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1.
PLoS One ; 17(9): e0271293, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36129920

RESUMO

BACKGROUND: Malignancies in the urinary tract and the kidney graft are quite common after kidney transplantation. In some selected cases tumours develop from donor-derived tissue. OBJECTIVES: We hypothesised that there is a clinical value to investigate donor/recipient origin in urologic malignancies in renal transplant recipients. METHODS: In this retrospective study, including patients transplanted between the years 1969 and 2014 at Uppsala University Hospital, Sweden, 11 patients with malignancies in urinary tract and 4 patients with malignancies in kidney transplants were investigated. Donor/recipient origin of tumour tissue was analysed by polymerase chain reaction (PCR) of human leucocyte antigen (HLA) genotypes or by fluorescence in situ hybridization (FISH analysis) of sex chromosomes. HLA genotype and sex chromosomes of the tumour were compared to the known HLA genotype and sex chromosomes of recipient and donor. RESULTS: Three of ten cancers in the urinary tract and three of four cancers in the kidney transplants were donor-derived. CONCLUSIONS: We suggest that urologic malignancies in renal transplant recipients can be investigated for transplant origin. In addition to conventional therapy the allograft immune response against these tumours can be valuable to treat donor-derived cancers.


Assuntos
Transplante de Rim , Neoplasias Urológicas , Sobrevivência de Enxerto , Antígenos HLA , Humanos , Hibridização in Situ Fluorescente , Transplante de Rim/efeitos adversos , Estudos Retrospectivos , Doadores de Tecidos , Neoplasias Urológicas/genética
2.
J Vis Exp ; (186)2022 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-36063020

RESUMO

Liver transplantation is regarded as the gold standard for the treatment of a variety of fatal hepatic diseases. However, unsolved issues of chronic graft failure, ongoing organ donor shortages, and the increased use of marginal grafts call for the improvement of current concepts, such as the implementation of organ machine perfusion. In order to evaluate new methods of graft reconditioning and modulation, translational models are required. With respect to anatomical and physiological similarities to humans and recent progress in the field of xenotransplantation, pigs have become the main large animal species used in transplantation models. After the initial introduction of a porcine orthotopic liver transplant model by Garnier et al. in 1965, several modifications have been published over the past 60 years. Due to specifies-specific anatomical traits, a veno-venous bypass during the anhepatic phase is regarded as a necessity to reduce intestinal congestion and ischemia resulting in hemodynamic instability and perioperative mortality. However, the implementation of a bypass increases the technical and logistical complexity of the procedure. Furthermore, associated complications such as air embolism, hemorrhage, and the need for a simultaneous splenectomy have been reported previously. In this protocol, we describe a model of porcine orthotopic liver transplantation without the use of a veno-venous bypass. The engraftment of donor livers after static cold storage of 20 h - simulating extended criteria donor conditions - demonstrates that this simplified approach can be performed without significant hemodynamic alterations or intraoperative mortality and with regular uptake of liver function (as defined by bile production and liver-specific CYP1A2 metabolism). The success of this approach is ensured by an optimized surgical technique and a sophisticated anesthesiologic volume and vasopressor management. This model should be of special interest for workgroups focusing on the immediate postoperative course, ischemia-reperfusion injury, associated immunological mechanisms, and the reconditioning of extended criteria donor organs.


Assuntos
Transplante de Fígado , Obtenção de Tecidos e Órgãos , Animais , Humanos , Fígado/cirurgia , Transplante de Fígado/métodos , Perfusão , Suínos , Doadores de Tecidos
3.
Sci Rep ; 12(1): 15061, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064740

