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1.
Organ Transplantation ; (6): 98-2022.
Article in Chinese | WPRIM | ID: wpr-907039

ABSTRACT

Objective To investigate the conversion rate, organ procurement rate and influencing factors of organ donation in a single center from Fujian province. Methods Baseline data of 182 potential organ donors of Fujian Medical University Union Hospital from November 2018 to June 2021 were retrospectively analyzed. The conversion rate of organ donation, baseline data of successful organ donors and the causes of failure of organ donors were identified. The organ procurement rate and the influencing factors of the number of organ donations were analyzed. Results Among 182 potential organ donors, 46 cases were successful organ donors with a conversion rate of 25.3%. In addition, 136 cases failed to donate organ. The main causes included disagreement from family members (58.1%), insufficient evaluation time (24.3%) and ineligible for donation criteria (17.6%). A total of 212 large organs and tissues were donated by 46 organ donors, including 88 kidneys, 42 livers, 15 lungs, 19 hearts and 48 corneas, with 4.6 large organs and tissues, and 3.6 large organs for each donor. Age, sex, native place, organ donation area and blood type were the influencing factors of the number of large organ donations. Organ donation area was the influencing factor of the number of tissue donations. Conclusions The conversion rate of organ donation is relatively low in a single center from Fujian province. Disagreement from family members is the main cause. Suitable potential organ donors should be selected for organ donation to improve the conversion rate and organ procurement rate of organ donation.

2.
Organ Transplantation ; (6): 12-2022.
Article in Chinese | WPRIM | ID: wpr-907027

ABSTRACT

With the reform of organ donation and transplantation in China, the establishment of Organ Procurement Organization (OPO) will become more centralized and enlarged in scale, evolving into the united OPO development stage coordinated by multiple hospitals. How to enhance the operation management and scientific development planning of united OPO has become an urgent and novel issue facing the administrators at all levels. At present, certain constraint factors of united OPO still exist in the integrated management, cost control, service homogenization, cultural integration and discipline layout. To give full play to the large-scale benefits and expand the supply of high-quality organ donation services, the development principle of putting connotation construction first and the appropriate direction of public welfare should be upheld. Leading and driving the development of organ donation services of our province are the responsibility, and discipline construction and talent training serve as the core. The overall development plan should be determined in a scientific pattern and homogeneous management should be implemented according to local conditions, aiming to provide successful experience for establishing a provincial unified OPO.

3.
Organ Transplantation ; (6): 651-2021.
Article in Chinese | WPRIM | ID: wpr-904547

ABSTRACT

Communication with families of donors is the critical procedure of organ and tissue donation, which is the key to determine the success of donation. Expert Consensus on Communication with Families of Organ and Tissue Donors was formulated by multidisciplinary experts to help the families of potential organ and tissue donors to understand the right of independent decision of organ donation given by law, improve the communication efficiency with families, fully showcase the humanistic care, enable relevant practitioners to maintain professional working status and healthy psychological state in the long term, share and summarize the optimal clinical experiences in different places, and discuss and resolve the difficulties during the communication with families. This expert consensus focuses on the key issues during the communication with families of organ and tissue donors and formulated by multidisciplinary experts after literature review. The expert panel has reached consensus by Delphi method for voting. Eighteen key elements and recommendations for communication with families of potential organ and tissue donors have been proposed, aiming to provide guidance for communication with families of organ and tissue donation. This consensus has been registered both in Chinese and English on International Practice Guidelines Registry Platform.

4.
Organ Transplantation ; (6): 384-2021.
Article in Chinese | WPRIM | ID: wpr-881521

ABSTRACT

Organ shortage is a common problem in the field of transplantation worldwide. It is urgent to expand the donor pool via different effective and safe approaches. Recently, "the statement from international collaborative on expanding controlled donation after the circulatory determination of death (cDCDD)" has attracted widespread attention from scholars. The statement aims to promote cDCDD in order to increase organ donation rates, with the ultimate goal of achieving self-sufficiency in transplantation. In this article, the key contents mentioned in the statement were summarized, the terminology update and relevant discussion of donation after the circulatory determination of death (DCDD), the development trend of DCDD, the basic part of the clinical pathway of cDCDD and the key factors affecting the implementation of cDCDD were illustrated, and the inspiration drew from this statement to the sustainable development of organ donation program in China was reflected.

