansion of tumor macromorphology may not be appropriate to create a safe extended criteria system. In contrast, rather the implementation of reliable prognostic parameters of tumor biology into selection process prior to LT is mandatory. Furthermore, a multidisciplinary approach of pre-, peri-, and posttransplant modulating of the tumor and/or the patient has to be established for improving prognosis in this special subset of patients. PMID:27335840

  19. Variation in Pediatric Organ Donor Management Practices Among US Organ Procurement Organizations.

    Science.gov (United States)

    Ream, Robert S; Armbrecht, Eric S

    2018-03-01

    Reports of actual pediatric organ donor management practice among US organ procurement organizations are sparse, and the use of standardized management guidelines is unknown. A recent consensus statement from the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations offers guidelines for the management of the pediatric organ donor. To describe the use of guidelines and routine practices in the management of the pediatric organ donor with respect to hemodynamics, lung and ventilator management, fluid and electrolytes, hormonal replacement therapy, the use of blood products, thermoregulation, and prophylactic antibiotics. Cross-sectional observational study using a survey and follow-up telephone interview with respondents from all 58 US organ procurement organizations. All 58 US Organ Procurement Organizations participated. A majority employed written guidelines for the management of pediatric donor hemodynamics, thermoregulation, fluids, and electrolytes. Management of blood products, the lung, and mechanical ventilation were less commonly committed to written guidelines, but common practices were described. All used various forms of hormonal replacement therapy and the majority administered empiric antibiotic therapy. Wide variation was observed in the management of the lung, mechanical ventilation, and glycemic control. Most OPOs used forms of standardized donor management for the pediatric organ donor although variation in the content of that management exists. Barriers to an evidence-based approach to the pediatric donor need to be determined and addressed.

  20. Proposed Diagnostic Criteria for Smartphone Addiction.

    Directory of Open Access Journals (Sweden)

    Yu-Hsuan Lin

    Full Text Available Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria.We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy.Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1 six symptom criteria, (2 four functional impairment criteria and (3 exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%, while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use.The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  1. Liver Transplantation: Evolving Patient Selection Criteria

    Directory of Open Access Journals (Sweden)

    Andy S Yu

    2001-01-01

    Full Text Available The widespread recognition of the success of liver transplantation as a treatment for most types of acute and chronic liver failure has led to increased referrals for transplantation in the setting of a relatively fixed supply of cadaver donor organs. These events have led to a marked lengthening of the waiting time for liver transplantation, resulting in increased deaths of those on the waiting list and sicker patients undergoing transplantation. Nearly 5000 liver transplantations were performed in the United States in 2000, while the waiting list grew to over 17,000 patients. The mounting disparity between the number of liver transplant candidates and the limited supply of donor organs has led to reassessment of the selection and listing criteria for liver transplantation, as well as revision of organ allocation and distribution policies for cadaver livers. The development of minimal listing criteria for patients with chronic liver disease based on a specific definition for decompensation of cirrhosis has facilitated the more uniform listing of patients at individual centres across the United States. The United Network for Organ Sharing, under pressure from transplant professionals, patient advocacy groups and the federal government, has continuously revised allocation and distribution policies based on the ethical principles of justice for the individual patient versus optimal utility of the limited organ supply available annually. Beginning in 2002, it is likely that the Model for End-stage Liver Disease (MELD score will be implemented to determine disease severity and direct donor organs to the sickest patients rather than to those with the longest waiting times.

  2. The role of donor age and ischemic time on survival following orthotopic heart transplantation.

    Science.gov (United States)

    Del Rizzo, D F; Menkis, A H; Pflugfelder, P W; Novick, R J; McKenzie, F N; Boyd, W D; Kostuk, W J

    1999-04-01

    The advances in immunotherapy, along with a liberalization of eligibility criteria have contributed significantly to the ever increasing demand for donor organs. In an attempt to expand the donor pool, transplant programs are now accepting older donors as well as donors from more remote areas. The purpose of this study is to determine the effect of donor age and organ ischemic time on survival following orthotopic heart transplantation (OHT). From April 1981 to December 1996 372 adult patients underwent OHT at the University of Western Ontario. Cox proportional hazards models were used to identify predictors of outcome. Variables affecting survival were then entered into a stepwise logistic regression model to develop probability models for 30-day- and 1-year-mortality. The mean age of the recipient population was 45.6 +/- 12.3 years (range 18-64 years: 54 56 years). The majority (329 patients, 86.1%) were male and the most common indications for OHT were ischemic (n = 180) and idiopathic (n = 171) cardiomyopathy. Total ischemic time (TIT) was 202.4 +/- 84.5 minutes (range 47-457 minutes). In 86 donors TIT was under 2 hours while it was between 2 and 4 hours in 168, and more than 4 hours in 128 donors. Actuarial survival was 80%, 73%, and 55% at 1, 5, and 10 years respectively. By Cox proportional hazards models, recipient status (Status I-II vs III-IV; risk ratio 1.75; p = 0.003) and donor age, examined as either a continuous or categorical variable ([age or = 35; risk ratio 1.98; p or = 50; risk ratio 2.20; p or = 50; risk ratio 1.83; p 50 years (p = 0.009). By stepwise logistic regression analysis, a probability model for survival was then developed based on donor age, the interaction between donor age and ischemic time, and patient status. Improvements in myocardial preservation and peri-operative management may allow for the safe utilization of donor organs with prolonged ischemic times. Older donors are associated with decreased peri-operative and long

  3. Early outcomes of liver transplants in patients receiving organs from hypernatremic donors.

    Science.gov (United States)

    Khosravi, Mohammad Bagher; Firoozifar, Mohammad; Ghaffaripour, Sina; Sahmeddini, Mohammad Ali; Eghbal, Mohammad Hossien

    2013-12-01

    Uncorrected hypernatremia in organ donors has been associated with poor graft or patient survival during liver transplants. However, recent studies have found no association between the donor serum sodium and transplant outcome. This study sought to show the negative effect donor hypernatremia has on initial liver allograft function. This is the first study to investigate international normalized ratio and renal factors of patients with normal and those with hypernatremic donor livers. This study was conducted at the Shiraz Transplant Research Center in Shiraz, Iran, between May 2009, and July 2011. Four hundred seven consecutive adult orthotopic liver transplants were performed at the University of Shiraz Medical Center. There were 93 donors in the group with hypernatremia with terminal serum sodium of 155 mEq/L or greater (group 1), and 314 with terminal serum sodium less than 155 mEq/L (group 2). Posttransplant data after 5 days showed that aspartate aminotransferase, alanine aminotransferase, international normalized ratio, and kidney function did not differ between the groups. Hypernatremia is the most important complication after brain death. Previous studies have suggested donor hypernatremia results in a greater incidence of early postoperative graft dysfunction in liver transplant and is considered one of the extended criteria donor. However, in recent years, this hypothesis has been questioned. Our study shows no difference between patients' initial results of liver and kidney functioning with normal and hypernatremic donor livers. This is the first study to investigate international normalized ratio as a fundamental factor in defining early allograft dysfunction and renal factors between patients with normal and hypernatremic donor's livers.

  4. First Danish experience with ex vivo lung perfusion of donor lungs before transplantation.

    Science.gov (United States)

    Henriksen, Ian Sune Iversen; Møller-Sørensen, Hasse; Møller, Christian Holdfold; Zemtsovski, Mikhail; Nilsson, Jens Christian; Seidelin, Casper Tobias; Perch, Michael; Iversen, Martin; Steinbrüchel, Daniel

    2014-03-01

    The number of lung transplantations is limited by a general lack of donor organs. Ex vivo lung perfusion (EVLP) is a novel method to optimise and evaluate marginal donor lungs prior to transplantation. We describe our experiences with EVLP in Denmark during the first year after its introduction. The study was conducted by prospective registration of donor offers and lung transplantations in Denmark from 1 May 2012 to 30 April 2013. Donor lungs without any contraindications were transplanted in the traditional manner. Taken for EVLP were donor lungs that were otherwise considered transplantable, but failed to meet the usual criteria due to possible contusions or because they were from donors with sepsis or unable to pass the oxygenation test. In the study period, seven of 33 Danish lung transplantations were made possible due to EVLP. One patient died of non-EVLP-related causes, but all other recipients were alive with normal graft function at the end of our registration period. All lungs showed an improved PaO2/FiO2 ratio from a median 23.1 kPa (8.8-38.9) within the donor to 58.8 kPa (34.9-76.5) (FiO2 = 1.0) after EVLP, which corresponds to a 155% improved oxygenation. The median time to extubation, time in intensive care unit and the admission period were 1, 7 and 39 days, respectively. In the first year after the introduction of EVLP in Denmark, seven pairs of donor lungs that previously would have been rejected have been transplanted as a result of their improved function. EVLP seems to be a safe way to increase the use of marginal donor lungs. no funding was granted for the present paper. not relevant.

  5. Alternative Donor Graft Sources for Adults with Hematologic Malignancies: A Donor for All Patients in 2017!

    Science.gov (United States)

    Kindwall-Keller, Tamila L; Ballen, Karen K

    2017-09-01

    Hematopoietic stem cell transplant (HSCT) is potentially curative for a wide variety of malignant diseases, including acute and leukemias, lymphoma, and myelodysplasia. Choice of a stem cell donor is dependent on donor availability, donor compatibility and health, recipient disease type, and recipient condition. Current sources of stem cell donation for HSCT are matched sibling donors (MSDs), matched unrelated donors (MUDs), 1-antigen mismatched unrelated donors (MMUDs), haploidentical donors (haplo), and umbilical cord blood (UCB) units. Historically, preferred donors for HSCT have been human leukocyte antigen (HLA)-matched sibling donors; however, only about 30% of U.S. patients will have a MSD available. The majority of patients referred for HSCT will require an alternative donor graft: MUD, MMUD, UCB, or haplo. The likelihood of finding a MUD varies depending on the ethnicity of the recipient. White Caucasians of European descent have the greatest chance of finding a MUD. Chances of finding a MUD are significantly less for African-American or Hispanic recipients due to HLA polymorphisms. Therefore, MMUD, UCB, and haplo donor graft sources expand the donor pool for recipients who do not have a MSD or MUD available. Given the variety of different donor stem cell sources available today, nearly every patient who needs an allogeneic HSCT has a potential donor in 2017. All transplant-eligible patients with hematologic malignancies should be evaluated by a transplant center to determine if HSCT is a viable treatment option for their underlying disease process. The goal of this review is to increase the awareness of oncology practitioners to the availability of alternative donor stem cell transplants for patients with hematologic malignancies. Despite new agents, stem cell transplant remains the only curative therapy for many patients with acute and chronic leukemia, myelodysplasia, and lymphoma. Given the variety of different donor stem cell sources available today

  6. Repository operational criteria analysis

    International Nuclear Information System (INIS)

    Hageman, J.P.; Chowdhury, A.H.

    1992-08-01

    The objective of the ''Repository Operational Criteria (ROC) Feasibility Studies'' (or ROC task) was to conduct comprehensive and integrated analyses of repository design, construction, and operations criteria in 10 CFR Part 60 regulations, considering the interfaces and impacts of any potential changes to those regulations. The study addresses regulatory criteria related to the preclosure aspects of the geologic repository. The study task developed regulatory concepts or potential repository operational criteria (PROC) based on analysis of a repository's safety functions and other regulations for similar facilities. These regulatory concepts or PROC were used as a basis to assess the sufficiency and adequacy of the current criteria in 10 CFR Part 60. Where the regulatory concepts were same as current operational criteria, these criteria were referenced. The operations criteria referenced or the PROC developed are given in this report. Detailed analyses used to develop the regulatory concepts and any necessary PROC for those regulations that may require a minor change are also presented. The results of the ROC task showed a need for further analysis and possible major rule change related to the design bases of a geologic repository operations area, siting, and radiological emergency planning

  7. CCS site characterisation criteria

    Energy Technology Data Exchange (ETDEWEB)

    Bachu, S.; Hawkes, C.; Lawton, D.; Pooladi-Darvish, M.; Perkins, E.

    2009-12-15

    IEA GHG recently commissioned the Alberta Research Counil in Canada to conduct a review of storage site selection criteria and site characterisation methods in order to produce a synthesis report. This report reviews the literature on the subject on the site seleciton and characterisation since the publication of the IPCC Special Report on CCS, and provides a synthesis and classification of criteria. 161 refs.

  8. Green Supplier Selection Criteria

    DEFF Research Database (Denmark)

    Nielsen, Izabela Ewa; Banaeian, Narges; Golinska, Paulina

    2014-01-01

    Green supplier selection (GSS) criteria arise from an organization inclination to respond to any existing trends in environmental issues related to business management and processes, so GSS is integrating environmental thinking into conventional supplier selection. This research is designed...... to determine prevalent general and environmental supplier selection criteria and develop a framework which can help decision makers to determine and prioritize suitable green supplier selection criteria (general and environmental). In this research we considered several parameters (evaluation objectives......) to establish suitable criteria for GSS such as their production type, requirements, policy and objectives instead of applying common criteria. At first a comprehensive and deep review on prevalent and green supplier selection literatures performed. Then several evaluation objectives defined to assess the green...

  9. Prisoners as Living Donors: A Vulnerabilities Analysis.

    Science.gov (United States)

    Ross, Lainie Friedman; Thistlethwaite, J Richard

    2018-01-01

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

  10. Imaging evaluation of potential donors in living-donor liver transplantation

    International Nuclear Information System (INIS)

    Low, G.; Wiebe, E.; Walji, A.H.; Bigam, D.L.

    2008-01-01

    Liver transplants, originally obtained from deceased donors, can now be harvested from living donors as well. This technique, called living-donor liver transplantation (LDLT), provides an effective alternative means of liver transplantation and is a method of expanding the donor pool in light of the demand and supply imbalance for organ transplants. Imaging plays an important role in LDLT programmes by providing robust evaluation of potential donors to ensure that only anatomically suitable donors with no significant co-existing pathology are selected and that crucial information that allows detailed preoperative planning is available. Imaging evaluation helps to improve the outcome of LDLT for both donors and recipients, by improving the chances of graft survival and reducing the postoperative complication rate. In this review, we describe the history of LDLT and discuss in detail the application of imaging in donor assessment with emphasis on use of modern computed tomography (CT) and magnetic resonance imaging (MRI) techniques

  11. Expectations and experiences of gamete donors and donor-conceived adults searching for genetic relatives using DNA linking through a voluntary register.

    Science.gov (United States)

    van den Akker, O B A; Crawshaw, M A; Blyth, E D; Frith, L J

    2015-01-01

    What are the experiences of donor-conceived adults and donors who are searching for a genetic link through the use of a DNA-based voluntary register service? Donor-conceived adults and donors held positive beliefs about their search and although some concerns in relation to finding a genetically linked relative were reported, these were not a barrier to searching. Research with donor-conceived people has consistently identified their interest in learning about-and in some cases making contact with-their donor and other genetic relatives. However, donor-conceived individuals or donors rarely have the opportunity to act on these desires. A questionnaire was administered for online completion using Bristol Online Surveys. The survey was live for 3 months and responses were collected anonymously. The survey was completed by 65 donor-conceived adults, 21 sperm donors and 5 oocyte donors who had registered with a DNA-based voluntary contact register in the UK. The questionnaire included socio-demographic questions, questions specifically developed for the purposes of this study and the standardized Aspects of Identity Questionnaire (AIQ). Motivations for searching for genetic relatives were varied, with the most common reasons being curiosity and passing on information. Overall, participants who were already linked and those awaiting a link were positive about being linked and valued access to a DNA-based register. Collective identity (reflecting self-defining feelings of continuity and uniqueness), as assessed by the AIQ, was significantly lower for donor-conceived adults when compared with the donor groups (P 0.05) for donor-conceived adults. Participants were members of a UK DNA-based registry which is unique. It was therefore not possible to determine how representative participants were of those who did not register for the service, those in other countries or of those who do not seek information exchange or contact. This is the first survey exploring the

  12. Lobar lung transplantation from deceased donors: A systematic review.

    Science.gov (United States)

    Eberlein, Michael; Reed, Robert M; Chahla, Mayy; Bolukbas, Servet; Blevins, Amy; Van Raemdonck, Dirk; Stanzi, Alessia; Inci, Ilhan; Marasco, Silvana; Shigemura, Norihisa; Aigner, Clemens; Deuse, Tobias

    2017-02-24

    To systematically review reports on deceased-donor-lobar lung transplantation (ddLLTx) and uniformly describe size matching using the donor-to-recipient predicted-total lung-capacity (pTLC) ratio. We set out to systematically review reports on ddLLTx and uniformly describe size matching using the donor-to-recipient pTLC ratio and to summarize reported one-year survival data of ddLLTx and conventional-LTx. We searched in PubMed, CINAHL via EBSCO, Cochrane Database of Systematic Reviews via Wiley (CDSR), Database of Abstracts of Reviews of Effects via Wiley (DARE), Cochrane Central Register of Controlled Trials via Wiley (CENTRAL), Scopus (which includes EMBASE abstracts), and Web of Science for original reports on ddLLTx. Nine observational cohort studies reporting on 301 ddLLTx met our inclusion criteria for systematic review of size matching, and eight for describing one-year-survival. The ddLLTx-group was often characterized by high acuity; however there was heterogeneity in transplant indications and pre-operative characteristics between studies. Data to calculate the pTLC ratio was available for 242 ddLLTx (80%). The mean pTLCratio before lobar resection was 1.25 ± 0.3 and the transplanted pTLCratio after lobar resection was 0.76 ± 0.2. One-year survival in the ddLLTx-group ranged from 50%-100%, compared to 72%-88% in the conventional-LTx group. In the largest study ddLLTx ( n = 138) was associated with a lower one-year-survival compared to conventional-LTx ( n = 539) (65.1% vs 84.1%, P < 0.001). Further investigations of optimal donor-to-recipient size matching parameters for ddLLTx could improve outcomes of this important surgical option.

  13. Differences in social representation of blood donation between donors and non-donors: an empirical study.

    Science.gov (United States)

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

    2015-11-04

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

  14. Crew Transportation Operations Standards

    Science.gov (United States)

    Mango, Edward J.; Pearson, Don J. (Compiler)

    2013-01-01

    The Crew Transportation Operations Standards contains descriptions of ground and flight operations processes and specifications and the criteria which will be used to evaluate the acceptability of Commercial Providers' proposed processes and specifications.

  15. The impact of living-unrelated transplant on establishing deceased-donor liver program in Syria.

    Science.gov (United States)

    Saeed, Bassam

    2014-10-01

    Liver transplant is the criterion standard for patients with end-stage liver disease. Yet there is no liver transplant in Syria. Traveling abroad for a liver transplant is a luxury few Syrians can afford. There is currently an on-going debate whether to start a liver transplant program using living or deceased donors. In 2003, a new law was enacted, authorizing the use of organs from volunteer strangers and deceased donors. Despite the positive aspects of this law (allowing unrelated donors to increase the number of transplants in the country); the negative aspects also were obvious. The poor used the law to sell their organs to the rich, and this model is in violation of the Istanbul Declaration. To better document transplant communities' perceptions on organ donation, an e-mail survey was sent to a nationally representative sample of physicians (n = 115) that showed that 58% of respondents did not support the start of liver transplant from live donors, as they fear a considerable risk for the donor and the recipient. Seventy-one percent of respondents believe that unrelated kidney donation has contributed to tarnishing the reputation of transplant, and 56% believe that a deceased-donor program can run in parallel with unrelated organ donations. The interest in deceased-donor program has been affected negatively by the systematic approach of using poor persons as the source of the organ. This lack of interest has affected starting a liver program that relies on deceased donors; especially the need for kidneys is more than livers. Health authorities in Syria were inclined to initiate a liver transplant program from live donors, despite the risks of serious morbidities and mortality. In conclusion then, paid kidney donation in actual effect is actually a hindrance to establishing a deceased-donor liver program.

  16. Experiences of offspring searching for and contacting their donor siblings and donor.

    Science.gov (United States)

    Jadva, Vasanti; Freeman, Tabitha; Kramer, Wendy; Golombok, Susan

    2010-04-01

    This study investigates a new phenomenon whereby individuals conceived by donor insemination are searching for and contacting their donor and/or 'donor siblings' (i.e. donor offspring conceived by the same donor who are their genetic half siblings). On-line questionnaires were completed by members of the Donor Sibling Registry (DSR), a US-based registry that facilitates contact between donor conception families who share the same donor. Of the 165 donor offspring who completed the survey, 15% were searching for their donor siblings, 13% were searching for their donor, and 64% were searching for both. Differences were found according to family type and age of disclosure. Fewer offspring from heterosexual couple families had told their father about their search when compared with offspring from lesbian couple families who had told their co-parent. Offspring who had found out about their conception after age 18 were more likely to be searching for medical reasons, whereas those who had found out before age 18 tended to be searching out of curiosity. Some offspring had discovered large numbers of half siblings (maximum=13). The majority of offspring who had found their donor relations reported positive experiences and remained in regular contact with them. Copyright (c) 2010 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Risk reduction strategies in laparoscopic donor nephrectomy: A comparative study

    Directory of Open Access Journals (Sweden)

    T Manohar

    2006-01-01

    Full Text Available OBJECTIVES: As the advancements, modifications and standardization of laparoscopy are taking place, there is a need for the reduction in morbidity associated with laparoscopic live donor nephrectomy. This study was performed to determine and reconfirm the advantages of laparoscopic donor nephrectomy over its open counterpart. MATERIALS AND METHODS: Two hundred open live donor nephrectomy (ODN cases were compared to 264 cases of laparoscopic live donor nephrectomy (LDN. Pretransplant functional and radiological evaluation was done routinely by excretory urogram and renal arteriography. In case of vascular variations, CT angiography was preferred. Open cases were done by conventional method and laparoscopic group underwent certain technical and surgical modifications, including meticulous planning for the port placement. Operative time, analgesia requirement, start of the orals, hospital stay, blood loss, late allograft function, incidence of rejection, complications and technical problems were analyzed. RESULTS: Operative time was 135.8 ± 43 and 165 ± 44.4 min ( P < 0.0001, requirement of analgesia was 60.5 ± 40 and 320 ± 120 mg ( P < 0.0001, hospital stay was 4 ± 0.04 and 5.7 ± 2.03 days ( P < 0.0001, warm ischemia time was 6.1 ± 2.0 and 4.1 ± 0.80 min ( P < 0.0001 and time taken for the serum creatinine to stabilize in the recipient was 4.1 ± 1.6 and 4.32 ± 1.40 days ( P =0.06 for LDN and ODN groups respectively. There was a significant reduction in the blood loss in LDN group ( P =0.0005. Overall complications were 6.81 and 14.5% and ureteric injury was seen in 0.37 and 1% in LDN and ODN respectively. CONCLUSION: Laparoscopic live donor nephrectomy can now be performed with low morbidity and mortality to both donors and recipients and is proving to be the preferred operation to open donor nephrectomy. Our continued innovations in technical modifications have made this novel operation successful.

