Background
Organs transplantation is the only treatment for end-stage organ failure. However, the disparity between organs availability and the number of patients in the waiting lists is widening ...globally, especially in Iraq for many reasons. This study aims to assess the level of attitudes and perceptions among Iraqi young adults towards organs donation and transplantation as the first study to be conducted in Iraq for such purpose. Methods: This observational study was conducted among 912 Iraqi young adults through a structured questionnaire which was disseminated among social media platforms. Participants consented before filling the questionnaire and their responses were analyzed to test the hypothesis of the study.
Results
Most of the participants were females, Muslims and in their undergraduate level. Overall, 84.2% of the participants were willing to donate their organs after death and (97.9%) of them actually agreed to sign for organs donation. Most of those who were not willing to donate have no idea whether their religion approves it or not. There was no statistically significant difference in willingness to donate between different socioeconomic classes or residency areas.
Conclusions
Most of the participants are convinced with donating their organs after death and are willing to sign for organ donation programs, advocating for initiating an official governmental transplant agency with multiple local committees distributed among health directorates all over the country managing it. The hesitancy to donate organs was attributed mostly to religious and associated with lack of knowledge issues, thus education might be the key to positive attitudes.
Introduction: Renal transplantation performed on patients with chronic renal disease (CRD) stage five, is an alternative treatment that prolongs survival, reduces morbidity, accelerate social and ...medical rehabilitation. However it is necessary to carry out studies to evaluate the quality of life of these patients. Objective: Establishing the socio-demographic, clinical and service characteristics of the health insurer that explain the life quality of kidney transplanted patients who consulted a health institution in Medellin in 2016. Materials and methods: Quantitative and transversal survey carried out in 228 patients to whom the SF-36 instrument were applied. There were calculated the statistical tests of Kolmogorov Smirnov for normality, U de Mann Whitney, Kruskal Wallis and the Spearman correlation coefficient. In the multivariate analysis the median regression model was selected. Results: 50% of the patients got 83.3 or less in its life quality score. The multivariate regression model shown significant differences in the time variables after transplantation and readmission to hospital in the last year; by each readmission to hospital, the values of life quality decreased in 3.82 points; according to the time after the transplantation, it was found that going from a state where the patient has a term between 7 and 36 months, to a state where the patient has a term over 36 months, shown a decrease of 12.03 points in life quality, adjusted by the other variables. Conclusions: The variables that best explained the life quality of the kidney transplanted patients who consulted a health institution were the time of transplantation and the number of readmissions to hospital.
The aim of this paper is to present the teaching of the Catholic Church regarding the brain death and the human organ transplantation.
The analysis of the official documents of the Holy See as well ...as the teaching and speeches of popes was made.
The Catholic Church supports transplants from deceased persons and considers donating their organs after death for transplantation as the gift of the greatest love. However, it is not unconditional acceptance. The most important conditions are: the patient’s informed consent for organ donation and a precise statement of the death of the donor. The currently used definition of brain death has been declared by the Church not only as sufficient but also as definitive criterion of the death of a man. In Christian ethics, this criterion allows an ethical judgment, which is called as moral certainty and provides the basis for an ethically proper action. It is also stressed that the donation of organs for transplantation must be altruistic. It is unacceptable to expect and to receive any payment for such an act.
Aim: to analyze nosocomial infections and risk factors caused by enterococci. Review of the foreign and domestic literature on biology and virulence factors of enterococci being the leading causative ...agents of nosocomial infections is done. Information on risk factors and postoperative infectious complications, pathogens of which are enterococci, in surgical hospitals and hospitals for organ transplantations is provided. The growth of antibiotic resistance in enterococci and the relationship between mortality rate and prevalence rate of antibiotic resistant strains are emphasized
The transplant of cadaveric organs must be performed in a short period of time in order to achieve satisfactory results. In Hospital S. João (HSJ), a large Portuguese hospital, during 2008 and 2009, ...65 and 61 respectively potential donors were identified, but 12 and 19 of them were not validated as such in time. The number of validated donors could increase if the information workflow between donor hospitals and coordinator offices became more efficient. The goal of this work is to design and implement a multi-agent software platform to assist the information workflow between donor hospitals and coordinator offices. Through several meetings with HSJ coordinator office it was characterized a set of basic data that would allow coordinator offices to early identify possible organs donors. This preliminary characterization provided the necessary grounds for the development of an agent based software application allowing the storage and management of potential donors' information and optimizing the information workflow. The information workflow and the current communication processes characterization allowed the development of a multi-agent web platform, providing a way to assist the information workflow, between coordinator hospitals and their attached hospitals network. The platform also improves direct communication between coordinator offices about most relevant facts. By using this tool or a similar one the information workflow between donor hospitals and coordinator offices can become more efficient, optimizing the pre-transplantation tasks and consequently the number of successful transplants in our country.
