Transplantation proceedings
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The measurement of blood pressure (BP) and the management of hypertension in patients with continuous-flow ventricular assist devices (CF-VADs) can present unique challenges. Patients with CF-VADs often do not have a palpable pulse, and therefore traditional blood pressure measurement by auscultation or automated cuff is less reliable. We tested the efficacy of blood pressure estimation using sphygmomanometry combined with finger pulse oximetry only after a hemodynamic optimization was effected to make the values estimated approximately similar to mean arterial pressure. ⋯ According to our results, the pulse oximeter method showed a high success rate and a good correlation level with the standard procedure. Our data encourage the use of oximeters for domiciliary blood pressure assessment in patients implanted with a continuous flow device.
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The number of organs retrieved from donation after circulatory death (DCD) donors has continued to rise in recent years. The functional superiority of DCD organs is achieved when the lungs are perfused with cold perfusion and livers with normothermic regional perfusion (NRP). Thus, a precise surgical technique is required to combine thoracic and abdominal organ procurement. ⋯ In 2016, 3 livers and 6 lungs were harvested at our center using the technique described. After a minimum follow-up of 1 year, no evidence of biliary complications was observed. The combined procurement of lungs after room temperature perfusion and liver after NRP without initial clamping of the thoracic VC is feasible, with excellent function post-transplantation.
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In this study we assessed burnout and resilience levels among transplant nurses to analyze the relationship between these 2 variables, and to address whether demographic factors were associated with burnout. ⋯ Transplant nurses in China experience burnout. Resilience was negatively related to emotional exhaustion and depersonalization, and was positively associated with personal accomplishment. Older age, being married, and having children may increase the risk of burnout. Nurses with a high monthly income, high title or position, and adequate exercise are not likely to experience burnout.
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To measure the awareness regarding the concepts of brain death and organ donation among secondary school students within the age range of 12-18 years in the southern region of Saudi Arabia. ⋯ The knowledge of and attitude toward brain death and organ donation are very poor among the young Saudi population, and have not evolved over a period of time. The information regarding the religious fatwas has not been transmitted to the level of the educational institutions.
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Comparative Study
Kidney Transplantation Using Expanded-Criteria Deceased Donors: A Comparison With Ideal Deceased Donors and Non-Expanded-Criteria Deceased Donors.
The use of expanded-criteria deceased-donor (ECD) kidneys must be evaluated within the objective perspective of critical organ shortage and graft function and survival. In this study, we aimed to compare the clinical outcomes of ECD reliance with concurrent use of ideal-criteria deceased donors (IDDs) and non-ECDs in adult renal transplantation. ⋯ Although the long-term renal function followed longitudinally was lower in ECD kidney recipients, the use of renal grafts from ECDs is an acceptable method to resolve the disparity of critical organ shortage. However, the classification of the high-risk group should be updated with consideration given to differences in regional characteristics.