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2.
Swiss Med Wkly ; 150: w20447, 2020 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-33382904

RESUMO

The Swiss stepwise shutdown approach in organ donation and transplantation helped to maintain a limited national organ procurement and vital organ transplant activity, avoiding a complete nationwide shutdown of organ donation and transplant activity. .


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/organização & administração , Transplante de Órgãos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Humanos , Pandemias , Estudos Retrospectivos , Suíça
3.
Epidemiol Serv Saude ; 30(1): e2020754, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33331601

RESUMO

OBJECTIVE: To describe organ donations and transplants in Ceará state, Brazil, following the declaration of the COVID-19 pandemic. METHODS: This was a descriptive study using data from the Brazilian Organ Transplantation Association. The number of donors and transplants from April to June 2020 was compared to the same period in 2019 and to the first quarter of 2020. RESULTS: In the first half of 2020, the state registered 72 effective donors, just 17 (23.6%) of whom related to the second quarter. Of the 352 transplants in the first half of 2020, 37 (10.7%) were performed in the second quarter. Compared with the period from April to June 2019, there was a reduction of 67.9% and 89.3% in the number of donors and transplants, respectively, in the same period of 2020. CONCLUSION: The number of donors and transplants in Ceará showed an important fall in the three months following the declaration of the COVID-19 pandemic, especially for kidney, heart and cornea transplants.


Assuntos
Transplante de Órgãos/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Brasil , Humanos
5.
Cell Tissue Bank ; 21(4): 557-562, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33063150

RESUMO

On March 19 World Health Organization declare the pandemic situation by outbreak coronavirus disease 2019 in the world. The pressure on the health care system has been very high in several countries. Spanish National Transplant Organization (ONT) have made many efforts in maintaining transplantation activity. Although the impact of the pandemic on organ activity has been analysed, to date, less data exist regarding the impact on tissue activity. The aim of this study has been the evaluation of the possible impact on the procurement, processing and distribution of tissues during the peak period of the pandemic COVID-19 in Spain. For this study, a multicentre analysis has been made with a survey of the tissue banks in Spain, during the period March 1 to April 30, 2020. Our data suggest that the impact of coronavirus in Spain has affected dramatically tissue donation but with a moderate effect on stored tissues such as bone, valves, vessels or skin. Tissue banks should prepare if future next pandemic waves surges so that tissue provision is guaranteed both in urgent and elective surgeries.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Bancos de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Transplante/estatística & dados numéricos , Betacoronavirus , Humanos , Pandemias , Espanha/epidemiologia , Inquéritos e Questionários
6.
Rev. cir. (Impr.) ; 72(5): 482-491, oct. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1138744

RESUMO

Resumen La donación de órganos en Chile es insuficiente, con una tasa histórica de alrededor de seis donantes por millón de habitantes. Las reformas legales, mejoras organizacionales y campañas comunicacionales han permitido hacer del año 2019 el más exitoso en cuanto a donación de órganos y trasplantes. El trasplante hepático en Chile fue realizado por primera vez en el año 1969 en el Hospital Naval de Valparaíso, falleciendo el receptor precozmente. El primer trasplante exitoso fue realizado en el año 1985 en el Hospital Militar de Santiago. Desde esa fecha hasta la actualidad se han realizado 1.812 trasplantes de hígado, el 43,6% en hospitales universitarios, el 35,1% en clínicas privadas y un 21,5% en hospitales estatales. El 23,1% en la Pontificia Universidad Católica (PUC), el 20,6% en el Hospital Clínico de la Universidad de Chile (HCUCH), el 15,9% en el Hospital Luis Calvo Mackenna (HLCM), el 15,9% en Clínica Las Condes (CLC), el 14,3% en Clínica Alemana de Santiago (CA), el 5,6% en el Hospital del Salvador (HdS), 2% en Clínica Dávila (CD), 2% en el Sanatorio Alemán de Concepción (SA) y 0,9% en Clínica Santa María (CSM) De este total, 455 son en pacientes pediátricos, de ellos 63,3% en Hospital Luis Calvo Mackenna el 21,1% en la Clínica Las Condes el 7,7% en la Pontificia Universidad Católica de Chile, el 6,4% en la Clínica Alemana y 1,5% en el Sanatorio Alemán. Desde el 2015, aproximadamente el 80% de los trasplantes pediátricos se realizan en el HLCM. Sobrevidas reportadas en adultos van del 75% a 85% al año y de 75% a 92% al año en pacientes pediátricos dependiendo el período. Hay centros que nunca han reportado sus resultados. Se espera mejorar la educación en pro de una sociedad proclive en la donación, mejorar la organización de detección, mantención y procuramiento, aumentar la utilización de órganos, potenciar la utilización los de donantes cadáveres, con técnica Split o hígado dividido y, mientras no tengamos un sistema de donación que dé cuenta de las necesidades del país, mantener los programas de donante vivo. Finalmente debe motivarse a generaciones jóvenes para que se dediquen a esta importante actividad.