RESUMO

Donor specific anti-HLA antibodies (DSA) and donor-derived cell-free DNA (dd-cfDNA) have lead to substantial progress in the non-invasive monitoring of the renal allograft by being able to detect or rule out subclinical rejection and guide immunosuppressive changes. In this study we sought to analyze the clinical, de novo DSA (dnDSA) and histological determinants of dd-cfDNA levels. The study included a cohort of stable renal function kidney transplant (KT) recipients who underwent anti-HLA dnDSA and dd-cfDNA testing between September 2017-December 2019. Statistical models were constructed to detect association with predictors of dd-cfDNA levels and other clinical characteristics. 171 renal allograft recipients were tested for dd-cfDNA and dnDSA at a median 1.06 years posttransplant (IQR: 0.37-4.63). Median dd-cfDNA was 0.25% (IQR: 0.19-0.51), 18.7% of patients having a dd-cfDNA ≥ 1%. In a multivariate linear regression model the presence of dnDSA MFI ≥ 2500 was the best independent determinant of dd-cfDNA level (p < 0.001). Among patients tested, 54 had concurrent dd-cfDNA determination at the time of an allograft biopsy. dd-cfDNA had an AUC of 0.82 (95% CI 0.69-0.91; p < 0.001) and of 0.96 (95% CI 0.87-0.99) to discriminate any rejection and ABMR, respectively. After multivariate adjustment, the models that included ABMR (R = 0.82, R2 = 0.67, p < 0.001), or ptc (R = 0.79, R2 = 0.63, p < 0.001) showed the best correlation with dd-cfDNA level. We are confirming a strong association of dd-cfDNA with dnDSA and underlying alloimmune-mediated injury in renal allograft recipients in a cohort of patients with unsuspecting clinical characteristics for rejection and excellent allograft function. Our findings support the need for noninvasive biomarker surveillance in KT recipients and we propose that dd-cfDNA may complement dnDSA screening.


Assuntos
Ácidos Nucleicos Livres , Transplante de Rim , Anticorpos , Biomarcadores , Ácidos Nucleicos Livres/genética , Rejeição de Enxerto , Humanos , Transplante de Rim/efeitos adversos , Doadores de Tecidos
4.
Transpl Int ; 35: 10489, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36090776

RESUMO

Advanced age of liver donor is a risk factor for graft loss after transplant. We sought to identify recipient characteristics associated with negative post-liver transplant (LT) outcomes in the context of elderly donors. Using 2014-2019 OPTN/UNOS data, LT recipients were classified by donor age: ≥70, 40-69, and <40 years. Recipient risk factors for one-year graft loss were identified and created a risk stratification system and validated it using 2020 OPTN/UNOS data set. At transplant, significant recipient risk factors for one-year graft loss were: previous liver transplant (adjusted hazard ratio [aHR] 4.37, 95%CI 1.98-9.65); mechanical ventilation (aHR 4.28, 95%CI 1.95-9.43); portal thrombus (aHR 1.87, 95%CI 1.26-2.77); serum sodium <125 mEq/L (aHR 2.88, 95%CI 1.34-6.20); and Karnofsky score 10-30% (aHR 2.03, 95%CI 1.13-3.65), 40-60% (aHR 1.65, 95%CI 1.08-2.51). Using those risk factors and multiplying HRs, recipients were divided into low-risk (n = 931) and high-risk (n = 294). Adjusted risk of one-year graft loss in the low-risk recipient group was similar to that of patients with younger donors; results were consistent using validation dataset. Our results show that a system of careful recipient selection can reduce the risks of graft loss associated with older donor age.


Assuntos
Transplante de Rim , Transplante de Fígado , Transplantes , Adulto , Idoso , Sobrevivência de Enxerto , Humanos , Transplante de Rim/efeitos adversos , Transplante de Fígado/efeitos adversos , Doadores de Tecidos
5.
Transpl Int ; 35: 10482, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36090778

RESUMO

Kidney transplantation is the therapy of choice for people living with kidney failure who are suitable for surgery. However, the disparity between supply versus demand for organs means many either die or are removed from the waiting-list before receiving a kidney allograft. Reducing unnecessary discard of deceased donor kidneys is important to maximize utilization of a scarce and valuable resource but requires nuanced decision-making. Accepting kidneys from deceased donors with heterogenous characteristics for waitlisted kidney transplant candidates, often in the context of time-pressured decision-making, requires an understanding of the association between donor characteristics and kidney transplant outcomes. Deceased donor clinical factors can impact patient and/or kidney allograft survival but risk-versus-benefit deliberation must be balanced against the morbidity and mortality associated with remaining on the waiting-list. In this article, the association between deceased kidney donor characteristics and post kidney transplant outcomes for the recipient are reviewed. While translating this evidence to individual kidney transplant candidates is a challenge, emerging strategies to improve this process will be discussed. Fundamentally, tools and guidelines to inform decision-making when considering deceased donor kidney offers will be valuable to both professionals and patients.