5.
Organ Transplantation ; (6): 376-2021.
Article in Chinese | WPRIM | ID: wpr-881520

ABSTRACT

Objective At present, the novel coronavirus pneumonia (COVID-19) pandemic is still raging in certain regions around the globe, and the prevention and control of the pandemic should be strengthened. Under the challenges of respective social environment and allocation of medical resources, and support from the inertia and inherent productivity of the system on which the industry depends, extensive attempts are being delivered to push forward the work of organ donation and transplantation in each country. Under the guidance of national experts and committee members, Shanxi Provincial Human Organ Procurement and Allocation Service Center was established on August 28, 2018 approved by the former Shanxi Provincial Health and Family Planning Commission. It is the only independent non-profit medical institution in Shanxi Province. In this article, the system construction of citizen's organ donation and transplantation fitting national and provincial conditions was further explored according to the data analysis of organ donation and transplantation in the United States and Spain during the COVID-19 pandemic combined with the implementation of organ donation work in Shanxi Provincial Human Organ Procurement and Allocation Service Center.

6.
Organ Transplantation ; (6): 369-2021.
Article in Chinese | WPRIM | ID: wpr-881519

ABSTRACT

Quality assurance is the responsibility of Organ Procurement Organization (OPO). The establishment of OPO quality management system is a novel task for implementing high-quality human organ donation. At present, the quality management of OPO still has certain problems, such as lack of comprehensive management organization, standardized management process, scientific evaluation index, qualified professionals and strong safety culture atmosphere, etc. It is necessary to deliver top-level design from three perspectives of ideological concept change, quality management system construction and process implementation management in combination with the actual situation of OPO and reference to the criteria of international general quality management system. More importantly, the managers of OPO should play a leading role in ensuring the efficient operation of OPO in the persistent improvement of quality management system.

7.
Organ Transplantation ; (6): 503-2021.
Article in Chinese | WPRIM | ID: wpr-886776

ABSTRACT

Human organ transplantation is an effective method to treat organ failure and save the life of patients. The practicing qualification certification of human organ transplantation is recognized as an administrative examination and approval item of the national health authority. National health authorities shall organize experts to conduct on-site audit of medical institutions that have applied for practicing qualification certification and have passed preliminary supervision at the provincial level. In this article, the management of on-site audit on the practicing qualification certification of human organ transplantation was illustrated and discussed from the practical significance, principles and highlights of on-site audit, and key points during on-site audit, aiming to provide reference for ensuring high-quality development of organ transplantation and strengthening the management of practicing qualification certification of human organ transplantation in medical institutions.

8.
Organ Transplantation ; (6): 123-2021.
Article in Chinese | WPRIM | ID: wpr-873721

ABSTRACT

In recent years, the fields of donation after citizen's death and organ transplantation in China have developed rapidly with remarkable achievements and revolutionary changes in the source of transplant organs.How to transform the development of organ donation and transplantation from high-speed to high-quality growth mode?It is extremely urgent to establish the expenditure and management system of organ donation and transplantation.In this article, the establishment and management of clinical use price of organs from donation after citizen's death were investigated from the perspectives of policy basis, accounting items, accounting methods, price formation and price management, aiming to provide reference for resolving the problem of cost accounting and price determination of clinical use of donated organs.

9.
Organ Transplantation ; (6): 288-2020.
Article in Chinese | WPRIM | ID: wpr-817607

ABSTRACT

Organ transplantation is an effective treatment for end-stage organ failure. However, organ shortage has always been a common problem faced by countries around the world. The recognition and active participation of intensive care unit (ICU) medical staff in organ donation contributes to promoting the development of organ donation, thereby alleviating the shortage of donor organ. In this article, the key strategies of ICU donor management to promote organ donation and the key strategies of ICU medical staff management to promote organ donation were summarized, aiming to provide reference for organ donation practitioners (especially ICU medical staff) and jointly facilitate the professional development of organ donation.