Organ donation in Chile is insufficient, with a historical rate of six donors per million inhabitants. Legal reforms, organizational improvements, and communications campaigns have made 2019 the most successful year in terms of organ donations and transplants. The first liver transplant in Chile was performed in 1969 at the Naval Hospital in Valparaíso. However, the patient passed away shortly after. The first successful transplant was performed in 1985 at the Militar Hospital in Santiago. As of that date to present day, 1.812 liver transplants have been performed: 43.6% of these in university hospitals, 35.1% in private clinics, and 21.5% in state hospitals. Of these, 23.1% were performed at the Pontificia Universidad Católica de Chile (PUC), 20.6% at the Universidad de Chile Clinical Hospital (HCUCH), 15.9% at the Luis Calvo Mackenna Hospital (HLCM), 15.9% at the Las Condes Clinic (CLC), 14.3% at the Alemana Clinic in Santiago (CA), 5.6% at the del Salvador Hospital (HdS), 2% at the Dávila Clinic (CD), 2% at the Alemán Sanatorium in Concepción (SA), and 0.9% at the Santa María Clinic (CSM). Of this total, 455 correspond to pediatric patients. Of these patients, 63.3% were at the Luis Calvo Mackenna Hospital, 21.1% at the Las Condes Clinic, 7.7% at the Pontificia Universidad Católica de Chile, 6.4% at the Alemana Clinic, and 1.5% at the Alemán Sanatorium. Since 2015, approximately 80% of pediatric transplants are performed at the HLCM. Reported one-year survival range from 75% to 85% in adults and 75% to 92% in pediatric patients per year, depending on the period. Some centers have never reported their results. It is expected that education of a society prone to organ donation improves, as well as improving the detection, maintenance, and procurement of potential donors, increasing the utilization of organs, enhancing the utilization of organs from deceased donors with Split technique, and, while we are building towards a donation system that responds to the needs of the nation, upholding live donor programs. Finally, younger generations are to be motivated so that they dedicate themselves to this important activity.


Assuntos
Humanos , Chile/epidemiologia , Transplante de Fígado/história , Transplantes/estatística & dados numéricos , Sobrevida , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/história , Obtenção de Tecidos e Órgãos/estatística & dados numéricos
7.
JAMA Cardiol ; 5(9): 1048-1052, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32936254

RESUMO

Importance: Solid organ transplants have declined significantly during the coronavirus disease (COVID-19) pandemic in the US. Limited data exist regarding changes in heart transplant (HT). Objective: To describe national and regional trends in waitlist inactivations, waitlist additions, donor recovery, and HT volume during COVID-19. Design, Setting, and Participants: This descriptive cross-sectional study used publicly available data from the United Network for Organ Sharing and US Centers for Disease Control and Prevention, using 8 prespecified United Network for Organ Sharing regions. Adult (18 years or older) HT candidates listed and deceased donors recovered between January 19 to May 9, 2020. Exposures: COVID-19 pandemic. Main Outcomes and Measures: Changes in waitlist inactivations, waitlist additions, deceased donor recovery, and transplant volumes from the pre-COVID-19 (January 19-March 15, 2020) to the COVID-19 era (March 15-May 9, 2020). Density mapping and linear regression with interrupted time series analysis were used to characterize changes over time and changes by region. Results: During the COVID-19 era, there were 600 waitlist inactivations compared with 343 during the pre-COVID era (75% increase). Waitlist additions decreased from 637 to 395 (37% reduction). These changes were most profound in the Northeast and Great Lakes regions with high rates of COVID-19. Deceased donor recovery decreased by 26% from 1878 to 1395; the most significant decrease occurred in the North Midwest despite low COVID-19 prevalence. Heart transplant volumes were significantly reduced across all regions except the Northwest. The largest decrease was seen in the Northeast where COVID-19 case rates were highest. From the pre-COVID-19 era to the COVID-19 era, there was significant regional variation in waitlist additions (eg, 69% decrease in the Northeast vs 8.5% increase in the South Midwest; P < .001) and deceased donor recovery (eg, 41% decrease in North Midwest vs 16% decrease in South Midwest; P = .02). Conclusions and Relevance: Heart transplant volumes have been significantly reduced in recent months, even in regions with a lower prevalence of COVID-19 cases. This has been accompanied by increased waitlist inactivations, decreased waitlist additions, and decreased donor recovery. Future studies are needed to determine if the COVID-19 pandemic is associated with changes in waitlist mortality.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transplante de Coração/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Listas de Espera , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Utilização de Procedimentos e Técnicas , Estados Unidos
9.
Transplantation ; 104(8): 1668-1674, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32732846

