RESUMO
On March 1, 2001, Mid-America Transplant, the organ procurement organization (OPO) located in St Louis, Missouri, performed the first organ recovery of a brain-dead donor in a hospital-independent, free-standing, organ recovery center (ORC), with successful transplantation of a liver. This was the inception of a paradigm shift in donor management and organ procurement, moving away from the traditional method of using the donor hospital. In the last 20 years, many advances have occurred in the ORC. Brain-dead donors are moved within hours of authorization to fully equipped intensive care units. Some ORCs are equipped with computed tomography scanners, portable radiography, laboratory facilities, bronchoscopy, and a cardiac catheterization laboratory. ORCs have dedicated surgical suites, and operating time is frequently during the day and is rarely delayed. Donor management in an ORC is more consistent, efficient, and effective than that in a donor hospital, and studies have demonstrated increased organ yield. Multiple studies have demonstrated a cost benefit of an ORC as well as providing an ideal environment for donor research studies. Currently, there are 24 of 57 OPOs that are using an independent or hospital-based ORC to manage their donors. We review the history and describe the current state of ORCs.
Assuntos
Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Estados Unidos , Humanos , Instalações de Saúde , Hospitais , Unidades de Terapia Intensiva , Morte EncefálicaRESUMO
The United States is not the only country dealing with privacy of health information. In the absence of clear legislative direction, this paper focuses on the common privacy principles that underlie Canadian privacy legislation and recommends a plan of action. The objective is to give plan administrators and trustees sufficient transition time to develop and implement the appropriate privacy strategies, thereby minimizing both the potential burden of compliance and the potential risks of noncompliance.