When tobacco hornworm moths (Manduca sexta) are tested in a wind tunnel with a source of female pheromones upwind, males but not normal females show pheromone-modulated anemotaxis and a ...characteristic mate-seeking behavioural sequence. These behaviours are produced by stimulation of sensory neurones found only in male antennae. These neurones project axons only to dendrites of pheromone-specific interneurones in the macroglomerular complex, a region of neuropil in the antennal lobe characteristic of males but not present in normal females. Some interneurones in the antennal lobes of female moths that have received grafts of male antennae (gynandromorphs) respond postsynaptically to stimulation with bombykal, a major component of the pheromone. They branch into a region resembling the macroglomerular complex, like their counterparts in normal males. We show here that gynandromorphic females respond to pheromonal stimulation with anemotaxis. We also find that normal females display a similar sequence in response to the odour of their egg-laying site, the tobacco plant. It is likely that a common motor path is used either by pheromone-specific interneurones in the antennal lobes of males or by tobacco-specific interneurones in females. We assume that the interneurones in gynandromorphic females that branch into the macroglomerular complex induced by a grafted male antenna can activate this pathway.
The ongoing severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) pandemic has a drastic impact on national health care systems. Given the overwhelming demand on facility capacity, the impact ...on all health care sectors has to be addressed. Solid organ transplantation represents a field with a high demand on staff, intensive care units, and follow‐up facilities. The great therapeutic value of organ transplantation has to be weighed against mandatory constraints of health care capacities. In addition, the management of immunosuppressed recipients has to be reassessed during the ongoing coronavirus disease 2019 (COVID‐19) pandemic. In addressing these crucial questions, transplant physicians are facing a total lack of scientific evidence. Therefore, the aim of this study was to offer an approach of consensus‐based guidance, derived from individual information of 22 transplant societies. Key recommendations were extracted and the degree of consensus among different organizations was calculated. A high degree of consensus was found for temporarily suspending nonurgent transplant procedures and living donation programs. Systematic polymerase chain reaction‐based testing of donors and recipients was broadly recommended. Additionally, more specific aspects (eg, screening of surgical explant teams and restricted use of marginal donor organs) were included in our analysis. This study offers a novel approach to informed guidance for health care management when a priori no scientific evidence is available.
This study summarizes recommendations of international societies on the management of transplant patients during the SARS‐CoV‐2 pandemic.
The coronavirus pandemic has significantly impacted solid organ transplantation (SOT). Early in the outbreak period, transplant societies recommended suspending living kidney transplant programs in ...communities with widespread transmission to avoid exposing recipients to increased risk of immunosuppression, while recommendations were made to reserve deceased-donor kidney transplantation for likely life-saving indications. SOT recipients may be at high risk from COVID-19 disease due to chronic immunosuppressive treatment and other medical comorbidities. Mortality rates reported between 13 to over 30% in SOT recipients. In addition to high rates of complications and mortality attributable to COVID-19 infections, the pandemic has also led to additional complexities in transplantation including new questions regarding screening of donors and recipients, decision making to accept a patient for kidney transplant or wait after pandemic. The clinical implications of COVID-19 infection may also differ depending on the type of the transplanted organ and recipient comorbidities which further impacts decisions on continuing transplantation during the pandemic. Transplant activity during a pandemic should be tailored with careful selection of both donors and recipients. Furthermore, while tremendous strides have been made in treatment strategies and vaccinations, the impact of these in transplant recipients may be attenuated in the setting of their immunosuppression. In this review, we aim to summarize several aspects of COVID-19 in transplantation, including the immune response to SARS-CoV-2, SARS-CoV-2 diagnostics, clinical outcomes in SOT recipients and end stage kidney disease patients, transplant activity during the pandemic and treatment options for COVID-19 disease.
COVID‐19 is a novel, rapidly changing pandemic: consequently, evidence‐based recommendations in solid organ transplantation (SOT) remain challenging and unclear. To understand the impact on ...transplant activity across the United States, and center‐level variation in testing, clinical practice, and policies, we conducted a national survey between March 24, 2020 and March 31, 2020 and linked responses to the COVID‐19 incidence map. Response rate was a very high 79.3%, reflecting a strong national priority to better understand COVID‐19. Complete suspension of live donor kidney transplantation was reported by 71.8% and live donor liver by 67.7%. While complete suspension of deceased donor transplantation was less frequent, some restrictions to deceased donor kidney transplantation were reported by 84.0% and deceased donor liver by 73.3%; more stringent restrictions were associated with higher regional incidence of COVID‐19. Shortage of COVID‐19 tests was reported by 42.5%. Respondents reported a total of 148 COVID‐19 recipients from <1 to >10 years posttransplant: 69.6% were kidney recipients, and 25.0% were critically ill. Hydroxychloroquine (HCQ) was used by 78.1% of respondents; azithromycin by 46.9%; tocilizumab by 31.3%, and remdesivir by 25.0%. There is wide heterogeneity in center‐level response across the United States; ongoing national data collection, expert discussion, and clinical studies are critical to informing evidence‐based practices.
In this national survey of transplant centers during the COVID‐19 pandemic, the authors report substantial reduction in transplant activity, wide variation in COVID‐19 testing practices, and use of off‐label or investigational therapies in the treatment of 148 COVID‐19‐SOT recipients.
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