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J Wałaszewski

Publications and source records attributed to J Wałaszewski.

At least 37 records · Page 2Linked to original sources
PubMed1996

Organ transplantation in Poland. A registry report.

Solid organ transplantation program in Poland is very limited. The main reason of this is organ shortage. All the organs procured are transplanted. It is a general feeling that recently issued legal regulations will favorably influence organ donation, however the improvement may be expected within a few years and will require very active educational campaign among society and medical staff. National Transplant Council prepared the plans of organ transplantation for the nearest five years. These plans were met with full support of the Ministry of Health and Welfare and Health Committee of the Polish Parlament.

Graft Survival↗
PubMed1996

Factors limiting renal transplantation program in Poland.

The shortage of donor organs has been the main obstacle to the expansion of transplantation programs. Recent public opinion survey documented acceptance of the cadaveric kidney procurement in our country but some reluctance to brain death and presumed consent concepts. Recently, the survey was carried out within the medical community to find out whether the level of knowledge and the attitude toward donation has an influence on the slow development of the transplantation program. A questionnaire was addressed to: 1010 general practitioners, neurosurgeons and anesthesiologists; 926 ICU and neurosurgical nurses and 1760 students of 12 medical schools of the country. Vast majority of doctors, nurses and last year medical students accept retrieval and transplantation of kidneys and the heart, but not of the liver. Acceptance of this procedure among junior medical students and university students was lower (78% vs 98%). Most of the respondents would agree to donate their kidneys and other organs, but 20% would protest against harvesting of the organs from their relatives. 100% of the physicians and 80% of medical students and nurses accept the brain death concept(which is accepted only by 60% of non medical university students) but only 44% of the doctors are prepared to switch off the respirator after diagnosis of brain death if harvesting is not taking place. Only half of the physicians would notify the transplantation unit about the possibility of organ retrieval. The reasons mentioned for such decision included fear of negative judgment of the local community and problems with deceased relatives. 60% of physicians talking to the family about retrieval would ask for the relatives' consent despite the fact, that the transplantation law in Poland is based on the presumed consent of each individual. The results of the knowledge survey among medical students documented inadequate medical education concerning problems of transplantation. Educational campaign is needed to promote and extend the cadaveric organ transplantation in our country.

Attitude of Health Personnel↗
PubMed1996

Erythropoietin production after kidney transplantation.

We studied production of erythropoietin (EPO) in long-term renal allograft recipients with posttransplant erythrocytosis (PTE). Among 951 recipients we found 74 patients with persistent elevation of hematocrit (Htc) value (female > 50%, male > 55%). However, only 63.5% of them had increased red-cell mass ( = "true" erythrocytosis). In all recipients with PTE known causes of secondary erythrocytosis were not found. EPO titer in peripheral blood was significantly higher in recipients with PTE (median 13.5 mIU/mL, range: 0.1-71.5 mIU/mL) as compared to healthy blood donors (median 5.75 mIU/mL, range: 0.1-19.5 mIU/mL) but not different from the group of renal allograft recipients without PTE (median 13.0, range 0.1-71.7 mIU/mL). However, EPO level measured in pretransplant sera was significantly higher in patients who developed PTE (median 16.4 mIU/mL, range: 1.0-281.2 mIU/mL) than in recipients without PTE (median 8.3, range: 1.0-50.3 mIU/mL). A significant difference in EPO level between systemic and effluent blood from native kidneys was found in 6 out of 14 recipients with PTE who underwent catheterization. After phlebotomy patients with PTE responded with higher increase in peak EPO titer than healthy blood donors (527 +/- 473% versus 194.5 +/- 44.2%, p < 0.05). Our results suggest that PTE develops spontaneously due to increased EPO production. Despite elevated EPO levels, regulation of EPO release remains preserved.

Adult↗
PubMed1994

In situ perfusion and UW solution used for storage did not decrease the incidence of ATN in kidneys harvested from hemodynamically unstable donors.

The incidence of acute tubular necrosis ATN after cadaveric kidney transplantation in our centre has been in the range of 50%. A prospective study was carried out in 1991 and 1992 to assess the effect of in situ perfusion and hypothermic storage of kidneys harvested from brain-dead haemodynamically stable and unstable donors. Three litres of Ringer's solution were used for in situ perfusion. In 40 cases, the kidneys were stored in Euro-Collins (EC) solution and in the other 78 cases, in University of Wisconsin (UW) solution. Among the factors that could contribute to ATN, we analysed warm ischaemia time, anastomosis time and cold storage time. Function was considered to be delayed if the patient required posttransplantation dialysis. The donors were considered haemodynamically unstable when hypotension before harvesting was present (BP < 70 mm Hg over 2 h) despite high doses (> 15 microg/kg per minute) of dopamine or when cardiac arrest occurred at the time of harvesting and oliguria had been present for at least 2 h. Haemodynamically stable donors with a BP greater than 80 mm Hg had a normal diuresis. In all donors in this group the dose of dopamine was lower than 10 microg/kg per minute. The study showed that storage in UW solution did not influence the incidence of ATN in kidneys harvested from haemodynamically unstable donors. Differences observed in our study were due to haemodynamic status preceding donor nephrectomy and length of cold storage time.

Adenosine↗
PubMed1989

The radiological examination of the pancreas harvested for transplantation.

The radiological examination of the pancreatic arterial blood supply was performed to show the presence of the arterial variability. 40 arteriograms of pancreatic vessels were made. The research confirmed the subsistence of the arterial variability concerning the dorsal pancreatic artery in particular. The importance of the previous arteriography in donor, before harvesting the pancreatic graft, was unterlined.

Angiography↗
PubMed1979

Factors responsible for the functional pattern of cadaveric kidneys stored up to 25 hours before transplantation.

The functional outcome after the transplantation of 97 cadaveric kidneys stored up to 25 hours with simple hypothermia was analysed in relation to age of donor, extent of pre-agonal kidney damage, the length of warm, cold and standardised ischaemic times and the presence of multiple renal arteries. Analysis of various factors showed that the most important for function after transplantation were pre-agonal anoxic damage and the ratio of the cold/warm ischaemia time. Based on that observation, a diagram has been proposed which allows calculation of the safe cold storage time after retrieval of the kidney.

Adolescent↗
PubMedDate not supplied

Questionnaire regarding the knowledge of the rules of organ procurement from cadaveric donors for transplantation directed to the directors of medical institutions in Poland.

We assessed the level of knowledge of organ procurement regulations among the directors of medical institutions in Poland. We also sought to promote the objection form, and the activity of the Central Register of Objections. A questionnaire consisting of 10 questions was sent to 381 random medical health care institution directors countrywide. In 89% of surveyed institutions, the written text of the organ procurement regulations was available and 94% of directors knew the forms of objection, but in 26% of institutions the form was not available and in 14% it was never obtainable. In the medical institutions directors' opinions, the estimated number of objections is 13% of the population in Poland. Organ transplantation is a form of treatment most medical institutions are familiar with, but the matter of donation is not as well known as transplantation, as observed in 48% of questioned institutions.

Cadaver↗
PubMedDate not supplied

Geography of the referred potential liver recipients and donors in Poland in 2004.

Our aim was to assess the accessibility of potential liver recipients to cadaveric organs and the ability of transplant teams to realize recipients needs in Poland in 2004. Our calculations revealed that in Poland the number of cadaveric liver transplants was two to three times lower than in other countries and is insufficient to meet the needs, also the number of referred potential liver recipients is two to three times lower than expected.

Geography↗