10.
Organ Transplantation ; (6): 276-2020.
Article in Chinese | WPRIM | ID: wpr-817605

ABSTRACT

The procurement, preservation and transportation of the donor organs directly affect the clinical prognosis of the recipients. The establishment of process optimization and quality control standards of organ procurement, preservation and transportation contributes to improving the quality and utilization rate of donor organs and reducing the medical risk. According to Guide to the Quality and Safety of Organs for Transplantation (6th edition) proposed by European Union, the 11th chapter of organ procurement, preservation and transportation was interpreted and summarized in this article.

11.
Organ Transplantation ; (6): 93-2020.
Article in Chinese | WPRIM | ID: wpr-781861

ABSTRACT

Organ transplantation has brought hope for healing of patients with end-stage organ failure. However, the shortage of human organs has become one of the important factors that severely restrict the development of human organ transplantation. Donation after cardiac death (DCD) is a safe way to expand the source of donors. While trying to make extensive effort to increase the quantity of donation after brain death (DBD), countries attempt to grasp the opportunity of DCD when conditions permit. In this article, the historical background and global development trend of DCD, fundamental conditions for the implementation of controllable DCD, key issues and ethical review in the practice of controllable DCD were discussed.

12.
Organ Transplantation ; (6): 614-2020.
Article in Chinese | WPRIM | ID: wpr-825581

ABSTRACT

The pilot work of organ donation after citizen's death has been implemented in China for 10 years. The number of organ donations was significantly increased from 34 cases in 2010 to more than 6 300 cases in 2018, accounting for over 15% of the global quantity of organ donations. China has established an organ donation and transplantation system that follows the international ethical standards, and conforms to our own social development stage and cultural tradition. Organ donation is a novel discipline created by multi-disciplinary integration in the new era of China, the process of which was reviewed from the perspectives of legal supervision, workflow, management mode, training and education mode, quality management and control system, organ donation in the epidemic of noval coronavirus pneumonia and application of innovative technologies, etc.

13.
Organ Transplantation ; (6): 599-2020.
Article in Chinese | WPRIM | ID: wpr-825578

ABSTRACT

Objective To get a knowledge of the current status of organ donation and utilization after citizen's death in Wuxi District, and thereby provide ideas and basis for further development of organ donation work in local areas. Methods Clinical data from 151 organ donors, included 37 successful donors and 114 potential donors, were retrospectively analyzed. The reasons for donation failure of potential donors were analyzed. The general information for successful donors was collected. And the information on organ donation and organ utilization in successful donors were analyzed. Results Among the 151 organ donors, 37 were successful donors, with the conversion rate reaching 24.5%. For the 114 donors with failed organ donation, the reasons for failure included family disagreement, failure to meet donation status criteria, insufficient evaluation time, and unresolved work injury disputes. The categories for organ donation included 34 cases of donation after brain death followed by cardiac death (DBCD), 3 cases of donation after brain death (DBD), and no case of donation after cardiac death (DCD). The reasons for death of donors includes 19 cases of craniocerebral trauma, 14 cases of stroke and 4 cases of others. Among the 37 cases of successful donors, the majority were floating population. A total of 154 major organs and tissues were donated, of which 124 were major organs. The number of major organs and tissues donated per citizen was (4.2± 1.6) and the number of major organs donated per citizen was (3.4± 1.1). The utilization rate of the 154 donated organs reached 96.7% (149/154), with Nanjing, Wuxi, Suzhou and Changzhou ranking the top 4 of organ distribution. Conclusions The rate for successful organ donation and conversion after citizen's death is low in Wuxi District. The organ donation work networks in local areas should be established. And organ donation promotion efforts and skills training for coordinators should be developed.

14.
Organ Transplantation ; (6): 400-2020.
Article in Chinese | WPRIM | ID: wpr-821550

ABSTRACT

As China enters the era of organ donation after the citizen's death, the organ donation cases with potential malignant tumor history increase gradually. Guide to the Quality and Safety of Organs for Transplantation (6th Edition) by European Committee was translated into Chinese in 2019. This article interprets Chapter 9 of the guideline "Risk of Malignant Tumor Transmission" to assist organ donation coordinator and transplant team in screening donors at risk of malignant tumor transmission in our country and to reduce the risk of donor-derived tumor transmission.