  18. BLOODR: blood donor and requester mobile application.

    Science.gov (United States)

    Tatikonda, Vamsi Krishna; El-Ocla, Hosam

    2017-01-01

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

  19. Criteria in implementation of paragraph 3 of section 11 of Act no.319 of 10 May 1976 laying down standards for the protection of waters against pollution. Dumping on the high seas

    International Nuclear Information System (INIS)

    1978-01-01

    A set of directives by the Ministry of Public Works (Committee of Ministers for the protection of waters against pollution) were published in the Italian Official Gazette of 9 August 1978. They lay down criteria to be met in implementation of Act no.319 of 10 May 1976 on the protection of waters against pollution. The Ministerial provisions prohibit the dumping of radioactive waste, except under certain conditions. Also, the definition of radioactive materials is the same as that contained in the recommendations of the International Atomic Energy Agency. (NEA) [fr

  20. Electrocardiographic Characteristics of Potential Organ Donors and Associations with Cardiac Allograft Utilization

    Science.gov (United States)

    Khush, Kiran K.; Menza, Rebecca; Nguyen, John; Goldstein, Benjamin A.; Zaroff, Jonathan G.; Drew, Barbara J.

    2012-01-01

    Background Current regulations require that all cardiac allograft offers for transplantation must include an interpreted 12-lead electrocardiogram (ECG). However, little is known about the expected ECG findings in potential organ donors, or the clinical significance of any identified abnormalities in terms of cardiac allograft function and suitability for transplantation. Methods and Results A single experienced reviewer interpreted the first ECG obtained after brainstem herniation in 980 potential organ donors managed by the California Transplant Donor Network from 2002-2007. ECG abnormalities were summarized, and associations between specific ECG findings and cardiac allograft utilization for transplantation were studied. ECG abnormalities were present in 51% of all cases reviewed. The most common abnormalities included voltage criteria for left ventricular hypertrophy (LVH), prolongation of the corrected QT interval (QTc), and repolarization changes (ST/T wave abnormalities). Fifty seven percent of potential cardiac allografts in this cohort were accepted for transplantation. LVH on ECG was a strong predictor of allograft non-utilization. No significant associations were seen between QTc prolongation, repolarization changes and allograft utilization for transplantation, after adjusting for donor clinical variables and echocardiographic findings. Conclusions We have performed the first comprehensive study of ECG findings in potential donors for cardiac transplantation. Many of the common ECG abnormalities seen in organ donors may result from the heightened state of sympathetic activation that occurs after brainstem herniation, and are not associated with allograft utilization for transplantation. PMID:22615333

  1. Multimodal freight investment criteria.

    Science.gov (United States)

    2010-07-01

    Literature was reviewed on multi-modal investment criteria for freight projects, examining measures and techniques for quantifying project benefits and costs, as well as ways to describe the economic importance of freight transportation. : A limited ...

  2. Aquatic Life Criteria - Ammonia

    Science.gov (United States)

    Documents related to EPA's final 2013 Aquatic Life Ambient Water Quality Criteria for Ammonia (Freshwater). These documents pertain to the safe levels of Ammonia in water that should protect to the majority of species.

  3. Aquatic Life Criteria - Copper

    Science.gov (United States)

    Documents pertain to Aquatic Life Ambient Water Quality criteria for Copper (2007 Freshwater, 2016 Estuarine/marine). These documents contain the safe levels of Copper in water that should protect to the majority of species.

  4. Integrated Criteria Document Chromium

    NARCIS (Netherlands)

    Slooff W; Cleven RFMJ; Janus JA; van der Poel P; van Beelen P; Boumans LJM; Canton JH; Eerens HC; Krajnc EI; de Leeuw FAAM; Matthijsen AJCM; van de Meent D; van der Meulen A; Mohn GR; Wijland GC; de Bruijn PJ; van Keulen A; Verburgh JJ; van der Woerd KF

    1990-01-01

    Betreft de engelse versie van rapport 758701001
    Bij dit rapport behoort een appendix onder hetzelfde nummer getiteld: "Integrated Criteria Document Chromium: Effects" Auteurs: Janus JA; Krajnc EI
    (appendix: see 710401002A)

  5. Development of Organ-Specific Donor Risk Indices

    Science.gov (United States)

    Akkina, Sanjeev K.; Asrani, Sumeet K.; Peng, Yi; Stock, Peter; Kim, Ray; Israni, Ajay K.

    2012-01-01

    Due to the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival using various combinations of donor and recipient characteristics. We will review the kidney donor risk index (KDRI) and liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The Kidney Donor Risk Index has a potential role in developing new kidney allocation algorithms. The Liver Donor Risk Index allows for greater appreciation of the importance of donor factors, particularly for hepatitis C-positive recipients; as the donor risk index increases, rates of allograft and patient survival among these recipients decrease disproportionately. Use of livers with high donor risk index is associated with increased hospital costs independent of recipient risk factors, and transplanting livers with high donor risk index into patients with Model for End-Stage Liver Disease scores Donor Risk Index has limited this practice. Significant regional variation in donor quality, as measured by the Liver Donor Risk Index, remains in the United States. We also review other potential indices for liver transplant, including donor-recipient matching and the retransplant donor risk index. While substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. PMID:22287036

  6. Selection criteria for dental radiography

    International Nuclear Information System (INIS)

    1998-01-01

    The Faculty of General Dental Practitioners (UK) has a declared commitment to 'improving the standards of patient care'. By the provision of standards and guidelines it aims to help the profession to achieve this goal. Standards and guidelines are simply tools a dentist may use to improve treatment planning and care outcomes. The Self-Assessment Manual and Standards, SAMS, first published in 1991, is now well known to the profession and has become a frequently quoted source in clinical audit and quality assurance initiatives. Since its publication the scientific methodology of systematic reviews of the literature has progressed dramatically and this book is based on these developments. Evidence-based care is well established in medicine and dentistry and these selection criteria and guidelines follow these established protocols by basing advice on the available scientific evidence wherever possible. This book's purpose is a practical one, it is not intended to be limiting or restrictive but to be useful in the decision-making process. This is the first in a series of standards documents from the FGDP(UK) which are based on reviews of the scientific literature and employ the Scottish Intercollegiate Guideline Network (SIGN) methodology for guideline production. They are not constraints but an aid to effective treatment planning and patient care

  7. Panel 1: Safety design criteria

    International Nuclear Information System (INIS)

    Yllera, Javier

    2013-01-01

    There is general consensus in the nuclear community, and more after the Fukushima accident, that the deployment of nuclear energy has to be done at the highest levels of nuclear safety and that safety cannot be compromised by other factors. It is well understood that reactors that are being licensed and the new generations of reactors that will be constructed in the future will need to reach higher safety levels than the existing ones. Several countries and international organizations or international groups are launching initiatives to harmonise safety goals, safety requirements, safety objectives, regulations, criteria or safety reference levels. There are differences in the meanings of these terms and the working approaches, but the overall purpose is the same: to specify how new plants can be safer. In this context, the IAEA has an statutory function for developing international nuclear safety standards. The IAEA safety standards are per se not mandatory for IAEA Member States. Regulating safety is a national responsibility, and many States have decided to adopt the IAEA’s standards for use in their national regulations in different ways. The IAEA Safety Standards represent international consensus on what must constitute a high level of safety for nuclear installations. In the area of NPP design, IAEA safety standards that are published are intended to apply primarily to new plants. It might not be practicable to apply all the requirements to plants that are already in operation. In addition, the focus is primarily on plants with water cooled reactors

  8. Normothermic machine perfusion for donor liver preservation

    NARCIS (Netherlands)

    Tolboom, H.

    2012-01-01

    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

  9. Predictors of hemoglobin in Danish blood donors

    DEFF Research Database (Denmark)

    Kotzé, Sebastian R; Pedersen, Ole B; Petersen, Mikkel S

    2015-01-01

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

  10. True HIV seroprevalence in Indian blood donors.

    Science.gov (United States)

    Choudhury, N; Ayagiri, A; Ray, V L

    2000-03-01

    The National AIDS Control Organization (NACO), the apex body for controlling AIDS in India, projected that HIV seroprevalence would increase from 7/1000 in 1995 to 21.2/1000 in 1997. A high incidence (8.2%) of HIV was observed in blood donors. This study was carried out to find out the true HIV positivity in Indian blood donors. Blood donors from our centre were followed for more than 5 years to determine the true HIV seroprevalence and our result was compared with similar studies from India. Voluntary and relative blood donors who visited the SGPGIMS, Lucknow, since 1993 to June 1998 were included. They were screened for HIV 1/2 by ELISA kits (WHO approved). First-time HIV-positive samples were preserved frozen for further study (stage-I). They were repeated in duplicate and retested with other kits. If found positive, the sample was labelled as ELISA positive (stage-II). ELISA-positive samples were confirmed by Western Blot (WB) at stage-III. A total of 65 288 donors were included and 834 (12.8/1000) were reactive at stage-I. But 1.1/1000 donors were found to be ELISA positive at stage-II, and 0.28/1000 donors were positive by WB at stage-III. The 'seropositivity' rate from the NACO was significantly (P commercial blood banks. The HIV prevalence of blood donors (and national prevalence) is to be reassessed.

  11. Negotiating boundaries: Accessing donor gametes in India.

    Science.gov (United States)

    Widge, A; Cleland, J

    2011-01-01

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

  12. Posttransplantation Disseminated Coccidioidomycosis Acquired from Donor Lungs

    OpenAIRE

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

    2004-01-01

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

  13. Psychosocial counselling in donor sperm treatment

    NARCIS (Netherlands)

    Visser, M.

    2018-01-01

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

  14. Dual Criteria Decisions

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten Igel

    2014-01-01

    The most popular models of decision making use a single criterion to evaluate projects or lotteries. However, decision makers may actually consider multiple criteria when evaluating projects. We consider a dual criteria model from psychology. This model integrates the familiar tradeoffs between...... to the clear role that income thresholds play in such decision making, but does not rule out a role for tradeoffs between risk and utility or probability weighting....

  15. Rating of environmental criteria

    Energy Technology Data Exchange (ETDEWEB)

    Glueck, K; Krasser, G

    1980-01-01

    After a general theoretical discussion on the question of rating within a framework of cost-benefit studies, first trials as to the quantification and standardisation of twelve selected environmental criteria by means of an indicator system are worked out and compiled. The selection includes the criteria exhaust gas, dust, micro climate, water pollution, water regime, land requirement, vibrations, traffic noise, landscape scene, urban scene, effect of separation and safety risks. An insight is given of the rating practice using an evaluation of the available literature, of a household interview and of an interview of experts. The interviewing of 156 experts as to their rating conception of ten criteria in the second round has provided contributions to the general problem of the evaluation estimate based on multi criteria analysis as well as differentiation of the twelve or ten environmental criteria. The following criteria ratings given by the experts and which are averaged and smoothed are: traffic noise 20,0% +- 8,5; air pollution 15,0% +- 7,0; safety risk 13,0% +- 7,0; soil and water pollution 8,5% +- 5,0; landscape scene 8,0% +- 4,5; urban scene 8,0% +- 4,5; water regime 6,5% +- 3,5 and vibrations 4,5% +- 2,5.

  16. Potential organ donor audit in Ireland.

    LENUS (Irish Health Repository)

    Hegarty, M

    2010-11-01

    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.

  17. Design criteria for plutonium gloveboxes

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    The standard defines criteria for the design of glovebox systems to be used for the handling of plutonium in any form or isotopic composition or when mixed with other elements or compounds. The glovebox system is a series of physical barriers provided with glove ports and gloves, through which process and maintenance operations may be performed, together with an operating ventilation system. The system minimizes the potential for release of radioactive material to the environment, protects operators from contamination, and mitigates the consequences of abnormal condiations. The standard covers confinement, construction, materials, windows, glove ports, gloves, equipment insertion and removal, lighting, ventilation, fire protection, criticality prevention, services and utilities, radiation shielding, waste systems, monitoring and alarm systems, safeguards, quality assurance, and decommissioning

  18. Best practice guidelines for the operation of a donor human milk bank in an Australian NICU.

    Science.gov (United States)

    Hartmann, B T; Pang, W W; Keil, A D; Hartmann, P E; Simmer, K

    2007-10-01

    Until the establishment of the PREM Bank (Perron Rotary Express Milk Bank) donor human milk banking had not occurred in Australia for the past 20 years. In re-establishing donor human milk banking in Australia, the focus of the PREM Bank has been to develop a formal and consistent approach to safety and quality in processing during the operation of the human milk bank. There is currently no existing legislation in Australia that specifically regulates the operation of donor human milk banks. For this reason the PREM Bank has utilised existing and internationally recognised management practices for managing hazards during food production. These tools (specifically HACCP) have been used to guide the development of Standard Operating Procedures and Good Manufacturing Practice for the screening of donors and processing of donor human milk. Donor screening procedures are consistent with those recommended by other human milk banks operating internationally, and also consistent with the requirements for blood and tissue donation in Australia. Controlled documentation and record keep requirements have also been developed that allow complete traceability from individual donation to individual feed dispensed to recipient and maintain a record of all processing and storage conditions. These operational requirements have been developed to reduce any risk associated with feeding pasteurised donor human milk to hospitalised preterm or ill infants to acceptable levels.

  19. Proposed diagnostic criteria for internet addiction.

    Science.gov (United States)

    Tao, Ran; Huang, Xiuqin; Wang, Jinan; Zhang, Huimin; Zhang, Ying; Li, Mengchen

    2010-03-01

    The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population. This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage (n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage (n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability. The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%. Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD.

  20. Higher Bilirubin Levels of Healthy Living Liver Donors Are Associated With Lower Posttransplant Hepatocellular Carcinoma Recurrence.

    Science.gov (United States)

    Han, Sangbin; Yang, Ju Dong; Sinn, Dong Hyun; Ko, Justin Sangwook; Kim, Jong Man; Shin, Jun Chul; Son, Hee Jeong; Gwak, Mi Sook; Joh, Jae-Won; Kim, Gaab Soo

    2016-09-01

    Serum bilirubin level, which may reflect the host defense against increased oxidative stress, is inversely associated with the risk of cancer development. In liver transplantation, the intrinsic bilirubin metabolism of donor liver is subsequently translated into recipient. Thus, we hypothesized that liver transplantation conducted with living donors with higher serum bilirubin reduces hepatocellular carcinoma (HCC) recurrence. Two hundred fifty recipients who underwent liver transplantation for treating HCC within the Milan criteria were included in the study. The association between donor preoperative total bilirubin concentration and the risk of HCC recurrence was analyzed using the Fine and Gray regression model with posttransplant death as a competing risk event with adjustment for tumor biology including α-fetoprotein, histological differentiation, and microvascular invasion. All donors were confirmed to have no underlying hepatobiliary diseases or hematological disorders. Donor preoperative total bilirubin concentration was 0.7 mg/dL in median and ranged from 0.2 to 2.7 mg/dL. Thirty-five (14.0%) recipients developed HCC recurrence. Multivariable analysis demonstrated that donor preoperative total bilirubin concentration was inversely associated with the recurrence risk (hazard ratio, 0.22; 95% confidence interval, 0.07-0.72; P = 0.013). The highest (≥1.0 mg/dL) versus lowest (≤0.6 mg/dL) tertile of donor preoperative total bilirubin showed a significant reduction of the recurrence risk (hazard ratio, 0.28; 95% confidence interval, 0.11-0.70; P = 0.006). Hepatocellular carcinoma recurrence risk decreases in relation to the increase in total serum bilirubin level of healthy living donors without underlying hepatobiliary or hematological disorders. Further validation of bilirubin as a potent anticancer substance against HCC is warranted.

  1. Donor, dad, or…? Young adults with lesbian parents' experiences with known donors.

    Science.gov (United States)

    Goldberg, Abbie E; Allen, Katherine R

    2013-06-01

    In this exploratory qualitative study of 11 young adults, ages 19-29 years, we examine how young people who were raised by lesbian parents make meaning out of and construct their relationships with known donors. In-depth interviews were conducted to examine how participants defined their family composition, how they perceived the role of their donors in their lives, and how they negotiated their relationships with their donors. Findings indicate that mothers typically chose known donors who were family friends, that the majority of participants always knew who their donors were, and that their contact with donors ranged from minimal to involved. Further, participants perceived their donors in one of three ways: as strictly donors and not members of their family; as extended family members but not as parents; and as fathers. The more limited role of donors in participants' construction of family relationships sheds light on how children raised in lesbian, gay, and bisexual families are contributing to the redefinition and reconstruction of complex kinship arrangements. Our findings hold implications for clinicians who work with lesbian-mother families, and suggest that young adulthood is an important developmental phase during which interest in and contact with the donor may shift, warranting a transfer of responsibility from mother to offspring in terms of managing the donor-child relationship. © FPI, Inc.

  2. Correlation between donor age and organs transplanted per donor: our experience in Japan.

    Science.gov (United States)

    Ashikari, J; Omiya, K; Konaka, S; Nomoto, K

    2014-05-01

    The shortage of available organs for transplantation is a worldwide issue. To maximize the number of transplantations, increasing the number of organs transplanted per donor (OTPD) is widely recognized as an important factor for improving the shortage. In Japan, we have had 211 donors, 1112 organs transplanted, and 924 recipients receiving the transplants, resulting in 4.4 ± 1.4 recipients receiving transplants per donor and 5.3 ± 1.6 OTPD as of February 2013. Because donor age is a well-recognized factor of donor suitability, we analyzed the correlation between donor age group and OTPD. Only the age group 60 to 69 years and the age group 70 to 79 years were significantly different (P donor under age 70 years has the potential to donate 4.6 to 6.7 organs. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Villamor-Martínez, Eduardo; Pierro, Maria; Cavallaro, Giacomo; Mosca, Fabio; Kramer, Boris W; Villamor, Eduardo

    2018-02-20

    Bronchopulmonary dysplasia (BPD) is the most common complication after preterm birth. Pasteurized donor human milk (DHM) has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF) if the mother's own milk (MOM) is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCTs could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (three studies, risk ratio (RR) 0.89, 95% confidence interval (CI) 0.60-1.32). However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67-0.90). An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (three studies, RR 0.80, 95% CI 0.68-0.95). Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (two studies, RR 0.77, 95% CI 0.62-0.96). In conclusion, our data suggest that DHM protects against BPD in very preterm infants.

  4. Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Eduardo Villamor-Martínez

    2018-02-01

    Full Text Available Bronchopulmonary dysplasia (BPD is the most common complication after preterm birth. Pasteurized donor human milk (DHM has increasingly become the standard of care for very preterm infants over the use of preterm formula (PF if the mother’s own milk (MOM is unavailable. Studies have reported beneficial effects of DHM on BPD. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs and observational studies on the effects of DHM on BPD and other respiratory outcomes. Eighteen studies met the inclusion criteria. Meta-analysis of RCTs could not demonstrate that supplementation of MOM with DHM reduced BPD when compared to PF (three studies, risk ratio (RR 0.89, 95% confidence interval (CI 0.60–1.32. However, meta-analysis of observational studies showed that DHM supplementation reduced BPD (8 studies, RR 0.78, 95% CI 0.67–0.90. An exclusive human milk diet reduced the risk of BPD, compared to a diet with PF and/or bovine milk-based fortifier (three studies, RR 0.80, 95% CI 0.68–0.95. Feeding raw MOM, compared to feeding pasteurized MOM, protected against BPD (two studies, RR 0.77, 95% CI 0.62–0.96. In conclusion, our data suggest that DHM protects against BPD in very preterm infants.

  5. Does Donor Age of Nonirradiated Achilles Tendon Allograft Influence Mid-Term Results of Revision ACL Reconstruction?

    Science.gov (United States)

    Zaffagnini, Stefano; Roberti di Sarsina, Tommaso; Bonanzinga, Tommaso; Nitri, Marco; Macchiarola, Luca; Stefanelli, Federico; Lucidi, Gianandrea; Grassi, Alberto

    2018-01-01

    Purpose  The purpose of the present study was to investigate if the donor age of nonirradiated Achilles tendon allograft could influence the clinical results of revision anterior cruciate ligament (ACL) reconstruction. Methods  All patients that underwent ACL revision between 2004 and 2008 with at least 4 years of follow-up were included. For all the patients that met the inclusion criteria, the age of the graft donor was obtained from the tissue bank. Lysholm score was administered to patients that met inclusion criteria. In addition, patients were divided in two groups based on the donor age (<45 years vs. ≥45 years), and the baseline characteristics and outcomes were compared. Results  Fifty-two patients were evaluated at a mean 4.8 ± 0.8 years follow-up with Lysholm score. The Lysholm significantly improved from 62.3 ± 6.6 at preoperative status to 84.4 ± 12.3 at final follow-up. The mean donor age was 48.7 ± 8.4 years; a significant difference in Lysholm score was noted between patients that received an allograft with a donor age <45 years (14 patients; 27%) and those receiving an allograft with a donor age ≥45 years (38; 73%) (89.5 ± 3.2 vs. 80.1 ± 11.1, respectively; p  = 0.0469). The multiple regression model showed the donor age, the final follow-up, and the preoperative Lysholm score as significant predictors of postoperative Lysholm score ( p  < 0.0002). Conclusion  Donor age of nonirradiated Achilles tendon allograft influenced the mid-term results of revision ACL reconstruction, thus advising the use of grafts from young donors. Level of Evidence  Level III, retrospective comparative study. PMID:29675501

  6. Live Donor Liver Transplantation Without Blood Products

    Science.gov (United States)

    Jabbour, Nicolas; Gagandeep, Singh; Mateo, Rodrigo; Sher, Linda; Strum, Earl; Donovan, John; Kahn, Jeffrey; Peyre, Christian G.; Henderson, Randy; Fong, Tse-Ling; Selby, Rick; Genyk, Yuri

    2004-01-01

    Objective: Developing strategies for transfusion-free live donor liver transplantation in Jehovah's Witness patients. Summary Background Data: Liver transplantation is the standard of care for patients with end-stage liver disease. A disproportionate increase in transplant candidates and an allocation policy restructuring, favoring patients with advanced disease, have led to longer waiting time and increased medical acuity for transplant recipients. Consequently, Jehovah's Witness patients, who refuse blood product transfusion, are usually excluded from liver transplantation. We combined blood augmentation and conservation practices with live donor liver transplantation (LDLT) to accomplish successful LDLT in Jehovah's Witness patients without blood products. Our algorithm provides broad possibilities for blood conservation for all surgical patients. Methods: From September 1998 until June 2001, 38 LDLTs were performed at Keck USC School of Medicine: 8 in Jehovah's Witness patients (transfusion-free group) and 30 in non-Jehovah's Witness patients (transfusion-eligible group). All transfusion-free patients underwent preoperative blood augmentation with erythropoietin, intraoperative cell salvage, and acute normovolemic hemodilution. These techniques were used in only 7%, 80%, and 10%, respectively, in transfusion-eligible patients. Perioperative clinical data and outcomes were retrospectively reviewed. Data from both groups were statistically analyzed. Results: Preoperative liver disease severity was similar in both groups; however, transfusion-free patients had significantly higher hematocrit levels following erythropoietin augmentation. Operative time, blood loss, and postoperative hematocrits were similar in both groups. No blood products were used in transfusion-free patients while 80% of transfusion-eligible patients received a median of 4.5+/− 3.5 units of packed red cell. ICU and total hospital stay were similar in both groups. The survival rate was 100% in

  7. Adult-to-Adult Living Donor Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Shimul A Shah

    2006-01-01

    Full Text Available The present review outlines the principles of living donor liver transplantation, donor workup, procedure and outcomes. Living donation offers a solution to the growing gap between the need for liver transplants and the limited availability of deceased donor organs. With a multidisciplinary team focused on donor safety and experienced surgeons capable of performing complex resection/reconstruction procedures, donor morbidity is low and recipient outcomes are comparable with results of deceased donor transplantation.