Assuntos
Falência Renal Crônica , Transplante de Rim , Humanos , Rim , Falência Renal Crônica/cirurgia , Doadores de Tecidos , Listas de Espera
6.
Cas Lek Cesk ; 161(3-4): 153-158, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36100456

RESUMO

Since time immemorial, bodies of deceased have been an integral part of teaching anatomy, and therefore the study of medicine. Without them, the teaching of anatomy, clinical anatomy and many research projects could not be realized. Nowadays, the European countries allow to use exclusively bodies of the deceased donors. Recently, we have registered a growing trend in the needs of the bodies not only for the purposes of medical education, but also for those of clinical anatomy. The question also arose of the suitability of using COVID-19 positive donors or the legislative possibility of obtaining bodies in the absence of donors in the donor program. Our communication addresses current issues of body donation for teaching and research purposes and their use in the Czech Republic.


Assuntos
COVID-19 , Educação Médica , COVID-19/epidemiologia , República Tcheca , Europa (Continente) , Humanos , Doadores de Tecidos
7.
Cas Lek Cesk ; 161(3-4): 159-162, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36100457

RESUMO

The Islamic Republic of Iran is a very progressive state in the field of medical research and its application. Although the country is fully subject to Islamic law (shari'a) and the influence of Shi'ite clerics, the development of medical science is not limited at all; Shi'ite medical ethics (unlike Sunnite) allows most of the modern medical techniques. Due to this attitude, Iran specializes today in many techniques that are prohibited in other countries for religious or ethical reasons. For example, Iranian research on cloning, cell and gene therapy reaches the world level, patients can use a third-party donor program and surrogacy for infertility treatment, the sale of kidney for transplantation was legalized, gender reassignment surgery is performed, and the country is a centre of cosmetic surgery. All of these services (excluding transplantation) are also offered to foreign patients. Thanks to these unlimited possibilities, high quality and low price, Iran has been currently gaining a strong position in the medical tourism market, not only in the Middle East region, but also worldwide.


Assuntos
Turismo Médico , Ética Médica , Humanos , Irã (Geográfico) , Islamismo , Doadores de Tecidos
8.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 2258-2261, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086591

RESUMO

Heart transplantation is a difficult procedure compared with other surgical operations, with a greater outcome uncertainty such as late rejection and death. We can model the success of heart transplants from predicting factors such as the age, sex, diagnosis, etc., of the donor and recipient. Although predictions can mitigate the uncertainty on the transplantation outcome, their accuracy is far from perfect. In this paper, we describe a new method to predict the outcome of a transplantation from textual operative reports instead of traditional tabular data. We carried out an experiment on 300 surgical reports to determine the survival rates at one year and five years. Using a truncated TF-IDF vectorization of the texts and logistic regression, we could reach a macro Fl of 59.1 %, respectively, 54.9% with a five-fold cross validation. While the size of the corpus is relatively small, our experiments show that the operative textual sources can discriminate the transplantation outcomes and could be a valuable additional input to existing prediction systems. Clinical Relevance- Heart transplantation involves a significant number of written reports including in the preoperative examinations and operative documentation. In this paper, we show that these written reports can predict the outcome of the transplantation at one and five years with macro 1s of 59.1 % and 54.9 %, respectively and complement existing prediction methods.


Assuntos
Transplante de Coração , Transplante de Coração/métodos , Humanos , Modelos Logísticos , Taxa de Sobrevida , Doadores de Tecidos
10.
Eur Rev Med Pharmacol Sci ; 26(16): 5635-5645, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36066134

RESUMO

Based on the research methods of literature review and philosophical reflection, this article points out the deficiencies and problems in the current research of brain banks: lack of nature analysis of brain banks and human brains; insufficient discussion of ethical, legal and social issues (ELSI) in the process of brain bank implementation - which has become the main research goal of this article. The article firstly clarifies the formation process of modern brain banks and briefly introduces the current development status of brain banks in the UK, the US and China, as well as the different types of modern brain banks. Next, the nature of brain banks and human brain samples are analyzed through an analogical model. Then, the ELSI issues at different stages are analyzed according to three stages: recruitment of donors, acquisition and storage of human brain tissue samples, and release and use of human brain tissue samples. Last, in the conclusion section, the main ideas of this paper are reiterated and questions for further reflection are presented.