15.
Organ Transplantation ; (6): 395-2020.
Article in Chinese | WPRIM | ID: wpr-821549

ABSTRACT

Organ shortage is one of the important factors restricting the development of human organ transplantation. The identification and referral of potential donors determine the total scale of organ donation. Whether potential donors can be identified and referred is the most important reason for the difference of organ donation rates in different regions. This paper interprets the chapter of the identification and referral of potential donors in the Guide to the Quality and Safety of Organs for Transplantation (6th edition) issued by European Union in order to provide reference for the staff of organ procurement organization and related medical personnel in China and improve the organ donation rate in China.

16.
Organ Transplantation ; (6): 731-2020.
Article in Chinese | WPRIM | ID: wpr-829688

ABSTRACT

Objective To summarize the experience of organ donation after citizen' s death during the novel coronavirus pneumonia (COVID-19) epidemic. Methods Eleven cases of potential donors of organ donation after citizen' s death during the COVID-19 epidemic were retrospectively analyzed, and the workflow and key points of infectionprevention and control were summarized. Results Among 11 cases of potential donors, 6 cases failed to implement organ donation. Five donors who were successfully performed organ donation had no respiratory symptoms before the onset of encephalopathy. CT scan of the lungs upon the onset of encephalopathy showed that one case was diagnosed with aspiration pneumonia, and the remaining four cases obtained negative results. During hospitalization, all of the 5 donors showed fever symptom and repeated chest CT scan detected lung inflammation. Bronchoalveolar lavage fluid or blood samples tested for novel coronavirus nucleic acids were all negative. No confirmed or suspected cases appeared among all staff and recipients who were in close contact with organ donors. Conclusions Targeted formulation of the workflow and prevention and control measures, in combination with selection and implementation of infection risk classification can effectivelyreduce the risk of COVID-19 infection and carry out organ donation after citizen' s death in a safe and organized manner.

17.
Chinese Journal of Burns ; (6): 243-247, 2019.
Article in Chinese | WPRIM | ID: wpr-805018

ABSTRACT

Allogeneic skin grafting has a history of nearly 150 years and is one of the key measures to repair extensive deep burn wounds. Allogeneic skin survives temporarily to cover the wound, providing a valuable opportunity for the ultimate wound repair using autografts. As the main methods for the repair of extensive deep burn wounds in China, both the microskin grafting technique and inlay skin grafting technique are based on allogeneic skin grafting. Since allogeneic skin is hardly available in recent years, many burn centers are in extreme lack of allogeneic skin, which seriously hampers clinical burn care. Organ Procurement Organization and allogeneic skin banks may be legal means of solving the problems of source and quality of allogeneic skin, and the successful development of ideal engineered skin is the fundamental solution to burn care without allogeneic skin grafting in the future.

18.
Article in Chinese | WPRIM | ID: wpr-662898

ABSTRACT

Objective To report the results of lung transplantation using graft lungs from donation after citizens death.Methods The clinical data of lung transplantation between January 2016 and June 2016 were analyzed retrospectively.Results Totally 20 patients with end stage lung diseases underwent lung transplantation.Of the 20 patients,11 cases (55%) underwent single lung transplantation and 9 cases (45 %) underwent bilateral lung transplantation.The top two diseases for lung transplantation were pulmonary fibrosis in 11 cases (55%) and emphysema in 6 cases (30%).Four cases (20%) were given intraoperative ECMO support.Median duration of postoperative intubation was 2 days:1 day for single lung transplantation and 4 days for bilateral lung transplantation,respectively.Acute rejections were diagnosed in 9 patients (45%) who were successfully treated with high-dose intravenous methylprednisolone or methylprednisolone combined with anti-human thymocyte globulin.Postoperative pneumonia episodes occurred in 16 cases (80%)and 4 of them were associated fungal pneumonia.Preoperative sputum culture showed positive bacteria in 16 donors (80%) and 17 kinds of strains were identified.Postoperative sputum culture showed positive bacteria in 19 recipients and 4 of them had the same strains as compared with the corresponding donors.One recipient died of primary graft dysfunction in early term (< 1 month)postoperatively,two recipients abandoned treatments and died in 1 week after the discharge,and the remaining 17 cases successfully recovered.Median hospital duration was 55 days:35 days for single lung transplantation and 67 days for bilateral lung transplantation,respectively.Conclusion LLung transplantation is an effective treatment for end-stage lung diseases.Carefully selecting donors,well protecting graft lung and proper peri-operative treatment are the key steps leading to successful lung transplantation using grafts from organ procurement organization.