  8. Making the case for directed organ donation to registered donors in Israel.

    Science.gov (United States)

    Siegal, Gil

    2014-01-23

    The number of deceased donor organ donations in Israel is lower than average when compared to other Western World countries. To address the organ gap, the 2008 Organ Transplantation Law provides new interventions, including important incentives to donors (and their families). The most notable of these was granting priority to registered donors (i.e., people on the waiting list who signed a donor card). The current study presents the normative arguments as well as the first documentation of public attitudes in Israel towards another possible incentive - allowing individuals to influence the allocation of their organs by permitting them to designate, to direct their donated organs [DD] to other registered donors, instead of the current allocation based primarily on medical criteria. A structured phone survey of 695 Israelis was conducted during Feb-March 2012. The sample is representative of the Israeli society in terms of age mix and gender, with adequate representation of the Arab and ultra-orthodox Jewish subgroups. Among all Israelis, 68% stated a willingness to donate their organs, but only 16% reported to have already signed a donor card. 85% stated their interest in receiving an organ if the need arises. Overall, 64% of respondents felt that DD to a group of others who have registered as donors is justified, and the rate was remarkably higher in the Arab group (84%), and lower in the religious and ultraorthodox Jewish groups (52% and 50% respectively). The majority of the Israeli public supports organ donation and its proven benefits. Thus, organ recovery policy should be grounded in a strong communitarian strategy as we all stand to benefit from cooperation. However, current legislation and practices are modeled on individual disposition based on an opt-in legal framework. DD allows personal choices of to-be donors that might interfere with social interests, principles, and values such as equal access to care (i.e. organs) or justice. However, based on the

  9. Does Traumatic Donor Cause of Death Influence Outcome after Lung Transplantation? A Single-Centre Analysis.

    Science.gov (United States)

    Pilarczyk, Kevin; Heckmann, Jens; Carstens, Henning; Lubarski, Jura; Jakob, Heinz; Pizanis, Nikolaus; Kamler, Markus

    2017-08-01

    Background  Owing to the shortage of donor organs in lung transplantation (LuTX), liberalization of donor selection criteria has been proposed. However, some studies suggested that donor traumatic brain damage might influence posttransplantation allograft function. This article aimed to investigate the association of donor cause of death (DCD) and outcome after LuTX. Methods  A retrospective analysis of 186 consecutive double LuTXs at our institution from January 2000 to December 2008 was performed. DCD was categorized into traumatic brain injury (TBI) and nontraumatic brain injury (NTBI). In addition, NTBI was sub classified as spontaneous intracerebral bleeding (B), hypoxic brain damage (H), and intracerebral neoplasia (N). Results  DCD was classified as TBI in 50 patients (26.9%) and NTBI in 136 patients (73.1%): B in 112 patients (60.2%), H in 21 patients (11.3%), and N in 3 patients (1.6%). Young male donors predominated in group TBI (mean age 36.0 ± 14.5 vs. 42.8 ± 10.7, p  donor ventilation time, or paO 2 /FiO 2 before harvesting. TBI donors received significantly more blood (3.4 ± 3.8 vs. 1.8 ± 1.9, p  = 0.03). A chest trauma was evident only in group T ( n  = 7 [3.7%] vs. 0 [0%], p  donor death did not affect the following indices of graft function: length of postoperative ventilation, paO 2 /FiO 2 ratio up to 48 hours, and lung function up to 36 months. One- and three-year survival was comparable with 84.4 and 70.4% for TBI donors versus 89.4% and 69.2% for NTBI donors. Five-year survival tended to be lower in the TBI group but did not reach statistical significance (43.4 vs. 53.9%). Conclusion  This study indicates that traumatic DCD does not affect outcome after LuTX. These results can be achieved with an ideal donor management combined with an individual case-to-case evaluation by an experienced LuTX surgeon. Georg Thieme Verlag KG Stuttgart · New York.

  10. Summarized water quality criteria

    International Nuclear Information System (INIS)

    Kempster, P.L.; Hattingh, W.H.J.; Van Vliet, H.R.

    1980-08-01

    The available world literature from 27 sources on existing water quality criteria are summarized for the 15 main uses of water. The minimum, median and maximum specified values for 96 different determinands are included. Under each water use the criteria are grouped according to the functional significance of the determinands e.g. aesthetic/physical effects, high toxic potential, low toxic potential etc. A synopsis is included summarizing salient facts for each determinand such as the conditions under which it is toxic and its relationship to other determinands. The significance of the criteria is briefly discussed and the importance of considering functional interactions between determinands emphasized in evaluating the potential for toxic or beneficial effects. From the source literature it appears that the toxic potential, in addition to being determined by concentration, is also affected by the origin of the substance concerned, i.e. whether from natural sources or from anthropogenic pollution

  11. Robotic-assisted single-port donor nephrectomy using the da Vinci single-site platform.

    Science.gov (United States)

    LaMattina, John C; Alvarez-Casas, Josue; Lu, Irene; Powell, Jessica M; Sultan, Samuel; Phelan, Michael W; Barth, Rolf N

    2018-02-01

    Although single-port donor nephrectomy offers improved cosmetic outcomes, technical challenges have limited its application to selected centers. Our center has performed over 400 single-port donor nephrectomies. The da Vinci single-site robotic platform was utilized in an effort to overcome the steric, visualization, ergonomic, and other technical limitations associated with the single-port approach. Food and Drug Administration device exemption was obtained. Selection criteria for kidney donation included body mass index da Vinci single-site platform. Our experience supported the safety of this approach but found that the technology added cost and complexity without tangible benefit. Development of articulating instruments, energy, and stapling devices will be necessary for increased application of robotic single-site surgery for donor nephrectomy. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The impact of disclosure on donor gamete participants: donors, intended parents and offspring.

    Science.gov (United States)

    Greenfeld, Dorothy A

    2008-06-01

    The present review examines recent publications that provide insight into how the trend toward nonanonymity and disclosure in gamete donation impacts donors, intended parents, and their donor-conceived children. Recent findings show an increase in donor programs that offer open-identity between donors and offspring. The psychological needs of gamete donors and their attitudes toward disclosure are increasingly given consideration. Qualitative research on how parents of donor gamete offspring make decisions about disclosure reveals that even when couples initially disagree about disclosing to offspring, most ultimately come to a united disclosure decision. The literature on the impact of disclosure on donor gamete offspring has extended to include children conceived through embryo donation and children born as a result of surrogacy. The absence of genetic or gestational link between parents and their child does not have a negative impact on parent-child relationships. Parents through surrogacy tend to disclose the method of family creation to their child, whereas parents through embryo donation tend to be secretive about their child's origins. The trend toward greater openness in gamete donation has been accompanied by an increase in programs offering open-identity donation. In addition, the psychological needs of gamete donors and their attitudes toward disclosure are increasingly being given consideration. Parents of donor gamete offspring give careful thought to their disclosure decisions, and the psychological well being of donor-conceived children does not seem to be impacted by those decisions.

  13. Inter- and Intrapersonal Barriers to Living Donor Kidney Transplant among Black Recipients and Donors.

    Science.gov (United States)

    Davis, LaShara A; Grogan, Tracy M; Cox, Joy; Weng, Francis L

    2017-08-01

    End-stage renal disease (ESRD) is more common among Blacks, but Blacks are less likely to receive a live donor kidney transplant (LDKT). The objective of this study is to identify barriers and coping mechanisms that Black LDKT recipients and donors experienced while receiving or donating a kidney. A qualitative study was conducted using structured interviews. Thematic analysis was used for data interpretation. All 20 participants identified as Black, with two participants identifying themselves as multiracial. The mean age for the 14 recipients was 60, and the average age for the 6 living donors was 47. Themes emerging from the data suggest both recipients and donors faced barriers in the LDKT experience. Recipients faced barriers associated with their denial and avoidance of the severity of their ESRD, their desire to maintain the privacy of their health status, and their refusal to approach potential donors. Donors encountered negative responses from others about the donors' desire to donate and the initial refusal of recipients to accept a LDKT offer. Recipients identified faith as a coping mechanism, while donors identified normalization of donation as their method of coping. Various types of social support helped donors and recipients navigate the transplant process. Black LDKT recipients and donors must overcome barriers prior to receiving or donating a kidney. Most of these barriers arise from communication and interactions with others that are either lacking or undesirable. Future interventions to promote LDKT among Blacks may benefit by specifically targeting these barriers.

  14. Donor Retention in Online Crowdfunding Communities: A Case Study of DonorsChoose.org.

    Science.gov (United States)

    Althoff, Tim; Leskovec, Jure

    2015-05-01

    Online crowdfunding platforms like DonorsChoose.org and Kick-starter allow specific projects to get funded by targeted contributions from a large number of people. Critical for the success of crowdfunding communities is recruitment and continued engagement of donors. With donor attrition rates above 70%, a significant challenge for online crowdfunding platforms as well as traditional offline non-profit organizations is the problem of donor retention. We present a large-scale study of millions of donors and donations on DonorsChoose.org, a crowdfunding platform for education projects. Studying an online crowdfunding platform allows for an unprecedented detailed view of how people direct their donations. We explore various factors impacting donor retention which allows us to identify different groups of donors and quantify their propensity to return for subsequent donations. We find that donors are more likely to return if they had a positive interaction with the receiver of the donation. We also show that this includes appropriate and timely recognition of their support as well as detailed communication of their impact. Finally, we discuss how our findings could inform steps to improve donor retention in crowdfunding communities and non-profit organizations.

  15. Donor-derived HLA antibody production in patients undergoing SCT from HLA antibody-positive donors.

    Science.gov (United States)

    Taniguchi, K; Yoshihara, S; Maruya, E; Ikegame, K; Kaida, K; Hayashi, K; Kato, R; Inoue, T; Fujioka, T; Tamaki, H; Okada, M; Onuma, T; Fujii, N; Kusunoki, Y; Soma, T; Saji, H; Ogawa, H

    2012-10-01

    Pre-existing donor-specific HLA antibodies in patients undergoing HLA-mismatched SCT have increasingly been recognized as a risk factor for primary graft failure. However, the clinical implications of the presence of HLA antibodies in donors remain unknown. We prospectively examined 123 related donors for the presence of HLA antibodies by using a Luminex-based single antigen assay. Of these, 1/57 (1.8%) male, 6/27 (22%) parous female and 0/39 (0%) nonparous female donors were HLA antibody-positive. Then, we determined the presence of HLA antibodies in seven patients who received SCT from antibody-positive donors. Of these, four became HLA antibody-positive after SCT. The specificities of the antibodies that emerged in the patients closely resembled those of the antibodies found in the donors, indicating their production by donor-derived plasma cells. Moreover, the kinetics of the HLA antibody levels were similar in all four patients: levels started increasing within 1 week after SCT and peaked at days 10-21, followed by a gradual decrease. These results suggest that donor-derived HLA antibody production frequently occurs in patients undergoing SCT from antibody-positive donors. Further studies are warranted for clarifying the clinical significance of donor-derived HLA antibodies, including the role of these antibodies in post transplant platelet transfusion refractoriness.

  16. Responses to recipient and donor B cells by genetically donor T cells from human haploidentical chimeras

    International Nuclear Information System (INIS)

    Schiff, S.; Sampson, H.; Buckley, R.

    1986-01-01

    Following administration of haploidentical stem cells to infants with severe combined immunodeficiency (SCID), mature T cells of donor karyotype appear later in the recipient without causing graft-versus-host disease. To investigate the effect of the host environment on the responsiveness of these genetically donor T cells, blood B and T lymphocytes from 6 SCID recipients, their parental donors and unrelated controls were purified by double SRBC rosetting. T cells were stimulated by irradiated B cells at a 1:1 ratio in 6 day cultures. Engrafted T cells of donor karyotype gave much smaller responses to irradiated genetically recipient B cells than did fresh donor T cells. Moreover, engrafted T cells of donor karyotype from two of the three SCIDs who are longest post-transplantation responded more vigorously (14,685 and 31,623 cpm) than fresh donor T cells (5141 and 22,709 cpm) to donor B cells. These data indicate that T lymphocytes which have matured from donor stem cells in the recipient microenvironment behave differently from those that have matured in the donor

  17. Being a haematopoietic stem cell donor for a sick sibling: Adult donors' experiences prior to donation.

    Science.gov (United States)

    Kisch, Annika; Bolmsjö, Ingrid; Lenhoff, Stig; Bengtsson, Mariette

    2015-10-01

    There is a lack of knowledge about sibling stem cell donors' experiences pre-donation and the waiting period before the donation might have been long. The donors and their corresponding sibling recipients were simultaneously included in two different interview studies. The results from the recipient study have been presented in a separate paper. The aim was to explore the experiences of being a stem cell donor for a sibling, prior to donation. Ten adult sibling donors were interviewed prior to stem cell donation. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. The main theme Being a cog in a big wheel describes the complex process of being a sibling donor prior to donation, covering a mixture of emotions and thoughts. The four subthemes Being available, Being anxious, Being concerned and Being obliged cover the various experiences. The sibling donors' experiences are influenced by the quality of the relationship with the sick sibling. Sibling stem cell donors go through a complex process once they have accidentally got involved in. They have been asked to become a donor; it was not a voluntary choice. In caring for sibling stem cell donors the nurses should be aware of the complexity of the process they experience and take into consideration their personal situation and needs. Providing optimal care for both sibling donors and their corresponding recipients is a challenge, and further improvement and exploration are needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Shallow hydrogen-related donors in silicon

    International Nuclear Information System (INIS)

    Hartung, J.; Weber, J.

    1993-01-01

    Photothermal ionization spectroscopy on neutron-irradiated and subsequently hydrogen-plasma-treated silicon reveals the existence of new shallow donors. The binding energies of the observed effective-mass-like donors are between 34 and 53 meV. The optical dipole transitions of the different donors are shifted towards higher energies by ΔE=0.1--0.2 cm -1 , when deuterium is used in the plasma instead of hydrogen. This isotope shift of the optical dipole transitions between the electronic levels of the defects is direct proof of the incorporation of hydrogen in these defects

  19. Donor policy rules and aid effectiveness

    DEFF Research Database (Denmark)

    Dalgaard, Carl-Johan Lars

    2008-01-01

    The present paper examines the macroeconomic impact of aid, by introducing endogenous aid allocations into a neoclassical growth framework. On this basis it is shown that donor policies can have important implications for the trajectory of recipients' GDP per capita. Depending on specific donor...... policy choices, aid disbursements may lead to faster transitional growth, stagnation or cyclical growth. Moreover, the analysis also suggests that donor policies may be part of the reason why foreign aid is not found to be uniformly effective in raising long-run productivity across recipients...

  20. Kidney for sale by live donor.

    Science.gov (United States)

    Brahams, D

    1989-02-04

    The capacity to consent to bodily harm is explored in relation to the trade in kidneys obtained from impoverished healthy live donors for cash. The British medical profession has unambiguously condemned the practice, but the law in Britain allows a donor to consent to serious injury where the act had some social purpose, recognized by the law as valid. Allegations against the private Humana Hospital Wellington that indigent Turks were brought to Britain to be paid kidney donors, and similar practices elsewhere, are discussed. Questions are raised about the illegality of such contracts in Britain and the possibility of a Parliamentary Act making brokerage and involvement with such cash transactions a criminal offense.

  1. Human decellularized bone scaffolds from aged donors show improved osteoinductive capacity compared to young donor bone.

    Directory of Open Access Journals (Sweden)

    Christopher A Smith

    Full Text Available To improve the safe use of allograft bone, decellularization techniques may be utilized to produce acellular scaffolds. Such scaffolds should retain their innate biological and biomechanical capacity and support mesenchymal stem cell (MSC osteogenic differentiation. However, as allograft bone is derived from a wide age-range, this study aimed to determine whether donor age impacts on the ability an osteoinductive, acellular scaffold produced from human bone to promote the osteogenic differentiation of bone marrow MSCs (BM-MSC. BM-MSCs from young and old donors were seeded on acellular bone cubes from young and old donors undergoing osteoarthritis related hip surgery. All combinations resulted in increased osteogenic gene expression, and alkaline phosphatase (ALP enzyme activity, however BM-MSCs cultured on old donor bone displayed the largest increases. BM-MSCs cultured in old donor bone conditioned media also displayed higher osteogenic gene expression and ALP activity than those exposed to young donor bone conditioned media. ELISA and Luminex analysis of conditioned media demonstrated similar levels of bioactive factors between age groups; however, IGF binding protein 1 (IGFBP1 concentration was significantly higher in young donor samples. Additionally, structural analysis of old donor bone indicated an increased porosity compared to young donor bone. These results demonstrate the ability of a decellularized scaffold produced from young and old donors to support osteogenic differentiation of cells from young and old donors. Significantly, the older donor bone produced greater osteogenic differentiation which may be related to reduced IGFBP1 bioavailability and increased porosity, potentially explaining the excellent clinical results seen with the use of allograft from aged donors.

  2. Blood donor incentives: A step forward or backward

    Directory of Open Access Journals (Sweden)

    Abolghasemi Hassan

    2010-01-01

    Full Text Available Dramatic increase in blood usage and critical seasonal blood shortages are faced by various countries. Countries which previously reached 100% voluntary nonremunerated donation have been led to offer different kinds of incentives to recruit blood donors and meet their blood demands. In some cases, these incentives are considered monetary and are in complete contrast with International standards like World Health Organization (WHO. It seems that attitudes toward sole dependency on nonremunerated voluntary blood donation have been changed in recent years and experts in some developed countries are reevaluating partial reliance on paid donation. On the other hand, besides the effects of such incentives on blood safety, several economic and psychological studies have shown that incentives have discouraging effects on pro-social behaviors like blood donation and will reduce the number of blood donors in long term. With regard to the results of such studies, it seems that implementing incentive-based blood donor recruitment programs to meet blood requirements by some countries is becoming a challenge for blood banks.

  3. Cancer risk in children born after donor ART.

    Science.gov (United States)

    Williams, C L; Bunch, K J; Murphy, M F G; Stiller, C A; Botting, B J; Wallace, W H; Davies, M C; Sutcliffe, A G

    2018-01-01

    Do children born after donor ART have an increased risk of developing childhood cancer in comparison to the general population? This study showed no overall increased risk of childhood cancer in individuals born after donor ART. Most large population-based studies have shown no increase in overall childhood cancer incidence after non-donor ART; however, other studies have suggested small increased risks in specific cancer types, including haematological cancers. Cancer risk specifically in children born after donor ART has not been investigated to date. This retrospective cohort study utilized record linkage to determine the outcome status of all children born in Great Britain (1992-2008) after donor ART. The cohort included 12 137 members who contributed 95 389 person-years of follow-up (average follow-up 7.86 years). Records of all children born in Great Britain (England, Wales, Scotland) after all forms of donor ART (1992-2008) were linked to the UK National Registry of Childhood Tumours (NRCT) to determine the number who subsequently developed cancer by 15 years of age, by the end of 2008. Rates of overall and type specific cancer (selected a priori) were compared with age, sex and calendar year standardized population-based rates, stratifying for potential mediating/moderating factors including sex, age at diagnosis, birth weight, multiple births, maternal previous live births, assisted conception type and fresh/ cryopreserved cycles. In our cohort of 12 137 children born after donor ART (52% male, 55% singleton births), no overall increased risk of cancer was identified. There were 12 cancers detected compared to 14.4 expected (standardized incidence ratio (SIR) 0.83; 95% CI 0.43-1.45; P = 0.50). A small, significant increased risk of hepatoblastoma was found, but the numbers and absolute risks were small (ART, the rarity of specific diagnostic subgroups of childhood cancer results in few cases and therefore wide CIs for such outcomes. As this is an

  4. Adult dual kidney transplantations obtained from marginal donors: two case reports.

    Science.gov (United States)

    Kim, Y H; Jung, J H; Song, K B; Chung, Y S; Park, J B; Cho, Y M; Jang, H J; Kim, S-C; Han, D J

    2012-01-01

    Organ shortage has led us to use grafts from expanded criteria donors (ECD). Dual kidney transplantation (DKT) using organs from an ECD, which are not acceptable for single kidney transplantation (KT), may overcome the insufficient functioning nephron mass. We performed DKTs in two recipients, the first DKT to be reported from Korea. In case 1, the donor was a 36-year-old man with hypertension. The cause of his brain death was intracranial hemorrhage. He had no known underlying renal disease; his serum creatinine level was 4.2 mg/dL. Despite the relatively young age of the donor, a biopsy revealed mild interstitial fibrosis and tubular atrophy with moderate arteriolar narrowing. The recipient's postoperative course was uneventful over the 69-month follow-up; her last serum creatinine was 1.3 mg/dL. In case 2, the 80-year-old male donor with a history of hypertension had a normal creatinine. The donor biopsy revealed mild glomerular sclerosis, tubular atrophy, and interstitial fibrosis with moderate arteriolar narrowing. The recipient had undergone a previous KT 14 years previously on the right side of the abdomen, but had resumed dialysis 2 years previously due to chronic allograft nephropathy. There was no delayed graft function. At month 4 posttransplantation, lymphoceles were treated by fenestration. At 6-month follow-up, her creatinine was 1.0 mg/dL. In our experience with these two cases, DKT with ECD kidney grafts seemed to be a successful strategy to avoid poor graft outcomes and overcome the donor organ shortage. Further studies including histological criteria for DKT, should be performed to determine the safest means to utilize ECD grafts. Copyright © 2012. Published by Elsevier Inc.

