Renal Procurement: Techniques for Optimizing the Quality of the Graft in the Cadaveric Setting

AbstractPurpose of ReviewKidney transplantation is the best treatment for end-stage renal disease. However, due to organ shortage, suboptimal grafts are increasingly being used.Recent FindingsWe carried out a review on the methods and techniques of organ optimization in the cadaveric setting.SummaryDonor care is the first link in a chain of care. Right after brain death, there is a set of changes, of which hormonal and hemodynamic changes are the most relevant. Several studies have been conducted to determine which drugs to administer, although in most cases, the results are not definitive. The main goal seems rather achieve a set of biochemical and hemodynamic objectives. The ischemia –reperfusion injury is a critical factor for kidney damage in transplantation. One of the ways found to deal with this type of injury is preconditioning. Local and remote ischemic preconditioning has been studied for various organs, but studies on the kidney are scarce. A new promising area is pha rmacological preconditioning, which is taking its first steps. Main surgical techniques were established in the late twentieth century. Some minor new features have been introduced to deal with anatomical variations or the emergence of donation after circulatory death. Finally, after harvesting, it is necessary to ensure the best conditions for the kidneys until the time of transplantation. Much has evolved since static cold preservation, but the best preservation conditions are yet to be determ...
Source: Current Urology Reports - Category: Urology & Nephrology Source Type: research

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Organ transplantation is undergoing profound changes. Contraindications for donation have been revised in order to better meet the organ demand. The use of lower-quality organs and organs with greater preoperative damage, including those from donation after cardiac death (DCD), has become an established routine but increases the risk of graft malfunction. This risk is further aggravated by ischemia and reperfusion injury (IRI) in the process of transplantation. These circumstances demand a preservation technology that ameliorates IRI and allows for assessment of viability and function prior to transplantation. Oxygenated h...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsThe findings of this survey indicate that Israel ’s citizens are willing to take part in decisions about organ allocation. Respondents did not seem to have a strict definition or concept of what they deem to be just; yet, in general, their preferences are compatible with current policy. Importantly, participants noted that they would be more wil ling to donate organs if their preferences were integrated into the allocation policy. Accordingly, we propose that allocation systems must strive to respect community values and perceptions while maintaining continued clinical effectiveness.
Source: Israel Journal of Health Policy Research - Category: International Medicine & Public Health Source Type: research
Abstract Organ transplantation is perhaps one area in which scientists have accomplished stunning outcomes in the 21st century. Nonetheless, the shortage of organs remains a major challenge of medical science, and worldwide, thousands of human organs are buried every day, especially from cerebrum-dead-injury victims. Using a method of philosophical analysis, this viewpoint study contends that the root cause of organ shortage is the dependence solely on altruistic organ donations. The unselfish organ donation is good, yet it is not enough. To close the gap between the demand and supply of organs, steps need to be t...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Abstract Many factors affect organ donations worldwide, including religious factors, legislative decisions, economic factors, presence of organ procurement organizations, cultural issues, the presence of commercial transplant, and other unknown factors. The number of patients with end-stage renal disease has increased by 6% worldwide. Even with more transplant procedures, these numbers have not combated the dramatically increased number of patients on wait lists. With regard to potential living donors, around 50% are either blood group or HLA incompatible with the recipient, which then requires patient desensitiza...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
2017 ended as a banner year for my family, but things didn’t look great at the start. A death sentence met us in a boxing ring, and we had to school ourselves on fighting to live. I never thought much about the 37 million American adults who suffer from kidney disease until my husband Neil became one of them. Celebrating our first year of marriage in 2001, we learned by accident through an unrelated medical exam that my husband has polycystic kidney disease, an illness which causes the kidneys to fill with cysts over time, rendering the organs unable to function properly. There is no cure. There was nothing to do but...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized health Healthcare medicine public health Source Type: news
Abstract Organ transplantation is often the ideal option for some end-stage organ diseases. However, organ donation is not keeping pace with growing demand for it. Saudi Arabia has one of the widest gaps between supply and demand with respect to transplants, estimated at 2-4 per million population. The purpose of this study is to survey the public's perceptions and opinion about organ donation and transplants in general. This is a cross-sectional study targeting the age group of 18-60 years as they represent potential organ donors in any community. An Arabic-language questionnaire was distributed online. The quest...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
Conclusions. Mild hypothermia in the donor safely reduced the rate of delayed graft function in kidney transplant recipients without adversely affecting donor physiology or extrarenal graft survival. Kidneys from standard criteria donors who received targeted mild hypothermia had improved 1-year graft survival.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science–General Source Type: research
Robert Chelsea turned down the first face he was offered. It was a fine face, one that could have taken him off the transplant waiting list after just a couple months. But Chelsea—severely disfigured after a catastrophic car accident five years earlier—was in no hurry. He’d gotten used to tilting his head back so food and water wouldn’t fall out of his nearly lipless mouth. He knew how to respond compassionately to children who stared in shock and fear. The face, offered in May 2018, had belonged to a man with skin that was much fairer than what remained of Chelsea’s—so light that Chelse...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Healthcare Source Type: news
Abstract Kidney replacement is the best treatment modality for chronic renal failure; however,the greatest obstacle for transplant is the scarce number of donor organs. In the United States and Europe, less than 1% of organs for transplant are provided from patients with lethal poisoning. In this paper, we present a successful kidney transplant from a donor with methanol poisoning. A 38-year-old-man who had methanol poisoning developed brain stem death after unsuccessful treatment and was a candidate to be a kidney donor for transplant to a 27-year-old male patient with chronic renal failure. Three weeks after kid...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
Heart transplantation remains the gold standard therapy for patients with advanced heart failure; however, the utilization of heart transplantation is constrained by the limited supply of donor organs. To expand the pool of available organ donors further, there has recently been renewed interest in the use of donation after circulatory death (DCD) hearts for transplantation. Kidney, liver, pancreas, and lung transplants are currently being performed in the United States with organs procured from these donors; however, there are no DCD heart transplants being performed.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Brief Research Report Source Type: research
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