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At least 19 recordsLinked to original sources

The rate of anti-HIV seropositivity among donated cadavers: experience in a cadaver donation center.

Cadavers are crucial for the medical education provided by medical schools. However, currently, donation is the only way to obtain cadavers for education in Thailand. Moreover, some traditional beliefs result in insufficient numbers of cadavers. Apart from finding donors, the occupational health of the workers in the cadaver donation center and the users, the medical students, residents, and staffs should be addressed. Screening for anti-HIV in donated organs is the current trend in transplantation medicine. Therefore, screening for anti-HIV in donated cadavers is useful. Here, we report the rate of anti-HIV seropositivity in cadavers in a 1-year period in our setting, the largest Thai Red Cross Society hospital. Of the total 84 cadavers received, two cadavers (2.4%) were anti-HIV seropositive. With the increasing rate of anti-HIV, screening for anti-HIV serology in donated cadavers for medical teaching is of great benefit.

Cadaver↗

An algorithm for cadaver kidney allocation based on a multivariate analysis of factors impacting on cadaver kidney graft survival and function.

The large imbalance between cadaver kidney supply and demand makes the implementation of equitable and effective organ allocation systems an urgent need. This has triggered a revision of the criteria used so far for cadaver kidney allocation within the North Italy Transplant program, not least in the light of the many changes that have occurred recently with respect to broader criteria for admission of patients to the waiting list, donor selection, tissue-typing methods, organ preservation and immunosuppressive protocols. We based the critical revision of our cadaver kidney allocation algorithm on univariate and multivariate analysis of a number of immunological, clinical, social and administrative factors that impacted on the transplant outcome in 2,917 patients transplanted in the 12 transplant centers operating within our organization from 1 January 1990 to 30 September 1997. This analysis indicated that younger donor age, absence of pretransplant transfusions, patient dialysis center and level of HLA match showed statistically significant positive associations with graft survival. Younger donor age and male donor gender showed a statistically significant association with excellent graft function at 4 years. The results of this analysis were used to develop a new computer-assisted version of our adult kidney allocation algorithm. It works in two steps (local pool first, then the entire waiting list) and four levels (0-1 HLA MM, PRA+; 2 HLA MM, PRA+; 0-1 MM, PRA-; 2-4 HLA MM, PRA-); within each level, selection takes into account waiting time and age difference from donor age. The evaluation of 731 transplants allocated in 19 months with the new algorithm, as against 698 transplants allocated in the preceding 19 months according to the previous algorithm, showed a significantly higher proportion of recipients who had been on the waiting list for more than 3 years (33.2% versus 22.6%). The use of the new algorithm was also associated with a significantly increased number of transplanted alloimmunized patients (18.8% versus 9.2% with the previous algorithm) and recipients with 0-1 HLA mismatches (22% versus 14.3%). Furthermore, the number of kidneys used locally has steadily increased. Differences in 6-month graft survival and percentage of patients with excellent function at 6 months were not statistically significant in recipients transplanted with the new versus the previous algorithm. Survivals were 93.7% versus 91.8%. Percentages of patients with excellent renal function were 69.9% and 71.8%, respectively. These preliminary data suggest that the new algorithm improves HLA match and reduces the number of patients on the waiting list for 3 or more years without determining significant modifications of 6-month graft survival and function. Moreover, it facilitates the achievement of a fair local balance between organs retrieved and transplanted, the compliance of operators with objective allocation rules and the documentation of the whole allocation process.

Adult↗

Glomerular endothelial cell detachment in paired cadaver kidney transplants: evidence that some cadaver donors have pre-existing endothelial injury.

Poor initial function is common in cadaveric renal transplantation, and is usually attributed to acute tubular necrosis (ATN) brought about by ischemia during harvesting/implantation. However, this is often an assumption rather than a specific diagnosis. Recently, in 4 kidneys from 2 cadaver donors, we found evidence of severe endothelial injury, prior to exposure to cyclosporine or other known endothelial toxins. The biopsies at the time of completion of the transplant revealed apparent loss of glomerular endothelial cells on light microscopy, corresponding on electron microscopy to shrinkage of the endothelial cells away from the basement membranes of the capillary loops. Extensive microvascular thrombi were present. All 4 grafts displayed impaired initial function, which partially recovered with time. The finding of these unusual lesions in both kidneys from each of 2 donors suggested donor factors, although the only factor common to both donors was massive brain disruption. Thus, in the differential diagnosis of poor initial function in kidneys transplanted from cadaver donors, one should consider renal endothelial injury, which could lead to microthrombus formation, abnormal vasomotion, and functional impairment in the transplant.

Adult↗

Anatomic variations of the coracoacromial ligament in neonatal cadavers: a neonatal cadaver study.