  5. Donor-estimated GFR as an appropriate criterion for allocation of ECD kidneys into single or dual kidney transplantation.

    Science.gov (United States)

    Snanoudj, R; Rabant, M; Timsit, M O; Karras, A; Savoye, E; Tricot, L; Loupy, A; Hiesse, C; Zuber, J; Kreis, H; Martinez, F; Thervet, E; Méjean, A; Lebret, T; Legendre, C; Delahousse, M

    2009-11-01

    It has been suggested that dual kidney transplantation (DKT) improves outcomes for expanded criteria donor (ECD) kidneys. However, no criteria for allocation to single or dual transplantation have been assessed prospectively. The strategy of DKT remains underused and potentially eligible kidneys are frequently discarded. We prospectively compared 81 DKT and 70 single kidney transplant (SKT) receiving grafts from ECD donors aged >65 years, allocated according to donor estimated glomerular filtration rate (eGFR): DKT if eGFR between 30 and 60 mL/min, SKT if eGFR greater than 60 mL/min. Patient and graft survival were similar in the two groups. In the DKT group, 13/81 patients lost one of their two kidneys due to hemorrhage, arterial or venous thrombosis. Mean eGFR at month 12 was similar in the DKT and SKT groups (47.8 mL/min and 46.4 mL/min, respectively). Simulated allocation of kidneys according to criteria based on day 0 donor parameters such as those described by Remuzzi et al., Andres et al. and UNOS, did not indicate an improvement in 12-month eGFR compared to our allocation based on donor eGFR.

  6. Radiological design criteria

    International Nuclear Information System (INIS)

    Selby, J.M.; Andersen, B.V.; Carter, L.A.; Waite, D.A.

    1977-01-01

    Many new nuclear facilities are unsatisfactory from a radiation protection point of view, particularly when striving to maintain occupational exposure as low as practicable 'ALAP'. Radiation protection is achieved through physical protective features supplemented by administrative controls. Adequate physical protective feature should be achieved during construction so that supplemental administrative controls may be kept simple and workable. Many nuclear facilities fall short of adequate physical protective features, thus, remedial and sometimes awkward administrative procedures are required to safely conduct work. In reviewing the various handbooks, reports and regulations which deal with radiation protection, it may be noted that there is minimal radiological design guidance for application to nuclear facilities. A set of criteria or codes covering functional areas rather than specific nuclear facility types is badly needed. The following are suggested as functional areas to be considered: characterization of the Facility; siting and access; design exposure limits; layout (people and materials flow); ventilation and effluent control; radiation protection facilities and systems. The application of such radiological design criteria early in the design process would provide some assurance that nuclear facilities will be safe, flexible, and efficient with a minimum of costly retrofitting or administrative restrictions. Criteria which we have found helpful in these functional areas is discussed together with justification for adoption of such criteria and identification of problems which still require solution

  7. Comments on confinement criteria

    International Nuclear Information System (INIS)

    Kurak, V.; Schroer, B.; Swieca, J.A.

    1977-01-01

    For a QED 2 model with SU(n) flavour, the nature of the physical states space is more subtle than one expects on the basis of the loop criterion for confinement. One may have colour confinement without confinement of the fundamental flavour representation. Attempts to formulate confinement criteria in which the quark fields play a more fundamental role are discussed [pt

  8. Thoracic epidural analgesia in donor hepatectomy: An analysis.

    Science.gov (United States)

    Koul, Archna; Pant, Deepanjali; Rudravaram, Swetha; Sood, Jayashree

    2018-02-01

    The purpose of this study is to analyze whether supplementation of general anesthesia (GA) with thoracic epidural analgesia (TEA) for right lobe donor hepatectomy is a safe modality of pain relief in terms of changes in postoperative coagulation profile, incidence of epidural catheter-related complications, and timing of removal of epidural catheter. Retrospective analysis of the record of 104 patients who received TEA for right lobe donor hepatectomy was done. Platelet count, international normalized ratio, alanine aminotransferase, and aspartate aminotransferase were recorded postoperatively until the removal of the epidural catheter. The day of removal of the epidural catheter and visual analogue scale (VAS) scores were also recorded. Any complication encountered was documented. Intraoperatively, central venous pressure (CVP), hemodynamic variables, and volume of intravenous fluids infused were also noted. Statistical analysis was performed by using SPSS statistical package, version 17.0 (SPSS Inc. Chicago, IL). Continuous variables were presented as mean ± standard deviation. A total of 90% of patients had mean VAS scores between 1 and 4 in the postoperative period between days 1 and 5. None of the patients had a VAS score above 5. Although changes in coagulation status were encountered in all patients in the postoperative period, these changes were transient and did not persist beyond postoperative day (POD) 5. There was no delay in removal of the epidural catheter, and the majority of patients had the catheter removed by POD 4. There was no incidence of epidural hematoma. Aside from good intraoperative and postoperative analgesia, TEA in combination with balanced GA and fluid restriction enabled maintenance of low CVP and prevention of hepatic congestion. In conclusion, vigilant use of TEA appears to be safe during donor hepatectomy. Living liver donors should not be denied efficient analgesia for the fear of complications. Liver Transplantation 24 214

  9. Air Quality Criteria for Particulate Matter.

    Science.gov (United States)

    National Air Pollution Control Administration (DHEW), Washington, DC.

    To assist states in developing air quality standards, this book offers a review of literature related to atmospheric particulates and the development of criteria for air quality. It not only summarizes the current scientific knowledge of particulate air pollution, but points up the major deficiencies in that knowledge and the need for further…

  10. 46 CFR 154.466 - Design criteria.

    Science.gov (United States)

    2010-10-01

    ... GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS FOR... § 154.466 Design criteria. (a) The insulation for a cargo tank without a secondary barrier must be... cargo tank with a secondary barrier must be designed for the secondary barrier at the design temperature...

  11. 46 CFR 154.460 - Design criteria.

    Science.gov (United States)

    2010-10-01

    ... GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS FOR... Barrier § 154.460 Design criteria. At static angles of heel up through 30°, a secondary barrier must (a) If a complete secondary barrier is required in § 154.459, hold all of the liquid cargo in the cargo...

  12. Establishing criteria for human mesenchymal stem cell potency.

    Science.gov (United States)

    Samsonraj, Rebekah M; Rai, Bina; Sathiyanathan, Padmapriya; Puan, Kia Joo; Rötzschke, Olaf; Hui, James H; Raghunath, Michael; Stanton, Lawrence W; Nurcombe, Victor; Cool, Simon M

    2015-06-01

    This study sought to identify critical determinants of mesenchymal stem cell (MSC) potency using in vitro and in vivo attributes of cells isolated from the bone marrow of age- and sex-matched donors. Adherence to plastic was not indicative of potency, yet capacity for long-term expansion in vitro varied considerably between donors, allowing the grouping of MSCs from the donors into either those with high-growth capacity or low-growth capacity. Using this grouping strategy, high-growth capacity MSCs were smaller in size, had greater colony-forming efficiency, and had longer telomeres. Cell-surface biomarker analysis revealed that the International Society for Cellular Therapy (ISCT) criteria did not distinguish between high-growth capacity and low-growth capacity MSCs, whereas STRO-1 and platelet-derived growth factor receptor alpha were preferentially expressed on high-growth capacity MSCs. These cells also had the highest mean expression of the mRNA transcripts TWIST-1 and DERMO-1. Irrespective of these differences, both groups of donor MSCs produced similar levels of key growth factors and cytokines involved in tissue regeneration and were capable of multilineage differentiation. However, high-growth capacity MSCs produced approximately double the volume of mineralized tissue compared to low-growth capacity MSCs when assessed for ectopic bone-forming ability. The additional phenotypic criteria presented in this study when combined with the existing ISCT minimum criteria and working proposal will permit an improved assessment of MSC potency and provide a basis for establishing the quality of MSCs prior to their therapeutic application. © 2015 AlphaMed Press.

  13. Laparoscopic donor nephrectomy increases the supply of living donor kidneys: a center-specific microeconomic analysis.

    Science.gov (United States)

    Kuo, P C; Johnson, L B

    2000-05-27

    A tenet of microeconomics is that new technology will shift the supply curve to the right. Laparoscopic donor nephrectomy (LDN) is a new technique for removal of living donor kidneys. Centers performing this procedure have noted an increased number of patients presenting for donor evaluation. This has not been previously studied. The records of all LDN performed from May 1998 to February 1999 were reviewed. The following variables were examined: sex, age, related vs. unrelated donation, estimated blood loss, i.v. analgesia, length of stay, and time out of work. Donors undergoing traditional open donor nephrectomy during January 1997 to May 1998 served as the control group. A composite cost index was constructed. LDN significantly decreased length of stay, pain, and time out of work; the supply function shifted to the right. Telephone interviews revealed that 47% donated solely because of the LDN procedure. LDN increases the supply of living donor kidneys.

  14. Donor-Derived Myeloid Sarcoma in Two Kidney Transplant Recipients from a Single Donor

    Directory of Open Access Journals (Sweden)

    Amudha Palanisamy

    2015-01-01

    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.

  15. A simplified donor risk index for predicting outcome after deceased donor kidney transplantation.

    Science.gov (United States)

    Watson, Christopher J E; Johnson, Rachel J; Birch, Rhiannon; Collett, Dave; Bradley, J Andrew

    2012-02-15

    We sought to determine the deceased donor factors associated with outcome after kidney transplantation and to develop a clinically applicable Kidney Donor Risk Index. Data from the UK Transplant Registry on 7620 adult recipients of adult deceased donor kidney transplants between 2000 and 2007 inclusive were analyzed. Donor factors potentially influencing transplant outcome were investigated using Cox regression, adjusting for significant recipient and transplant factors. A United Kingdom Kidney Donor Risk Index was derived from the model and validated. Donor age was the most significant factor predicting poor transplant outcome (hazard ratio for 18-39 and 60+ years relative to 40-59 years was 0.78 and 1.49, respectively, Pinformed consent.

  16. FORUM Paediatric living donor liver transplantation

    African Journals Online (AJOL)

    879 November 2012, Vol. 102, No. 11 SAMJ. REVIEW. Paediatric living donor liver transplantation ... been excellent after left lateral segmentectomy, with a usually quoted ... has led to the development of new surgical techniques to increase.

  17. [Psychological specificities of living donor kidney transplantation].

    Science.gov (United States)

    Papeloux-Heitzmann, Élodie

    2016-12-01

    For people with end-stage kidney disease, a transplant is the promise of a future without dialysis. Living donor kidney transplantation comprises many specificities and is distinct from cadaveric donor transplantation. Some psychological aspects explain these specificities. They may be subconscious and difficult to access, but it is essential to decipher them in order to adapt the support provided to these people. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Promoting Organ Donor Registries Through Public Education: What Is the Cost of Securing Organ Donors?

    Science.gov (United States)

    Razdan, Manik; Smith, Kenneth J; Bryce, Cindy L; Degenholtz, Howard B

    2016-06-01

    Transplant medicine's impact on America's public health is seriously limited by acute shortage of transplantable organs. Consequently, the United Sates has witnessed considerable investment in the promotion of organ donor registries. Although there is no evidence to support that donor registry promotion alleviates organ shortage, this belief continues to drive investments into registry promotion. In this study, return on investment in donor registry promotion was examined using cost-outcomes analysis. Cost of promoting the donor registry was estimated in US dollars whereas the outcome was measured as the number of individuals who join the registry (registrants) and their value in terms of organ donors. The study was conducted from the perspective of a regional Organ Procurement Organization (OPO). Costs were directly obtained from the OPO. The number of new registrants was obtained from the OPO and the departments of motor vehicles that maintain the donor registry. The value of registrants in terms of organ donors was computed based on a registrant's age-dependent risk of dying and age-dependent probability of becoming an organ donor. Six thousand seven hundred eight individuals joined the organ donor registry (95% confidence interval [95% CI], 5429-7956) at a cost of $455 per registrant (95% CI, US $383-US $562). These individuals result in 4.2 present-day donors (95% CI, 2.5-6.6) at a cost of US $726 000 (95% CI, US $462000-US $1.2 million). Because the cost per registrant and cost per donor is less than society's willingness to pay, donor registry promotion offers positive return on investment. Investment in registry promotion should at the minimum be maintained at current levels.

  19. Ex vivo lung perfusion to improve donor lung function and increase the number of organs available for transplantation.

    Science.gov (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

    2014-06-01

    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 donor organs and resulted in successful transplants with lungs that would have otherwise been rejected (ClinicalTrials.gov number: NCT01967953). © 2014 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.

  20. Management of blood donors and blood donations from individuals found to have a positive direct antiglobulin test.

    Science.gov (United States)

    Hannon, Judith L

    2012-04-01

    The medical literature is replete with articles addressing the diagnosis and management of patients with a positive direct antiglobulin test (DAT). However, there is scant information addressing the management of blood donors and blood donations found to have a positive DAT. Practices vary considerably between countries and blood suppliers within countries, and there is no standardized approach to the management of these blood donors or the blood products prepared from their donations. Recent evidence from Israel suggests that the finding of a positive DAT in a blood donor may not be as benign as previously thought. Therefore, it may be prudent for blood collection agencies to periodically reexamine their approach to the management of blood donors with a positive DAT and their donations. This article reviews the available literature and explores options for the management of DAT-positive blood donors and their blood donations. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Secrets and disclosure in donor conception.

    Science.gov (United States)

    Frith, Lucy; Blyth, Eric; Crawshaw, Marilyn; van den Akker, Olga

    2018-01-01

    This article considers the disclosure, sharing and exchange of information on being donor conceived within families, drawing on data from a study undertaken with donor-conceived adults registered with UK Donor Link (a voluntary DNA-linking register). This paper considers the narratives of how respondents found out they were donor-conceived and what events triggered disclosure of this information. This paper then goes on to examine the role secrecy played in their family life and uses the concept of 'display' to explore how secrecy affected their relationships with their immediate and extended family. Secrets are notoriously 'leaky' and we found complex patterns of knowing and uncertainty about whom in the family knew that the person was donor-conceived. We argue that what is kept secret and from whom provides insights into the multifaceted web of social relationships that can be created by donor-conception, and how knowledge can be managed and controlled in attempts to display and maintain family narratives of biogenetic connection. © 2017 Foundation for the Sociology of Health & Illness.

  2. DISPOSABLE CANISTER WASTE ACCEPTANCE CRITERIA

    Energy Technology Data Exchange (ETDEWEB)

    R.J. Garrett

    2001-07-30

    The purpose of this calculation is to provide the bases for defining the preclosure limits on radioactive material releases from radioactive waste forms to be received in disposable canisters at the Monitored Geologic Repository (MGR) at Yucca Mountain. Specifically, this calculation will provide the basis for criteria to be included in a forthcoming revision of the Waste Acceptance System Requirements Document (WASRD) that limits releases in terms of non-isotope-specific canister release dose-equivalent source terms. These criteria will be developed for the Department of Energy spent nuclear fuel (DSNF) standard canister, the Multicanister Overpack (MCO), the naval spent fuel canister, the High-Level Waste (HLW) canister, the plutonium can-in-canister, and the large Multipurpose Canister (MPC). The shippers of such canisters will be required to demonstrate that they meet these criteria before the canisters are accepted at the MGR. The Quality Assurance program is applicable to this calculation. The work reported in this document is part of the analysis of DSNF and is performed using procedure AP-3.124, Calculations. The work done for this analysis was evaluated according to procedure QAP-2-0, Control of Activities, which has been superseded by AP-2.21Q, Quality Determinations and Planning for Scientific, Engineering, and Regulatory Compliance Activities. This evaluation determined that such activities are subject to the requirements of DOE/RW/0333P, Quality Assurance Requirements and Description (DOE 2000). This work is also prepared in accordance with the development plan titled Design Basis Event Analyses on DOE SNF and Plutonium Can-In-Canister Waste Forms (CRWMS M&O 1999a) and Technical Work Plan For: Department of Energy Spent Nuclear Fuel Work Packages (CRWMS M&O 2000d). This calculation contains no electronic data applicable to any electronic data management system.

  3. Pre-banking microbial contamination of donor conjunctiva and storage medium for penetrating keratoplasty.

    Science.gov (United States)

    Inomata, Takenori; Ono, Koichi; Matsuba, Tsuyoshi; Shiang, Tina; Di Zazzo, Antonio; Nakatani, Satoru; Yamaguchi, Masahiro; Ebihara, Nobuyuki; Murakami, Akira

    2017-09-01

    The aims of this study were to investigate the incidence of positive donor tissue cultures before transfer to preservation medium (Optisol™-GS) for penetrating keratoplasty, to verify the efficacy of antibiotics contained in Optisol™-GS by examining the drug susceptibility and to assess the relationship between the results of our microbial assessments as well as donor factors and the incidence of contamination. We conducted a retrospective, cross-sectional study using Juntendo Eye Bank records for all corneal transplantations. Two hundred donor conjunctiva harvestings and storage medium (EP-II ® ) cultures were performed between July 2008 and June 2011. We analyzed the associations between donor factors (age, gender, history of cataract surgery, death-to-preservation interval, cause of death) and contamination rates using multivariate analysis by the generalized estimating equation model. We obtained positive bacterial cultures from 154 of the 200 eyes (77.0%). The isolated bacteria were indigenous, such as coagulase-negative Staphylococci, Corynebacterium sp., and methicillin-resistant Staphylococcus aureus (MRSA). There was significant resistance to levofloxacin (18 eyes, 9.0%) and gentamicin (12 eyes, 6.0%), and no vancomycin-resistant bacteria were detected. The donor factors did not correlate with the prevalence of bacterial contamination in our criteria. Pre-banking microbial assessment allows for microbial detection, bacterial susceptibility and resistance testing. This is useful for developing preservation mediums containing effective spectrum antibiotic agents for high quality control of corneal banking.

  4. Expanding the live kidney donor pool: ethical considerations regarding altruistic donors, paired and pooled programs.

    Science.gov (United States)

    Patel, Shaneel Rajendra; Chadha, Priyanka; Papalois, Vassilios

    2011-06-01

    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.

  5. Influence of kinship on donors' mental burden in living donor liver transplantation.

    Science.gov (United States)

    Erim, Yesim; Beckmann, Mingo; Kroencke, Sylvia; Sotiropoulos, Georgios C; Paul, Andreas; Senf, Wolfgang; Schulz, Karl-Heinz

    2012-08-01

    In the context of living donor liver transplantation (LDLT), German transplantation law stipulates that donor candidates should primarily be relatives of the recipients or persons with distinct and close relationships. In this study, we investigated the influence of the relationship between the donor and the recipient on the donor's emotional strain before transplantation. Donors were categorized according to the following subgroups: (1) parents donating for their children, (2) children donating for their parents, (3) siblings, (4) spouses, (5) other relatives, and (6) nonrelatives. The sample consisted of 168 donor candidates. Anxiety (F = 2.8, P = 0.02), depression (F = 2.6, P = 0.03), and emotional quality of life (F = 3.1, P = 0.01) differed significantly according to the relationship between the donor and the recipient. In comparison with healthy controls, parents donating for their children were significantly less stressed before LDLT and demonstrated fewer anxiety (P depression symptoms (P < 0.05). Adult children donating for their parents demonstrated the highest mental burden and the lowest emotional quality of life. However, this was not due to the responsibility of these children for their own families because differences between donors with children and donors without children could not be ascertained. This group should be given special attention before LDLT and during follow-up visits, and psychological help should be provided when it is necessary. Copyright © 2012 American Association for the Study of Liver Diseases.

  6. Treatment of thoraco-lumbar curves in adolescent females affected by idiopathic scoliosis with a progressive action short brace (PASB: assessment of results according to the SRS committee on bracing and nonoperative management standardization criteria

    Directory of Open Access Journals (Sweden)

    Perisano Carlo

    2009-09-01

    Full Text Available Abstract Background The effectiveness of conservative treatment of scoliosis is controversial. Some studies suggest that brace is effective in stopping curve progression, whilst others did not report such an effect. The purpose of the present study was to effectiveness of Progressive Action Short Brace (PASB in the correction of thoraco-lumbar curves, in agreement with the Scoliosis Research Society (SRS Committee on Bracing and Nonoperative Management Standardisation Criteria. Methods Fifty adolescent females (mean age 11.8 ± 0.5 years with thoraco-lumbar curve and a pre-treatment Risser score ranging from 0 to 2 have been enrolled. The minimum duration of follow-up was 24 months (mean: 55.4 ± 44.5 months. Antero-posterior radiographs were used to estimate the curve magnitude (CM and the torsion of the apical vertebra (TA at 5 time points: beginning of treatment (t1, one year after the beginning of treatment (t2, intermediate time between t1 and t4 (t3, end of weaning (t4, 2-year minimum follow-up from t4 (t5. Three situations were distinguished: curve correction, curve stabilisation and curve progression. The Kruskal Wallis and Spearman Rank Correlation tests have been used as statistical tests. Results CM mean value was 29,30 ± 5,16 SD at t1 and 14,67 ± 7,65 SD at t5. TA was 12.70 ± 6,14 SD at t1 and 8,95 ± 5,82 at t5. The variation between measures of Cobb and Perdriolle degrees at t1,2,3,4,5 and between CM t5-t1 and TA t5-t1 were significantly different. Curve correction was accomplished in 94% of patients, whereas a curve stabilisation was obtained in 6% of patients. Conclusion The PASB, due to its peculiar biomechanical action on vertebral modelling, is highly effective in correcting thoraco-lumbar curves.

  7. Nuclear reactor philosophy and criteria

    International Nuclear Information System (INIS)

    Atchison, R.J.

