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Biomedical subjects

P A Niles

Publications and source records attributed to P A Niles.

3 recordsLinked to original sources
PubMed2004

Correction of base deficits in deceased organ donors: effects on immediate renal allograft function.

Fluid status in the brain-dead donor is often difficult to assess. We hypothesized that using base deficit as a measure of tissue perfusion will facilitate fluid management in these donors, thereby improving renal allograft function. Consecutive donors over a 12-month period were prospectively studied. In Group I, resuscitation was based on maintaining normal blood pressure and urine output. In Group II, additional parameters of resuscitation included the correction of base deficit. Immediate renal allograft function was examined in the 48 recipients. Delayed graft function occurred in 48% of Group I, and in 19% of Group II recipients. Creatinine clearance on day 7, calculated by the Cockroft-Gault formula, was 29 +/- 6 mL/min in Group I versus 41 +/- 8 mL/min in Group II. We conclude that correcting base deficit is an extremely useful approach to expedite organ recovery and potentially improve function of transplanted kidneys.

Brain Death↗
PubMed1996

The timing factor in the consent process.

Organ procurement organizations have been educating the medical profession on the importance of timing during the donation request process. Separating the request for donation from the notification of death has been encouraged when approaching families for consent for organ donation. This study evaluated the timing of the family approach and consent rates. A 23-month study was performed on all organ donor referrals in a 1.1 million population base. During the study period there were 203 referrals: 67 were medically unsuitable, next-of-kin was not available in 2 cases, 7 were coroner refusals, and 127 were suitable for donation. In this latter group, families were offered the option of organ donation. No apparent difference when donation was requested before or after the death pronouncement was found. Data indicated, however, that when the family is told of the death and is asked for donation simultaneously, the consent rate decreases 32% to 37%.

Adolescent↗