One of the most common causes of pain and disability in the upper limb is inflammation of the rotator cuff tendons. When no significant bony abnormality exists in the surrounding structures, the coracoacromial ligament has been implicated as a possible cause of impingement on the cuff tendons and various morphological variants of the ligament have so far been claimed to be either the cause or the result of impingement. In this study, 110 shoulders from 60 neonatal cadavers that were preserved in a preparation of formaldehyde were dissected. Anatomic variations of coracoacromial ligaments were investigated with metric and histologic analysis. Three main ligament types were identified: quadrangular, broad band and U-shaped. The multiple banded ligament was not found. Histologic analysis showed that in U-shaped ligaments a thin tissue existed in the central part of the ligament close to the coracoid. Comparing our data with the adult measurements of a previous study we suggest that the primordial ligament is broad shaped, but assumes a quadrangular shape due to the different growth rates of the coracoid and acromial ends. We also suggest that broad and U-shaped ligaments account for the primordial and quadrangular and Y-shaped ligaments account for the adult types of the single or double banded anatomic variants respectively. Our results show that various types of the coracoacromial ligament are present at the neonatal period and that the final shape of the ligament should be defined by developmental factors, rather than degenerative changes.

Acromioclavicular Joint↗

[A proposal for the amendment of Law No. 644 of 2 December 1975 on Regulation of the removal of parts of cadavers for the purpose of therapeutic transplantation, and rules concerning the removal of the hypophysis from cadavers for the production of extracts for therapeutic use: (Off. Gazz. No. 344, 19 December 1975)].

Law No. 644 on organ transplants is examined in the light of personal experience and the international literature. Reference is made to the non-correspondence of ECG, absence of plantar reflexes, and paralytic mydriasis for the early diagnosis of cerebral death. Stress is laid on the importance of cerebral arteriography, retinal fluorangiography, and evoked potentials in association with clinical criteria.

Cadaver↗

[Legal and moral objections to medical research on cadavers and cadaver parts].

The interpretation of Section 190 öStGB by jurisdiction and doctrine makes medicinal research more difficult. In contrary to the ruling legal arguments an responsible scientifically research-work with corpses or parts of corpses cannot realize the facts of the case provided that the comprehension of the related laws are interpreted proper and accurate.

Autopsy↗

Arthroscopy of the shoulder joint--a cadaver and clinical study. Part 1: Cadaver study.

An experimental study of shoulder arthroscopy has been carried out over the past two years. Fifty-one cadaveric shoulders were investigated by different types of arthroscope. Dissections were carried out after each arthroscopic examination and the arthroscopic findings were investigated. Three approaches, namely, anterior, posterior and superior were used. The arthroscopic anatomy of the shoulder joint was divided into 5 regions: anterior, superior, central, inferior, and posterior. The posterior approach provides the widest field of view amongst all the approaches and also better orientation. The superior approach could cause damage to the critical area of supraspinatus tendon and its clinical application is not recommended.

Adolescent↗

Formulation of entomopathogenic nematode-infected cadavers.

Entomopathogenic nematodes are commercially applied in aqueous suspension. These biocontrol agents may also be applied in nematode-infected insect cadavers, but this approach may entail problems in storage and ease of handling. We determined the feasibility of formulating nematode-infected insect cadavers to overcome these hindrances. All experiments were conducted with Heterorhabditis bacteriophora Poinar and Galleria mellonella (L.). Nonformulated cadavers were used as controls. Of 19 formulations tested (including combinations of starches, flours, clays, etc.) 1 (starch-clay combination) was found to adhere to the cadaver and to have no significant deleterious effects on nematode reproduction and infectivity; other formulations exhibited poor adhesion or reduced nematode reproduction. Two formulations enabled cadavers to be partially desiccated without affecting reproduction; other formulations and nonformulated cadavers exhibited reduced reproduction upon desiccation. Four-day-old cadavers were more amenable to desiccation than 8-day-old cadavers. Formulated cadavers were more resistant to rupturing and sticking together during agitation than nonformulated cadavers.

Animals↗

Cadaver donation: a retrospective review at the King Chulalongkorn Memorial Hospital, Bangkok.

Cadavers are a crucial resource for medical education. Currently, donation is the only means of obtaining cadavers for use in Thai medical schools. Some traditional beliefs result in an insufficient number of donated cadavers. This shortage of cadavers may affect the quality of medical training. We report on the present situation regarding the quantity and usage of donated cadavers in the King Chulalongkorn Memorial Hospital, Bangkok, during the eight years between 1993 and 2000. During this period, 19,674 cadavers became available (2.459.3 +/- 1,243.7 cadavers/year) as the result of advanced donation. However, only 619 cadavers (3.1%) were actually obtained. Poor preservation and delayed delivery contributed to the underutilization; furthermore, some cadavers were reclaimed. In order to increase the number of cadavers and maintain the quality of medical education, the appropriateness and importance of cadaver donation should be emphasized to the public.

Attitude to Health↗