    1979-07-01

    Nuclear power plant safety criteria and principles developed in Canada are directed towards minimizing the chance of failure of the fuel and preventing or reducing to an acceptably low level the escape of fission products should fuel failure occur. Safety criteria and practices are set forth in the Reactor Siting Guide, which is based upon the concept of defence in depth. The Guide specifies that design and construction shall follow the best applicable code, standard or practice; the total of all serious process system failures shall not exceed one in three years; special safety systems are to be physically and functionally separate from process systems and each other; and safety systems shall be testable, with unavailability less than 10 - 3 . Doses to the most exposed member of the public due to normal operation, serious process failures, and dual failures are specified. Licensees are also required to consider the effects of extreme conditions due to airplane crashes, explosions, turbine disintegration, pipe burst, and natural disasters. Safety requirements are changing as nuclear power plant designs evolve and in response to social and economic pressures

  8. Mobilizing stem cells from normal donors: is it possible to improve upon G-CSF?

    Science.gov (United States)

    Cashen, A F; Lazarus, H M; Devine, S M

    2007-05-01

    Currently, granulocyte colony stimulating factor (G-CSF) remains the standard mobilizing agent for peripheral blood stem cell (PBSC) donors, allowing the safe collection of adequate PBSCs from the vast majority of donors. However, G-CSF mobilization can be associated with some significant side effects and requires a multi-day dosing regimen. The other cytokine approved for stem cell mobilization, granulocyte-macrophage colony stimulating factor (GM-CSF), alters graft composition and may reduce the development of graft-versus-host disease, but a significant minority of donors fails to provide sufficient CD34+ cells with GM-CSF and some experience unacceptable toxicity. AMD3100 is a promising new mobilizing agent, which may have several advantages over G-CSF for donor mobilization. As it is a direct antagonist of the interaction between the chemokine stromal-derived factor-1 and its receptor CXCR4, AMD3100 mobilizes PBSCs within hours rather than days. It is also well tolerated, with no significant side effects reported in any of the clinical trials to date. Studies of autologous and allogeneic transplantation of AMD3100 mobilized grafts have demonstrated prompt and stable engraftment. Here, we review the current state of stem cell mobilization in normal donors and discuss novel strategies for donor stem cell mobilization.

  9. Human Systems Design Criteria

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1982-01-01

    This paper deals with the problem of designing more humanised computer systems. This problem can be formally described as the need for defining human design criteria, which — if used in the design process - will secure that the systems designed get the relevant qualities. That is not only...... the necessary functional qualities but also the needed human qualities. The author's main argument is, that the design process should be a dialectical synthesis of the two points of view: Man as a System Component, and System as Man's Environment. Based on a man's presentation of the state of the art a set...... of design criteria is suggested and their relevance discussed. The point is to focus on the operator rather than on the computer. The crucial question is not to program the computer to work on its own conditions, but to “program” the operator to function on human conditions....

  10. Intelligent intefrace design criteria

    International Nuclear Information System (INIS)

    Sicard, Y.; Siebert, S.; Thebault, M.H.

    1990-01-01

    Optimum adequation between control means and the capacities of the teams of operators is sought for to achieve computerization of control and monitoring interfaces. Observation of the diagnosis activity of populations of operators in incident situations on a simulator enables design criteria well-suited to the characteristics of the detection, interpretation of symptoms and incident location tasks to be defined. A software tool based on a qualitative approach enables the design process to be systematized

  11. Prevalence of malaria parasitaemia among blood donors in Owerri ...

    African Journals Online (AJOL)

    A study of the prevalence of malaria parasitaemia among blood donors in the Federal Medical Centre, Owerri, Imo State, was carried out between December, 2003 and April, 2004. A total of 500 blood samples were collected from blood donors consisting of 262 commercial donors and 238 relation-donors, using ...

  12. Parvovirus B19 viraemia in Dutch blood donors

    NARCIS (Netherlands)

    Zaaijer, H. L.; Koppelman, M. H. G. M.; Farrington, C. P.

    2004-01-01

    Blood, donated by asymptomatic donors, may contain and transmit parvovirus B19. To investigate the dynamics of parvovirus viraemia in asymptomatic blood donors, we studied the amounts of parvovirus DNA in pools of donor plasma, the prevalence of parvovirus antibodies among blood donors in relation

  13. Cost-effectiveness of cadaveric and living-donor liver transplantation.

    Science.gov (United States)

    Sagmeister, Markus; Mullhaupt, Beat; Kadry, Zakiyah; Kullak-Ublick, Gerd A; Clavien, Pierre A; Renner, Eberhard L

    2002-02-27

    Cadaveric liver transplantation (5-year survival >80%) represents the standard of care for end-stage liver disease (ESLD). Because the demand for cadaveric organs exceeds their availability, living-donor liver transplantation has gained increasing acceptance. Our aim was to assess the marginal cost-effectiveness of cadaveric and living-donor orthotopic liver transplantation (OLT) in adults with ESLD. Using a Markov model, outcomes and costs of ESLD treated (1) conservatively, (2) with cadaveric OLT alone, and (3) with cadaveric OLT or living-donor OLT were computed. The model was validated with published data. The case-based scenario consisted of data on all 15 ESLD patients currently on our waiting list (3 women, 12 men; median age, 48 years [range, 33-59 years]) and on the outcome of all OLT performed for ESLD at our institution since 1995 (n=51; actuarial 5-year survival 93%). Living-donor OLT was allowed in 15% during the first year of listing; fulminant hepatic failure and hepatocellular carcinoma were excluded. Cadaveric OLT gained on average 6.2 quality-adjusted life-years (QALYs) per patient compared with conservative treatment, living-donor OLT, an additional 1.3 QALYs compared with cadaveric OLT alone. Marginal cost-effectiveness of a program with cadaveric OLT alone and a program with cadaveric and living-donor OLT combined were similar (E 22,451 and E 23,530 per QALY gained). Results were sensitive to recipient age and postoperative survival rate. Offering living-donor OLT in addition to cadaveric OLT improves survival at costs comparable to accepted therapies in medicine. Cadaveric OLT and living-donor OLT are cost-effective.

  14. Preoperative evaluation of hepatic arterial and portal venous anatomy using the time resolved echo-shared MR angiographic technique in living liver donors

    International Nuclear Information System (INIS)

    Lee, Min Woo; Lee, Jeong Min; Lee, Jae Young; Kim, Se Hyung; Park, Eun-Ah; Han, Joon Koo; Choi, Jin-Young; Choi, Byung Ihn; Kim, Young Jun; Suh, Kyung-Suk

    2007-01-01

    The purpose of this study was to determine whether MR angiography utilizing the time resolved echo-shared angiographic technique (TREAT) can provide an effective assessment of the hepatic artery (HA) and portal vein (PV) in living donor candidates. MR angiography (MRA)was performed in 27 patients (23 men and 4 women; mean age, 31 years) by using TREAT. Two blinded radiologists evaluated HA anatomy, origin of segment IV feeding artery and PV anatomy in consensus. Qualitative evaluations of MRA images were performed using the following criteria: (a) overall image quality, (b) presence of artifacts, and (c) degree of venous contamination of the arterial phase. Using intraoperative findings as a standard of reference, the accuracy for the HA anatomy, origin of segment IV feeding artery and PV anatomy on TREAT-MRA were 93% (25/27), 85% (23/27), and 96% (26/27), respectively. Overall image qualities were as follows: excellent (n=22, 81%), good (n=4, 15%), and fair (n=1, 4%). Significant artifacts or venous contamination of the arterial phase images was not noted in any patient. TREAT-MRA can provide a complete evaluation of HA and PV anatomy during preoperative evaluation of living liver donors. Furthermore, it provides a more detailed anatomy of the HA without venous contamination. (orig.)

  15. Hanford Site Solid Waste Acceptance Criteria

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-17

    This manual defines the Hanford Site radioactive, hazardous, and sanitary solid waste acceptance criteria. Criteria in the manual represent a guide for meeting state and federal regulations; DOE Orders; Hanford Site requirements; and other rules, regulations, guidelines, and standards as they apply to acceptance of radioactive and hazardous solid waste at the Hanford Site. It is not the intent of this manual to be all inclusive of the regulations; rather, it is intended that the manual provide the waste generator with only the requirements that waste must meet in order to be accepted at Hanford Site TSD facilities.

  16. Hanford Site Solid Waste Acceptance Criteria

    International Nuclear Information System (INIS)

    1993-01-01

    This manual defines the Hanford Site radioactive, hazardous, and sanitary solid waste acceptance criteria. Criteria in the manual represent a guide for meeting state and federal regulations; DOE Orders; Hanford Site requirements; and other rules, regulations, guidelines, and standards as they apply to acceptance of radioactive and hazardous solid waste at the Hanford Site. It is not the intent of this manual to be all inclusive of the regulations; rather, it is intended that the manual provide the waste generator with only the requirements that waste must meet in order to be accepted at Hanford Site TSD facilities

  17. Adult-to-adult living donor liver transplantation

    OpenAIRE

    Shah, Shimul A; Levy, Gary A; Adcock, Lesley D; Gallagher, Gary; Grant, David R

    2006-01-01

    The present review outlines the principles of living donor liver transplantation, donor workup, procedure and outcomes. Living donation offers a solution to the growing gap between the need for liver transplants and the limited availability of deceased donor organs. With a multidisciplinary team focused on donor safety and experienced surgeons capable of performing complex resection/reconstruction procedures, donor morbidity is low and recipient outcomes are comparable with results of decease...

  18. Relationship between Serum Iron Profile and Blood Groups among the Voluntary Blood Donors of Bangladesh.

    Science.gov (United States)

    Hoque, M M; Adnan, S D; Karim, S; Al-Mamun, M A; Faruki, M A; Islam, K; Nandy, S

    2016-04-01

    Blood donation results in a substantial iron loss and subsequent mobilization from body stores. Chronic iron deficiency is a well-recognized complication of regular blood donation. The present study conducted to compare the level of serum ferritin, serum iron, total iron binding capacity (TIBC) and percentage transferrin saturation in different ABO and Rhesus type blood groups among the voluntary blood donors of Bangladesh. The present prospective study included 100 healthy voluntary donors attending at Department of Blood Transfusion, Dhaka Medical College, Dhaka between the periods of July 2013 to Jun 2014. From each donor 10mL venous blood sample was taken and divided into heparinized and non-heparinized tubes for determination of hemoglobin (Hb), hematocrit (Hct), serum iron (SI), total iron binding capacity (TIBC) and serum ferritin by standard laboratory methods. Percentage of transferrin saturation (TS) calculated from serum iron and TIBC. Data were analyzed with SPSS (version 16) software and comparisons between groups were made using student's t-test and one way ANOVA. In the present study mean±SD of age of the respondents was 27.2±6.5 years with a range of 18 to 49 years and 81.0% were male and 19.0% were female. Among the donors 18.0% had blood group A, 35.0% had blood group B, 14.0% had blood group AB and 33.0% had blood group O. Among the donors 91.0% had rhesus positive and 9.0% had rhesus negative. Donors with blood group O had lowest haemoglobin, serum iron and transferring saturation levels. Donors with blood group A had highest TIBC level. Donors with blood group B had lowest serum ferritin level. An independent samples 't' test showed statistically significant difference in serum ferritin and percentage transferrin saturation between blood group AB and blood group O and in percentage transferrin saturation between blood group B and blood group O. One way ANOVA showed that there is no significant difference in haemoglobin, serum iron, serum

  19. Towards a standardised informed consent procedure for live donor nephrectomy: the PRINCE (Process of Informed Consent Evaluation) project-study protocol for a nationwide prospective cohort study

    NARCIS (Netherlands)

    Kortram, Kirsten; Spoon, Emerentia Q. W.; Ismail, Sohal Y.; d'Ancona, Frank C. H.; Christiaans, Maarten H. L.; van Heurn, L. W. Ernest; Hofker, H. Sijbrand; Hoksbergen, Arjan W. J.; Homan van der Heide, Jaap J.; Idu, Mirza M.; Looman, Caspar W. N.; Nurmohamed, S. Azam; Ringers, Jan; Toorop, Raechel J.; van de Wetering, Jacqueline; Ijzermans, Jan N. M.; Dor, Frank J. M. F.

    2016-01-01

    Introduction: Informed consent is mandatory for all (surgical) procedures, but it is even more important when it comes to living kidney donors undergoing surgery for the benefit of others. Donor education, leading to informed consent, needs to be carried out according to certain standards. Informed

  20. Gamete donors' reasons for, and expectations and experiences of, registration with a voluntary donor linking register.

    Science.gov (United States)

    Blyth, Eric; Crawshaw, Marilyn; Frith, Lucy; van den Akker, Olga

    2017-12-01

    This paper reports on a study of the views and experiences of 21 sperm donors and five egg donors registered with UK DonorLink (UKDL), a voluntary DNA-based contact register established to facilitate contact between adults who wish to identify and locate others to whom they are genetically related following donor conception. Specifically, the paper examines donors' reasons for searching for, or making information about themselves available to donor-conceived offspring. Their expectations of registration with UKDL, experiences of being registered and finally, the experiences of those who had contacted donor-conceived offspring and other genetic relatives are investigated. While most respondents reported largely positive experiences of registration, the study found significant issues relating to concerns about donation, DNA testing, possible linking with offspring and expectations of any relationship that might be established with offspring that have implications for support, mediation and counselling. Research that puts the experiences, perceptions and interests of gamete donors as the central focus of study is a relatively recent phenomenon. This study contributes to this debate and highlights directions for future research in this area.

  1. Storage characteristics of multiple-donor pooled red blood cells compared to single-donor red blood cell units.

    Science.gov (United States)

    Mathur, Aabhas; Chowdhury, Raquibul; Hillyer, Christopher D; Mitchell, W Beau; Shaz, Beth H

    2016-12-01

    Each unit of blood donated is processed and stored individually resulting in variability in the amount of red blood cells (RBCs) collected, RBC properties, and the 24-hour posttransfusion RBC survivability. As a result, each unit differs in its ability to deliver oxygen and potentially its effects on the recipient. The goal of this study was to investigate the storage of pooled RBCs from multiple donors in comparison to control standard RBC units. Two units of irradiated, leukoreduced RBCs of same ABO, D, E, C, and K antigen phenotype were collected from each of five donors using apheresis. One unit from each donor was pooled in a 2-L bag and remaining units were used as controls. After being pooled, RBCs were separated in five bags and stored at 4°C along with the controls. Quality indexes were measured on Days 2, 14, and 28 for all the units. Adenosine triphosphate assays for both pooled and controls showed a slight decrease from Day 2 to Day 28 (pooled/control from 5.22/5.24 to 4.35/4.33 µmol/g hemoglobin [Hb]). 2,3-Diphosphoglycerate was successfully rejuvenated for all RBC units on Day 28 (pooled 11.46 µmol/g Hb; control 11.86 µmol/g Hb). The results showed a nonsignificant difference between pooled and control units, with a general trend of lower standard deviation for pooled units when compared to controls. Pooled units have reduced unit-to-unit variability. Future exploration of their immunogenicity is required before using pooled units for transfusion. © 2016 AABB.

  2. Restless legs syndrome is associated with major comorbidities in a population of Danish blood donors

    DEFF Research Database (Denmark)

    Didriksen, M.; Allen, R. P.; Burchell, B. J.

    2018-01-01

    the Cambridge–Hopkins RLS questionnaire, the 12-item short-form standardized health survey (SF-12), the Major Depression Inventory (MDI), body mass index, smoking status, alcohol consumption, and education were available for 24,707 participants enrolled in the Danish Blood Donor Study from May 1, 2015...

  3. The development and current status of Intensive Care Unit management of prospective organ donors

    Directory of Open Access Journals (Sweden)

    Margaret Kathleen Menzel Ellis

    2016-01-01

    Conclusions: Management of deceased organ donors should focus first on maintaining adequate perfusion to all organ systems through adherence to standard critical care guidelines, early referral to OPOs, and family support. Furthermore, several specific DMGs and strategies have been recently shown to improve both the rates and outcomes of organ transplantation.

  4. Development of organ-specific donor risk indices.

    Science.gov (United States)

    Akkina, Sanjeev K; Asrani, Sumeet K; Peng, Yi; Stock, Peter; Kim, W Ray; Israni, Ajay K

    2012-04-01

    Because of the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival with various combinations of donor and recipient characteristics. Here we review the kidney donor risk index (KDRI) and the liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The KDRI has a potential role in developing new kidney allocation algorithms. The LDRI allows a greater appreciation of the importance of donor factors, particularly for hepatitis C virus-positive recipients; as the donor risk index increases, the rates of allograft and patient survival among these recipients decrease disproportionately. The use of livers with high donor risk indices is associated with increased hospital costs that are independent of recipient risk factors, and the transplantation of livers with high donor risk indices into patients with Model for End-Stage Liver Disease scores indices for liver transplantation, including donor-recipient matching and the retransplant donor risk index. Although substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival. Copyright © 2012 American Association for the Study of Liver Diseases.

  5. Are live kidney donors at risk

    International Nuclear Information System (INIS)

    Kamran, T.; Zaheer, K.; Hussain, S.W.; Zahid, K.H.; Akhtar, M.S.

    2003-01-01

    Objective: To share experience of live donor nephrectomy (including intraoperative variables, morbidity and ethical aspects) and to give an overview of surgical technique being practiced. Results: Majority of the donors (58.5%) were 31-50 years old and 70.6% were first-degree relatives. Left sided kidney was taken in 96.5% cases. Mean operative time was 145 minutes. Mean renal warm ischemia time from cross clamping of renal vessels to cold perfusion on the bench was 1.5 minutes per operation. Operative complications encountered were injury to lumbar veins in 5.1 % cases, slipping of satinsky clamp on vena cava stump in 1.7 % and accidental pleural damage in 5.1 % cases. Postoperative morbid complications found were urinary retention in 6.4 % cases, epididymo-orchitis in 1.7 %, prolonged lymph drain in 3.4 %, stitch infection in 1.7 % and prolonged wound discomfort in 5.1 % patients. Conclusions: Open live donor nepherectomy appears to be safe procedure for harvesting kidney. Related or emotionally related donors must be the choice in all cases. Non-related donors may be entertained in selected cases despite the probability of organ vending in our society. (author)

  6. Breast milk donation: women's donor experience.

    Science.gov (United States)

    Alencar, Lucienne Christine Estevez de; Seidl, Eliane Maria Fleury

    2009-02-01

    To describe the characteristics of donation behavior and identify reasons, beliefs and feelings relative to this practice, based on the reports of donor women. Personal and social-environmental aspects, which seem to affect donation behavior in donors and former donors, were also investigated. An exploratory, descriptive and cross-sectional study was carried out with women donors at two breast-milk banks within the public health system of the Brazilian Federal District. Data was collected from July to September 2005. The participants were 36 women, aged 14 to 33 years (average=24.78; SD=5.22), with different levels of schooling, 58.3% of which were first-time mothers. Data gathering was based on interviews carried out during home visits. In addition to descriptive statistical analyses of quantitative data, a qualitative data categorical analysis was also performed. The most frequently reported reasons for donating breast milk were altruism and excess milk production. The most frequent time interval for donation was 13 days after delivery. Contact by phone with the milk bank was the most common means of communication used by the majority of participants (n=22) to obtain information that enabled the donating process. Psychosocial aspects identified and the experience of donors can contribute to the empowerment of the formal and informal social donation-support network, in addition to serving as a driver for the implementation of technical and policy strategies in promoting future donation practices.

  7. Ex-vivo partial nephrectomy after living donor nephrectomy: Surgical technique for expanding kidney donor pool

    Directory of Open Access Journals (Sweden)

    Yaw A Nyame

    2017-01-01

    Full Text Available Renal transplantation has profound improvements in mortality, morbidity, and overall quality of life compared to renal replacement therapy. This report aims to illustrate the use of ex-vivo partial nephrectomy in a patient with a renal angiomyolipoma prior to living donor transplantation. The surgical outcomes of the donor nephrectomy and recipient transplantation are reported with 2 years of follow-up. Both the donor and recipient are healthy and without any significant comorbidities. In conclusion, urologic techniques such as partial nephrectomy can be used to expand the living donor pool in carefully selected and well informed transplant recipients. Our experience demonstrated a safe and positive outcome for both the recipient and donor, and is consistent with other reported outcomes in the literature.

  8. Foreign criteria and programs

    International Nuclear Information System (INIS)

    Swinth, K.L.; Thompson, I.M.G.

    1993-03-01

    The concept of measurement quality assurance (MQA) as embodied in National Institute of Standards and Technology (NIST) programs is not generally used within European programs for testing or accreditation. Although the essential elements of quality control and quality assurance are in the European programs, the concept of testing the capability of the laboratory itself, in terms of its performance for the designated measurements, may not be included. Rather, the European programs use the concept of periodic calibration of laboratory reference standards against the next highest level of standards. Thus, they embody the concept of measurement traceability to appropriate primary standards. Within Europe a series of calibration accreditation programs has been established in the various countries tied together through a multilateral agreement. The radiation measurement programs are based on the International Organization for Standardization (ISO) 9000 series of standards. The purpose of this paper is to outline the overall operation of European Accreditation Programs in the radiation calibration and measurement areas. The operation of the radiation measurement programs of the National Measurement Accreditation Service (NAMAS) in the United Kingdom is described in detail along with other European programs. The manner in which these programs relate to individual dosimetry service programs is also described

  9. Diversification criteria for power systems

    International Nuclear Information System (INIS)

    Kharbach, Mohammed

    2016-01-01

    Growing power demand, fuel availability and prices, technology changes, the environmental impacts of energy consumption, the changing regulatory environments and the uncertainties around such elements make the planning for optimal power mix a challenging task. The diversity approach is advocated as a most appropriate planning methodology for the optimal energy mix (Hickey et al., 2010). Shannon Wiener Index (SWI), which is the most cited diversity metric has been used to assess power systems diversity mainly from an energy perspective. To our best knowledge, there is no rigorous justification why energy has been the main variable used in diversification exercises rather than other variables such as capacity. We use a stylized power generation framework to show that diversity based on energy or capacity could lead to different outcomes in terms of vulnerability to fuel exposure, among others. We also introduce a Shannon Wiener Index ratio (SWIR) that we believe captures better the diversity of a power system compared to the standard SWI. - Highlights: • Ranking power systems, from a diversity perspective, based on one criteria has many shortcomings. • Diversity based on energy or capacity could lead to different outcomes in terms of vulnerability to fuel exposure, among others. • A Shannon Wiener Index ratio (SWIR) captures better the diversity of a power system compared to the standard SWI.

  10. Seismic design criteria for special isotope separation plant structures

    International Nuclear Information System (INIS)

    Wrona, M.W.; Wuthrich, S.J.; Rose, D.L.; Starkey, J.