RESUMO

BACKGROUND: Substantial differences exist in the clinical characteristics of donors across the 58 donor service areas (DSAs). Organ procurement organization (OPO) performance metrics incorporate organs donated after circulatory determination of death (DCDD) donors but do not measure potential DCDD donors. METHODS: Using 2011-2016 United Network for Organ Sharing data, we examined the variability in DCDD donors/all deceased donors (%DCDD) across DSAs. We supplemented United Network for Organ Sharing data with CDC death records and OPO statistics to characterize underlying process and system factors that may correlate with donors and utilization. RESULTS: Among 52 184 deceased donors, the %DCDD varied widely across DSAs, with a median of 15.1% (interquartile range [9.3%, 20.9%]; range 0.0%-32.0%). The %DCDD had a modest positive correlation with 4 DSA factors: median match model for end-stage liver disease, proportion of white deaths out of total deaths, kidney center competition, and %DCDD livers by a local transplant center (all Spearman coefficients 0.289-0.464), and negative correlation with 1 factor: mean kidney waiting time (Spearman coefficient -0.388). Adjusting for correlated variables in linear regression explained 46.3% of the variability in %DCDD. CONCLUSIONS: Donor pool demographics, waitlist metrics, center competition, and DCDD utilization explain only a portion of the variability of DCDD donors. This requires further studies and policy changes to encourage consideration of all possible organ donors.


Assuntos
Benchmarking/estatística & dados numéricos , Transplante de Órgãos/estatística & dados numéricos , Melhoria de Qualidade/organização & administração , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/organização & administração , Adulto , Aloenxertos/estatística & dados numéricos , Aloenxertos/provisão & distribução , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tempo para o Tratamento/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Estados Unidos/epidemiologia , Listas de Espera , Adulto Jovem
10.
Transplant Proc ; 52(9): 2607-2613, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32773284

RESUMO

The concerns generated by coronavirus disease 2019 (COVID-19) pandemic are having profound impact on solid organ transplantation (SOT). Non-pharmaceutical interventions (NPI) are currently the only measures available to contain COVID-19 in the general population and in more vulnerable recipients of any organ transplant. In this cross-sectional case control study from a patient survey undertaken in 2 transplant centers (TxC) in the Kingdom of Saudi Arabia and Italy, we aimed to appraise awareness of the NPI implemented by respective these governments. We have also evaluated the impact of COVID-19 on our kidney transplant (KT) recipients and a control group of kidney living donors (KLD). In our series, there were zero cases of COVID-19 among 111 KT recipients and 70 KLD of the control group. Demography, transplant type, immunosuppression regimes, and, importantly, the different COVID-19 prevalence in the 2 regions of the TxC did not appear to influence incidence of COVID-19 in our KT recipients. The absence of COVID-19 cases in our series was unexpected. Our findings suggest that awareness of NPI is associated with a successful containment of COVID-19 in vulnerable, immunosuppressed KT recipients.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/epidemiologia , Hospedeiro Imunocomprometido/imunologia , Transplante de Rim/efeitos adversos , Pneumonia Viral/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Adulto , Estudos de Casos e Controles , Infecções por Coronavirus/imunologia , Estudos Transversais , Feminino , Humanos , Incidência , Itália/epidemiologia , Doadores Vivos/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/imunologia , Complicações Pós-Operatórias/imunologia , Complicações Pós-Operatórias/virologia , Prevalência , Arábia Saudita/epidemiologia , Coleta de Tecidos e Órgãos/efeitos adversos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos
12.
S Afr Med J ; 110(2): 132-134, 2020 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-32657684