Assuntos
Encéfalo , Doadores de Tecidos , Bancos de Espécimes Biológicos , China , Humanos
11.
Artigo em Inglês | MEDLINE | ID: mdl-36078336

RESUMO

This study examined how intrinsic motivation and its respective underlying mechanism influence people's attitude and intentions of organ donation. The findings revealed the importance of meeting people's customized psychological needs. For the general population, especially non-organ donors, autonomous appeal message will be more effective in promoting their intention of becoming an organ donor. For registered organ donors, competence-based organ donation messages are more effective in increasing their promotion and seeking behavior of organ donation. This study also discovered underlying mechanisms of intrinsic motivation, such as self-integrity, pride, and sympathy. Pairing underlying mechanism with competence-based messages can maximize the message impact.


Assuntos
Obtenção de Tecidos e Órgãos , Humanos , Intenção , Motivação , Autonomia Pessoal , Doadores de Tecidos/psicologia
12.
Adv Exp Med Biol ; 1388: 173-191, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36104621

RESUMO

The study of human anatomy has long been inseparable from illustration, as the portrayal of the dissected body alongside a descriptive text supports the understanding of this complex topic. With the advent of new technologies, applications for revealing the details of the human body have increased to include Computed Tomography and Magnetic Resonance Imaging scanning, digital photography and videography, and three-dimensional (3D) printing. In addition, the distribution of the captured image has become widespread in both online teaching and in hard copy textbooks. While these digital images and applications are invaluable for online teaching, particularly during pandemics, anatomists must consider whether the use of the images and data derived from human bodies (either donor or unclaimed) is ethical, as it is not always clear whether permission has been obtained for their creation.Questions regarding the ethical sourcing and use of images will become more urgent as the utilization of electronic data becomes routine. Particularly concerning is the distribution of images and videos in the public domain on social media, where the context and link with education may be severed. Other considerations include respect for the privacy of the deceased, ownership of images, and commercialization. An initial question that should be posed is "Who is responsible for the oversight of digital and 3D printed models of bodies?" The ethical use of such images needs to be considered by the global anatomy community in order to ensure that anatomists do not retreat into the ethical mire of their forefathers.


Assuntos
Tecnologia Digital , Impressão Tridimensional , Humanos , Doadores de Tecidos , Tomografia Computadorizada por Raios X
14.
J Vis Exp ; (186)2022 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-36036592

RESUMO

Controlled donation after circulatory death (cDCD) has contributed to increasing donor numbers all over the world. Experiences published in the last years confirm that the outcomes after lung transplantation from cDCD are similar to those from brain death donors; however, the utilization of lungs from asystole donors remains low. Several reasons may be involved: different legal frameworks among countries and centers with different premortem interventions, inadequate lung donor care before procurement, or even poor experience with cDCD procedures and protocols. Initially, the rapid recovery technique was commonly employed for the procurement of thoracic and abdominal organs in cDCD, but, in the last decade, abdominal normothermic regional perfusion (ANRP) with extracorporeal membrane oxygenation devices has become a useful method to restore blood flow to abdominal organs, allowing their quality improvement and their functional assessment prior to transplantation. This makes the donation procedure more complex and generates doubts about injury to the grafts due to dual temperature. The aim of this article is to describe a protocol based on a single center experience with Maastricht III donors combining lung cooling rapid recovery in the thorax and abdominal normothermic regional perfusion. Tips and tricks focused on premortem interventions and lung procurement procedure techniques are explained. This may help to minimize the reluctance among professionals to use this combined technique and encourage other donor centers to use it, despite the increased complexity of the procedure.


Assuntos
Preservação de Órgãos , Doadores de Tecidos , Humanos , Pulmão/cirurgia , Preservação de Órgãos/métodos , Perfusão/métodos , Tórax
15.
Clin Transplant ; 36(9): e14783, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35920407

RESUMO

Heart donation after circulatory death (DCD) can significantly expand the heart donor pool, helping to overcome the problem of organ shortage and the increase in waiting list mortality and morbidity. To improve the outcome of DCD heart transplantation, thoraco-abdominal normothermic regional perfusion (TA-NRP) can be performed by selectively restoring circulation followed by in vivo functional heart assessment. Here, we report on the use of periprocedural transoesophageal echocardiography (TOE) as a minimally invasive cardiac assessment tool during different stages of a DCD heart procurement procedure using TA-NRP. We conclude that TOE is a valuable method to assess the donor heart for transplantation eligibility before and after withdrawal of life-sustaining therapy and during subsequent TA-NRP.