    1989-01-01

    This paper describes the seismic criteria for the design of the Special Isotope Separation (SIS) production plant. These criteria are derived from the applicable Department of Energy (DOE) orders, references and proposed standards. The SIS processing plant consistent of Load Center Building (LCB), Dye Pump Building (DPB), Laser Support Building (LSB) and Plutonium Processing Building (PPB). The facility-use category for each of the SIS building structures is identified and the applicable seismic design criteria and parameters are selected

  11. Energy status of pig donor organs after ischemia is independent of donor type.

    Science.gov (United States)

    Stadlbauer, Vanessa; Stiegler, Philipp; Taeubl, Philipp; Sereinigg, Michael; Puntschart, Andreas; Bradatsch, Andrea; Curcic, Pero; Seifert-Held, Thomas; Zmugg, Gerda; Stojakovic, Tatjana; Leopold, Barbara; Blattl, Daniela; Horki, Vera; Mayrhauser, Ursula; Wiederstein-Grasser, Iris; Leber, Bettina; Jürgens, Günther; Tscheliessnigg, Karlheinz; Hallström, Seth

    2013-04-01

    Literature is controversial whether organs from living donors have a better graft function than brain dead (BD) and non-heart-beating donor organs. Success of transplantation has been correlated with high-energy phosphate (HEP) contents of the graft. HEP contents in heart, liver, kidney, and pancreas from living, BD, and donation after cardiac death in a pig model (n=6 per donor type) were evaluated systematically. BD was induced under general anesthesia by inflating a balloon in the epidural space. Ten hours after confirmation, organs were retrieved. Cardiac arrest was induced by 9V direct current. After 10min of ventricular fibrillation without cardiac output, mechanical and medical reanimation was performed for 30min before organ retrieval. In living donors, organs were explanted immediately. Freeze-clamped biopsies were taken before perfusion with Celsior solution (heart) or University of Wisconsin solution (abdominal organs) in BD and living donors or with Histidine-Tryptophan-Ketoglutaric solution (all organs) in non-heart-beating donors, after perfusion, and after cold ischemia (4h for heart, 6h for liver and pancreas, and 12h for kidney). HEPs (adenosine triphosphate, adenosine diphosphate, adenosine monophosphate, and phosphocreatine), xanthine, and hypoxanthine were measured by high-performance liquid chromatography. Energy charge and adenosine triphosphate-to-adenosine diphosphate ratio were calculated. After ischemia, organs from different donor types showed no difference in energy status. In all organs, a decrease of HEP and an increase in hypoxanthine contents were observed during perfusion and ischemia, irrespective of the donor type. Organs from BD or non-heart-beating donors do not differ from living donor organs in their energy status after average tolerable ischemia. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. The effect of whole-blood donor adverse events on blood donor return rates.

    Science.gov (United States)

    Newman, Bruce H; Newman, Daniel T; Ahmad, Raffat; Roth, Arthur J

    2006-08-01

    Some blood donation-related adverse events (AEs) can negatively impact the blood donor return rate (BDRR) and decrease donor retention. One-thousand randomly selected whole-blood donors were interviewed 3 weeks after a 525-mL index whole-blood donation for seven AEs. The number of return visits and duration of follow-up were recorded for each of the 1000 donors. A negative binomial regression analysis was used to determine the contribution of the four most common AEs to the BDRR, and interactions between these AEs were also evaluated. The four most common AEs were bruise alone (15.1%), sore arm "alone" (7.0%), fatigue "alone" (5.1%), and donor reaction "alone" (4.2%), where "alone" is defined to also include donors who had a bruise but no other AE. The estimated BDRR for donations without AEs was 1.32 visits per year. The estimated BDRRs for the four most common AEs were: bruise alone, 1.32 visits per year; sore arm alone, 1.30 visits per year (2% reduction in BDRR); fatigue alone, 1.06 visits per year (20% reduction in BDRR); and donor reaction alone, 0.87 visits per year (34% reduction in BDRR). The BDRR for donor reaction, fatigue, and sore arm together was 0.20 visits per year (85% reduction in BDRR). Donor reaction had the most negative impact on the BDRR. There appears to be a synergistic effect between donor reaction, fatigue, and sore arm. Theoretically, amelioration of some AEs has the potential to improve BDRRs.

  13. The Psychosocial and Independent Living Donor Advocate Evaluation and Post-surgery Care of Living Donors.

    Science.gov (United States)

    Rudow, Dianne LaPointe; Swartz, Kathleen; Phillips, Chelsea; Hollenberger, Jennifer; Smith, Taylor; Steel, Jennifer L

    2015-09-01

    Solid organ transplantation as a treatment for end stage organ failure has been an accepted treatment option for decades. Despite advances in medicine and technology, and increased awareness of organ donation and transplantation, the gap between supply and demand continues to widen. Living donation has been an option that has increased the number of transplants despite the continued shortage of deceased organs. In the early 2000s live donor transplantation reached an all-time high in the United States. As a result, a consensus meeting was convened in 2000 to increase the oversight of living donor transplantation. Both the Centers for Medicare and Medicaid Services and the United Network for Organ Sharing developed regulations that transplant programs performing live donor transplantation. These regulations and guidelines involve the education, evaluation, informed consent process and living donor follow-up care. Two areas in which had significant changes included the psychosocial and the independent living donor advocate (ILDA) evaluation. The purpose of this paper was to outline the current regulations and guidelines associated with the psychosocial and ILDA evaluation as well as provide further recommendations for the administration of a high quality evaluation of living donors. The goals and timing of the evaluation and education of donors; qualifications of the health care providers performing the evaluation; components of the evaluation; education provided to donors; documentation of the evaluation; participation in the selection committee meeting; post-decline and post-donation care of donors is described. Caveats including the paired donor exchange programs and non-directed and directed donation are also considered.

  14. Techniques used for the screening of hemoglobin levels in blood donors: current insights and future directions

    Directory of Open Access Journals (Sweden)

    Chaudhary R

    2017-07-01

    Full Text Available Rajendra Chaudhary,1 Anju Dubey,2 Atul Sonker3 1Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, 2Department of Transfusion Medicine, T.S. Misra Medical College and Hospital, 3Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India Abstract: Blood donor hemoglobin (Hb estimation is an important donation test that is performed prior to blood donation. It serves the dual purpose of protecting the donors’ health against anemia and ensuring good quality of blood components, which has an implication on recipients’ health. Diverse cutoff criteria have been defined world over depending on population characteristics; however, no testing methodology and sample requirement have been specified for Hb screening. Besides the technique, there are several physiological and methodological factors that affect accuracy and reliability of Hb estimation. These include the anatomical source of blood sample, posture of the donor, timing of sample and several other biological factors. Qualitative copper sulfate gravimetric method has been the archaic time-tested method that is still used in resource-constrained settings. Portable hemoglobinometers are modern quantitative devices that have been further modified to reagent-free cuvettes. Furthermore, noninvasive spectrophotometry was introduced, mitigating pain to blood donor and eliminating risk of infection. Notwithstanding a tremendous evolution in terms of ease of operation, accuracy, mobility, rapidity and cost, a component of inherent variability persists, which may partly be attributed to pre-analytical variables. Hence, blood centers should pay due attention to validation of test methodology, competency of operating staff and regular proficiency testing of the outputs. In this article, we have reviewed various regulatory guidelines, described the variables that affect the measurements and compared the validated

  15. Safety and reliability criteria

    International Nuclear Information System (INIS)

    O'Neil, R.

    1978-01-01

    Nuclear power plants and, in particular, reactor pressure boundary components have unique reliability requirements, in that usually no significant redundancy is possible, and a single failure can give rise to possible widespread core damage and fission product release. Reliability may be required for availability or safety reasons, but in the case of the pressure boundary and certain other systems safety may dominate. Possible Safety and Reliability (S and R) criteria are proposed which would produce acceptable reactor design. Without some S and R requirement the designer has no way of knowing how far he must go in analysing his system or component, or whether his proposed solution is likely to gain acceptance. The paper shows how reliability targets for given components and systems can be individually considered against the derived S and R criteria at the design and construction stage. Since in the case of nuclear pressure boundary components there is often very little direct experience on which to base reliability studies, relevant non-nuclear experience is examined. (author)

  16. Combining the IADPSG criteria with the WHO diagnostic criteria for ...

    African Journals Online (AJOL)

    Macrosomia or at least one adverse outcome were more likely in GDM patients who met the diagnostic criteria by both the IADPSG and WHO criteria (P = 0.001). Conclusion: A diagnosis of GDM that meets both the WHO and IADPSG criteria provides stronger prediction for adverse pregnancy outcome than a diagnosis that ...

  17. 32 CFR 101.6 - Criteria for satisfactory performance.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Criteria for satisfactory performance. 101.6..., MILITARY AND CIVILIAN PARTICIPATION IN RESERVE TRAINING PROGRAMS § 101.6 Criteria for satisfactory...) Shall require members to: (1) Meet the standards of satisfactory performance of training duty set forth...

  18. 45 CFR 1308.15 - Eligibility criteria: Autism.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Eligibility criteria: Autism. 1308.15 Section 1308... Services Performance Standards § 1308.15 Eligibility criteria: Autism. A child is classified as having autism when the child has a developmental disability that significantly affects verbal and non-verbal...

  19. Ambient water quality criteria for mercury: Technical appendix

    Energy Technology Data Exchange (ETDEWEB)

    Nagpal, N.K.

    1989-01-01

    This document discusses the effects of mercury on various water uses, including drinking water, aquatic life, wildlife, livestock water supply, irrigation, recreation and aesthetics, and industrial water supplies. Standards, objectives, and criteria from national and international jurisdictions are reviewed, providing a basis, along with other information available from the literature, for criteria recommended to protect water uses in British Columbia from anthropogenic mercury.

  20. 45 CFR 1308.16 - Eligibility criteria: Traumatic brain injury.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Eligibility criteria: Traumatic brain injury. 1308... DISABILITIES Health Services Performance Standards § 1308.16 Eligibility criteria: Traumatic brain injury. A child is classified as having traumatic brain injury whose brain injuries are caused by an external...

  1. 40 CFR 146.4 - Criteria for exempted aquifers.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) UNDERGROUND INJECTION CONTROL PROGRAM: CRITERIA AND STANDARDS General Provisions § 146.4 Criteria... of a permit application for a Class II or III operation to contain minerals or hydrocarbons that... public water system. (Clean Water Act, Safe Drinking Water Act, Clean Air Act, Resource Conservation and...

  2. Developing criteria to establish Trusted Digital Repositories

    Science.gov (United States)

    Faundeen, John L.

    2017-01-01

    This paper details the drivers, methods, and outcomes of the U.S. Geological Survey’s quest to establish criteria by which to judge its own digital preservation resources as Trusted Digital Repositories. Drivers included recent U.S. legislation focused on data and asset management conducted by federal agencies spending $100M USD or more annually on research activities. The methods entailed seeking existing evaluation criteria from national and international organizations such as International Standards Organization (ISO), U.S. Library of Congress, and Data Seal of Approval upon which to model USGS repository evaluations. Certification, complexity, cost, and usability of existing evaluation models were key considerations. The selected evaluation method was derived to allow the repository evaluation process to be transparent, understandable, and defensible; factors that are critical for judging competing, internal units. Implementing the chosen evaluation criteria involved establishing a cross-agency, multi-disciplinary team that interfaced across the organization. 

  3. Syntheses of donor-acceptor-functionalized dihydroazulenes

    DEFF Research Database (Denmark)

    Broman, Søren Lindbæk; Jevric, Martyn; Bond, Andrew

    2014-01-01

    The dihydroazulene (DHA)/vinylheptafulvene (VHF) photo/thermoswitch has been of interest for use in molecular electronics and advanced materials. The switching between the two isomers has previously been found to depend strongly on the presence of donor and acceptor groups. The fine-tuning of opt......The dihydroazulene (DHA)/vinylheptafulvene (VHF) photo/thermoswitch has been of interest for use in molecular electronics and advanced materials. The switching between the two isomers has previously been found to depend strongly on the presence of donor and acceptor groups. The fine...

  4. Radioimmunological determination of neopterin in blood donors

    International Nuclear Information System (INIS)

    Haas, R.; Gerstner, L.

    1985-01-01

    In 518 sera from blood donors below 30 years of age neopterin was determined by radioimmunoassay. 21 of these patients (4.05%) showed elevated serum levels for neopterin. By clinical investigation of these cases viral infections of the upper airways were found. Furthermore after elimination of elevated values significant differences in normal neopterin serum levels could be demonstrated for female and male blood donors (p < 0.01). Because elevated neopterin serum levels indicate immune responses to several antigens, determination of neopterin from serum may be useful for detection of infectious blood samples. (author)

  5. Criteria Based Audit of the Management of Severe Preeclampsia ...

    African Journals Online (AJOL)

    ... of the Management of Severe Preeclampsia/ Eclampsia in a Nigerian Teaching ... Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria. ... pre-determined standard of care based on 18 criteria, the performance score ...

  6. Contrast-enhanced magnetic resonance angiography: evaluation of renal arteries in living renal transplant donors

    International Nuclear Information System (INIS)

    Firat, Ali; Akin, Oguz; Muhtesem Agildere, Ahmet; Aytekin, Cuneyt; Haberal, Mehmet

    2004-01-01

    One of the most important steps before living-donor nephrectomy is assessment of renal vascular anatomy. The number, origins and lengths of the renal arteries and variations of renal veins must be determined in order to identify the kidney that is most suitable for transplantation. Digital subtraction angiography was long considered the standard procedure for this purpose, but this method has been replaced by non-invasive techniques. Contrast-enhanced magnetic resonance angiography is an accurate, safe and reliable method for imaging vasculature. This article reviews the technique and the clinical features of this method in the evaluation of living renal transplant donors

  7. Best Practices to Limit Contamination of Donor Milk in a Milk Bank.

    Science.gov (United States)

    Froh, Elizabeth B; Vanderpool, Jill; Spatz, Diane L

    2018-01-02

    Human milk donated to a milk bank can become contaminated in a number of ways, but processes exist to eradicate pathogenic bacterial growth. Donor human milk may be cultured before or after pasteurization or both. The purpose of this article is to describe standard operations of the Mothers' Milk Bank of the Children's Hospital of Philadelphia, best practices to limit the bacterial contamination of donor human milk, and implications for future research. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  8. Contrast-enhanced magnetic resonance angiography: evaluation of renal arteries in living renal transplant donors

    Energy Technology Data Exchange (ETDEWEB)

    Firat, Ali; Akin, Oguz; Muhtesem Agildere, Ahmet; Aytekin, Cuneyt; Haberal, Mehmet

    2004-10-01

    One of the most important steps before living-donor nephrectomy is assessment of renal vascular anatomy. The number, origins and lengths of the renal arteries and variations of renal veins must be determined in order to identify the kidney that is most suitable for transplantation. Digital subtraction angiography was long considered the standard procedure for this purpose, but this method has been replaced by non-invasive techniques. Contrast-enhanced magnetic resonance angiography is an accurate, safe and reliable method for imaging vasculature. This article reviews the technique and the clinical features of this method in the evaluation of living renal transplant donors.

  9. Initial experience with purely laparoscopic living-donor right hepatectomy.

    Science.gov (United States)

    Hong, S K; Lee, K W; Choi, Y; Kim, H S; Ahn, S W; Yoon, K C; Kim, H; Yi, N J; Suh, K S

    2018-05-01

    There may be concerns about purely laparoscopic donor right hepatectomy (PLDRH) compared with open donor right hepatectomy, especially when performed by surgeons accustomed to open surgery. This study aimed to describe technical tips and pitfalls in PLDRH. Data from donors who underwent PLDRH at Seoul National University Hospital between December 2015 and July 2017 were analysed retrospectively. Endpoints analysed included intraoperative events and postoperative complications. All operations were performed by a single surgeon with considerable experience in open living donor hepatectomy. A total of 26 donors underwent purely laparoscopic right hepatectomy in the study interval. No donor required transfusion during surgery, whereas two underwent reoperation. In two donors, the dissection plane at the right upper deep portion of the midplane was not correct. One donor experienced portal vein injury during caudate lobe transection, and one developed remnant left hepatic duct stenosis. One donor experienced remnant portal vein angulation owing to a different approach angle, and one experienced arterial damage associated with the use of a laparoscopic energy device. One donor had postoperative bleeding due to masking of potential bleeding foci owing to intra-abdominal pressure during laparoscopy. Two donors experienced right liver surface damage caused by a xiphoid trocar. Purely laparoscopic donor hepatectomy differs from open donor hepatectomy in terms of angle and caudal view. Therefore, surgeons experienced in open donor hepatectomy must gain adequate experience in laparoscopic liver surgery and make adjustments when performing PLDRH. © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

  10. Profitability of our lung retrieval program from non heart beating donors.

    Science.gov (United States)

    Fernández, Elena; Calatayud, Joaquín; Jarabo, José Ramón; Hernando, Florentino; Rodríguez, Olga; Gómez, Ana María; Soria, Ana; Del Río, Francisco

    2009-02-01

    In 2002 the first lung transplant from non heart beating (NHB) donors took place in Madrid. The objective of this study was to analyse our Maastricht type I NHB lung donors retrieval program and to check out its profitability. Based on the NHB lung donors retrieval program carried out at Hospital Clínico San Carlos (Madrid) in association with Hospital Puerta de Hierro (Madrid), all lung donors from the beginning of the program from June 2002 to December 2006 have been analysed. When faced with a case of sudden death, advanced life support manoeuvres are initiated before 15 min. If the patient meets a given set of criteria, code 0/9 is activated. Arrival time to the hospital cannot exceed 90 min. Femoral artery and vein are cannulated, extracorporeal circulation is started and lungs are preserved. After the relatives' and judicial authorisation lungs are retrieved. Out of a total of 322 occurrences of code 0/9, 43 lung retrievals and 25 implants were reported. A total of 95% of donors were male, with an average age of 41 years and 91% with blood group A or O. 2004 saw the highest number of retrievals (14). January, May and December showed the highest number of retrievals. Incidence of sudden deaths was higher from 7 to 10 a.m. and from 7 to 10 p.m. Twenty-three implants at Hospital Puerta de Hierro and three more at Hospital Marqués de Valdecilla (Santander) were reported. A considerable amount of preserved lungs, valid for transplant, were not retrieved because of a lack of an appropriate recipient at the time. A total of 58.1% of preserved lungs were implanted. The ratio of obtained lungs was 11.4% of actual donors and 7.7% of total occurrences. However, this percentage could have been higher if we take into account the number of valid lungs that were not transplanted because of the lack of recipients.

  11. National Recommended Water Quality Criteria

    Data.gov (United States)

    U.S. Environmental Protection Agency — The National Recommended Water Quality Criteria is a compilation of national recommended water quality criteria for the protection of aquatic life and human health...

  12. Peer-to-peer milk donors' and recipients' experiences and perceptions of donor milk banks.

    Science.gov (United States)

    Gribble, Karleen D

    2013-07-01

    To explore the intersection of peer-to-peer milk sharing and donor milk banks. A descriptive survey design containing closed and open-ended questions was used to examine women's perceptions of peer-to-peer milk sharing and milk banking. Closed-ended questions were analyzed using descriptive statistics and conventional qualitative content analysis was used to analyze open-ended responses. Participants were recruited via the Facebook sites of two online milk-sharing networks (Human Milk 4 Human Babies and Eats on Feet). Ninety-eight milk donors and 41 milk recipients who had donated or received breast milk in an arrangement that was facilitated via the Internet. One half of donor recipients could not donate to a milk bank because there were no banks local to them or they did not qualify as donors. Other respondents did not donate to a milk bank because they viewed the process as difficult, had philosophical objections to milk banking, or had a philosophical attraction to peer sharing. Most donor respondents felt it was important to know the circumstances of their milk recipients. No recipient respondents had obtained milk from a milk bank; it was recognized that they would not qualify for banked milk or that banked milk was cost prohibitive. Peer-to-peer milk donors and recipients may differ from milk bank donors and recipients in significant ways. Cooperation between milk banks and peer sharing networks could benefit both groups. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  13. CORAL REEF BIOLOGICAL CRITERIA: USING THE CLEAN ...

    Science.gov (United States)

    Coral reefs are declining at unprecedented rates worldwide due to multiple interactive stressors including climate change and land-based sources of pollution. The Clean Water Act (CWA) can be a powerful legal instrument for protecting water resources, including the biological inhabitants of coral reefs. The objective of the CWA is to restore and maintain the chemical, physical and biological integrity of water resources. Coral reef protection and restoration under the Clean Water Act begins with water quality standards - provisions of state or Federal law that consist of a designated use(s) for the waters of the United States and water quality criteria sufficient to protect the uses. Aquatic life use is the designated use that is measured by biological criteria (biocriteria). Biocriteria are expectations set by a jurisdiction for the quality and quantity of living aquatic resources in a defined waterbody. Biocriteria are an important addition to existing management tools for coral reef ecosystems. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework to aid States and Territories in their development, adoption, and implementation of coral reef biocriteria in their respective water quality standards. The Technical Support Document “Coral Reef Biological Criteria: Using the Clean Water Act to Protect a National Treasure” will provide a framework for coral re

  14. Comparison of donor, and early and late recipient outcomes following hand assisted and laparoscopic donor nephrectomy.

    Science.gov (United States)

    Lucas, Steven M; Liaw, Aron; Mhapsekar, Rishi; Yelfimov, Daniel; Goggins, William C; Powelson, John A; Png, Keng Siang; Sundaram, Chandru P

    2013-02-01

    While laparoscopic donor nephrectomy has encouraged living kidney donation, debate exists about the safest laparoscopic technique. We compared purely laparoscopic and hand assisted laparoscopic donor nephrectomies in terms of donor outcome, early graft function and long-term graft outcome. We reviewed the records of consecutive laparoscopic and hand assisted laparoscopic donor nephrectomies performed by a single surgeon from 2002 to 2011. Donor operative time and perioperative morbidity were compared. Early graft function for kidneys procured by each technique was evaluated by rates of delayed graft function, need for dialysis and recipient discharge creatinine. Long-term outcomes were evaluated by graft function. A total of 152 laparoscopic donor nephrectomies were compared with 116 hand assisted laparoscopic donor nephrectomies. Hand assisted procedures were more often done for the right kidney (41.1% vs 17.1%, p recipient outcomes were also similar. Delayed function occurred after 0% hand assisted vs 0.9% purely laparoscopic nephrectomies, dialysis was required in 0.9% vs 1.7% and rejection episodes developed in 9.7% vs 18.4% (p >0.05). At last followup the organ was nonfunctioning in 6.1% of hand assisted and 7.7% of purely laparoscopic cases (p >0.05). The recipient glomerular filtration rate at discharge home was similar in the 2 groups. Hand assisted laparoscopic donor nephrectomy had shorter warm ischemia time but perioperative donor morbidity and graft outcome were comparable. The choice of technique should be based on patient and surgeon preference. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. [Survey of blood donors on the topic of "reimbursement for blood donors"].

