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Results for “Directed Tissue Donation”

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At least 379 records · Page 21Linked to original sources
PubMed2003

Modified mandated choice for organ procurement.

Presumed consent to organ donation looks increasingly unlikely to be a palatable option for increasing organ procurement in the UK following the publication of the report into events at Alder Hey and elsewhere. Yet, given that the alternative to increasing the number of cadaveric organs available is either to accept a greater number of live donations, or accept that people will continue to die for the want of an organ, public policy makers remain obliged to consider other means of increasing the procurement rate. In this paper, we meet the main objections to mandated choice (namely that it undermines autonomy and that mandated donation is preferable). We have modified the traditional approach to mandated choice to take into account the force of the objection that mandated donation is preferable, by accepting that people can and do make bad decisions about organ donation and proposing that all accompanying public education and information about cadaveric donation should be directed in favour of donation.

Cadaver↗
PubMed2000

Organ procurement and mandated choice: an alternative to the existing system.

One of the greatest problems facing medicine today is the allocation of scarce resources. A manifestation of this problem that affects everyone is the procurement and allocation of donor organs. This paper examines the current system of donor organ procurement in the US, points to its weaknesses, and examines three proposed alternatives. It proposes the adoption of one these alternatives, the system of mandated choice, wherein all potential donors are required to make an informed and legally binding decision to donate or not.

Advance Directives↗
PubMed1995

Health care professional attitudes toward donation: effect on practice and procurement.

Failure to procure organs, tissues, and corneas for transplantation can be attributed to a number of factors. The existing literature is largely speculative concerning why health care professionals (HCPs) fail to approach the families of medically suitable donors and why requests for donation are not successful. This study is based on the direct examination of 1,797 HCP attitudes and knowledge about donation in conjunction with how HCPs performed when faced with a donor-eligible patient. HCP attitudes, rather than knowledge, are more important to the successful procurement of organs. The HCPs with more positive attitudes about donation and their role in the procurement process were more likely to request donation. HCPs were more successful in obtaining consent to donation when they believed that the donation process would benefit the donor family and that their efforts to procure organs would be successful. These results indicate that educating HCPs about the donation process to make them more comfortable with it is crucial.

Attitude of Health Personnel↗
PubMed1992

Philippine law on donations of human organs.

The Philippines "Organ Donation Act of 1991" updates the "1949 Act to legalize permissions to use human organs". Under the new legislation, each individual can donate all or any part of his body by way of legacy or will. The members of the family may also authorize such a donation in the absence of contrary intention by the decedent. Donations are only valid when made for therapy, research or medical education. International sharing of organs is recognized but subject to approval by the Department of Health. Regulations are about to be formulated in order to implement the Act which will be largely publicized to encourage donations.

Advance Directives↗
PubMed2001

Characterization of viable autofluorescent macrophages among cultured peripheral blood mononuclear cells.

BACKGROUND: Inflammatory macrophages that demonstrate intense autofluorescence have been isolated directly from alveolar and peritoneal tissues, but their generation in vitro remains vague. We use flow cytometry to identify a population of autofluorescent macrophages as they arise among nonadherent populations of cultured blood mononuclear cells. METHODS: Cells were obtained from donated blood buffy coats and placed in culture for 14 days. Unstained populations from the cells remaining in suspension were sampled daily using flow cytometry. During the first 5 culture days, a distinct population of autofluorescent cells arose and comprised an average of < or =14% of the total cell population. This population declined to less than 6% by culture day 8. RESULTS: The cells were identified as viable macrophages expressing CD68, lysozyme, and HLA-DR. Quantitative reverse transcription-polymerase chain reaction (RT-PCR) demonstrated a unique cytokine profile with IL-1 alpha expression levels 138-fold higher than those measured in uncultured monocytes. No significant elevation in the levels of other cytokines was identified. Upon replating, the sorted populations became readherent, were able to ingest plastic beads, and remained viable for 6 or more additional weeks in culture without evidence of proliferation or multinucleation. CONCLUSION: Viable autofluorescent macrophage populations arising among cultured peripheral blood may be easily identified and isolated for further study using flow cytometry. Cytometry 44:38-44, 2001. Published 2001 Wiley-Liss, Inc.

Cell Differentiation↗
PubMed2002

Media appeals for directed altruistic living liver donations: lessons from Camilo Sandoval Ewen.

Recently, a Canadian couple sought media help to find a person who was willing to donate part of his or her liver to their infant son, Camilo Sandoval Ewen, who suffered from biliary atresia. Although Canadian transplant programs do not perform transplants from non-emotionally related living donors, they are accepted by some U.S. transplant centers, particularly when donated in a nondirected fashion. This paper examines the ethical questions raised by media appeals for directed altruistic living donations of solid organs, specifically liver lobes, and argues that media-directed altruistic donations are ethically problematic. While they can and do succeed, they raise ethical concerns regarding (1) who has access to the media; (2) who will be successful in their media campaigns; and (3) how coercion and inducement by brokers (families or institutions) can be prevented. Justice requires that the media adopt a policy not to cover organ appeals by families, despite their human interest value, and that transplant centers develop a unified policy restricting directed living donations to those who have an emotional relationship.

Adult↗
PubMed1997

[Brain death and organ procurement: a specific context].