Assuntos
Transplante de Coração , Obtenção de Tecidos e Órgãos , Ecocardiografia Transesofagiana , Transplante de Coração/métodos , Humanos , Perfusão/métodos , Doadores de Tecidos
16.
EBioMedicine ; 83: 104201, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35932640

RESUMO

BACKGROUND: Heart transplantation is the definitive treatment for many cardiovascular diseases. However, no ideal approach is established to evaluate heart grafts and it mostly relies on qualitative interpretation of surgeon based on the organ aspect including anatomy, color and manual palpation. In this study we propose to assess quantitatively the Shear Wave Velocity (SWV) using ultrasound as a biomarker of cardiac viability on a porcine model. METHODS: The SWV was assessed quantitatively using a clinical ultrasound elastography device (Aixplorer, Supersonics Imagine, France) linked to a robotic motorized arm (UR3, Universal Robots, Denmark) and the elastic anisotropy was obtained using a custom ultrasound research system. SWV was evaluated as function of time in two porcine heart model during 20h at controlled temperature (4°C). One control group (N = 8) with the heart removed and arrested by cold cardioplegia and immerged in a preservation solution. One ischemic group (N = 6) with the organ harvested after 30 min of in situ warm ischemia, to mimic a donation after cardiac death. Hearts graft were revived at two preservation times, at 4 h (N = 11) and 20 h (N = 10) and the parameters of the cardiac function evaluated. FINDINGS: On control hearts, SWV remained unchanged during the 4h of preservation. SWV increased significantly between 4 and 20h. For the ischemic group, SWV was found higher after 4h (3.04 +/- 0.69 vs 1.69+/-0.19 m/s, p = 0.007) and 20h (4.77+/-1.22 m/s vs 3.40+/-0.75 m/s, p = 0.034) of preservation with significant differences. A good correlation between SWV and cardiac function index was found (r2=0.88) and manual palpation score (r2=0.81). INTERPRETATION: Myocardial stiffness increase was quantified as a function of preservation time and harvesting conditions. The correlation between SWV and cardiac function index suggests that SWV could be used as a marker of graft viability. This technique may be transposed to clinical transplantation for assessing the graft viability during transplantation process. FUNDING: FRM PME20170637799, Agence Biomédecine AOR Greffe 2017, ANR-18-CE18-0015.


Assuntos
Técnicas de Imagem por Elasticidade , Transplante de Coração , Animais , Técnicas de Imagem por Elasticidade/métodos , Coração , Transplante de Coração/efeitos adversos , Humanos , Suínos , Doadores de Tecidos , Ultrassonografia
17.
Int J Surg ; 105: 106839, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35987333

RESUMO

BACKGROUND: Profound organ shortages worldwide have led to the increased utilization of marginal organs from older individuals. However, the effectiveness of liver transplantation (LT) with organs from elderly donors for patients with hepatocellular carcinoma (HCC) remains controversial. The objective of the current study was to assess the overall survival (OS) and disease-free survival (DFS) of patients with HCC following LT using grafts from deceased donors over 60 years old. MATERIAL AND METHODS: Patients with HCC who underwent LT between 2015 and 2018 were identified in the China Liver Transplant Registry database. The overall survival and disease-free survival of older liver donors (OLDs) were compared with those of younger liver donors (YLDs) after propensity score matching. RESULTS: From January 2015 to December 2018, a total of 4971 HCC patients were enrolled in the study according to the screening criteria. The absolute and relative utilization of liver grafts from elderly patients over 60 years for HCC patients increased every year, from 65 (9.3%) in 2015 to 268 (14.5%) in 2018. Disease-free survival (DFS) was significantly lower in HCC patients with elderly donors (both P < 0.05) after propensity score matching. The OLD group had worse DFS than YLD group if patients had tumors beyond the Milan criteria (P < 0.05). CONCLUSIONS: The use of older donors for LT has been growing quickly in the last few years in China. Grafts from older donors can be safely used in HCC recipients with similar OS and comparable perioperative complications. However, further investigation into whether older donor has an impact on recurrence is warranted, especially among those with tumors beyond the Milan criteria.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Transplante de Fígado , Idoso , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Doadores de Tecidos
18.
Ann Transplant ; 27: e936271, 2022 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-36039026