    Science.gov (United States)

    Zeiler, T; Kretschmer, V

    1995-02-01

    Remuneration for blood donors, in the way as presently handled by governmental and communal blood transfusion services in Germany, is not generally accepted. It is feared that donors are recruited with increased risk to transmit infectious diseases, especially AIDS. Alternative incentives are discussed. After the so-called AIDS scandal in Germany, a change in the donor motivation was to be expected, associated with an increased willingness to renounce remuneration. Therefore, we performed the present survey, in which we evaluated the donor's willingness to renounce remuneration, possibilities of cashless remuneration and other alternative incentives. During March and April 1994, a total of 1,157 blood donors of the University Blood Bank Marburg were questioned anonymously by a questionnaire in the framework of whole-blood donations. Beside the above-mentioned aspects demoscopic data were included (age, sex, profession, journey). Cutting of remuneration without any other compensation was refused by 86.1% of the donors, 77% would not want to further donate blood in this case. Transfer of money to a bank account instead of cash payment was accepted by 78.6%, the use of non-negotiable cheques by 68.7%. Alternative compensation by tickets for theater, concert, cinema or coupons for restaurants met with the approval of only 27.3%; under these circumstances, 36.9% would be willing to continue blood donation. With increasing age and number of donations, but largely independent of social status, donors attached greater importance to retention of remuneration. Cutting of remuneration would result in a considerable reduction of the willingness to donate blood within the population of donors of the governmental and communal blood transfusion services. However, an increase of virus safety of the blood products would not be reached in this way, since especially the long-term donors would be driven away. Considerable bottlenecks, particularly in the specific blood supply of

  16. Live-donor liver transplantation: the USC experience.

    Science.gov (United States)

    Jabbour, N; Genyk, Y; Mateo, R; Peyre, C; Patel, R V; Thomas, D; Ralls, P; Palmer, S; Kanel, G; Selby, R R

    2001-01-01

    Liver transplantation is currently the standard of care for patients with end stage liver disease. However due to the cadaveric organ shortage, live donor liver transplantation (LDLT), has been recently introduced as a potential solution. We analyzed and support our initial experience with this procedure at USC. From September 1998 until July 2000, a total of 27 patients underwent LDLT at USC University Hospital and Los Angeles Children's Hospital. There were 12 children with the median age of 10 months (4-114) and 15 adults with the median age of 56 years (35-65). The most common indication for transplantation was biliary atresia for children and hepatitis C for adults. All donors did well postoperatively; the median postoperative stay was five days (5-7) for left lateral segmentectomy and seven days (4-12) for lobar donation. None of the donors required blood transfusion, re-operation or postoperative invasive procedure. However, five of them (18%) experienced minor complications. The survival rate in pediatric patients was 100% and only one graft was lost at nine months due to rejection. Two adult recipients died in the postoperative period, one from graft non-function and one from necrotizing fascitis. 37% of adult recipients experienced postoperative complications, mainly related to biliary reconstruction. Also 26% of the recipients underwent reoperation for some of these complications. LDLT is an excellent alternative to cadaveric transplantation with excellent results in the pediatric population. However, in adult patients it still carries a significant complication rate and it should be used with caution.

  17. Electronic messaging and communication with living kidney donors.

    Science.gov (United States)

    Ruck, Jessica M; Zhou, Sheng; Thomas, Alvin G; Cramm, Shannon L; Massie, Allan B; Montgomery, John R; Berger, Jonathan C; Henderson, Macey L; Segev, Dorry L

    2018-02-01

    New regulations require living kidney donor (LKD) follow-up for 2 years, but donor retention remains poor. Electronic communication (eg, text messaging and e-mail) might improve donor retention. To explore the possible impact of electronic communication, we recruited LKDs to participate in an exploratory study of communication via telephone, e-mail, or text messaging postdonation; communication through this study was purely optional and did not replace standard follow-up. Of 69 LKDs recruited, 3% requested telephone call, 52% e-mail, and 45% text messaging. Telephone response rate was 0%; these LKDs were subsequently excluded from analysis. Overall response rates with e-mail or text messaging at 1 week, 1 month, 6 months, 1 year, and 2 years were 94%, 87%, 81%, 72%, and 72%. Lower response rates were seen in African Americans, even after adjusting for age, sex, and contact method (incidence rate ratio (IRR) nonresponse 2.07 5.81 16.36 , P = .001). Text messaging had higher response rates than e-mail (IRR nonresponse 0.11 0.28 0.71 , P = .007). Rates of nonresponse were similar by sex (IRR 0.68, P = .4) and age (IRR 1.00, P > .9). In summary, LKDs strongly preferred electronic messaging over telephone and were highly responsive 2 years postdonation, even in this nonrequired, nonincentivized exploratory research study. These electronic communication tools can be automated and may improve regulatory compliance and postdonation care. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Reimbursing live organ donors for incurred non-medical expenses: a global perspective on policies and programs.

    Science.gov (United States)

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

    2009-12-01

    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.

  19. Reimbursing Live Organ Donors for Incurred Non-Medical Expenses: A Global Perspective on Policies and Programs

    Science.gov (United States)

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

    2015-01-01

    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. PMID:19788503

  20. Diagnostic Criteria for Pediatric MS

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-06-01

    Full Text Available Investigators at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago review the diagnostic criteria for pediatric multiple sclerosis, the differential diagnosis, the 2010 McDonald criteria, and Callen criteria.

  1. Recruitment of aged donor heart with pharmacological stress echo. A case report

    Directory of Open Access Journals (Sweden)

    Bombardini Tonino

    2006-01-01

    Full Text Available Abstract Background The heart transplant is a treatment of the heart failure, which is not responding to medications, and its efficiency is already proved: unfortunately, organ donation is a limiting step of this life-saving procedure. To counteract heart donor shortage, we should screen aged potential donor hearts for initial cardiomyopathy and functionally significant coronary artery disease. Donors with a history of cardiac disease are generally excluded. Coronary angiography is recommended for most male donors older than 45 years and female donors older than 50 years to evaluate coronary artery stenoses. A simpler way to screen aged potential donor hearts for initial cardiomyopathy and functionally significant coronary artery disease should be stress echocardiography. Case report A marginal donor (A 57 year old woman meeting legal requirements for brain death underwent a transesophageal (TE Dipyridamole stress echo (6 minutes accelerated protocol to rule out moderate or severe heart and coronary artery disease. Wall motion was normal at baseline and at peak stress (WMSI = 1 at baseline and peak stress, without signs of stress inducible ischemia. The pressure/volume ratio was 9.6 mmHg/ml/m2 at baseline, increasing to 14 mmHg/ml/m2 at peak stress, demonstrating absence of latent myocardial dysfunction. The marginal donor heart was transplanted to a recipient "marginal" for co-morbidity ( a 63 year old man with multiple myeloma and cardiac amyloidosis , chronic severe heart failure, NYHA class IV. Postoperative treatment and early immunosuppressant regimen were performed according to standard protocols. The transplanted heart was assessed normal for dimensions and ventricular function at transthoracic (TT echocardiography on post-transplant day 7. Coronary artery disease was ruled out at coronary angiography one month after transplant; left ventriculography showed normal global and segmental LV function of the transplanted heart. Conclusion For

  2. Electrostatically defined silicon quantum dots with counted antimony donor implants

    Energy Technology Data Exchange (ETDEWEB)

    Singh, M., E-mail: msingh@sandia.gov; Luhman, D. R.; Lilly, M. P. [Sandia National Laboratories, Albuquerque, New Mexico 87185 (United States); Center for Integrated Nanotechnologies, Sandia National Laboratories, Albuquerque, New Mexico 87175 (United States); Pacheco, J. L.; Perry, D.; Garratt, E.; Ten Eyck, G.; Bishop, N. C.; Wendt, J. R.; Manginell, R. P.; Dominguez, J.; Pluym, T.; Bielejec, E.; Carroll, M. S. [Sandia National Laboratories, Albuquerque, New Mexico 87185 (United States)

    2016-02-08

    Deterministic control over the location and number of donors is crucial to donor spin quantum bits (qubits) in semiconductor based quantum computing. In this work, a focused ion beam is used to implant antimony donors in 100 nm × 150 nm windows straddling quantum dots. Ion detectors are integrated next to the quantum dots to sense the implants. The numbers of donors implanted can be counted to a precision of a single ion. In low-temperature transport measurements, regular Coulomb blockade is observed from the quantum dots. Charge offsets indicative of donor ionization are also observed in devices with counted donor implants.

  3. Marrow donor registry and cord blood bank in Taiwan.

    Science.gov (United States)

    Lee, Tsung Dao

    2002-08-01

    Unrelated Bone marrow transplant was initiated thirty years ago. Though there are over millions of donors registered with the bone marrow registries worldwide, Asian patients rarely find a match with all these donors. Tzu Chi Marrow Donor Registry was established to meet this need. It has become the largest Asian marrow donor registry in the world. With the introduction of high technology to test the HLA of the donors and recipients, the success rate of bone marrow transplant is greatly improved among Asian countries. 50% of blood disease Asian patients who cannot find a bone marrow matched donor will be complemented by the establishment of cord blood banks in Taiwan.

  4. Compliance with donor age recommendations in oocyte donor recruitment advertisements in the USA.

    Science.gov (United States)

    Alberta, Hillary B; Berry, Roberta M; Levine, Aaron D

    2013-04-01

    IVF using donated oocytes offers benefits to many infertile patients, yet the technique also raises a number of ethical concerns, including worries about potential physical and psychological risks to oocyte donors. In the USA, oversight of oocyte donation consists of a combination of federal and state regulations and self-regulatory guidelines promulgated by the American Society for Reproductive Medicine. This study assesses compliance with one of these self-regulatory guidelines - specifically, ASRM's preferred minimum age for donors of 21. To assess compliance, 539 oocyte donor recruitment advertisements from two recruitment channels (Craigslist and college newspapers) were collected and evaluated. Of these, 61% in the Craigslist dataset and 43% in the college newspaper dataset listed minimum ages between 18 and 20, which is inconsistent with ASRM's preferred minimum age recommendation of 21. Advertisements placed by oocyte donor recruitment agencies were more likely than advertisements placed by clinics to specify minimum ages between 18 and 20. These results indicate that ASRM should evaluate and consider revising its donor age guidelines. IVF using donated human eggs can help many patients who have difficulty having children. However, the technique also raises ethical concerns, including concerns about potential physical and psychological harms to egg donors. In the USA, oversight of egg donation relies on a combination of federal and state regulation and professional self-regulation. Governmental regulations address only limited aspects of egg donation, such as the potential spread of infectious diseases and the reporting of success rates, leaving voluntary guidelines developed by an association of medical professionals to address most issues, including ethical concerns raised by the practice. One of these voluntary guidelines recommends that egg donors should be at least 21 years of age. In this article, we analysed 539 egg donor recruitment advertisements

  5. Telemetry Standards, RCC Standard 106-17. Chapter 3. Frequency Division Multiplexing Telemetry Standards

    Science.gov (United States)

    2017-07-01

    Standard 106-17 Chapter 3, July 2017 3-5 Table 3-4. Constant-Bandwidth FM Subcarrier Channels Frequency Criteria\\Channels: A B C D E F G H Deviation ...Telemetry Standards , RCC Standard 106-17 Chapter 3, July 2017 3-i CHAPTER 3 Frequency Division Multiplexing Telemetry Standards Acronyms...Frequency Division Multiplexing Telemetry Standards ................................ 3-1 3.1 General

  6. Does donor arterial partial pressure of oxygen affect outcomes after lung transplantation? A review of more than 12,000 lung transplants.

    Science.gov (United States)

    Zafar, Farhan; Khan, Muhammad S; Heinle, Jeffrey S; Adachi, Iki; McKenzie, E Dean; Schecter, Marc G; Mallory, George B; Morales, David L S

    2012-04-01

    In lung transplantation (LTx), the arterial partial pressure of oxygen (PaO(2)) is traditionally regarded as critical information for assessment of donor lung function. Each center sets its own thresholds; by convention, a donor PaO(2) of less than 300 mm Hg has been considered disqualifying. Limited literature exists to support such a practice. We analyzed all LTxs performed in the United States over a 9-year period to assess the effect of donor PaO(2) on graft survival. The United Network for Organ Sharing (UNOS) database was queried for LTx (January 2000-November 2009). Of 12,545 LTx performed, 12,045 (96%) had donor PaO(2) data on a fraction of inspired oxygen of 1.0, recorded at the time of procurement. Mean donor PaO(2) was 407 ± 140 mm Hg. The majority of LTxs had a donor PaO(2) greater than 300 mm Hg (9593 (80%]) whereas PaO(2) was 200 mm Hg or less in 1830 (15%) and 201 to 300 in 582 (5%) donors. Use of donors with a PaO(2) of less than 200 increased over time from 5% (45) in 2000 to 21% (295) in 2009 (P = .002). Kaplan-Meier survival analysis showed no difference in graft survival with differing donor PaO(2)s, irrespective of whether patients had a single or double LTx. A Cox multivariable analysis of 21 donor characteristics demonstrated that donor PaO(2) had no association with graft survival. Donor PaO(2) levels did not affect graft survival. The use of donors with lower PaO(2)s could substantially increase the donor pool. We are not suggesting that donor PaO(2) is not important when assessing potential lung donors but its level of importance in regard to other criteria appears less than previously believed. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  7. Quality criteria for electronic publications in medicine.

    Science.gov (United States)

    Schulz, S; Auhuber, T; Schrader, U; Klar, R

    1998-01-01

    This paper defines "electronic publications in medicine (EPM)" as computer based training programs, databases, knowledge-based systems, multimedia applications and electronic books running on standard platforms and available by usual distribution channels. A detailed catalogue of quality criteria as a basis for development and evaluation of EPMs is presented. The necessity to raise the quality level of electronic publications is stressed considering aspects of domain knowledge, software engineering, media development, interface design and didactics.

  8. Properties of Excitons Bound to Ionized Donors

    DEFF Research Database (Denmark)

    Skettrup, Torben; Suffczynski, M.; Gorzkowski, W.

    1971-01-01

    Binding energies, interparticle distances, oscillator strengths, and exchange corrections are calculated for the three-particle complex corresponding to an exciton bound to an ionized donor. The results are given as functions of the mass ratio of the electron and hole. Binding of the complex is o...

  9. Non-organ donors' attitudes toward incentives.

    Science.gov (United States)

    Tumin, Makmor; Noh, Abdillah; Chong, Chin-Sieng; Lim, Soo-Kun; Abdullah, Nawi; Ng, Kok-Peng

    2013-01-01

    Malaysians indicating that they did not intend to become organ donors upon their death were surveyed regarding interest in non-fungible financial incentives to be granted to surviving family members. Among the 730 (56% of the total sample of 1311) indicating unwillingness to be donors, 29.6% (216/730) subsequently indicated that they would be willing donors if the government introduced policies that, upon their death, "rewarded your (their) family with incentives for your (their) deeds." Among the 69% (504/730) who insisted that they would not become organ donor even with incentive, nearly 80% (404/501) of them were able to identify relevant incentives they thought should be provided by the state to those who make organ donations upon death. The majority of both groups preferred the state provide medical benefits to a surviving family member, suggesting this may be an attractive policy option for the state to raise the deceased organ donation pool. © 2013 John Wiley & Sons A/S.

  10. [Outcome of living kidney donors for transplantation].

    Science.gov (United States)

    Lanot, Antoine; Bouvier, Nicolas; Chatelet, Valérie; Lecouf, Angélique; Tillou, Xavier; Hurault de Ligny, Bruno

    2017-11-01

    Nowadays, several treatments exist to treat terminal chronic renal failure. Best results for the recipients are obtained with kidney transplantation concerning mortality and quality of life. Transplantation is also the cheaper option for society. Living kidney donation raises the issue of the becoming of the donor, an absolutely healthy subject who gets to a surgical procedure. The becoming of living kidney donors has been compared with the one of controls subjects in several studies. The evaluations focused on the complications of nephrectomy in the short and long-term: kidney failure, hypertension, proteinuria, possibility of pregnancy, quality of life, and mortality. The first results did not show any risk linked to kidney donation, compared to general population. However, since 2013, kidney donors were found at higher risk for kidney failure and even for mortality, compared with controls selected like donor candidates. The risk of kidney donation is nevertheless acceptable and minimal, on the condition of rigorous selection of candidates and regular follow-up. Copyright © 2017 Société francophone de néphrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.

  11. BLOOD DONOR HAEMATOLOGY PARAMETERS IN TWO ...

    African Journals Online (AJOL)

    hi-tech

    2005-03-03

    Mar 3, 2005 ... determine distribution frequencies (including mean and median) and 95% percentile ranges (defined as the mean ± 2SD). These were determined individually for Kisumu and Nairobi, and comparisons between the two donor groups were made using the independent samples t-test. RESULTS. Red blood ...

  12. Electron Donor Acceptor Interactions. Final Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Ana L. [Arizona State Univ., Tempe, AZ (United States)

    2002-08-16

    The Gordon Research Conference (GRC) on Electron Donor Acceptor Interactions was held at Salve Regina University, Newport, Rhode Island, 8/11-16/02. Emphasis was placed on current unpublished research and discussion of the future target areas in this field.

  13. Seroprevalence of transfusion-transmissible infections (HBV, HCV, syphilis and HIV) among prospective blood donors in a tertiary health care facility in Calabar, Nigeria; an eleven years evaluation.

    Science.gov (United States)

    Okoroiwu, Henshaw Uchechi; Okafor, Ifeyinwa Maryann; Asemota, Enosakhare Aiyudubie; Okpokam, Dorathy Chioma

    2018-05-22

    Provision of constant and safe blood has been a public health challenge in Sub-Saharan Africa with high prevalence of transfusion-transmissible infections (TTIs). This study was aimed at determining the trend and seroprevalence of HBV, HCV, syphilis and HIV across the years within study among prospective blood donors at blood bank in University of Calabar Teaching Hospital (UCTH), Calabar, Nigeria. A retrospective analysis of blood donor data from January 2005 to December 2016 was conducted in Blood Bank/Donor Clinic of University of Calabar Teaching Hospital, Calabar, Nigeria. Sera samples were screened for hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (HCV), human immunodeficiency virus (HIV) 1 and 2 and Treponema pallidum using commercially available immunochromatic based kits. Out of the 24,979 screened prospective donors in the 2005-2016 study period, 3739 (14.96%) were infected with at least one infective agent. The overall prevalence of HBV, HCV, syphilis and HIV were 4.1, 3.6, 3.1 and 4.2%, respectively. During the period of study, the percentage of all transfusion-transmissible infections declined significantly with remarkable decline in HIV. The study showed male dominated donor pool (98.7%) with higher prevalence (4.2%) of transfusion-transmissible infections than in female donors (0.0%). Commercial donors constituted majority (62.0%) of the donors and as well had the highest prevalence of transfusion-transmissible infections. Majority (62.9%) of the donors were repeat donors. HBV, HCV, syphilis and HIV have remained a big threat to safe blood transfusion in Nigeria and Sub-Saharan Africa at large. Strict adherence to selection criteria and algorithm of donor screening are recommended.

  14. Predictors of Donor Heart Utilization for Transplantation in United States.

    Science.gov (United States)

    Trivedi, Jaimin R; Cheng, Allen; Gallo, Michele; Schumer, Erin M; Massey, H Todd; Slaughter, Mark S

    2017-06-01

    Optimum use of donor organs can increase the reach of the transplantation therapy to more patients on waiting list. The heart transplantation (HTx) has remained stagnant in United States over the past decade at approximately 2,500 HTx annually. With the use of the United Network of Organ Sharing (UNOS) deceased donor database (DCD) we aimed to evaluate donor factors predicting donor heart utilization. UNOS DCD was queried from 2005 to 2014 to identify total number of donors who had at least one of their organs donated. We then generated a multivariate logistic regression model using various demographic and clinical donor factors to predict donor heart use for HTx. Donor hearts not recovered due to consent or family issues or recovered for nontransplantation reasons were excluded from the analysis. During the study period there were 80,782 donors of which 23,606 (29%) were used for HTx, and 38,877 transplants (48%) were not used after obtaining consent because of poor organ function (37%), donor medical history (13%), and organ refused by all programs (5%). Of all, 22,791 donors with complete data were used for logistic regression (13,389 HTx, 9,402 no-HTx) which showed significant predictors of donor heart use for HTx. From this model we assigned probability of donor heart use and identified 3,070 donors with HTx-eligible unused hearts for reasons of poor organ function (28%), organ refused by all programs (15%), and recipient not located (9%). An objective system based on donor factors can predict donor heart use for HTx and may help increase availability of hearts for transplantation from existing donor pool. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Seropositive abdominal and thoracic donor organs are largely underutilized.

    Science.gov (United States)

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

    2010-12-01

    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 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 donor organs were significantly lower compared with seronegative organ donors (P 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.

  16. Impact of HLA diversity on donor selection in organ and stem cell transplantation.

    Science.gov (United States)

    Tiercy, Jean-Marie; Claas, Frans

    2013-01-01

    The human major histocompatibility complex is a multigene system encoding polymorphic human leucocyte antigens (HLA) that present peptides derived from pathogens to the immune system. The high diversity of HLA alleles and haplotypes in the worldwide populations represents a major barrier to organ and allogeneic hematopoietic stem cell transplantation, because HLA incompatibilities are efficiently recognized by T and B lymphocytes. In organ transplantation, pre-transplant anti-HLA antibodies need to be taken into account for organ allocation. Although HLA-incompatible transplants can be performed thanks to immunosuppressive drugs, the de novo production of anti-HLA antibodies still represents a major cause of graft failure. The HLAMatchmaker computer algorithm determines the immunogenicity of HLA mismatches and allows to define HLA antigens that will not induce an antibody response. Because of the much higher stringency of HLA compatibility criteria in stem cell transplantation, the best donor is a HLA genotypically identical sibling. However, more than 50% of the transplants are now performed with hematopoietic stem cells from volunteer donors selected from the international registry. The development of European national registries covering populations with different HLA haplotype frequencies is essential for optimizing donor search algorithms and providing the best chance for European patients to find a fully compatible donor.

  17. Criteria, standards and policies regarding decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    Detilleux, E.; Lennemann, W.

    1977-01-01

    The paper discusses the decontamination and decommissioning experiences encountered at the Eurochemic fuel reprocessing plant, their implications and the knowledge gained from these experiences. It includes the results of technical reviews made by the Nuclear Energy Agency of OECD and the International Atomic Energy Agency regarding decommissioning nuclear facilities. The conlusions which are presented should weigh heavily in the considerations of the national authorities involved in regulating nuclear power programmes. The paper notes the special planning that should be arranged between those responsible for the nuclear facility and competent public authorities who jointly should make a realistic determination of the eventual disposition of the nuclear facility, even before it is built. Recommendations cover the responsibilities of nuclear plant entrepreneurs, designers, operators, and public and regulatory authorities [fr

  18. Criteria, standards and policies regarding decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    Detilleux, E.; Lennemann, W.L.

