Transplantation proceedings
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Comparative Study
RIFLE criteria for acute kidney dysfunction following heart transplantation: incidence and risk factors.
There are few data regarding the occurrence of (RIFLE)-based acute kidney dysfunction (AKD) after heart transplantation (HT) and its risk factors. The aim of this study was to apply RIFLE criteria in patients who developed AKD following HT to compare patients with and without AKD and to determine incidence and risk factors of AKD. ⋯ Our results suggest that based on RIFLE criteria, AKD occur in more than half of HTs postoperatively. Older age and use of cyclosporine are associated with AKD following HT.
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Despite an increase in patients with end-stage heart failure, the acceptance rate has been going down in recent years owing to a change in donor demographics. Furthermore, the rate of emergency heart transplantation has progressively increased. The result is an increase in the time awaiting heart transplantation in elective patients and therefore in the risk of sudden death in this population. Implantable cardioverter defibrillators (ICDs) could be a preventive option in these cases. However, indications for the implantation in this population are not well established. ⋯ This study suggests that ICD could reduce the risk of sudden death in patients with LVEF ≤ 30% while awaiting heart transplantation. However, more studies are needed to confirm these results.
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Observational Study
Outcomes in renal transplantation with expanded-criteria donors.
Kidney transplantation is the treatment of choice for patients with end-stage renal disease. In recent years donor criteria have changed to increase the percentage of expanded-criteria donors (ECDs). The aim of this study was to analyze transplants from ECDs obtained at our institution from. 2010 to 2012. We studied the comorbidity of ECD, preimplantation histologic study, renal function, and survival of transplanted grafts. ⋯ We found no differences in graft survival from ECD compared with the control group of standard-criteria donors. The evaluation of grafts from ECD may be a strategy to increase the number of kidney transplants.
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Organ and human tissue donation is not well developed in Morocco. This is due in part to the refusal of families, but also to a lack of awareness. We conducted a survey of a representative sample of doctors more exposed to the donation process to assess their knowledge and attitudes toward organ donation and their training needs. ⋯ Our findings show that there is discordance between knowledge and attitudes of doctors in our hospital toward organ donation. The promotion of organ donation requires good training of our teams to sensitize the population.
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Multicenter Study
Organ Donation European Quality System: ODEQUS project methodology.
Differences in the number of organ donors among hospitals cannot be explained only by the number of intensive care unit beds used or neurologic patients treated. The figures obtained are influenced by the organizational structure of the donation process and how efficient it is. The Organ Donation European Quality System (ODEQUS) is a 3-year project (from October 2010 to September 2013) co-financed by the European Agency for Health and Consumers (EAHC20091108) which aims to define a methodology to evaluate organ procurement performance at the hospital level. ⋯ Two types of training have been designed and performed: one concerns the development of quality criteria and quality indicators, whereas another is focused on how to use evaluation tools. Following this methodology, the project has so far identified 131 quality criteria and developed 31 quality indicators. Currently, the quality indicators are being tested in 11 selected hospitals.