19.
Article in Chinese | WPRIM | ID: wpr-660974

ABSTRACT

Objective To report the results of lung transplantation using graft lungs from donation after citizens death.Methods The clinical data of lung transplantation between January 2016 and June 2016 were analyzed retrospectively.Results Totally 20 patients with end stage lung diseases underwent lung transplantation.Of the 20 patients,11 cases (55%) underwent single lung transplantation and 9 cases (45 %) underwent bilateral lung transplantation.The top two diseases for lung transplantation were pulmonary fibrosis in 11 cases (55%) and emphysema in 6 cases (30%).Four cases (20%) were given intraoperative ECMO support.Median duration of postoperative intubation was 2 days:1 day for single lung transplantation and 4 days for bilateral lung transplantation,respectively.Acute rejections were diagnosed in 9 patients (45%) who were successfully treated with high-dose intravenous methylprednisolone or methylprednisolone combined with anti-human thymocyte globulin.Postoperative pneumonia episodes occurred in 16 cases (80%)and 4 of them were associated fungal pneumonia.Preoperative sputum culture showed positive bacteria in 16 donors (80%) and 17 kinds of strains were identified.Postoperative sputum culture showed positive bacteria in 19 recipients and 4 of them had the same strains as compared with the corresponding donors.One recipient died of primary graft dysfunction in early term (< 1 month)postoperatively,two recipients abandoned treatments and died in 1 week after the discharge,and the remaining 17 cases successfully recovered.Median hospital duration was 55 days:35 days for single lung transplantation and 67 days for bilateral lung transplantation,respectively.Conclusion LLung transplantation is an effective treatment for end-stage lung diseases.Carefully selecting donors,well protecting graft lung and proper peri-operative treatment are the key steps leading to successful lung transplantation using grafts from organ procurement organization.

20.
Organ Transplantation ; (6): 435-439, 2017.
Article in Chinese | WPRIM | ID: wpr-731704

ABSTRACT

Objective To evaluate the application value of donor liver from organ donation after citizen's death (organ donation) in clinical liver transplantation. Methods Clinical data of 75 pairs of donors and recipients undergoing liver transplantation from organ donation in the First People's Hospital of Foshan from October 2011 to December 2016 were retrospectively analyzed. The conditions of the donors were strictly evaluated. Clinical prognosis and the incidence of postoperative complications of the recipients were summarized. Results The 1-year and 3-year accumulated survival rates of 75 liver transplantation recipients were 88% and 78%. Four recipients died from the recurrence and metastasis of liver cancer, 1 case from graft-versus-host disease, 1 case from severe pulmonary infection, 1 case from recurrence of virus B hepatitis (hepatitis B) and liver failure, 1 case from postoperative multiple organ failure and 1 case from massive hemorrhage of the upper digestive tract. Thirteen recipients suffered from biliary tract stenosis. One case was mitigated spontaneously and 1 recipient was healed after percutaneous transhepatic biliary drainage (PTBD). Eleven cases were treated with endoscopic retrograde cholangiopancreatography (ERCP). Among them, 5 cases were healed,2 recipients were switched to choledochojejunostomy and 4 cases were still monitored in clinical practice. Conclusions Liver transplantation from organ donation yields high clinical efficacy. Strict evaluation of donor conditions, standard perioperative management of the recipients, maintenance immunosuppressive therapy without adrenocortical hormone,timely and effective treatment of complications, regular postoperative follow-up are pivotal measures to guarantee the success of liver transplantation from organ donation and long-term survival of the recipients.

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