    1977-01-01

    At the end of this century, there will probably be around 2500 operating nuclear power reactors, along with all the other nuclear fuel cycle facilities supporting their operation. Eventually these facilities, one by one, will be shut down and it will be necessary to dispose of them as with any redundant industrial facility or plant. Some parts of a nuclear fuel cycle facility can be dismantled by conventional methods, but those parts which have become contaminated with radioactive nuclear products or induced radioactivity must be subject to rigid controls and restrictions and handled by special dismantling and disposal procedures. In many cases, the resulting quantity of radioactive waste is likely to be relatively large and dismantling quite costly. Decommissioning nuclear facilities is a multifaceted problem involving planners, design engineers, operators, waste managers and regulatory authorities. Preparation for decommissioning should begin as early as site selection and plant design. The corner stone for the preparation of a decommissioning programme is the definition of its extent, meeting the requirements for public and environmental protection during the period that the radioactive material is of concern. The paper discusses the decontamination and decommissioning experience at the Eurochemic fuel reprocessing plant, the implications and the knowledge gained from this experience. It includes the results of technical reviews made by the Nuclear Energy Agency of OECD and the International Atomic Energy Agency regarding decommissioning nuclear facilities. The paper notes the special planning that should be arranged between those responsible for the nuclear facility and competent public authorities who should jointly make a realistic determination of the eventual disposition of the nuclear facility, even before it is built. Recommendations cover the responsibilities of nuclear plant entrepreneurs, designers, operators, and public and regulatory authorities. (author)

  19. Standardization of growth and fermentation criteria of Lasiodiplodia ...

    African Journals Online (AJOL)

    GREGO

    2007-03-19

    Mar 19, 2007 ... maximum growth on solid as well as liquid media. Optimum .... Extraction and measurement of JA: JA was extracted from fungal cultural filtrate of L. .... be related to consumption of JA due to carbon limitation or change in pH in the .... Activated by an Enzyme That Conjugates It to Isoleucine in. Arabidopsis.

  20. Common Risk Criteria Standards for National Test Ranges

    Science.gov (United States)

    2017-09-01

    capability greater than 150 kilometers (km), ranges should coordinate with the Joint Space Operations Squadron (JSpOC) for conjunction assessment if...insurance to cover such potential mishaps and has historically not required conjunction assessments for mission assurance or unmanned asset protection...into a sustainable orbit, the duration of the conjunction assessment required for manned and active spacecraft protection shall be applied from

  1. Management of split skin graft donor site in the West African sub region: survey of plastic surgeons' practice.

    Science.gov (United States)

    Olawoye, O A; Ademola, S A; Iyun, A O; Michael, A I; Oluwatosin, O M

    2017-06-30

    Split skin graft (SSG) is one of the most commonly performed operations on any Plastic Surgery service. Rate of donor site healing is affected by various factors including the type of dressing applied. The aim of this study was to survey the practice of plastic surgeons in the sub region with respect to management of SSG donor site and see how it conforms to international standards. Structured questionnaires on various aspects of the harvest and management of SSG donor sites were administered to plastic surgeons during the 53rd annual conference of the West African College of Surgeons (WACS) at Lome, Togo in March 2013. The data were analyzed using descriptive statistics. There were 47 respondents out of 55 plastic surgeons from four West African countries, which represented 85.4% of registered participants at the plastic surgery section of the conference. All the respondents performed SSG regularly, and the thigh was the most commonly used donor site. Different types of paraffin gauze remained the most commonly used primary donor site dressing. Only 17% of the respondents apply a topical local anaesthetic agent on the donor site. The choice of SSG donor site dressing in the sub region was driven mainly by availability. Concerted efforts must be made to access newer wound care products for optimum management of this commonly performed operation.

  2. A brief motivational interview with action and coping planning components enhances motivational autonomy among volunteer blood donors.

    Science.gov (United States)

    France, Christopher R; France, Janis L; Carlson, Bruce W; Kessler, Debra A; Rebosa, Mark; Shaz, Beth H; Madden, Katrala; Carey, Patricia M; Fox, Kristen R; Livitz, Irina E; Ankawi, Brett; Slepian, P Maxwell

    2016-06-01

    In contrast to standard donor retention strategies (e.g., mailings, phone calls, text messages), we developed a brief telephone interview, based on motivational interviewing principles, that encourages blood donors to reflect upon their unique motivators and barriers for giving. This study examined the effect of this motivational interview, combined with action and coping plan components, on blood donor motivations. The design was to randomly assign blood donors to receive either a telephone-delivered motivational interview with action and coping plan components or a control call approximately 6 weeks after their most recent donation. Participants completed a series of surveys related to donation motivation approximately 3 weeks before telephone contact (precall baseline) and then repeated these surveys approximately 1 week after telephone contact (postcall). The sample was 63% female, included a majority (52.6%) of first-time blood donors, and had a mean age of 30.0 years (SD, 11.7 years). A series of analyses of variance revealed that, relative to controls (n = 244), donors in the motivational interview group (n = 254) had significantly larger increases in motivational autonomy (p = 0.001), affective attitude (p = 0.004), self-efficacy (p = 0.03), anticipated regret (p = 0.001), and intention (p = motivational interviewing with action and coping planning as a novel strategy to promote key contributors to donor motivation. © 2016 AABB.

  3. Integrated criteria document mercury

    International Nuclear Information System (INIS)

    Sloof, W.; Beelan, P. van; Annema, J.A.; Janus, J.A.

    1995-01-01

    The document contains a systematic review and a critical evaluation of the most relevant data on the priority substance mercury for the purpose of effect-oriented environmental policy. Chapter headings are: properties and existing standards; production, application, sources and emissions (natural sources, industry, energy, households, agriculture, dental use, waste); distribution and transformation (cinnabar; Hg 2+ , Hg 2 2+ , elemental mercury, methylmercury, behavior in soil, water, air, biota); concentrations and fluxes in the environment and exposure levels (sampling and measuring methods, occurrence in soil, water, air etc.); effects (toxicity to humans and aquatic and terrestrial systems); emissions reduction (from industrial sources, energy, waste processing etc.); and evaluation (risks, standards, emission reduction objectives, measuring strategies). 395 refs

  4. Licensed reactor nuclear safety criteria applicable to DOE reactors

    International Nuclear Information System (INIS)

    1993-11-01

    This document is a compilation and source list of nuclear safety criteria that the Nuclear Regulatory Commission (NRC) applies to licensed reactors; it can be used by DOE and DOE contractors to identify NRC criteria to be evaluated for application to the DOE reactors under their cognizance. The criteria listed are those that are applied to the areas of nuclear safety addressed in the safety analysis report of a licensed reactor. They are derived from federal regulations, USNRC regulatory guides, Standard Review Plan (SRP) branch technical positions and appendices, and industry codes and standards

  5. Decision criteria in PSA applications

    International Nuclear Information System (INIS)

    Holmberg, J.E.; Pulkkinen, U.; Rosqvist, T.; Simola, K.

    2001-11-01

    Along with the adoption of risk informed decision making principles, the need for formal probabilistic decision rule or criteria has been risen. However, there are many practical and theoretical problems in the application of probabilistic criteria. One has to think what is the proper way to apply probabilistic rules together with deterministic ones and how the criteria are weighted with respect to each other. In this report, we approach the above questions from the decision theoretic point of view. We give a short review of the most well known probabilistic criteria, and discuss examples of their use. We present a decision analytic framework for evaluating the criteria, and we analyse how the different criteria behave under incompleteness or uncertainty of the PSA model. As the conclusion of our analysis we give recommendations on the application of the criteria in different decision situations. (au)

  6. MR urography for the preoperative evaluation of living renal donors

    Energy Technology Data Exchange (ETDEWEB)

    Bakker, Jeannette; Kort, Gerard A.P. de; Lo, Rob; Gils, A.P.G. van; Beek, Frederik J.A. [Department of Radiology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Hene, Ronald J. [Department of Nephrology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Lock, Tycho M.T.W. [Department of and Urology, University Hospital Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Burger, Huib [Julius Center for Patient Oriented Research, University of Utrecht, 3584 CX Utrecht (Netherlands)

    2002-08-01

    The purpose of this study was to assess the image quality and diagnostic value of MR urography in detecting abnormalities of the urinary collecting system relevant for the preoperative evaluation of living renal donors. Study subjects were selected from the existing intravenous urography (IVU) reports: 18 consecutive patients with a duplication or another abnormality of the collecting system and 20 consecutive patients with normal anatomy. They underwent a respiratory-triggered 3D T2-weighted fast spin-echo acquisition after oral administration of furosemide, without and with abdominal compression. The MR images were evaluated by two independent blinded observers. The IVU was used as the standard of reference. Image quality of the MR urograms with compression was overall better than those without compression, and the former were regarded as adequate for the evaluation of small filling defects and deformities of the pelvis and calyces in 76-81% of the kidneys and 74-79% of the patients. Both observers correctly diagnosed all 13 kidneys with a partial or complete duplication. The image quality of MR urography was inadequate to evaluate the calyces and pelvis for small filling defects or deformities in approximately 25% of the patients; however, the technique was accurate in the detection of abnormalities of the urinary collecting system relevant for the preoperative evaluation of living renal donors. (orig.)

  7. Prediction of occult hepatitis B virus infection in liver transplant donors through hepatitis B virus blood markers.

    Science.gov (United States)

    Tandoi, Francesco; Caviglia, Gian Paolo; Pittaluga, Fabrizia; Abate, Maria Lorena; Smedile, Antonina; Romagnoli, Renato; Salizzoni, Mauro

    2014-11-01

    Occult hepatitis B virus infection is defined as detectable HBV-DNA in liver of HBsAg-negative individuals, with or without detectable serum HBV-DNA. In deceased liver donors, results of tissue analysis cannot be obtained prior to allocation for liver transplantation. we investigated prevalence and predictability of occult hepatitis B using blood markers of viral exposure/infection in deceased liver donors. In 50 consecutive HBsAg-negative/anti-HBc-positive and 20 age-matched HBsAg-negative/anti-HBc-negative donors, a nested-PCR assay was employed in liver biopsies for diagnosis of occult hepatitis B according to Taormina criteria. All donors were characterized for plasma HBV-DNA and serum anti-HBs/anti-HBe. In liver tissue, occult hepatitis B was present in 30/50 anti-HBc-positive (60%) and in 0/20 anti-HBc-negative donors (pdonors with detectable HBV-DNA in plasma (n=5) or anti-HBs>1,000 mIU/mL (n=5) eventually showed occult infection, i.e, 10/30 occult hepatitis B-positive donors which could have been identified prior to transplantation. In the remaining 40 anti-HBc-positive donors, probability of occult infection was 62% for anti-HBe-positive and/or anti-HBs ≥ 58 mIU/mL; 29% for anti-HBe-negative and anti-HBsdonors, combining anti-HBc with other blood markers of hepatitis B exposure/infection allows to predict occult hepatitis B with certainty and speed in one third of cases. These findings might help refine the allocation of livers from anti-HBc-positive donors. Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  8. Predonation psychosocial evaluation of living kidney and liver donor candidates: a systematic literature review.

    Science.gov (United States)

    Duerinckx, Nathalie; Timmerman, Lotte; Van Gogh, Johan; van Busschbach, Jan; Ismail, Sohal Y; Massey, Emma K; Dobbels, Fabienne

    2014-01-01

    Evaluating a person's suitability for living organ donation is crucial, consisting not only of a medical but also of a thorough psychosocial screening. We performed a systematic literature review of guidelines, consensus statements, and protocols on the content and process of psychosocial screening of living kidney and liver donor candidates. We searched PubMed, Embase, CINAHL, and PsycINFO until June 22, 2011, following the PRISMA guidelines, complemented by scrutinizing guidelines databases and references of identified publications. Thirty-four publications were identified, including seven guidelines, six consensus statements, and 21 protocols or programs. Guidelines and consensus statements were inconsistent and lacked concreteness for both their content and process, possibly explaining the observed variability in center-specific evaluation protocols and programs. Overall, recommended screening criteria are not evidence-based and an operational definition of the concept "psychosocial" is missing, causing heterogeneity in terminology. Variation also exists on methods used to psychosocially evaluate potential donors. The scientific basis of predonation psychosocial evaluation needs to be strengthened. There is a need for high-quality prospective psychosocial outcome studies in living donors, a uniform terminology to label psychosocial screening criteria, and validated instruments to identify risk factors. © 2013 Steunstichting ESOT. Published by John Wiley & Sons Ltd.

  9. 75 FR 58400 - Donor Management Research: Improvements in Clinical Management of Deceased Organ Donors

    Science.gov (United States)

    2010-09-24

    ... needed. Upon review of research possibilities being discussed in meetings and in the literature, HRSA... their experiences and opinions regarding the importance of further study into donor management and its...

  10. Blood donation and blood donor mortality after adjustment for a healthy donor effect

    DEFF Research Database (Denmark)

    Ullum, Henrik; Rostgaard, Klaus; Kamper-Jørgensen, Mads

    2015-01-01

    BACKGROUND: Studies have repeatedly demonstrated that blood donors experience lower mortality than the general population. While this may suggest a beneficial effect of blood donation, it may also reflect the selection of healthy persons into the donor population. To overcome this bias, we...... investigated the relation between blood donation frequency and mortality within a large cohort of blood donors. In addition, our analyses also took into consideration the effects of presumed health differences linked to donation behavior. STUDY DESIGN AND METHODS: Using the Scandinavian Donation...... and mortality. The magnitude of the association was reduced after adjustment for an estimate of self-selection in the donor population. Our observations indicate that repeated blood donation is not associated with premature death, but cannot be interpreted as conclusive evidence of a beneficial health effect....

  11. ِAnalysis of donor motivations in living donor liver transplantation

    Directory of Open Access Journals (Sweden)

    Hesham eAbdeldayem

    2014-07-01

    Full Text Available Objectives: The introduction of the living donor liver transplantation (LDLT in Egypt as in elsewhere, has raised important psychological conflicts and ethical questions. The objective of this study was to get better understanding of the potential donors’ motives towards LDLT.Methods:This study was conducted on consecutive 193 living –liver donors who underwent partial hepatectomy as donors for LDLT during the period between April 2003 and January 2013, at the National Liver Institute Menoufeyia University, Egypt. Potential donors were thoroughly evaluated preoperatively through a screening questionnaire and interviews as regard their demographic data, relationship to the potential recipient and motives towards proceeding to surgery. They were assured that the information shared between them and the transplant centre is confidential. Results.The donors’ mean age was 25.53± 6.39 years with a range of 18-45 years. Males represented 64.7 % and females were 35.3%. The most common donors (32.1%, n_62, were sons and daughters to their parents (sons: n_43, daughters: n_19 while parents to their offsprings represent 15% (mothers: n_21, fathers: n_8. Brothers and sisters represent 16.5 % (brothers: n_22, sisters: n_10. Nephews & nieces giving their uncles or aunts were 14%. The number of wives donating to their husbands was 11 (5.7%. Interestingly, there was no single husband who donated his wife. Among the remaining donors, there were 11 cousins & one uncle. Unrelated donors were 20 (10.4%. Several factors seemed to contribute to motivation for donation: the seriousness of the potential recipient condition, the relationship and personal history of the donor to the potential recipient, the religious beliefs, the trust in the health care system, and family dynamics and obligations.Conclusions. Absolute absence of coercion on the living-liver donor’s motives may not be realistic because of the serious condition of the potential recipient. It is

  12. Determination of Dornic acidity as a method to select donor milk in a milk bank.

    Science.gov (United States)

    Vázquez-Román, Sara; Garcia-Lara, Nadia Raquel; Escuder-Vieco, Diana; Chaves-Sánchez, Fernando; De la Cruz-Bertolo, Javier; Pallas-Alonso, Carmen Rosa

    2013-02-01

    Dornic acidity may be an indirect measurement of milk's bacteria content and its quality. There are no uniform criteria among different human milk banks on milk acceptance criteria. The main aim of this study is to report the correlation between Dornic acidity and bacterial growth in donor milk in order to validate the Dornic acidity value as an adequate method to select milk prior to its pasteurization. From 105 pools, 4-mL samples of human milk were collected. Dornic acidity measurement and culture in blood and McConkey's agar cultures were performed. Based on Dornic acidity degrees, we classified milk into three quality categories: top quality (acidity pasteurize in a human milk bank based in quality and safety criteria.

  13. ACR appropriateness criteria jaundice.

    Science.gov (United States)

    Lalani, Tasneem; Couto, Corey A; Rosen, Max P; Baker, Mark E; Blake, Michael A; Cash, Brooks D; Fidler, Jeff L; Greene, Frederick L; Hindman, Nicole M; Katz, Douglas S; Kaur, Harmeet; Miller, Frank H; Qayyum, Aliya; Small, William C; Sudakoff, Gary S; Yaghmai, Vahid; Yarmish, Gail M; Yee, Judy

    2013-06-01

    A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  14. Criteria of site assessment

    International Nuclear Information System (INIS)

    Gibbs, P.; Fuchs, H.

    1975-01-01

    The criteria which lead to the choice of a particular site for a nuclear power station are in general very similar to those which would apply to any other type of power station. The principal differences derive from the simpler transport problems for the fuel compared with, say, solid fuel and the special safety considerations which attach to nuclear reactors. The search for a suitable site obviously starts by considering where the power is needed, i.e. where the load centers are and also the existing transmission network which may help to bring the power from a more remote site to the load centers. This economic incentive to put the plant close to loads conflicts directly with the nuclear safety argument which favours more remote siting, and part of the problem of site selection is to reconcile these two matters. In addition, there are many other important matters which will be considered later concerning the adequacy of cooling water supplies, foundation conditions, etc., all of which must be examined in considerable detail. (orig./TK) [de

  15. Criteria for decommissioning

    International Nuclear Information System (INIS)

    Ricci, P.F.

    1988-01-01

    In this paper the authors describe three risk acceptability criteria as parts of a strategy to clean up decommissioned facilities, related to both the status quo and to a variety of alternative technical clean-up options. The acceptability of risk is a consideration that must enter into any decision to establish when a site is properly decommissioned. To do so, both the corporate and public aspects of the acceptability issue must be considered. The reasons for discussion the acceptability of risk are to: Legitimize the process for making cleanup decisions; Determine who is at risk, who benefits, and who bears the costs of site cleanup, for each specific cleanup option, including the do nothing option; Establish those factors that, taken as a whole, determine measures of acceptability; Determine chemical-specific aggregate and individual risk levels; and Establish levels for cleanup. The choice of these reasons is pragmatic. The method consistent with these factors is risk-risk-effectiveness: the level of cleanup must be consistent with the foreseeable use of the site and budget constraints. Natural background contamination is the level below which further cleanup is generally inefficient. Case-by-case departures from natural background are to be considered depending on demonstrated risk. For example, a hot spot is obviously a prima facie exception, but should be rebuttable. Rebuttability means that, through consensus, the ''hot spot'' is shown not to be associated with exposure

  16. Computerized Assessment of Competence-Related Abilities in Living Liver Donors: The Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL)

    Science.gov (United States)

    Freeman, Jason; Emond, Jean; Gillespie, Brenda W.; Appelbaum, Paul S.; Weinrieb, Robert; Hill-Callahan, Peg; Gordon, Elisa J.; Terrault, Norah; Trotter, James; Ashworth, April; Dew, Mary Amanda; Pruett, Timothy

    2014-01-01

    Background Despite its importance, determination of competence to consent to organ donation varies widely based on local standards. We piloted a new tool to aid transplant centers in donor assessment. Methods We assessed competence-related abilities among potential living liver donors (LDs) in the 9-center A2ALL study. Prospective LDs viewed an educational video, and were queried to assess Understanding, Appreciation, Reasoning, and ability to express a Final Choice using the MacArthur Competence Assessment Tool for Clinical Research, adapted for computerized administration in LDs (“MacLiver”). Videotaped responses were scored by a clinical neuropsychologist (JF). Results Ninety-three LDs were assessed. Mean (standard deviation; domain maximum) scores were: Understanding: 18.1 (2.6; max=22), Appreciation: 5.1 (1.0; max=6), Reasoning: 3.1 (0.8; max=4), and Final Choice: 3.8 (0.5; max=4). Scores did not differ by demographics, relationship to the recipient, eligibility to donate, or eventual donation (p>0.4). Higher education was associated with greater Understanding (p=0.004) and Reasoning (p=0.03). Conclusion Standardized, computerized education with independent ratings of responses may (1) alert the clinical staff to potential donors who may not be competent to donate, and (2) highlight areas needing further assessment and education, leading to better informed decision-making. PMID:23859354

  17. Comparison of outcomes from smoking and nonsmoking donors: thirteen-year experience.

    Science.gov (United States)

    Berman, Marius; Goldsmith, Kim; Jenkins, David; Sudarshan, Catherine; Catarino, Pedro; Sukumaran, Nair; Dunning, John; Sharples, Linda D; Tsui, Steven; Parmar, Jasvir

    2010-12-01

    Lung transplantation remains the best treatment option for a variety of end-stage lung diseases. Pressure on the limited donor pool has led to the use of extended criteria donors. One aspect of this has been the liberalization of the use of smoking donors (SmD). This study is a retrospective review of lung transplants performed between April 1995 and August 2008 at a single institute. We examined the impact of donor smoking on short-term and long-term survival in relationship to recipient and donor demographics such as ischemic time, cytomegalovirus status, rates of rejection and infection, ventilation, and intensive care stay. Endpoints were survival, infection, and rejection. During this 13-year period, 454 lung transplants were performed. Smoking history was available on 424 (93.4%) of these (SmD, n = 184; NSmD, n = 240). Seventy-one patients died within 3 months of transplant leaving 353 alive at 3 months posttransplant. Fatalities within the first 3 months were significantly higher in the SmD group (21% vs 13%, odds ratio 1.9, hazard ratio 3.3, p = 0.04). No significant difference in rejection and infection rates between recipients of lungs from SmD and NSmD at 3 months and at 1 year posttransplantation (p = 0.51 and 0.09) was found. Although recipients of lungs from SmD had higher odds of ventilation for more than 10 hours, the odds were only increased by 20%, which was not statistically significant. Recipients from SmD had significantly longer stays in the intensive care (odds ratio 1.9, p = 0.002). There was little evidence for an effect of SmD on the development of bronchiolitis obliterans. In this large cohort of patients, donor smoking