RESUMO

BACKGROUND: South Africa (SA) has one of the lowest deceased organ donor rates in the world (1.4 donors per million population), with thousands of patients awaiting solid-organ transplantation. In order to improve access to transplantation we have to clearly define the reasons for the low deceased donation rate, specific to the population we serve. OBJECTIVES: Review of actual donor statistics highlights our successes, yet is not able to contextualise the factors responsible for the unsuccessful conversion of referred organ donors to actual organ donors. In an attempt to identify key factors preventing referred donors from becoming actual donors, we analysed the donor referral patterns at our institution over a 10-year period. METHODS: This was a retrospective descriptive study of consecutive deceased donor referrals at Groote Schuur Hospital, Cape Town, SA (from January 2007 to December 2016), utilising a regional donor referral registry. Qualitative and quantitative data were collected and presented as descriptive statistics and temporal trends. RESULTS: Over the 10-year study period, 861 possible organ donors were referred, with a steady increase in the number of referrals over time. Of the referrals, 514 (59.7%) were eligible for donation of at least one solid organ. Of the 508 families that were approached for consent to donation, 342 declined consent for a variety of reasons, resulting in a consent rate of 32.7%. Ultimately, at least one solid organ was obtained from 159 of the 166 consented donors. Despite the increasing number of possible and eligible donors, a statistically significant decline in consent rate was observed over time (ptrend=0.023). Furthermore, increasing trends in medical (as opposed to trauma) (ptrend<0.001) and extended criteria (as opposed to standard criteria) donor referrals (ptrend<0.001) were observed over the 10-year study period. CONCLUSIONS: Donor referral patterns have changed over time, with a notable increase in medical and extended criteria donors. Despite the increase in possible and eligible donors, the consent rate has declined. Further qualitative and quantitative research studies are required to understand and address this trend.


Assuntos
Transplante de Órgãos/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adulto , Feminino , Hospitais Públicos , Humanos , Masculino , Encaminhamento e Consulta/tendências , Sistema de Registros , Estudos Retrospectivos , África do Sul , Centros de Atenção Terciária , Obtenção de Tecidos e Órgãos/tendências , Adulto Jovem
13.
S Afr Med J ; 110(3): 204-209, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32657697

RESUMO

BACKGROUND: South Africa (SA) has very low and unchanging organ donation rates. A key point in the pathway of organ donation is obtaining informed consent from the family, which is necessary before organ donation can proceed. There is no published SA research on the consent rate and factors that influence this. OBJECTIVES: To describe the number of requests for consent and factors influencing this process in the SA context. METHODS: A prospective descriptive study was performed of all requests to families for organ donation in Western Cape Province, SA, by Groote Schuur Hospital (state sector), Red Cross War Memorial Children's Hospital (state sector) and Netcare (private sector) transplant co-ordinators from 1 May 2017 to 1 May 2018 to describe factors influencing consent rates. RESULTS: The 6 co-ordinators (3 state sector and 3 private sector) recorded data of 83 consecutive families approached in 16 hospitals over the 1-year period. Consent to organ donation was granted for 23 family requests (n=18 (state sector); n=5 (private sector)). The number of families approached was greater in the state sector (n=74) than in the private sector (n=9). The overall consent rate was 27.7% (24.3% (state sector); 55.5% (private sector)). The majority of referrals came from trauma and emergency units (n=55; 66.3%) and very few from intensive care units (n=25; 30.1%). Immediate fluid resuscitation was required in 56 (67.5%) potential donors. The majority of families (n=74; 89.2%) were receptive to the organ donation request, independent of their ultimate decision regarding donation. The main reason given for refusing to consent was that it was against their religion (n=21) or culture (n=18). CONCLUSIONS: This study showed that the number of families approached for consent to organ donation were low in the Western Cape (lower in the private sector), with a low consent rate (lower in the state sector). Donor management by clinical teams needs to be ongoing and active during the consent process. Consent discussions (and public awareness initiatives) need to be sensitive to and deal with religious and cultural reservations about organ donation.