Brain death is defined as an irreversible damage to the brain stem associated with lesions of the hemispheres. It determines the irremediable destruction of the whole body which occurs within a short delay. Brain death diagnosis is identified from a series of neurological criteria, i.e.: the loss of consciousness, the disappearance of brainstem reflexes, the lack of spontaneous breathing movements. Legal considerations in use in France imply that brain death must be confirmed by two isoelectric encephalographs or by the absence of cerebral perfusion on cerebral arteriography. The diagnosis must be established by two practitioners who are not involved in transplantation activity. Prexisting cardiac activity and organ perfusion allow indeed organs and tissue procurement for transplantation. Organ procurement is supported by intensive care of the brain dead patient aiming to correct hemodynamic, ventilatory and metabolic disorders related to brain death. Organ donation implies that one would know the patient's will which would have been clearly expressed during his lifetime. Organ harvesting is organized according to guidelines for local practice and regional and national allocation. In consideration of transplantation requirements there is a persisting organ shortage for several years. Efforts must be directed toward an improvement in brain dead patients identification and management.

Brain Death↗
PubMed1984

The effect of tocopherol and dimethyl sulfoxide on focal edema and lipid peroxidation induced by isocortical injection of ferrous chloride.

Addition of iron salts to suspensions of subcellular organelles or polyunsaturated fatty acids results in the formation of oxidative free radicals with subsequent initiation of lipid peroxidation. Pretreatment of rats with anti-oxidants prevents peroxidation following isocortical ferrous chloride injection, and increases the rate of resolution of iron-induced focal edema. In this experiment, treatment of rats at the time of injection of 5 microliters of 100 mM FeCl2 with tocopherol and DMSO caused decreased formation of brain peroxidation at the injection site, as measured by formation of MDA. Tocopherol failed to change the quantity of tissue fluid accumulation. However, DMSO alone, or combined with tocopherol, hastened the resolution of brain edema. Tocopherol may terminate peroxidation reactions by donation of a phenolic hydrogen, forming a quinone of tocopherol. DMSO has many pharmacologic effects; however, inhibition of initiation reactions by scavenging hydroxyl radicals, and direct and indirect effects on focal edema accumulation may account for our observations.

Animals↗
PubMed2006

Organ donation and utilization, 1995-2004: entering the collaborative era.

Continued progress in organ donation will help enable transplantation to alleviate the increasing incidence of end-stage organ disease. This article discusses the implementation and effect of the federally initiated Organ Donation Breakthrough Collaborative; it then reviews organ donation data, living and deceased, from 1995 to 2004. It is the first annual report of the Scientific Registry of Transplant Recipients to include national data following initiation of the collaborative in 2003. Prior to that, annual growth in deceased donation was 2%-4%; in 2004, after initiation of the collaborative, deceased donation increased 11%. Identification and dissemination of best practices for organ donation have emphasized new strategies for improved consent, including revised approaches to minority participation, timing of requests and team design. The number of organs recovered from donation after cardiac death (DCD) grew from 64 in 1995 to 391 in 2004. While efforts are ongoing to develop methodologies for identifying expanded criteria donors (ECD) for organs other than kidney, it is clear DCD and ECD raise questions regarding cost and recovery. The number of living donor organs increased from 3493 in 1995 to 7002 in 2004; data show trends toward more living unrelated donors and those providing non-directed donations.

Ethnicity↗
PubMed1992

[Medical use of fetal cells and tissue: ethical aspects].

After considering the moral status of the living and of the dead human fetus, the article examines various ethical arguments connected with the use of fetal remains following elective abortion: financial or humanitarian incentives for the termination of pregnancy, conflicts of interest between mother and user, authority over fetal remains and modality of donation and utilization of the fetus. To prevent improper use of fetal remains it is recommended: to separate completely the decisions relating to abortion (first) and to the subsequent use of fetal tissues (second); to obtain explicit informed consent from the mother, making it impossible for her to direct any specific use of the fetal tissues; to base decisions on the method and timing of an abortion on the mother's health care needs alone; to exclude those involved in the process of abortion from any use of the fetus; to protect the anonymity of donor and recipient through an intermediary (tissue bank).

Abortion, Induced↗
PubMed1993

Obstetric performance of patients after oocyte donation.

OBJECTIVE: The purpose of this study was to evaluate the obstetric performance of patients after oocyte donation. STUDY DESIGN: A review of five patients in the author's private practice who underwent successful donation with conception and a literature review specific to obstetric outcome were undertaken. RESULTS: All five patients were delivered of healthy infants; however, significant maternal complications occurred, particularly in two patients with twin gestations. A literature review substantiates increased incidence of (1) multiple gestation, (2) pregnancy-induced hypertension, (3) placenta previa, (4) preterm labor, and (5) cesarean birth. Infant outcomes, however, were good. CONCLUSIONS: Women with premature ovarian failure and women over 40 years old can successfully conceive with oocyte and preembryo donation and successfully deliver healthy infants. More attention needs to be directed at maternal performance, particularly in those women over 40 years old.

Adult↗
PubMed1997

Who gets a heart? Rationing and rationalizing in heart transplantation.

National policy on organ transplantation is made by the United Network for Organ Sharing (UNOS), a representative body composed of health care professionals and patients. Standardized criteria for determining when a patient should be placed on the waiting list for heart transplantation are now in effect nationwide. Current and future directions to maximize the utilization of available donated organs are explored.

Guidelines as Topic↗