Transplantation proceedings
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The family advocate plays a crucial role in the organ and tissue procurement process for transplantation and research. This responsibility can weigh profoundly on the consent/conversion rates for family advocates. Some potential donor families consider time as a critical factor when deciding to donate. It was hypothesized that case time will decrease by >or=20% if family advocates were trained to become level 1 recovery coordinators and utilized during organ only cases with brain-dead donors. ⋯ The results indicate that family advocates who can function in the role of level 1 recovery coordinators may decrease donor management by hours. Incorporating family services with donor management can improve the standard in the donation process.
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Severe sepsis in transplant recipients results in an extremely high morbidity mortality rate. Microvascular alterations play an important role in the development of sepsis-induced organ dysfunction. ⋯ Comparable trials in humans are still not available for the other coagulation, inhibitor antithrombin. We also report clinical trials discussing whether hyperimmune products reduce the infection rate during myelosuppression, but further trials are requested for the feasible evaluation of these products.
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No religion formally forbid donation or receipt of organs or is against transplantation from living or deceased donors. Only some orthodox jews may have religious objections to "opting in." However, transplantation from deceased donors may be discouraged by Native Americans, Roma Gypsies, Confucians, Shintoists, and some Orthodox rabbis. Some South Asia Muslim ulemas (scholars) and muftis (jurists) oppose donation from human living and deceased donors because the human body is an "amanat" (trusteeship) from God and must not be desecrated following death, but they encourage xenotransplantation research. ⋯ Addressing the participants at the XVIII International Congress of the Transplantation Society in 2000, Pope John Paul II said "Accordingly, any procedure which tends to commercialize human organs or to consider them as items of exchange or trade must be considered morally unacceptable, because to use the body as an object is to violate the dignity of the human person" and later on added "The criteria for assigning donated organs should in no way be discriminatory (i.e. based on age, sex, race, religion, social standing, etc.) or utilitarian (i.e. based on work capacity, social usefulness, etc.)." To conclude, according to the Catechism of the Catholic Church Compendium signed by Pope Benedict XVI on june 28, 2005, 476. Are allowed transplantation and organ donation, before and after death? Organ transplantation is morally acceptable with the consent of the donor and without excessive risks for him/her. For the noble act of organ donation after death, the real death of the donor must be fully ascertained.
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Transplantation of vital human organs is a lifesaving therapy for patients with end-stage organ failure who are medically fit to undergo the surgical procedure. However, deceased donor management remains one of the most neglected areas in transplantation medicine. ⋯ Donor optimization leads to increased organ procurement and contributes to improved organ function in the recipient. This article reviews the management advances and controversies of the brainstem-dead donor in an intensive care unit.
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Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi. Chagas disease following solid-organ transplantation has occurred in Latin America. This report presents the occurrence of Chagas disease despite negative serological tests in both the donor and the recipient, as well as the effectiveness of treatment. ⋯ At the moment of submission, the patient remains in functional class I. This case highlighted that more appropriate screening for T cruzi infection is mandatory in potential donors and recipients of solid-organ transplants in regions where Chagas disease is prevalent. Moreover, it stressed that this diagnosis should always be considered in recipients who develop cardiac complications, since negative serological tests do not completely discard the possibility of disease transmission and since good results can be achieved with prompt trypanocidal therapy.