An analysis of the quality indicators of the organ donation process in São Paulo, Brazil.

BACKGROUND: Few studies have investigated whether quality initiatives in the process of organ donation yield better results of the organ donation process. OBJECTIVE: To analyze whether the indicators of the organ donation process in Brazilian hospitals meet the standards established by the Organ Donation European Quality System (ODEQUS). DESIGN: We evaluated the quality of the organ donation in a selected group of Brazilian hospitals served by the Nucleus of Organ Procurement (NOP) using standards of the ODEQUS. RESULTS: Structural and process indicators had 100% conformity. Indicators of results showed a family consent rate of 61% (29% lower than ODEQUS goal); a conversion rate of potential donors to effective donors of 47% (28% below the goal); and a 12% rate of sudden cardiac arrest (higher than the quality limit). CONCLUSIONS: Our findings highlight the importance for the development of quality initiatives in identifying gaps and weaknesses in the process that should be corrected or even restructured, therefore maximizing the number of donors and organs transplanted. Hospitals that participate in the NOP process met 61% of the quality indicators proposed by ODEQUS. Identification of potential donors, family consent, conversion, and sudden cardiac arrest rates are areas that did not conform to ODEQUS standard and revealed a great opportunity for improvement.

[Protective effect of sodium bicarbonate on radiological contrast medium-induced nephropathy in rats]. / O efeito protetor do bicarbonato de sódio na nefropatia induzida por contraste radiológico em ratos.

Radiological iodinated contrasts (IC) agents cause acute kidney injury (AKI). To evaluate the renoprotective effect of sodium bicarbonate (Bic) on renal function (creatinine clearance [Clcr], Jaffé, and Clcr mLmin -1 x100 g-1) and the oxidative profile (peroxide excretion, urinary peroxides, urinary malondialdehyde, FOX-2 expression, and thiobarbituric acid reactive substance [TBARS; nmol/mg Cr]) in rats treated with an IC agent. Adult male Wistar rats weighing 250-300 g were treated once daily for 5 days with one of the following treatments: saline (0.9%, 3 mL.kg-1xday-1 intraperitoneally [i.p.]), IC agent (sodium and meglumine ioxitalamate, 3 mL/kg, i.p.), Bic + Saline (3-mL/kg Bic, i.p., 1 h before and after saline treatment), and Bic + IC (3-ml/kg Bic, i.p., 1 h before and after the IC treatment). The IC agent induced AKI, and the antioxidant renoprotective effect of Bic was confirmed (Clcr/TBARS/urinary peroxide: saline group, 0.59+/- 0.03/0.11 +/-0.02/1.29+/- 0.24; Bic+Saline group, 0.58 +/-0.03/0.13+/- 0.02/1.32+/- 0.64; IC group, 0.22 +/- 0.02/0.19 +/- 0.02/4.77 +/- 0.24; Bic +Clgroup, 0.51+/- 0.04/0.13+/- 0.3/1.80+/- 0.04; p<0.05). The protective effect of Bic in the IC-induced AKI was confirmed; hence, Bic administration may be considered as a therapeutic option for patients undergoing IC-enhanced radiography.