Clinical transplantation
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Clinical transplantation · Mar 2008
Case ReportsGeneralized lymphedema in a sirolimus-treated renal transplant patient.
Generalized lymphedema is an extremely rare effect of sirolimus therapy in renal transplant recipients. We describe the development of this complication in a 56-yr-old woman, who was given an experimental protocol with cyclosporine, sirolimus, steroids, and basiliximab. Following the protocol, after one month, the patient was randomized to the "sirolimus only" group, while cyclosporine was completely suspended and the oral steroids were continued. ⋯ A chest radiography and an ultrasound study of the heart showed a moderate pleural and pericardial effusion. An abdominal ultrasound scan showed two small lymphoceles next to the transplanted kidney, confirmed with a CT scan. After sirolimus discontinuation the generalized lymphedema started to improve and three months later all the symptoms had disappeared.
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Clinical transplantation · Mar 2008
Attitude of health care professionals to brain death: influence on the organ donation process.
The acceptance and application of the concept that brain death is a valid determination of death is the central issue in organ donation. However, whether attitude to brain death of health care professionals influences the organ procurement process has not been systematically studied. ⋯ The understanding and acceptance of brain death as a valid determination of death was associated with a positive effect on the level of comfort of health care professionals in performing key donor-related tasks. Reinforcing a positive attitude to brain death among health care professionals may facilitate the procurement process.