Assuntos
Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Cultura , Família , Humanos , Consentimento Livre e Esclarecido , Estudos Prospectivos , Religião , África do Sul
15.
Am J Gastroenterol ; 115(7): 1022-1023, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32618651

RESUMO

Over the past several years, single- and multi-center case series have reported on the successful use of livers from hepatitis C virus (HCV)-antibody positive and HCV-viremic donors to HCV-negative recipients. Several authors have studied not only the efficacy of this practice but also its cost-effectiveness of transplanting HCV-infected organs to HCV-negative donors. However, previous studies had limited follow-up and had not examined transplants beyond the beginning of 2018. Using national data from 2014-2018, Thuluvath et al. demonstrated that post-transplant outcomes of recipients from either HCV-antibody and/or HCV-viremic donors were not different than those using livers from HCV-negative donors.


Assuntos
Hepatite C Crônica , Transplante de Fígado , Fígado/virologia , Transplantados/estatística & dados numéricos , Antivirais/uso terapêutico , Rejeição de Enxerto , Sobrevivência de Enxerto , Hepatectomia , Hepatite C Crônica/tratamento farmacológico , Humanos , Doadores de Tecidos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Viremia
16.
Transplant Proc ; 52(9): 2578-2583, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32709414

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak has unfavorably influenced solid organ donation activity. AIM: The aim of this study is to investigate the effect of COVID-19 on transplantation in the North Italy Transplant program (NITp). MATERIAL AND METHODS: This cross-sectional study included all consecutive potential deceased donors proposed in the NITp in 6 weeks after February 21, 2020 (period A) compared to all potential donors during the same time frame of the previous years (period B) and all potential donors 6 weeks before February 20, 2020 (period C). RESULTS: Fifty-eight deceased donors were proposed during period A, 95 were proposed during period B, and 128 were proposed during period C. After the evaluation process, 32 of 58 (55.2%), 60 of 95 (63.2%), and 79 of 128 (61.7%) donors were used for organ donation in periods A, B, and C, respectively (P value = .595). We observed a 47% donation reduction in period A compared to period B and a 60% reduction compared to period C. There was a reduction of 44% and 59% in transplantation comparing period A with period B and period C, respectively. CONCLUSIONS: This study showed an important reduction of donations and transplants during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Transplante de Órgãos/estatística & dados numéricos , Pandemias , Pneumonia Viral , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Betacoronavirus , Estudos Transversais , Humanos , Itália/epidemiologia
19.
Transplantation ; 104(7): 1305-1307, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32568998
20.
Transplant Proc ; 52(6): 1647-1649, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32576472

RESUMO

OBJECTIVES: This report presents an audit of utilization of various organs from deceased donors in different states of India over a 3-year period METHODS: Data released by the various regions on their official website was analyzed from 2015 to 2017.Regions with less than 25 donations per year were excluded while calculating utilization rates. RESULTS: Total organ donation in India had increased from 570 to 843 donations from 2015 to 2017 (47.8% increase) with southern states performing exceedingly well compared with northern states. Total organs retrieved during the 3-year period were 6659 with a 54.7% increase in organ retrieval in 2017 compared with 2015 (2592 vs 1675 respectively). The net utilization rate of kidneys was 87.35%. Total liver transplants done during this period were 1894. Net liver utilization rate was 86.81% over 3 years. Total Heart transplants during this period were 641 with net utilization rate of 28.98%. An increase in utilization rates was observed from 2015 to 2017 (19.33%-34.46%). A total of 217 lung transplants were done with net utilization rate of 8.86% with an increase in yearly utilization rate from 6.5% in 2015 to 11.97% in 2017. Total pancreas transplants remained low with 48 transplants over 3 year duration with net utilization rate of 2.25% but an increase in utilization rate was observed. (0.92% in 2015 to 2.1% in 2017). CONCLUSION: There is a significant regional variability in organ utilization in India. Evaluating and addressing the cause of high variability can further increase the transplant activity.


Assuntos
Transplante de Órgãos/estatística & dados numéricos , Doadores de Tecidos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Transplantes/estatística & dados numéricos , Feminino , Humanos , Índia , Estudos Retrospectivos , Doadores de Tecidos/provisão & distribução
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