RESUMO

BACKGROUND Adequate donor and recipient matching in liver transplantation is crucial to improve patient survival. Our objective was to propose and validate a new model for predicting outcomes using donor and recipient scoring criteria. MATERIAL AND METHODS We retrospectively analyzed data of all patients (n=932) who underwent liver transplantation (n=1106) from January 2006 to December 2018. For score standardization, 30% (n=280) of patients were randomly selected for analysis and divided into 3 categories: ≤4 points, 5 to 8 points, and >8 points. Scoring system validation was performed on a dataset with 70% (n=652) of the patients. RESULTS Survival of the stratified group (30%) was significant (P<0.001). Scores of 4 to 8 points presented lower risk of death (1.74 [CI 0.97-3.13; P=0.062]), while >8 points presented higher risk (2.74 [CI 1.36-5.57; P=0.005]). In the validation score (70%), global survival was significant (P<0.0016); patients with scores of 4 to 8 points had lower risk of death (1.16 [CI 1.16-2.38; P=0.005]); and scores >8 points (2.22 [CI 1.40-3.50; P<0.001]), retransplant, fulminant hepatitis, previous large abdominal/biliary tree surgery, MELD score, and serum creatinine before liver transplantation >1.5 mg/dL (P<0.05) presented higher risk. Individual recipient factors with 4 to 8 points had a lower risk of death (2.29 [CI 1.82-2.87; P<0.0001]) than those with scores >8 points (4.02 [CI 2.22-7.26; P<0.0001]). CONCLUSIONS A novel prognostic-based scoring system using donor and recipient characteristics was proposed and clinically validated. Two-factor scoring indicated the superiority of the predictability outcome and improved prediction of higher mortality.


Assuntos
Transplante de Fígado , Sobrevivência de Enxerto , Humanos , Transplante de Fígado/efeitos adversos , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Doadores de Tecidos
19.
Methods Mol Biol ; 2573: 249-259, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36040600

RESUMO

Recent advances in ex vivo perfusion have enabled an extended preservation time for solid organs prior to transplantation allowing for possible resuscitation of the donor organ during the preservation period. Opportunities to provide viral vector-mediated gene therapy to the entire cardiac graft during this extended preservation period may lead to improvements in cardiac transplantation outcomes. Here we describe how to achieve successful gene delivery using viral vectors to an entire cardiac graft by normothermic, ex vivo perfusion. This protocol has been confirmed with the most highly utilized viral vector types in gene therapy clinical studies (adenoviral [Ad] and adeno-associated viral vector [AAV]).


Assuntos
Transplante de Coração , Terapia Genética/métodos , Vetores Genéticos/genética , Transplante de Coração/métodos , Humanos , Perfusão/métodos , Doadores de Tecidos
20.
Indian J Ophthalmol ; 70(9): 3284-3288, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36018104

RESUMO

Purpose: To report the factors influencing eye donation among families of successful eye donors in India. Methods: The consenting family members of 434 deceased individuals who donated eyes between April 2019 and March 2020 were retrospectively interviewed via a telephonic questionnaire survey. Details regarding the donors and their families, motivating factors for eye donation, and time taken for tissue recovery were collected and analyzed. Results: The mean age of donors was 66.8 years, and only 13.9% of them had pledged to donate their eyes before death. For 62.3% of donations, children of donors were the primary consenters for eye donation. In 18.8% of donors, there was a previous history of eye donation in the family. Many donations were motivated by a non-governmental organization volunteer (40.5%) or by a grief counselor at the hospital (27.4%). Hospital-based corneal retrieval programs and donations where the first eye bank contact was made through hospital personnel had the greatest percentage of rapid enucleations (performed within 3 h after death) (48.7% and 49.1%, respectively; P = 0.001 and P = 0.02, respectively). Conclusion: Children of donors, typically in the working-age group, most often make the decision for donation, and hence, future awareness programs should focus on this specific population. All types of hospitals should advocate for eye donation as they are a common point of contact for a grieving family, and health-care professionals at all levels should be considered for training as motivators for eye donation.


Assuntos
Obtenção de Tecidos e Órgãos , Criança , Córnea , Humanos , Índia , Estudos Retrospectivos , Inquéritos e Questionários , Doadores de Tecidos
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