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G T Armstrong

Publications and source records attributed to G T Armstrong.

6 recordsLinked to original sources

Utilization of donated lungs in Australia: 1989-1997.

Lung and heart-lung transplantation was first undertaken in Australia in the late 1980s and early 1990s. Although detailed data are available on Australian lung transplantation outcomes, little data are available regarding the utilization of donated lungs. This study examines donated lung utilization rates and considers various factors that may affect these rates. Australian donation and transplantation data were analyzed for the years 1989 through 1997. Results showed that 24% of overall donors were lung donors. The percentage of donors from whom at least 1 lung was transplanted increased from 6% in 1989 to 36% in 1997. Heart-lung transplantation rates changed little (2%-9%), whereas bilateral lung transplantation increased from 1% to 23% of donors. Single-lung donors accounted for 32% of lung donors in 1997. Uniform basic donor criteria and management guidelines, simple allocation mechanisms, and cooperative retrieval have evolved during this time. Close collaboration at the time of donation between units, coordinators, and ICUs has allowed early retrieval from well-managed donors.

Australia↗

A modification of the primary nasal correction in the rotation-advancement unilateral cleft lip repair.

Primary correction of the unilateral cleft lip nasal deformity remains a challenge to the cleft surgeon. We wish to present a method of primary nasal correction utilizing presurgical orthopedics with the Latham dentomaxillary advancement appliance, concomitant rotation-advancement cleft lip repair, gingivoperiosteoplasty, and immediate correction of the nasal cartilage distortion with an "open technique" utilizing the rotation-advancement incisions. Direct elevation and suture fixation of the cleft side alar cartilage is performed as well as recreation of the normal upper lateral/lower lateral cartilage relationship, repair of nasal web, and release of the vestibular lining utilizing an L-flap pedicled to the alar base. Details of the operative technique, observations of unilateral cleft nasal anatomy as visualized with the "open technique," and preliminary results are illustrated in patients followed as long as 5 years.

Cartilage↗

Assessment of organ acquisition costs for an Australian public health system.

Available data on the cost of organ acquisition in Australia's socialized public health systems are minimal. The purpose of this study was to determine the cost for organ acquisition by a state transplant service, and to provide (1) an assessment of acquisition costs within one Australian public health system, (2) a baseline for future cost assessments, and (3) an indication of cost-effectiveness in international terms. Between July and December 1993, 51 kidneys, 21 livers, and 15 hearts were provided for transplantation in the system. Data collected during this period were used to calculate the acquisition cost for each transplanted organ. Direct and indirect costs were included in the calculations. The distribution of costs incurred for organ acquisition were direct, 67%; indirect, 14%; and organ-specific, 19%. Of the total direct costs, aircraft charter accounted for 75%, or 50% of the total acquisition costs. The provision of an organ by a donor coordination service accounted for 20% of the total costs, or a mean of A$783 (US$563) per organ. This study provides a baseline for organ acquisition cost in the Australian healthcare system. The geographic and demographic nature of Australia imposes the largest single cost factor (i.e., air charter), which highlights the need for alternative retrieval and transport systems of organs wherever possible. The acquisition costs reported in this study indicate that the system is cost-effective in international terms.

Australia↗

Age: an indicator of willingness to donate?

Answers to the question about consent for organ donation on the Queensland Transport Driver's Licence Database were reviewed to determine if age is an indicator of willingness to donate. As of November 1994, the database contained records on 1,969,382 persons (54% male, 46% female), accounting for 86.7% of the population 17 years of age or older. Fifty-four percent had answered yes to the question; 46% had indicated no or had not answered. The data were divided into three groups, males only, females only, and males plus females, and then subgrouped by age. The number of subjects who had not answered the question was included in the number who had answered no. In the males-plus-females group, the percentage of yes answers by age remained relatively constant (56%-62%) for persons 17 to 49 years old but decreased to 39% for persons 70 years old. The data for males only and females only showed a similar decrease. Slightly more females than males had answered yes among persons 17 to 49 years old (mean difference, 5%; range, 1%-8%). This difference decreased with age. A higher willingness to donate in the younger age groups may augur well for the future. The data indicate that more attention must be given to persons 50 years of age and older to increase their awareness of their ability to donate.

Adolescent↗